Drugs in American Society [3 volumes]: An Encyclopedia of History, Politics, Culture, and the Law [Illustrated] 161069595X, 9781610695954

Table of contents :
Cover
Title
Copyright
Contents
Guide to Related Topics
Preface
Introduction
Chronology: Significant Events in Drug and Alcohol Use through History
VOLUME I
Addiction
Addiction Liability
Addiction Medications
Addictive Personality
Adolescent Tobacco Use
Advisory Commission on Narcotic and Drug Abuse
African Americans and Drug Use
Al-Anon
Alateen
Alcohol Bootlegging and Smuggling
Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (1992)
Alcohol Mutual Aid Societies
Alcohol to Subdue Victims
Alcohol Use
Alcohol-Facilitated Sexual Assault
Alcoholics Anonymous (AA)
Alcoholism
Alpert, Richard
Alternative Addiction Treatment
American Association for the Study and Cure of Inebriety (AASCI)
American Society of Addiction Medicine (ASAM)
American Temperance Society (ATS)
Amphetamines
Analgesics
Andean Trade Preference Act (1991)
Anslinger, Harry J.
Antidepressants
Anti-Drug Abuse Acts
Anti-Saloon League (ASL)
Anxiety Disorders
Armstrong, Lance
Asset Forfeiture
Association Against the Prohibition Amendment (AAPA)
Authors and Drug Use
Aviation Drug-Trafficking Control Act (1984)
Bad Boys
Barbiturates
Barnes, Nicky
Barry, Marion S.
Bath Salts and Synthetic Cannabis ("K2" or "Spice")
Beatniks
Behavioral Addictions
Belushi, John
Bennett, William
Betty Ford Center
Bias, Len
Binge Drinking
Biological and Psychological Reasons for Substance Abuse
Black Tar Heroin
Blanco, Griselda
Blood-Alcohol Content (BAC)
Blow
Boggs Act (1951)
Boylan Act (1914)
Brown, Bobby
Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF)
Bureau of Drug Abuse Control
Bureau of International Narcotics and Law Enforcement Affairs
Bush, George H. W.
Bush, George W.
Cabinet Committee on International Narcotics Control
Caffeine
Cali Drug Cartel
Califano, Joseph, Jr.
Camarena Salazar, Enrique
Campaign against Marijuana Planting (CAMP)
Cannabis
Carter, Jimmy
Center for Substance Abuse Prevention (CSAP)
Center on Addiction and Substance Abuse (CASA)
Centers for Disease Control and Prevention (CDC)
Central Intelligence Agency (CIA), United States
Child Sexual Abuse and Substance Abuse
Children of Alcoholics
China and the Chinese and Drugs
Cigarettes
Cigars
Cipollone v. Liggett Group, Inc. et al.
Clinton, Bill
Cobain, Kurt
Coca
Coca-Cola
Cocaine and Crack
Cocaine Anonymous (CA)
Cocaine Cowboys
Codeine
Codependency
Colombian Cartels
Combat Methamphetamine Act (2005)
Commission on Marihuana and Drug Abuse
Committee on Drug Addiction (1928-1938)
Committee on Drug Addictions (1921-1928)
Common Sense for Drug Policy
Compassionate Use Act (1996)
Comprehensive Drug Abuse Prevention and Control Act (1970)
Comprehensive Methamphetamine Control Act (1996)
Compulsions and Impulses
Conant v. Walters
Controlled Substances Act (CSA) (1970)
Council for Tobacco Research
The Counterculture and Drugs
Crack Epidemic
Crime Control Act (1990)
Crime Victims and Drugs
Crop Eradication
Cross-Addiction and Cross-Tolerance
Dadeland Massacre (Miami, Florida) (1979)
Dai, Bingham
Date Rape Drugs
Decriminalization
Demand Reduction
Dependence
Depressants
Designer Drugs
Dimethyltryptamine (DMT)
Disease Model of Addiction
Dole, Vincent
Domestic Abuse and Alcohol
Domestic Abuse and Drugs
Drug Abuse
Drug Abuse and Treatment Act (1972)
Drug Abuse Control Amendments (1965)
Drug Abuse Resistance Education (DARE)
Drug Abuse Warning Network
Drug Addiction and Public Policy
Drug Cartels
Drug Classes
Drug Courts
Drug Czar
Drug Enforcement Administration (DEA)
Drug Interdiction and International Cooperation Act (1986)
Drug Intervention Programs
Drug Kingpin Death Penalty Act (1988, 1994)
Drug Nomenclature
Drug Paraphernalia
Drug Policy Alliance Network
Drug Possession
Drug Purity
Drug Reform Act (1986)
Drug Screening and Testing
Drug Sentencing
Drug Smuggling
Drug Tolerance
Drug Trade
Drug Trafficking
Drug Trafficking and Organized Crime
Drug Trafficking Networks
Drug Typologies
Drug Use Forecasting
Drug Watch International
Drug-Facilitated Rape
Drug-Free America Act (1986)
Drug-Free America Foundation
Drug-Free Federal Workplace
Drug-Free School Zones
Drug-Free Schools and Community Act (1988-1989)
Drugged Driving
Drug-Related Asset Seizures
VOLUME II
E-Cigarettes
Ecstasy (MDMA)
Eighteenth Amendment
Eisenhower, Dwight D.
Elders, Joycelyn
Electronic Dance Music (EDM/House Music)
Employment Division, Department of Human Resources of Oregon v. Smith
Energy Drinks
Engle v. R.J. Reynolds
Entertainers and Drug Use
Ephedrine and Pseudoephedrine
Escobar, Pablo
European Committee to Combat Drugs
Extradition
Fair Sentencing Act (2010)
Families Against Mandatory Minimums (FAMM)
Farley, Chris
Fast and Furious
Federal Alcohol Administration Act (1935)
Federal Bureau of Investigation (FBI)
Federal Bureau of Narcotics (FBN)
Female Alcohol Use
Female Tobacco Use
Ferguson v. City of Charleston
Fetal Alcohol Syndrome (FAS)
Fisher, Guy
Flashbacks
Florida v. Jardines
Food and Drug Administration (FDA)
Food, Drug, and Cosmetic Act (1938)
Ford, Betty
Ford, Gerald R.
Four Loko
French Connection
Freud, Sigmund
Gateway Drugs
Gateway Hypothesis
Ginsberg, Allen
Global Commission on Drug Policy (2011)
Golden Crescent
Golden Triangle
Grateful Dead
Green Rush
Guadalajara Cartel
Guillot-Lara, Jaime
Gulf Cartel
Gutka
Hague Convention
Haight-Ashbury
Hallucinogens
Hangovers
Hard Drugs vs. Soft Drugs
Harm Reduction Programs
Harrison, Francis
Harrison Narcotics Act (1914)
Hashish (Hash)
Hazelden Foundation
Hemp
Hendrix, Jimi
Heroin
High-Intensity Drug-Trafficking Areas (HIDTAs)
Hip-Hop and Drugs
Hippies
HIV/AIDS and Drug Use
Hoffman, Philip Seymour
Hofmann, Albert
Hookah
Hoover, J. Edgar
Ibogaine
Inhalants
International Narcotics Control Act (1989)
International Narcotics Research Conference (INRC)
Intervention
Intoxication
Investigational New Drug Program
Jackson, Michael
Jazz Culture
Jellinek, E. Morton
Johnson, Lyndon Baines
Jones, Marion
Joplin, Janis
Juárez Cartel
Jung, George
Kennedy, John F.
Ketamine
Khat
Koop, C. Everett
The La Guardia Report
Labeling and the Criminalization Process
Latinos and Drug Use
Leary, Timothy
Legalization
Legalized Marijuana
Leonhart, Michele M.
LifeRing
Lincoln, Abraham
Linder v. United States
Lindesmith, Alfred R.
Long-Term Potentiation
LSD (Lysergic Acid Diethylamide)
Lucas, Frank
Mandatory Treatment
Marihuana Tax Act (1937)
Marijuana
Marijuana Businesses
Master Settlement Agreement (MSA)
McCaffrey, Barry R.
McCoy, Bill
Medellín Cartel
Medical Marijuana
Meese, Edwin
Mescaline
Meth Labs
Methadone
Methadone Treatment Programs
Methamphetamine
Mexican Drug Trade
Military and Drug Use
Minnesota Model
Minorities and Drug Use
Moncrieffe v. Holder
Monitoring the Future Survey
Monroe, Marilyn
Morality Policy
Morphine
Mothers Against Drunk Driving (MADD)
Mullen, Francis
Nadelmann, Ethan
Naltrexone
Narcotic Addict Rehabilitation Act (1966)
Narcotic Clinics
Narcotic Control Act (1956)
Narcotic Drugs Import and Export Act (1922)
Narcotics
Narcotics Anonymous (NA)
Nation, Carrie
National Association of State Alcohol and Drug Abuse Directors
National Clearinghouse for Alcohol and Drug Information (U.S.)
National Council on Alcoholism and Drug Dependence (NCADD)
National Drug Control Strategy
National Drug Policy Board
National Household Survey on Drug Abuse
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
National Institute on Drug Abuse (NIDA)
National Minimum Drinking Age Act (1984)
National Narcotics Border Interdiction System (NNBIS)
National Organization for the Reform of Marijuana Laws (NORML)
National Research Council Report on Drug Enforcement Activities
National Treasury Employees Union v. Von Raab
National Youth Anti-Drug Media Campaign
Native Americans and Substance Abuse
Needle Exchange Programs
Neurotransmitters
Nicotine
Nixon, Richard M.
Noriega, Manuel Antonio
Nutt, Levi G.
Nyswander, Marie
Oakland Cannabis Buyers' Cooperative
Obama, Barack
Office for Drug Abuse Law Enforcement
Office of National Drug Control Policy (ONDCP)
Opiates
Opium
Opium Control Act (1942)
Opium Dens
Opium Trade
Opium Wars
Organized Crime Drug Enforcement Task Force Program
Over-the-Counter Drugs
Oxycodone/OxyContin
Parents Resource Institute for Drug Education (PRIDE) Surveys
Partnership for the Drug-Free America
Patent Medicines
Peyote
Pharmacology
Phencyclidine (PCP)
Phoenix House
Pizza Connection
Popular Culture
Porter, Stephen G.
Porter Narcotic Farm Act (1929)
Predatory Drugs
Prescription Drugs
President's Advisory Commission on Narcotic and Drug Abuse (1963)
President's Drug Advisory Council (George H. W. Bush)
Presley, Elvis
Prevention
Prison Inmates and Drug Use
Prohibition
Prohibition Party
Prohibition Unit
Prometa
Psilocybin and Psilocin (Mushrooms)
Psychedelic Drugs
Psychotherapeutic Drugs
Public Health Service Narcotic Hospitals
Public Opinion and Drug Use
Pure Food and Drug Act (1906)
VOLUME III
Quaalude
Raich v. Ashcroft
Randall, Robert
Raytheon v. Hernandez
Reagan, Ronald, and Nancy Reagan
Recovery
Recovery Circles
Recreational Use of Drugs
Reefer Madness
Ribbon Reform Clubs
Risk Factors for Drug Use
Robinson v. California
Rockefeller Drug Laws
Rodriguez, Alex
Ruffin, David
Rural Drug Use
Rush, Benjamin
Scarface
Schedule of Controlled Substances (I-V)
Secondhand Smoke
Sedatives, Hypnotics, and Anxiolytics
Seniors and Drug Use
Sentencing Disparities
Sertürner, Friedrich
Shisha
Shulgin, Alexander "Sasha,"
Skinner v. Railway Labor Executives' Association
Smith, Robert Holbrook ("Dr. Bob")
Smokers' Rights
Smoking Opium Exclusion Act (1909)
Sonora Cartel
Soros, George
Special Action Office of Drug Abuse Prevention
Special Narcotic Committee
State Drug and Alcohol Control Laws
STDs and Drug Use
Steroids, Anabolic
Steroids and Sports
Steroids in Baseball
Stimulants
Students Against Destructive Decisions (SADD)
Studio 54
Substance Abuse and Mental Health Services Administration (SAMHSA)
Substance Abuse Services Amendments of 1986
Substance Addiction
Supply-Side Strategy
Surgeon General's Reports on Tobacco
Synanon
Synthetic Drugs
Syrup
Television and Drugs
Temperance Movement
Terrorism and Illicit Drugs
Terry, Luther
"Texas Heroin Massacre" and Drug Use in the 1990s
THC (Tetrahydrocannabinol)
Theories of Drug Addiction
Tijuana Cartel
Tobacco
Tobacco Institute
Tranquilizers
Treatment
Truman, Harry S.
Twelve-Step Programs
Undocumented Immigrants and Drug Use
United Nations Commission on Narcotic Drugs
United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988)
United Nations Convention on Psychotropic Substances (1971)
United Nations International Conference on Drug Abuse and Illicit Trafficking (1987)
United Nations International Day Against Drug Abuse and Illicit Trafficking
United Nations Office on Drugs and Crime
United Nations Single Convention on Narcotic Drugs (1961)
United Nations Surveys on Crime Trends and the Operations of Criminal Justice Systems (UN-CTS)
United States Bureau of Narcotics and Dangerous Drugs (BNDD)
United States Coast Guard
United States Customs and Border Protection
United States Immigration and Customs Enforcement (ICE)
United States International Drug Control Efforts
United States National Narcotics Control Act (1956)
United States v. Doremus and Webb et al. v. United States
United States v. Flores-Montano (2004)
United States v. Jin Fuey Moy (1916)
Urinalysis
Violent Crime Control and Law Enforcement Act (1994)
Vollmer, August
Volstead, Andrew
Volstead Act (Eighteenth Amendment)
War on Drugs
Webb et al. v. United States
Webb-Kenyon Act (1913)
Whiskey Rebellion
White, Walter
White House Conference for a Drug-Free America
White House Conference on Narcotics and Drug Abuse
Wilson, William G. ("Bill W.")
Withdrawal from Drug Use
Woman's Christian Temperance Union (WCTU)
Women, Pregnancy, and Drugs
Women, Victimization, and Substance Abuse
Women's Organization for National Prohibition Reform (WONPR)
World Federation Against Drugs
World Narcotics Conference
Wright, Hamilton
Youths and Illicit Drug Use in the United States
Zero Tolerance Policy Program (U.S.)
Appendix: Documents Related to Drug Use in America
1. The First Drug Law in America, 1875
2. Pure Food and Drug Act (1906)
3. Harrison Narcotics Act (1915)
4. Eighteenth Amendment to the U.S. Constitution (1920-1933)
5. Porter Narcotic Farm Act (1929)
6. Marihuana Tax Act (1937)
7. Richard Nixon's Special Message to the Congress on Drug Abuse Prevention and Control (1971)
8. "Just Say No" Speech by Ronald and Nancy Reagan (1986)
9. Executive Order 12564: Drug-Free Federal Workplace (1986) (Ronald Reagan)
10. Anti-Drug Abuse Act (1986)
11. Anti-Drug Abuse Act (1988)
12. George Bush: Address to Nation on the National Drug Control Strategy (1989)
13. Executive Order 12880: National Drug Control Program (1993) (Bill Clinton)
14. Memorandum for Selected United States Attorneys (Medical Marijuana) (2009)
15. Cole Memorandum (Marijuana Dispensary Raids) (2011)
Recommended Resources
About the Editors and Contributors
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
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W
X
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Citation preview

Drugs in American Society

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Drugs in American Society an encyclopedia of history, politics, culture, and the law Volume 1: A–D

Nancy E. Marion and Willard M. Oliver, Editors

Copyright © 2015 by ABC-CLIO, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, except for the inclusion of brief quotations in a review, without prior permission in writing from the publisher. Library of Congress Cataloging-in-Publication Data   Drugs in American society : an encyclopedia of history, politics, culture, and the law / Nancy E. Marion and Willard M. Oliver, editors.    volumes ; cm   ISBN 978-1-61069-595-4 (alk. paper) — ISBN 978-1-61069-596-1 (ebook) 1. Drug abuse— United States. 2. Drugs—United States. 3. Drug utilization—United States. I. Marion, Nancy E., editor. II. Oliver, Willard M., editor. HV5825.D848 2015 363.290973—dc23   2014017383 ISBN: 978-1-61069-595-4 EISBN: 978-1-61069-596-1 19 18 17 16 15  1 2 3 4 5 This book is also available on the World Wide Web as an eBook. Visit www.abc-clio.com for details. ABC-CLIO, LLC 130 Cremona Drive, P.O. Box 1911 Santa Barbara, California 93116-1911 This book is printed on acid-free paper Manufactured in the United States of America

Contents

Guide to Related Topics,  xv

Alcohol Use,  32

Preface, xxiii

Alcohol-Facilitated Sexual Assault,  37

Introduction, xxv

Alcoholics Anonymous (AA),  39

Chronology: Significant Events in Drug and Alcohol Use through History,  xxxvii

Alcoholism, 42 Alpert, Richard,  47 Alternative Addiction Treatment,  49

VOLUME 1

American Association for the Study and Cure of Inebriety (AASCI),  51

Addiction, 1 Addiction Liability,  7

American Society of Addiction Medicine (ASAM), 53

Addiction Medications,  7

American Temperance Society (ATS),  56

Addictive Personality,  11

Amphetamines, 58

Adolescent Tobacco Use,  13

Analgesics, 60

Advisory Commission on Narcotic and Drug Abuse,  16

Andean Trade Preference Act (1991),  63

African Americans and Drug Use,  17

Anslinger, Harry J.,  65

Al-Anon, 20

Antidepressants, 68

Alateen, 22

Anti–Drug Abuse Acts,  71

Alcohol Bootlegging and Smuggling,  24

Anti-Saloon League (ASL),  73

Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (1992), 27

Anxiety Disorders,  76 Armstrong, Lance,  77 Asset Forfeiture,  80

Alcohol Mutual Aid Societies,  28

Association Against the Prohibition Amendment (AAPA),  82

Alcohol to Subdue Victims,  30 v

vi  Contents

Authors and Drug Use,  84

Bush, George W.,  140

Aviation Drug-Trafficking Control Act (1984), 86

Cabinet Committee on International Narcotics Control,  145

Bad Boys,  89

Caffeine, 146

Barbiturates, 91

Cali Drug Cartel,  148

Barnes, Nicky,  93

Califano, Joseph, Jr.,  153

Barry, Marion S.,  95

Camarena Salazar, Enrique,  154

Bath Salts and Synthetic Cannabis (“K2” or “Spice”), 97

Campaign against Marijuana Planting (CAMP), 156

Beatniks, 99

Cannabis, 157

Behavioral Addictions,  100

Carter, Jimmy,  159

Belushi, John,  103

Center for Substance Abuse Prevention (CSAP), 161

Bennett, William,  106 Betty Ford Center,  107 Bias, Len,  109

Center on Addiction and Substance Abuse (CASA), 163

Binge Drinking,  110

Centers for Disease Control and Prevention (CDC), 164

Biological and Psychological Reasons for Substance Abuse,  114

Central Intelligence Agency (CIA), United States, 166

Black Tar Heroin,  115

Child Sexual Abuse and Substance Abuse, 168

Blanco, Griselda,  117 Blood-Alcohol Content (BAC),  119 Blow,  122 Boggs Act (1951),  124 Boylan Act (1914),  126 Brown, Bobby,  129 Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF),  130

Children of Alcoholics,  170 China and the Chinese and Drugs,  173 Cigarettes, 175 Cigars, 178 Cipollone v. Liggett Group, Inc. et al.,  182 Clinton, Bill,  185 Cobain, Kurt,  188

Bureau of Drug Abuse Control,  134

Coca, 190

Bureau of International Narcotics and Law Enforcement Affairs,  135

Coca-Cola, 193

Bush, George H. W.,  136

Cocaine and Crack,  194 Cocaine Anonymous (CA),  197

Contents  vii

Cocaine Cowboys,  198

Date Rape Drugs,  242

Codeine, 200

Decriminalization, 244

Codependency, 201

Demand Reduction,  245

Colombian Cartels,  202

Dependence, 248

Combat Methamphetamine Act (2005), 204

Depressants, 250

Commission on Marihuana and Drug Abuse, 206 Committee on Drug Addiction (1928–1938), 210 Committee on Drug Addictions (1921–1928), 211 Common Sense for Drug Policy,  213 Compassionate Use Act (1996),  214 Comprehensive Drug Abuse Prevention and Control Act (1970),  216 Comprehensive Methamphetamine Control Act (1996),  218 Compulsions and Impulses,  219 Conant v. Walters,  220 Controlled Substances Act (CSA) (1970), 222 Council for Tobacco Research,  224 The Counterculture and Drugs,  226 Crack Epidemic,  228 Crime Control Act (1990),  230 Crime Victims and Drugs,  232

Designer Drugs,  252 Dimethyltryptamine (DMT),  255 Disease Model of Addiction,  256 Dole, Vincent,  257 Domestic Abuse and Alcohol,  259 Domestic Abuse and Drugs,  262 Drug Abuse,  264 Drug Abuse and Treatment Act (1972),  267 Drug Abuse Control Amendments (1965), 269 Drug Abuse Resistance Education (DARE), 271 Drug Abuse Warning Network,  273 Drug Addiction and Public Policy,  275 Drug Cartels,  279 Drug Classes,  285 Drug Courts,  288 Drug Czar,  290 Drug Enforcement Administration (DEA), 292

Crop Eradication,  234

Drug Interdiction and International Cooperation Act (1986),  295

Cross-Addiction and Cross-Tolerance,  236

Drug Intervention Programs,  296

Dadeland Massacre (Miami, Florida) (1979), 239

Drug Kingpin Death Penalty Act (1988, 1994), 298

Dai, Bingham,  240

Drug Nomenclature,  299

viii  Contents

Drug Paraphernalia,  300

Eighteenth Amendment,  357

Drug Policy Alliance Network,  303

Eisenhower, Dwight D.,  359

Drug Possession,  304

Elders, Joycelyn,  360

Drug Purity,  305

Electronic Dance Music (EDM/House Music), 361

Drug Reform Act (1986),  308 Drug Screening and Testing,  309 Drug Sentencing,  311 Drug Smuggling,  314 Drug Tolerance,  316 Drug Trade,  317 Drug Trafficking,  318 Drug Trafficking and Organized Crime, 321 Drug Trafficking Networks,  324 Drug Typologies,  326 Drug Use Forecasting,  330

Employment Division, Department of Human Resources of Oregon v. Smith,  363 Energy Drinks,  365 Engle v. R.J. Reynolds,  367 Entertainers and Drug Use,  369 Ephedrine and Pseudoephedrine,  372 Escobar, Pablo,  373 European Committee to Combat Drugs, 375 Extradition, 376 Fair Sentencing Act (2010),  379

Drug Watch International,  332

Families Against Mandatory Minimums (FAMM), 381

Drug-Facilitated Rape,  334

Farley, Chris,  383

Drug-Free America Act (1986),  336

Fast and Furious,  386

Drug-Free America Foundation,  338

Federal Alcohol Administration Act (1935), 389

Drug-Free Federal Workplace,  340 Drug-Free School Zones,  341 Drug-Free Schools and Community Act (1988–1989), 343

Federal Bureau of Investigation (FBI),  391 Federal Bureau of Narcotics (FBN),  394 Female Alcohol Use,  396

Drugged Driving,  345

Female Tobacco Use,  399

Drug-Related Asset Seizures,  349

Ferguson v. City of Charleston,  401 Fetal Alcohol Syndrome (FAS),  403

VOLUME 2

Fisher, Guy,  408

E-Cigarettes, 353

Flashbacks, 409

Ecstasy (MDMA),  355

Florida v. Jardines,  411

Contents  ix

Food and Drug Administration (FDA),  413

Hemp, 476

Food, Drug, and Cosmetic Act (1938),  415

Hendrix, Jimi,  478

Ford, Betty,  417

Heroin, 480

Ford, Gerald R.,  419 Four Loko,  421

High-Intensity Drug-Trafficking Areas (HIDTAs), 483

French Connection,  423

Hip-Hop and Drugs,  486

Freud, Sigmund,  424

Hippies, 488

Gateway Drugs,  429

HIV/AIDS and Drug Use,  489

Gateway Hypothesis,  433

Hoffman, Philip Seymour,  491

Ginsberg, Allen,  434

Hofmann, Albert,  493

Global Commission on Drug Policy (2011), 436

Hookah, 495

Golden Crescent,  437 Golden Triangle,  440 Grateful Dead,  443 Green Rush,  446 Guadalajara Cartel,  447 Guillot-Lara, Jaime,  449 Gulf Cartel,  450 Gutka, 454

Hoover, J. Edgar,  496 Ibogaine, 499 Inhalants, 500 International Narcotics Control Act (1989), 503 International Narcotics Research Conference (INRC),  504 Intervention, 505 Intoxication, 507

Hague Convention,  457

Investigational New Drug Program,  509

Haight-Ashbury, 460

Jackson, Michael,  511

Hallucinogens, 462

Jazz Culture,  513

Hangovers, 464

Jellinek, E. Morton,  515

Hard Drugs vs. Soft Drugs,  465

Johnson, Lyndon Baines,  517

Harm Reduction Programs,  467

Jones, Marion,  519

Harrison, Francis,  469

Joplin, Janis,  521

Harrison Narcotics Act (1914),  470

Juárez Cartel,  523

Hashish (Hash),  473

Jung, George,  525

Hazelden Foundation,  474

Kennedy, John F.,  527

x  Contents

Ketamine, 528

Meth Labs,  594

Khat, 531

Methadone, 597

Koop, C. Everett,  534

Methadone Treatment Programs,  598

The La Guardia Report,  539

Methamphetamine, 599

Labeling and the Criminalization Process, 541

Mexican Drug Trade,  603

Latinos and Drug Use,  543 Leary, Timothy,  544 Legalization, 546 Legalized Marijuana,  550 Leonhart, Michele M.,  552 LifeRing, 553 Lincoln, Abraham,  555 Linder v. United States,  557

Military and Drug Use,  606 Minnesota Model,  607 Minorities and Drug Use,  608 Moncrieffe v. Holder,  609 Monitoring the Future Survey,  611 Monroe, Marilyn,  613 Morality Policy,  615 Morphine, 616

Lindesmith, Alfred R.,  558

Mothers Against Drunk Driving (MADD), 617

Long-Term Potentiation,  559

Mullen, Francis,  619

LSD (Lysergic Acid Diethylamide),  560

Nadelmann, Ethan,  621

Lucas, Frank,  563

Naltrexone, 622

Mandatory Treatment,  567

Narcotic Addict Rehabilitation Act (1966), 624

Marihuana Tax Act (1937),  568 Marijuana, 570 Marijuana Businesses,  573 Master Settlement Agreement (MSA), 577 McCaffrey, Barry R.,  580 McCoy, Bill,  584 Medellín Cartel,  585 Medical Marijuana,  588 Meese, Edwin,  592 Mescaline, 593

Narcotic Clinics,  626 Narcotic Control Act (1956),  628 Narcotic Drugs Import and Export Act (1922), 630 Narcotics, 631 Narcotics Anonymous (NA),  632 Nation, Carrie,  635 National Association of State Alcohol and Drug Abuse Directors,  638 National Clearinghouse for Alcohol and Drug Information (U.S.),  639

Contents  xi

National Council on Alcoholism and Drug Dependence (NCADD),  640 National Drug Control Strategy,  643 National Drug Policy Board,  645 National Household Survey on Drug Abuse, 647 National Institute on Alcohol Abuse and Alcoholism (NIAAA),  649 National Institute on Drug Abuse (NIDA), 651 National Minimum Drinking Age Act (1984), 653

Obama, Barack,  696 Office for Drug Abuse Law Enforcement, 699 Office of National Drug Control Policy (ONDCP), 700 Opiates, 703 Opium, 705 Opium Control Act (1942),  708 Opium Dens,  709 Opium Trade,  711 Opium Wars,  715

National Narcotics Border Interdiction System (NNBIS),  655

Organized Crime Drug Enforcement Task Force Program,  716

National Organization for the Reform of Marijuana Laws (NORML),  657

Over-the-Counter Drugs,  717

National Research Council Report on Drug Enforcement Activities,  659

Parents Resource Institute for Drug Education (PRIDE) Surveys,  721

National Treasury Employees Union v. Von Raab,  660

Partnership for the Drug-Free America,  723

National Youth Anti-Drug Media Campaign, 661

Oxycodone/OxyContin, 719

Patent Medicines,  725 Peyote, 726

Native Americans and Substance Abuse, 663

Pharmacology, 729

Needle Exchange Programs,  671

Phoenix House,  732

Neurotransmitters, 673

Pizza Connection,  734

Nicotine, 677

Popular Culture,  736

Nixon, Richard M.,  686

Porter, Stephen G.,  739

Noriega, Manuel Antonio,  688

Porter Narcotic Farm Act (1929),  741

Nutt, Levi G.,  691

Predatory Drugs,  744

Nyswander, Marie,  692

Prescription Drugs,  747

Oakland Cannabis Buyers’ Cooperative, 695

President’s Advisory Commission on Narcotic and Drug Abuse (1963),  749

Phencyclidine (PCP),  730

xii  Contents

President’s Drug Advisory Council (George H. W. Bush),  751 Presley, Elvis,  752 Prevention, 755 Prison Inmates and Drug Use,  759 Prohibition, 762 Prohibition Party,  764

Rockefeller Drug Laws,  802 Rodriguez, Alex,  804 Ruffin, David,  806 Rural Drug Use,  808 Rush, Benjamin,  810 Scarface, 813

Prohibition Unit,  766

Schedule of Controlled Substances (I–V), 815

Prometa, 768

Secondhand Smoke,  817

Psilocybin and Psilocin (Mushrooms),  769

Sedatives, Hypnotics, and Anxiolytics,  818

Psychedelic Drugs,  771

Seniors and Drug Use,  819

Psychotherapeutic Drugs,  773

Sentencing Disparities,  820

Public Health Service Narcotic Hospitals, 775

Sertürner, Friedrich,  822

Public Opinion and Drug Use,  777 Pure Food and Drug Act (1906),  779

Shisha, 823 Shulgin, Alexander “Sasha,”  824 Skinner v. Railway Labor Executives’ Association,  826

VOLUME 3

Smith, Robert Holbrook (“Dr. Bob”),  827

Quaalude, 781

Smokers’ Rights,  829

Raich v. Ashcroft,  783

Smoking Opium Exclusion Act (1909), 831

Randall, Robert,  784 Raytheon v. Hernandez,  785 Reagan, Ronald, and Nancy Reagan,  787 Recovery, 790 Recovery Circles,  792 Recreational Use of Drugs,  794

Sonora Cartel,  832 Soros, George,  833 Special Action Office of Drug Abuse Prevention, 835 Special Narcotic Committee,  836

Reefer Madness,  795

State Drug and Alcohol Control Laws, 837

Ribbon Reform Clubs,  797

STDs and Drug Use,  839

Risk Factors for Drug Use,  799

Steroids, Anabolic,  841

Robinson v. California,  800

Steroids and Sports,  843

Contents  xiii

Steroids in Baseball,  846 Stimulants, 848 Students Against Destructive Decisions (SADD), 850 Studio 54,  852 Substance Abuse and Mental Health Services Administration (SAMHSA),  853 Substance Abuse Services Amendments of 1986, 858 Substance Addiction,  859 Supply-Side Strategy,  864 Surgeon General’s Reports on Tobacco, 866 Synanon, 868 Synthetic Drugs,  870 Syrup, 871 Television and Drugs,  875 Temperance Movement,  879 Terrorism and Illicit Drugs,  882 Terry, Luther,  884 “Texas Heroin Massacre” and Drug Use in the 1990s,  885 THC (Tetrahydrocannabinol),  890 Theories of Drug Addiction,  891 Tijuana Cartel,  894 Tobacco, 897 Tobacco Institute,  899 Tranquilizers, 901 Treatment, 902

Undocumented Immigrants and Drug Use, 913 United Nations Commission on Narcotic Drugs, 914 United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988),  916 United Nations Convention on Psychotropic Substances (1971),  917 United Nations International Conference on Drug Abuse and Illicit Trafficking (1987), 918 United Nations International Day Against Drug Abuse and Illicit Trafficking, 919 United Nations Office on Drugs and Crime, 920 United Nations Single Convention on Narcotic Drugs (1961),  921 United Nations Surveys on Crime Trends and the Operations of Criminal Justice Systems (UN-CTS),  922 United States Bureau of Narcotics and Dangerous Drugs (BNDD),  923 United States Coast Guard,  924 United States Customs and Border Protection, 926 United States Immigration and Customs Enforcement (ICE),  929 United States International Drug Control Efforts, 932 United States National Narcotics Control Act (1956),  934

Truman, Harry S.,  907

United States v. Doremus and Webb et al. v. United States,  934

Twelve-Step Programs,  909

United States v. Flores-Montano (2004),  937

xiv  Contents

United States v. Jin Fuey Moy (1916),  938 Urinalysis, 940 Violent Crime Control and Law Enforcement Act (1994),  943 Vollmer, August,  944 Volstead, Andrew,  946

Appendix: Documents Related to Drug Use in America 1. The First Drug Law in America, 1875, 985 2. Pure Food and Drug Act (1906),  985 3. Harrison Narcotics Act (1915),  990

Volstead Act (Eighteenth Amendment),  948

4. Eighteenth Amendment to the U.S. Constitution (1920–1933),  996

War on Drugs,  951

5. Porter Narcotic Farm Act (1929),  997

Webb et al. v. United States,  952

6. Marihuana Tax Act (1937),  999

Webb-Kenyon Act (1913),  953

7. Richard Nixon’s Special Message to the Congress on Drug Abuse Prevention and Control (1971),  1009

Whiskey Rebellion,  955 White, Walter,  957 White House Conference for a Drug-Free America, 958

8. “Just Say No” Speech by Ronald and Nancy Reagan (1986),  1019

White House Conference on Narcotics and Drug Abuse,  959

9. Executive Order 12564: Drug-Free Federal Workplace (1986) (Ronald Reagan), 1024

Wilson, William G. (“Bill W.”),  960

10. Anti–Drug Abuse Act (1986),  1029

Withdrawal from Drug Use,  961

11. Anti–Drug Abuse Act (1988),  1041

Woman’s Christian Temperance Union (WCTU), 962

12. George Bush: Address to Nation on the National Drug Control Strategy (1989), 1089

Women, Pregnancy, and Drugs,  964 Women, Victimization, and Substance Abuse, 968 Women’s Organization for National Prohibition Reform (WONPR),  971 World Federation Against Drugs,  972

13. Executive Order 12880: National Drug Control Program (1993) (Bill Clinton),  1095 14. Memorandum for Selected United States Attorneys (Medical Marijuana) (2009), 1097

World Narcotics Conference,  973

15. Cole Memorandum (Marijuana Dispensary Raids) (2011),  1100

Wright, Hamilton,  973

Recommended Resources,  1103

Youths and Illicit Drug Use in the United States, 977

About the Editors and Contributors,  1113

Zero Tolerance Policy Program (U.S.), 983

Index, 1117

Guide to Related Topics

Following are entries in this encyclopedia, arranged under broad topics, for enhanced searching. Readers should also consult the index at the end of the encyclopedia for more specific subjects.

Fetal Alcohol Syndrome (FAS) National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Minimum Drinking Age Act Whiskey Rebellion

Addiction/Use Addiction Addiction Liability Addiction Medications Addictive Personality Behavioral Addictions Compulsions/Impulses Disease Model of Addiction Drug Abuse Drug Addiction and Public Policy Substance Addiction Theories of Drug Addiction

Commissions and Boards Advisory Commission on Narcotic and Drug Abuse Bureau of Drug Abuse Control Bureau of International Narcotics and Law Enforcement Affairs Cabinet Committee on International Narcotics Control Campaign against Marijuana Planting (CAMP) Center for Substance Abuse Prevention Center on Addiction and Substance Abuse (CASA) Commission on Marihuana and Drug Abuse Committee on Drug Addiction (1928–1938) Committee on Drug Addictions (1921–1928) European Committee to Combat Drugs Global Commission on Drug Policy National Drug Policy Board National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Institute on Drug Abuse (NIDA) President’s Advisory Commission on Narcotic and Drug Abuse President’s Drug Advisory Council

Alcohol Alcohol Bootlegging and Smuggling Alcohol to Subdue Victims Alcohol Use Alcohol-Facilitated Sexual Assault Alcoholism American Association for the Study and Cure of Inebriety (AASCI) Binge Drinking Blood-Alcohol Content (BAC) Children of Alcoholics Domestic Abuse and Alcohol Female Alcohol Use xv

xvi   Guide to Related Topics

Special Action Office for Drug Abuse Prevention Special Narcotic Committee United Nations Commission on Narcotic Drugs White House Conference for a Drug-Free America White House Conference on Narcotics and Drug Abuse White House Drug Abuse Policy Office

Court Cases Cipollone v. Liggett Group, Inc. et al. Conant v. Walters Employment Division, Department of Human Resources of Oregon v. Smith Engle v. R.J. Reynolds Ferguson v. City of Charleston Florida v. Jardines Linder v. United States Moncrieffe v. Holder National Treasury Employees Union v. Von Raab Oakland Cannabis Buyers’ Cooperative Raich v. Ashcroft Raytheon v. Hernandez Robinson v. California Skinner v. Railway Labor Executives’ Association United States v. Doremus and Webb et al v. United States United States v. Flores-Montano United States v. Jin Fuey Moy Webb et al. v. United States Drug Trafficking Cali Drug Cartel Colombian Cartels Dadeland Massacre (Miami, Florida) Drug Cartels French Connection Golden Crescent Golden Triangle Guadalajara Cartel

Gulf Cartel Juárez Cartel Medellín Cartel Mexican Drug Trade Sonora Cartel Tijuana Cartel

Drugs Amphetamines Anabolic Steroids Analgesics Antidepressants Barbiturates Bath Salts and Synthetic Cannabis Black Tar Heroin Caffeine Cannabis Coca Coca-Cola Cocaine and Crack Codeine Crack Epidemic Date Rape Drugs Depressants Designer Drugs Dimethyltryptamine (DMT) Drug Classifications Ecstasy (MDMA) Ephedrine and Pseudoephedrine Gutka Hallucinogens Hashish Hemp Heroin Ibogaine Inhalants Ketamine Khat LSD Mescaline Methadone Methamphetamine Morphine Naltrexone

Guide to Related Topics  xvii

Narcotics Nicotine Opiates Opium Over-the-Counter Drugs Oxycodone/OxyContin Phencyclidine (PCP) Patent Medicines Peyote Predatory Drugs Prescription Drugs Prometa Psilocybin and Psilocin (Mushrooms) Psychedelic Drugs Psychotherapeutic drugs Quaalude Sedatives, Hypnotics, and Anxiolytics Shisha Stimulants Synthetic Drugs Syrup THC Tobacco Tranquilizers

Entertainment Bad Boys Blow Cocaine Cowboys Electronic Dance Music (EDM/House Music) Entertainers and Drug Use Grateful Dead Haight-Ashbury Hip-Hop and Drugs Hoffman, Philip Seymour Jazz Culture National Youth Anti-Drug Media Campaign Popular Culture Reefer Madness Scarface Television and Drugs White, Walter

Interest Groups Common Sense for Drug Policy Drug Free America Foundation Drug Policy Alliance Network Families Against Mandatory Minimums Mothers Against Drunk Driving (MADD) National Association of State Alcohol and Drug Abuse Directors National Organization for the Reform of Marijuana Laws Students Against Destructive Decisions (SADD) International Bureau of International Narcotics and Law Cabinet Committee on International Narcotics Law Cali Drug Cartel China (Chinese) and Drugs Colombian Cartels Crop Eradication Demand Reduction Drug Cartels Drug Smuggling Drug Trade Drug Trafficking Drug Trafficking and Organized Crime Drug Trafficking Networks Drug Watch International European Committee to Combat Drugs Global Commission on Drug Policy Guadalajara Cartel Gulf Cartel Hague Convention Illicit Drugs and Terrorism Juárez Cartel Medellín Cartel Mexican Drug Trade National Narcotics Border Interdiction System Opium Trade Opium Wars Organized Crime Drug Enforcement Task Force Program

xviii   Guide to Related Topics

Pizza Connection Psychotropic Substances Sonora Cartel Supply-Side Strategy Tijuana Cartel United Nations Commission on Narcotic Drugs United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances United Nations Convention on Psychotropic Substances United Nations International Conference on Drug Abuse and Illicit Trafficking United Nations International Day Against Drug Abuse and Illicit Trafficking United Nations Office on Drugs and Crime United Nations Single Convention on Narcotic Drugs United Nations Surveys on Crime Trends and Operations of Criminal Justice Systems United States International Drug Control Efforts World Federation Against Drugs World Narcotics Conference

Law Enforcement Asset Forfeiture Bureau of Alcohol Tobacco, Firearms and Explosives (ATF) Camarena Salazar, Enrique Central Intelligence Agency (CIA) Drug Czar Drug Enforcement Administration (DEA) Extradition Fast and Furious Federal Bureau of Investigation (FBI) Federal Bureau of Narcotics (FBN) Food and Drug Administration (FDA) High-Intensity Drug-Trafficking Areas (HIDTAs) National Narcotics Border Interdiction System

Office for Drug Abuse Law Enforcement Organized Crime Drug Enforcement Task Force Program United States Bureau of Narcotics and Dangerous Drugs (BNDD) United States Coast Guard United States Customs and Border Protection United States Immigration and Customs Enforcement (ICE)

Legislation Alcohol, Drug Abuse, and Mental Health Reorganization Act (1992) Andean Trade Preference Act (1991) Anti–Drug Abuse Acts Aviation Drug-Trafficking Control Act (1984) Boggs Act (1951) Boylan Act (1914) Combat Methamphetamine Act (2005) Compassionate Use Act (1996) Comprehensive Drug Abuse Prevention and Control Act (1970) Comprehensive Methamphetamine Control Act (1996) Controlled Substances Act (1970) Crime Control Act (1990) Drug Abuse and Treatment Act (1972) Drug Abuse Control Amendments (1965) Drug Interdiction and International Cooperation Act (1986) Drug Kingpin Death Penalty Act (1988, 1994) Drug Reform Act (1986) Drug-Free America Act (1986) Drug-Free Schools and Communities Act (1988–1989) Fair Sentencing Act (2010) Federal Alcohol Administration Act (1935) Food, Drug, and Cosmetic Act (1938) Harrison Narcotics Act (1914) International Narcotics Control Act (1989) Marihuana Tax Act (1937)

Guide to Related Topics  xix

Narcotic Addict Rehabilitation Act (1966) Narcotic Control Act (1956) Narcotic Drugs Import and Export Act (1922) National Minimum Drinking Age Act (1984) Opium Control Act (1942) Porter Narcotic Farm Act (1929) Pure Food and Drug Act (1906) Smoking Opium Exclusion Act (1909) Substance Abuse Services Amendments (1986) United States National Narcotics Control Act (1956) Violent Crime Control and Law Enforcement Act (1994) Volstead Act (Eighteenth Amendment) Webb-Kenyon Act (1913)

Marijuana/Medical Marijuana Campaign Against Marijuana Planting Cannabis Conant v. Walters Legalized Marijuana Marihuana Tax Act (1937) Marijuana Marijuana Businesses Medical Marijuana Oakland Cannabis Buyers’ Cooperative Reefer Madness THC Movies. See Entertainment Music Brown, Bobby Cobain, Kurt Electronic Dance Music (EDM/House Music) Grateful Dead Haight-Ashbury Hendrix, Jimi Hip-Hop and Drugs Jazz Culture

Jackson, Michael Joplin, Janis Popular Culture Presley, Elvis

People Alpert, Richard Anslinger, Harry J. Armstrong, Lance Barry, Marion S. Bennett, William Bias, Len Blanco, Griselda Brown, Bobby Bush, George H. W. Bush, George W. Clinton, Bill Cobain, Kurt Dai, Bingham Dole, Vincent Eisenhower, Dwight C. Elders, Joycelyn Escobar, Pablo Farley, Chris Ford, Betty Ford, Gerald R. Freud, Sigmund Ginsberg, Allen Guillot-Lara, Jaime Harrison, Francis Hendrix, Jimi Hoffman, Philip Seymour Hofmann, Albert Hoover, J. Edgar Jackson, Michael Jellinek, E. Morton Johnson, Lyndon B. Jones, Marion Joplin, Janis Jung, George Kennedy, John F. Koop, C. Everett Leary, Timothy Leonhart, Michele M.

xx   Guide to Related Topics

Lincoln, Abraham Lindesmith, Alfred McCoy, Bill Meese, Edwin Mullen, Francis Nadelmann, Ethan Nixon, Richard M. Noriega, Manuel Antonio Nutt, Levi G. Nyswander, Marie Obama, Barack Porter, Stephen G. Presley, Elvis Randall, Robert Reagan, Ronald, and Nancy Reagan Ruffin, David Rush, Benjamin Sertürner, Friedrich Shulgin, Alexander Smith, Robert “Dr. Bob” Holbrook Soros, George Terry, Luther Truman, Harry S. Vollmer, August Volstead, Andrew White, Walter Wilson, William “Bill” Griffith Wright, Hamilton

Prevention Drug Abuse Resistance Education (DARE) Intervention Prevention Drug-Free School Zones Research Centers for Disease Control and Prevention Drug Abuse Warning Network International Narcotics Research Conference Investigational New Drug Program National Clearinghouse for Drug Abuse Information and Education

National Council on Alcoholism and Drug Dependence National Household Survey on Drug Abuse National Research Council on Drug Enforcement Activities Substance Abuse and Mental Health Services Administration (SAMHSA)

Social and Cultural Issues African Americans and Drug Use Alcohol-Facilitated Sexual Assault Biological and Psychological Reasons for Substance Abuse Child Sexual Abuse and Substance Abuse Children of Alcoholics Codependency Counterculture and Drugs Domestic Abuse and Drugs Drug Intervention Programs Drug-Facilitated Rape Fetal Alcohol Syndrome (FAS) Intervention Hippies Latinos and Drug Use Military and Drug Use Native Americans and Substance Abuse Popular Culture Prison Inmates and Drug Use Public Opinion and Drug Use Recreational Use of Drugs Rural Drug Use Seniors and Drug Use Steroids in Baseball Steroids and Sports Women, Pregnancy, and Drugs Women, Victimization, and Substance Abuse Youth and Illicit Drug Use in the United States Temperance American Temperance Society Anti-Saloon League

Guide to Related Topics  xxi

Association Against Prohibition Amendment Eighteenth Amendment Prohibition Prohibition Party Prohibition Unit Temperance Volstead Act Woman’s Christian Temperance Union Women’s Organization for National Prohibition Reform (WONPR)

Tobacco Adolescent Tobacco Use Cigarettes Cigars Cipollone v. Liggett Group, Inc. et al. E-Cigarettes Master Settlement Agreement Nicotine Female Tobacco Use Secondhand Smoke Smokers’ Rights Tobacco Tobacco Institute Treatment Addiction Medications Al-Anon Ala-Teen Alcoholics Anonymous Alcohol Mutual Aid Societies Alternative Addiction Treatment American Society of Addiction Medicine

Betty Ford Center Cocaine Anonymous Drug Courts Drug Intervention Programs Harm Reduction Programs Hazelden Foundation Intervention LifeRing Mandatory Treatment Methadone Methadone Treatment Programs Minnesota Model Narcotics Anonymous Needle Exchange Programs Phoenix House Public Health Service Narcotic Hospitals Recovery Recovery Circles Synanon Treatment Twelve-Step Programs Urinalysis

Youth Adolescent Tobacco Use Child Sexual Abuse and Substance Abuse Electronic Dance Music (EDM/House Music) Hip-Hop and Drugs National Youth Anti-Drug Media Campaign Parents Resource Institute for Drug Education (PRIDE) Surveys Youths and Illicit Drug Use in the United States

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Preface

The problem of drug use and abuse has been a concern to many people in society for hundreds of years. Why people take drugs, the effects of the drugs, and the best treatment for those addicted to drugs are questions that remain unanswered, even after many years of research and study. The current book is a collection of 468 entries that describe aspects of drugs, drug use, and drug abuse that have affected American society. It is intended for those who have an interest in learning more about all aspects of drugs: the composition of drugs and how they are made, trends in drug use, the physical effects of drugs on a user’s body, crimes that result from drug use and trafficking, significant people in the drug war, and the political and governmental aspects of drugs, including laws pertaining to illicit drugs and court decisions related to drug use. The primary audience for the book is anyone with an interest in learning about all or any aspects of drug use, and anyone who seeks to have their questions answered in a clear and concise way. There are many books about drugs and drug use that have already been published and widely read, so one might ask, why another book on the same topic? The answer to this is that this book provides a wealth of information on a variety of topics in short, succinct essays. A reader can obtain a basic understanding of a concept, a person, or an

event very quickly. Readers can then use the resources provided to pursue a deeper understanding of that topic, if they desire. Each entry in the book has a list of further reading, and, at the end of the book, there is a helpful, annotated guide to recommended sources on drugs in America. Also at the end of the book is an appendix of nearly 20 government documents, arranged in chronological order, showing the steps that the U.S. government has taken to discourage and enforce prosecution of illicit drug abuse and sales. The entries in the book are arranged alphabetically, with similar or related terms crossreferenced. Boxes and tables with relevant information are included when needed to help further a reader’s knowledge about the field. Each entry describes a different aspect of drugs. Entries have been written by 25 contributors, including academics, health practitioners, and researchers. Some of the entries have appeared previously in other ABCCLIO sources, whereas others are new and discuss newly emerging trends in the field of drug abuse. Entries cover a range of time periods, providing a solid coverage of the history of drug use, from 19th-century attempts to curb drug and alcohol use, to information on newly developed drugs and patterns of drug use. It also includes information from different geographic locations around the

xxiii

xxiv  Preface

world, as drug trafficking is a worldwide phenomenon that deeply affects American society. And, it has been argued that Americans’ need for illicit drugs has in turn affected other countries, as for example, in Mexico, where ruthless drug lords and their cartels have violently disrupted Mexican life as they fight to supply drugs to Americans and others worldwide.

Acknowledgments Many people need to be acknowledged for their role in writing this book. We would particularly like to thank Stacy O’Hara Leiter, Lindsay Powley, and Adam Stilgenbauer for their work on the project. Dr. Josh Hill was also an integral part of the writing process and provided many relevant entries. My thanks go out to each of these people.

Introduction

A drug is a chemical substance that affects a user’s body in a particular way other than by providing nutrition or hydration (Henderson 2004). Drugs are any substance other than food, either natural (i.e., a plant) or humanmade (synthetic), which by their chemical nature affect the functioning of the body when ingested. All drugs are psychoactive, meaning that they influence the body’s biological function in some way (Benavie 2009, 9) as to alter a user’s mood and also to give pleasure to that user. Every drug affects a user’s motivation, thinking processes, and mood, both biologically and psychologically. Drugs can be used legally or illegally. Typically the distinction is made between uses for medical or nonmedical (recreational) reasons. Legal drugs are those that can be sold, possessed, and used by an individual to treat a disease or alleviate a symptom of an illness. Illegal drugs are those that have limits on their use, or are “controlled” or even banned by the government. If a drug is classified as controlled, the manufacture, sale, distribution, possession, or use under particular circumstances is a criminal activity. Some drugs are illegal at all times, no matter what (e.g., heroin). Most drugs are illegal if they are used for nonmedical (recreational) reasons, with the exception of alcohol and nicotine (if the user is of legal age). Some drugs are used for both legal and

illegal purposes. For example, OxyContin can be used medically (and legally) if prescribed to relieve pain. But it can also be abused for nonmedical reasons by someone without a prescription or by prescription holders if they use the drug in a way other than prescribed. The legal restrictions on drugs vary. There may be requirements that a user meet a certain age in order to purchase the drug (i.e., alcohol or nicotine—tobacco—or over-thecounter medications) or have a prescription from a recognized physician (e.g., Valium, OxyContin) in order to use it. Some drugs are illegal if used without the oversight of a physician. Other drugs are legal in one place but not another, or under some circumstances but not others. For example, marijuana can be legally used to treat symptoms of disease in some states but not in others. It can now be used recreationally in a few states, but not in others. For most people, drug use is not a problem. They can ingest a drug in moderation and in a safe manner, causing no harm to themselves or others. However, other users abuse those same drugs. Drug abuse occurs when a user repeatedly takes a drug more often or in higher quantities than prescribed (Kleiman, Caulkins, and Hawken 2011), or when it is used simply for recreational reasons rather than for medical reasons. Some xxv

xxvi  Introduction

users become addicted to the effects of a drug and have difficulty ending their use of that substance. Extreme drug abuse can cause great harm to the individual and to others. It can result in injury from accidents, accidental poisonings, or even suicide or death from overdose. It can cause diseases and disorders (cardiovascular disease, cancer, mental disorders); and can lead to infectious diseases such as HIV, sexually transmitted diseases, or hepatitis, when drug paraphernalia is shared; and can cause permanent harm to unborn children if the user is pregnant at the time of ingestion. Estimates show that around 375,000 infants are born with some exposure or effects from their mother’s drug use each year. Around 60,000 of those infants are born with fetal alcohol syndrome (FAS), a source of developmental and learning problems (Henderson 2004). Drug abuse can reduce workplace productivity and cause some employees to lose entire workdays. Those with severe drug addictions may become unemployed and/or homeless. Often, drug abuse causes crime because users tend to be violent under the effects of the drug, or because they commit crimes in order to get more of the drug. Moreover, according to the National Institute of Drug Abuse, the total cost of drug abuse and addiction is estimated to be about $524 billion each year. Abuse of illicit drugs costs $181 billion in health care costs, the loss of productivity, incarceration and enforcement (National Institute on Drug Abuse 2008). According to the 2012 National Survey on Drug Abuse and Health completed annually by the Substance Abuse and Mental Health Services Administration in the Department of Health and Human Services, an estimated 23.9 million Americans aged 12 and older used an illicit drug (e.g., marijuana/hashish, cocaine, heroin, hallucinogens, inhalants, or

prescription psychotherapeutics) during the month before the survey. Marijuana was the most commonly used illicit drug. It was used by 18.9 million Americans, with 7.6 million reporting they used it each day. Moreover, the survey found 1.6 million Americans who used cocaine and 1.1 million people who used hallucinogens (U.S. Department of Health and Human Services 2013). It is not clearly understood why people take illicit drugs or become addicted to them. Some use substances to feel better, or to temporarily escape from their problems. In these cases, users may be self-medicating as a way to escape a broken or abusive home or physical abuse. Many users had parents who used drugs themselves, making them more comfortable and familiar with the purchase and ingestion of illegal drugs. Some drugs also are used illegally by people who seek to increase their concentration and stay alert. Other people who are uncomfortable around strangers or large crowds turn to illegal drugs to help them navigate social situations. Some researchers have proposed that users who become addicted to drugs do so because of biological reasons—they have a genetic predisposition to becoming reliant on a drug. One well-known physician, Andrew Weil, believes that the desire to alter our consciousness is an innate, normal drive that is found in all people (Weil 2004). In fact, people have been using drugs to alter their consciousness for thousands of years and in all cultures. For many years in the United States, narcotics were relied upon as accepted medicine to treat a variety of medical conditions, from mild to severe. Opiates and coca leaf derivatives were used regularly as pain killers and anesthetics and were essential to the medical profession. Physicians regularly used narcotics to treat chronic pain. Many nineteenth-century “patent medicines” contained powerful drugs

Introduction  xxvii

that were readily available without a prescription, with no regulation of their use. But this began to change in the early 1900s, when evidence accumulated that patent medicines could be both dangerous and addictive to consumers. At that time, the government established laws intended to reduce the damage done by some drugs to users, their family members, and others in the community. The first drug-related law passed by a state came in 1872, when California regulated laudanum. This was the first anti-opium law in the United States. A second law passed in 1881 outlawed opium dens, which were managed primarily by Chinese immigrants. The laws made it a misdemeanor to operate a place in which opium was sold, given away, or smoked. The first federal law to regulate drugs was the Pure Food and Drug Act, passed in 1906. This new law required that all products that contained a drug have the ingredients clearly labeled. Moreover, the manufacturers were not permitted to make unwarranted health claims about their products. This law was followed by the Harrison Anti-Narcotic Act of 1914, which was also a way to increase revenue to the government. Under this law, anyone who imported, manufactured, produced or compounded, sold, dispensed or distributed opiates or cocaine had to register with the Department of Internal Revenue, within the Treasury Department. They also had to purchase a tax “stamp,” and record all transactions in which they dispensed the drugs. Another requirement forced the handler to file a monthly narcotic report with the government showing their activities. In essence, the Harrison act was a revenue mechanism that was also designed as a way for the federal government to exert some minimal control over the use and distribution of narcotics and other drugs. Interestingly, if there were charges made against a physician

under the Harrison Act, the investigation was a tax investigation as opposed to a criminal investigation. Any doctors found to have violated the law lost their tax stamps, their authority to handle narcotics, and their medical licenses (Frydl 2013). The temperance movement in the late 1800s focused on the negative effects of alcohol use, which was blamed for poverty, broken families, domestic abuse, and other social harms. Carrie Nation and other activists successfully made the use of alcohol illegal in many parts of the country. In 1920 continued protests against alcohol finally resulted in Prohibition, a federal ban on the production, sale, and transport of alcoholic beverages that lasted until 1933. Another theory of Prohibition’s implementation is that it was encouraged by a declining social elite, who attempted to set more controls over new immigrant groups who used alcohol often. The federal government continued its fight against the dangers of drug use in the 1930s. President Hoover created the Federal Bureau of Narcotics in 1930 as a way to focus federal attention on stopping drug use. Congress also continued to pass new laws restricting drug use throughout this time. In 1937 it passed the Marijuana Tax Act, using the Harrison Act’s revenue provisions as a model, in an effort to eradicate all use of the drug. The new law mandated that all batches of marijuana be accompanied by a federal tax stamp. Additionally, every transaction involving marijuana, whether used for medical or other purposes, had to be documented. However, since most states had already passed their own laws banning marijuana by this time, anyone who bought a stamp would be opening him or herself up to an arrest. But if a physician failed to pay the tax and purchase a stamp, federal agents could arrest that person for violating the law.

xxviii  Introduction

People convicted of violating the Marijuana Tax Act were subject to a sentence of five years in prison, a fine of $2,000, or both. The Food, Drug and Cosmetic Act was passed in 1938. This legislation created the Food and Drug Administration, which was given legal authority over medicinal drugs in the United States. Federal action against illegal drugs continued through the 1960s. The country saw a “War on Drugs” that started when presidential candidate Richard Nixon promised a battle against drugs in his campaign for office in 1968. At that time, the use of illicit drugs for pleasure was becoming more accepted in popular culture. Illegal drugs were readily available and cheap, and were used openly by middle-class youth. To address this growing problem, Nixon established the President’s National Commission on Marijuana and Drug Abuse. In 1970 Congress passed the Controlled Substances Act (CSA), a landmark piece of legislation that impacted drug laws for years to come. This law was the first comprehensive anti-drug bill passed by the federal government since the Harrison Narcotic Act of 1914. The CSA established a series of drug “schedules” or categories in which drugs were identified based on their addictiveness, medical purposes, and dangerousness. It also allowed for the diversion of drug-involved nonviolent offenders from the criminal justice system into drug abuse treatment programs. The Drug Enforcement Administration (DEA) was formed by Nixon in 1973 to bring together all of the different agencies that had some role in the drug war. Each of these separate agencies were combined to become a single department responsible for enforcing federal narcotics laws. Another agency formed to further our knowledge about drug use and abuse was the National Institute on Drug Abuse, formed in 1974.

This agency was given the task of funding and overseeing research into the reasons why people take drugs and the best methods for treating addiction. Nixon also created the Special Action Office for Drug Abuse Prevention, which advocated a new approach to drug addiction: Treatment Alternatives to Street Crime (TASC). This program, funded by the Law Enforcement Assistance Administration and the National Institute of Mental Health, was a national program designed to reduce drug abuse by diverting drug-involved offenders into community-based treatment programs instead of incarceration. The first TASCs became operational in 1972. It was hoped that participants in these treatment programs would avoid the stigma of prison, kick their dependence on drugs, and become law-abiding citizens. The TASC program ended in 1982. Despite these anti-drug actions, drug use and abuse in the United States continued to grow. In the 1970s, cocaine was the popular drug. It was supplanted in the 1980s by crack cocaine, a cheaper alternative that was highly addictive. As the number of people addicted to drugs grew, crime also grew alongside. With the growing attention to the problem, Congress passed The Anti–Drug Abuse Act of 1986, which allocated massive amounts of federal dollars for drug control programs. This was followed in 1988 with the Anti– Drug Abuse Act. Provisions of this law created the Office of National Drug Control Policy, the head of which became known unofficially as the nation’s “drug czar.” This person was tasked with coordinating national policies regarding drug use and abuse and recommending policy changes to the administration as needed. America’s “war on drugs” has been waged in one way or another by every president since Nixon. Presidents Ronald Reagan

Introduction  xxix

and George H. W. Bush emphasized a conservative approach to drug control, which included harsh punishments. Their administrations de-emphasized treatment for those who suffered from substance abuse or who committed crimes while under the influence of chemical substances. President Bill Clinton, a conservative Democrat when it came to drugs and crime, reversed that approach a bit. President George W. Bush emphasized international cooperation alongside increased punishment (and some treatment programs mixed in), while President Barack Obama has increased federal resources for treatment and diversion programs. Although their methods have differed, each president has tried to reduce or eliminate the consumption of illicit substances by Americans. The government has spent billions to do this, but so far, the policy seems not to have greatly affected the price, the purity, or, most important, the supply of illegal drugs. Most experts and non-experts alike would agree that it is not possible to reduce or eliminate drug use in the country. Nonetheless, the War on Drugs continues. The approach to reducing drug use has two elements. One is Demand Reduction— finding ways to reduce the number of people who choose to use illicit drugs for recreation. The focus of demand reduction is on methods to prevent people, and especially young people, from starting drug use altogether. This is done by educating people about the dangers of drug use. The most popular program to do this has been the D.A.R.E. (Drug Abuse Resistance Education) program, started in 1984, where police officers teach children (typically at a school presentation) how to resist drugs. It has, however, been criticized for lack of effectiveness. Another method to reduce demand is through media campaigns (including public service announcements) that reinforce the dangers of drug use.

Another aspect of demand reduction is law enforcement. By enforcing laws against drug production, distribution, possession, and use, authorities create negative consequences for drug use. People are discouraged from buying, possessing, or using drugs because of the probability they will be caught and punished. Increased law enforcement also makes drugs more difficult to buy because it lessens supply, therefore making them more expensive. This lowers the demand and use because it creates more risks and costs to the user. The second approach is Supply Reduction, which is focused on reducing the amount of drugs available to users. The United States has used supply reduction techniques for many years. For example, in 2001 the United States passed the Andean Counterdrug Initiative, an attempt to reduce drug production in Peru, Colombia, Panama, and Bolivia, a region of the world in which the majority of drugs imported into the United States are produced. The plants are grown and harvested by peasants, and the raw materials are shipped to labs where the drugs are produced. The drugs then have to be smuggled into the United States. Many cartels have grown wealthy from this process, and much violence has accompanied it. Under the Andean Initiative, the United States would provide assistance to foreign governments in their attempt to eradicate coca and heroin poppy crops. American officials have also worked with the Andean countries to decrease the cultivation of drug crops there. One way this is done is by providing farmers with financial assistance for the development of alternative crops like grains or coffee. Moreover, U.S. Customs officials have seized millions worth of drugs along the U.S.-Mexico border. They have also attacked the precursor drugs and chemicals that are used to process cocaine and other illicit drugs.

xxx  Introduction

Generally, the United States uses elements of both demand reduction and supply reduction. Presidents seek to establish a balanced approach to reducing drugs. Beginning with the George W. Bush administration, the president’s approach to halting drug use is outlined in the Drug Control Strategy, published by the Office of National Drug Control Policy. It is important to reduce illicit drug use because of the link between drugs and both property crime and violent crime. Property crimes associated with drug use include burglary or robbery that is committed by an offender as a way to get money to pay for more drugs. Addicts will steal from a store, home, or place of employment, and then sell the stolen goods. The money they make will allow the offender to buy their next hit. Many violent crimes, such as domestic violence and assault, are committed by addicts while they are under the influence of the drug. The drugs prevent an addict from thinking clearly, or may cause a user to be more violent. Crimes are also committed internationally. The global production and trafficking of drugs can lead to money laundering, in which criminal organizations engage in financial transactions designed to disguise the proceeds, sources, or nature of their activities. Drug smuggling and trafficking activities also frequently cross national borders, and they often are accompanied by violence from turf wars or gang behavior. While some evidence indicates that the War on Drugs is working and fewer people are using illicit drugs, other observers say that the war on drugs has failed. Moreover, they assert that it has caused much damage (Benavie 2009), namely more violent crimes. It is common for drug traffickers or different gangs to use violence to settle disputes between them. There is also violence between

law enforcement and traffickers. This is in addition to those who commit crimes to get money to purchase more drugs. The criminalization of drugs has also led to injuries and deaths due to drug contamination. Because the drugs are sold unregulated through the black market, the government cannot oversee the quality or ingredients in the drugs. Illicit substances are often contaminated with toxic substances that can cause overdoses. They may be too potent or “cut” with added harmful ingredients, such as when cocaine is cut with methamphetamines, or they may be diluted, as when cocaine is diluted with baking powder. There have also been arguments made that the criminalization of drugs has led to public corruption in the form of law enforcement officials and other office holders who accept bribes to look the other way and ignore drug offenses. Law enforcement officers and agencies also have been accused of violating offenders’ constitutional rights, particularly Fourth Amendment rights against unreasonable searches and seizures. Because drug deals take place secretly, police use wiretaps and other law enforcement tactics that are seen by some as an unreasonable expansion of police power (Husak 2002). Government officials have also been criticized for taking the personal property of offenders through a program called asset forfeiture under which officials can seize and keep any property purchased with drug profits. They have also been accused of racial profiling, targeting certain ethnic groups more so than others without cause. Despite all of these controversies, the federal government’s War on Drugs continues, as outlined in the National Drug Control Strategy. And people continue to use illicit drugs for recreation.

Introduction  xxxi

Drugs Used Different drugs have different effects on users, and some effects last longer than others. Through the years, different drugs have trended. In the 1950s, heroin emerged. In the 1960s, tastes changed to marijuana, LSD, and amphetamines. The list of popular drugs in the 1970s expanded to include barbiturates and PCP. These latter drugs were eclipsed by crack and crack cocaine in the 1980s and 1990s. The 2000s has seen an increase in the abuse of prescription drugs like Vicodin, OxyContin, and Xanax. Even though a drug might not be “popular” at the time, it is readily available and can still be used. Many classes of drugs exist and are used on a daily basis. Alcohol The drug that has been popular throughout time is alcohol, and its use can be traced to the ancient Egyptians, Greeks, and Romans. In the United States in the 1800s into the early 1900s, alcohol use was blamed for most of the social problems of the time, particularly poverty and domestic abuse. In 1874, a group of women activists formed the Women’s Christian Temperance Union for the purpose of eliminating drinking in America. As a result of this growing temperance movement, many states passed laws against alcohol use. In 1919, the U.S. Congress passed the Eighteenth Amendment to the Constitution prohibiting the manufacture and use of alcohol. Fourteen years later it was repealed. Today, alcohol is legal for adults over the age of 21 in the United States and ranks as the most commonly used drug in the country. A depressant, alcohol is absorbed directly into the bloodstream without digestion. When this blood reaches the brain, it has an intoxicating effect on the user. Those who drink alcohol are less inhibited and

experience feelings of euphoria. Some users become depressed and fall asleep when they are under the influence of alcohol. A drug on which many users become dependent, alcohol, if consumed in large volumes over a long period, can lead to severe and fatal liver problems, as well as neurological impairment and heart muscle damage, among other health problems.

Prescription Drugs The abuse of prescribed drugs has been increasing in recent years, especially by young people. Part of the problem is that the number and variety of prescription drugs is increasing so the drugs are more readily available. Prescription drugs are also considered to be more acceptable than illicit drugs and seen as less dangerous. But they can be debilitating for the person addicted to them. They cause harm not only to the user, but to others as well. Users often get the drugs from friends or family members who have prescriptions, or from robberies of pharmacies. Some users go “doctor shopping,” visiting one doctor after another to get multiple prescriptions for the drugs. Tobacco Tobacco was used by settlers in Virginia because it was believed to have medicinal value. Use of tobacco was popular until the 1960s when medical studies showed the harms of tobacco smoke. As a way to let people know of the potential harm of the drug, the U.S. government began requiring warnings on cigarette packages. Tobacco use has been linked to lung cancer, emphysema, and heart disease. Users of tobacco become addicted to the nicotine entering their bloodstream. Once addicted, it is extremely difficult to quit. Most cigarette tobacco also includes different chemicals and tar, which damage the lungs when inhaled.

xxxii  Introduction

Marijuana Marijuana is the most widely used illegal drug in the United States. Originally grown in Central Asia and China, it has been part of American culture for well over 200 years. The plant was cultivated for its hemp fibers by colonists, and even by presidents George Washington and Thomas Jefferson. In the 1930s, marijuana was associated with immigrant groups and was reported to cause crime and insanity. It was banned in the Marihuana Tax Act in 1937 and placed into Schedule I of the Controlled Substances Act. This classification means that in the government’s view, it has no medical use and a high potential for abuse. Marijuana is harvested from the plant Cannabis sativa. When consumed, it often causes the user to feel euphoria and lightness in the limbs. The active ingredient that produces the effect of being “high” is THC, or tetrahydrocannabinol. While the long-term effects of marijuana use are unknown, its use has been associated with tachycardia, lung damage or cancer, impaired judgment, and memory loss. Many states (and the District of Columbia) have made the medical use of marijuana legal, despite federal laws prohibiting it. Supporters of legalization assert that the drug can reduce pain and other symptoms associated with many medical ailments, including glaucoma, nausea, seizures, and wasting syndrome associated with HIV/ AIDS (Marion 2013). In 2012 Colorado and Washington legalized recreational marijuana use by adults. Marijuana is considered by some to be a gateway drug, leading people to take more serious drugs for a more intense effect, though proponents of its use and legalization argue that it does not necessarily lead to more dangerous drug use.

Opium and Opiates Opium is one of the oldest drugs used by man. Long used to relieve pain, it has even been fashionable to give opium to babies as a way to soothe teething pains. Opium and its derivatives, called opiates, belong to a class of drugs known as narcotics. The main ingredient in opium is morphine, discovered in Germany in 1805. Morphine subsequently surged in popularity because it was cheap and readily available. It became even more popular with the invention of the hypodermic needle, which allowed users to inject the drug directly into their bodies. Opium was also commonly used in America before 1800 in prescriptions, or in laudanum (a mixture of morphine and codeine). This was prescribed often by physicians to treat colds and coughs as well as gastrointestinal illnesses. Codeine was discovered in 1832, and used in the United States as a popular medicine, mostly for relieving pain. Heroin was then introduced by Bayer in 1898. Today, the popular narcotic is OxyContin. This drug, like all opiates, is especially dangerous because users can become addicted very quickly. Barbiturates Barbiturates are a class of drugs that produce a sedative effect on the user, followed by a short burst of energy. These drugs are used medically as sedatives and to help those suffering from insomnia. As such, they cause muscle relaxation, calmness, and drowsiness. They can also cause impaired memory and slurred speech. Some barbiturates that take effect very quickly are used as sleep aids. Other forms of barbiturates have a more gradual effect. Medically, these drugs are also used to treat anxiety or to treat convulsions. Examples of these drugs are Valium, Librium, and Xanax.

Introduction  xxxiii

Cocaine Cocaine acts as a stimulant on the body. It creates a feeling of energy, elation, exaggerated confidence, and mild euphoria. If taken in large amounts, it can result in seizures and hallucinations. Because of the increased energy it may provide users, cocaine became a popular ingredient in soda, teas, and other food, most notably in Coca-Cola, in the 19th century. As an illegal drug, cocaine reached the height of its popularity in the 1980s. It was originally thought that cocaine was not addictive, but it turns out that the drug is quite addictive. When cocaine is cooked into “rocks” it is called “crack cocaine.” When this drug is smoked, it reaches the brain more quickly and provides the user with a more intense high. However, this drug is extremely addictive and damaging to the user. Amphetamines and Methamphetamines Amphetamines also act as stimulants on the body. They may elicit a wide range of effects on users, including euphoria, aggression, agitation, nausea, and vomiting. Long-term use has been associated with anorexia. Stronger forms of amphetamines are methamphetamines, also called “meth.” The effects of this drug last longer than other forms of the drug. The popularity of meth surged in the 1990s, but has recently started to decrease. According to the 2012 National Survey on Drug Use and Health, about 1.2 million people self-reported that they used meth within the previous year. This was a decrease from past years (National Institute on Drug Abuse 2013). Hallucinogens Hallucinogens are drugs that cause the user to have altered perceptions and visual illusions. While they are not physically addictive, users do build up a tolerance and

require more of the drug to achieve the same effect. Examples of hallucinogens include peyote and LSD, which was first created by Dr. Albert Hofmann in 1938. Even after the drug wears off, users may experience flashbacks in which they feel the effects of the drug without using it.

Designer Drugs Designer drugs are those that have been created by chemists in labs. The best known example of a designer drug is MDMA, or Ecstasy. They are sometimes used by attendees at raves or dance parties to reduce their social inhibitions. These drugs can cause the user to be easily dehydrated and overheated, leading to death. Treatment for Drug Abusers When an individual abuses drugs, the question often becomes: should that person be punished or treated? Treatment programs are becoming more professional, requiring increased education and training of the counselors or professionals providing the care. These counselors collaborate with other health care providers to provide treatment instead of the more traditional confrontational or adversarial style that was popular at one time. One very popular avenue for providing treatment for drug-addicted individuals is through drug courts. These diversion programs emphasize the treatment of drug offenders as opposed to punishment. They were originally introduced in New York City in the 1970s as a way to handle the massive numbers of people arrested for drug-related offenses after the state enacted a series of tough new sentencing guidelines, collectively known as Rockefeller Drug Laws. It was hoped that the drug court system would be a way to speed cases through the courts and relieve overcrowding in the state prison system.

xxxiv  Introduction

Under this program, first-time, nonviolent drug offenders could choose to have their cases heard in a drug court instead of a criminal court. Defendants who make this choice waive rights to a grand jury hearing and appear in front of a judge. The defen­ dant must attend a drug treatment program. During the treatment time, the defendant is closely supervised and the judge monitors the offender’s progress. If, at any time, the defendant stops attending the program, or is arrested for another drug charge, they can be returned to criminal court for a trial. On the other hand, if the defendant successfully completes the treatment plan, the charges against the defendant are dropped. Another treatment option for drugaddicted individuals is Opioid Therapy, otherwise known as methadone maintenance. This program is primarily for heroin users, but can also help those addicted to morphine and opium. For those addicts, they can receive daily doses of orally administered methadone, a maintenance drug. The drug stops the symptoms of withdrawal experienced by addicts, but does not cause the “high” feeling that prohibits an addict from functioning. First used by Vincent Dole and Marie Nyswander in the 1960s, methadone can be used for detox or maintenance. Needle and Syringe Exchange programs have also been introduced to reduce the health risks associated with drug use. The goal is to reduce harm caused by the potential spread of HIV/AIDS and hepatitis that can result when used needles are shared among addicts. Peer-led self-help groups are also popular treatment methods for addicts. Programs such as Alcoholic Anonymous and Narcotics Anonymous use “12-Step” programs to help addicts stay clean. They provide a supportive program for addicted individuals to share their feelings with others and

stay away from further drug use. These programs often feature a strong theme of spirituality.

International Organizations The problem of drug abuse today is a global problem. Drugs are routinely trafficked from one country to another as demand dictates. No country is immune to the dangers caused by drug abuse. Drug production and trafficking are a serious international concern, and it is necessary to take a world perspective on this problem. The first international meeting to discuss drug abuse was held in 1909 in Shanghai, China. The focus of the meeting was specifically on the opium problem, and representatives from 13 nations attended. In that meeting, the U.S. officials sought to establish a total ban on opium, but Britain did not support the proposal. Thus, no final agreement was made. In 1912 the Hague Convention for the Suppression of Opium and Other Drugs was passed. This treaty required that production, sale, and use of opium, heroin, morphine, and cocaine be limited for medical and other legitimate purposes only. Representatives from the United States and Italy sought to include cannabis in the agreement, but they did not have the support of other countries and it was omitted from the final treaty. Today, there are many international bodies that are involved in the implementation and enforcement of these and other treaties. One is the Commission on Narcotic Drugs, a political body with states elected as members by the Economic and Social Council of the United Nations. The UN Office on Drugs and Crime serves as the administrative body for the United Nations’ programs regarding drugs and associated criminal activity. Another notable group is the International Narcotics Control Board (INCB). The INCB

Introduction  xxxv

has 13 members who are elected by the UN Economic and Social Council (ECOSOC). This body ensures that international drug conventions are adhered to, and makes sure that the licit (medical) market has access to drug supplies for their legitimate needs. In doing so, the INCB also works to suppress illicit drug trafficking. The World Health Organization (WHO) also plays a role in reducing global drug trafficking. The WHO plays a technical role in the implementation of various treaties and conventions by, for example, recommending whether particular substances should be scheduled under a particular convention. These classifications have a major impact on a drug’s production, distribution, and use. The WHO also established the International Convention against Doping in Sport in 2005. There are currently three main international treaties in effect to attack the problem of global drug abuse and trafficking, all implemented by the United Nations. The first is the 1961 Single Convention on Narcotic Drugs. This treaty criminalized the distribution, sale, and possession of substances derived from opium, cannabis, and coca leaves, and approved various guidelines for the punishment and/or treatment of users of these drugs. The second treaty, the United Nations’ 1971 Convention on Psychotropic Substances, extended the scope of the 1961 treaty. This agreement covered the manufacture of synthetic drugs such as LSD, amphetamines, and barbiturates. Finally, the UN’s 1998 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances linked the violence associated with drug trafficking to national security and the corruption of officials. It also covered the role that drug trafficking plays in undermining economic development.

Conclusion The use and abuse of illicit drugs has been a problem in the United States and around the globe for many years, despite the myriad of laws intended to stop it. The number of drugs, and the availability of those drugs, continues to rise, as does the number of people using those drugs. The illicit drug trade has become a billion-dollar business. Drug use and abuse causes great harm to users and their families, friends, and communities. Unfortunately, many observers believe that the number of people who choose to use drugs illegally will probably increase in the future, despite attempts to reduce demand and supply. If this comes to pass, experts forecast increases in drug-related violence and health problems as well. Further Reading Benavie, Arthur. 2009. Drugs: America’s Holy War. New York: Routledge. Frydl, Kathleen J. 2013. The Drug Wars in America, 1940–1973. Cambridge: Cambridge University Press. Henderson, Harry. 2004. Drug Abuse. New York: Facts on File, 5. Husak, Douglas. 2002. Legalize This: The Case for Decriminalizing Drugs. London: Verso. Kleiman, Mark A. R., Jonathan P. Caulkins, and Angela Hawken. 2011. Drugs and Drug Policy: What Everyone Needs to Know. New York: Oxford University Press. Marion, Nancy E. 2013. The Medical Marijuana Maze: Politics and Policy. Durham, NC: Carolina Academic Press. National Commission on Marijuana and Drug Abuse. 1973. Drug Use in America: Problem in Perspective. http://www.drugtext .org/index.pho/en/reports/233-the=report -of-the-national-commission-on-marijuana -and-drug-abuse.

xxxvi  Introduction National Institute on Drug Abuse. 2008. “Addiction Science: From Molecules to Managed Care.” http://www.drugabuse.gov/ publications/addiction-science-molecules-to -managed-care/introduction/drug-abuse -costs-united-states-economy-hundreds -billions-dollars-in-increased-health. National Institute on Drug Abuse. 2013. “Methamphetamine.” http://www.drugabuse.gov/ publications/research-reports/metham phetamine/what-scope-methamphetamine -abuse-in-united-states.

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. 2013. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” Washington, D.C. Weil, Andrew. 2004. The Natural Mind: A Revolutionary Approach to the Drug Problem. Boston: Houghton Mifflin.

Chronology: Significant Events in Drug and Alcohol Use through History

5000 bce

Early Opium Use The Sumerians (located in modern-day Iraq) are said to have used opium because of the fact that they have an ideogram for it which has been translated as hul, meaning “joy” or “rejoicing.”

3500 bce

Early Alcohol Use The earliest historical record of the production of alcohol is the description of a brewery in an Egyptian papyrus.

3000 bce

Early Tea Use The earliest historical record of the first use of tea is in China.

2500 bce

Early Use of Poppy Seeds The earliest historical evidence of the eating of poppy seeds is among the “Lake Dwellers” in Switzerland.

2000 bce

Earliest Known Prohibition The earliest record of prohibitionist teaching is by an Egyptian priest, who writes to his pupil: “I, thy superior, forbid thee to go to the taverns. Thou art degraded like beasts.”

350 bce

Early Biblical Proverb Referencing Alcohol Proverbs 31:6–7 states: “Give strong drink to him who is perishing, and wine to those in bitter distress; let them drink and forget their poverty, and remember their misery no more.”

300 bce

First Use of Poppy Juice Theophrastus (371–287 bce), a Greek naturalist and philosopher, records what is believed to be the earliest reference to the use of poppy juice.

250 bce

Early Biblical Psalm Referencing Alcohol Psalm 104:14–15 states: “Thou dost cause grass to grow for the cattle and plants for man to cultivate, that he may bring forth food from the earth, and wine to gladden the heart of man.”

xxxvii

xxxviii   Chronology: Significant Events in Drug and Alcohol Use through History

350 ce

Early Recording of Tea The earliest writing regarding the usage of tea is found in a Chinese dictionary.

400

Early Reference to the Issues of Alcohol St. John Chrysostom (345–407), the Bishop of Constantinople, writes: “I hear man cry, ‘Would there be no wine! O folly! O madness!’ Is it wine that causes this abuse? No, for if you say, ‘Would there were no light!’ because of the informers, and would there were no women because of adultery?”

450

Early Mention of Drugs The Babylonian Talmud states: “Wine is at the head of all medicines; where wine is lacking, drugs are necessary.”

1000

Opium Usage Early evidence demonstrates that opium is widely used in China and the Far East during this time period.

1492

Columbus Discovers America The Italian Christopher Columbus discovers America when he actually lands in the Bahamas. On his very first day in the New World, Columbus meets with friendly Indians who offer him a valuable gift—tobacco.

1493

First European Use of Tobacco The use of tobacco is introduced into Europe by Christopher Columbus when his crew returns with the dried tobacco leaves.

1500

Early Cure for Alcohol According to J. D. Rolleston, a British medical historian, a medieval Russian cure for drunkenness consisted in “taking a piece of pork, putting it secretly in a Jew’s bed for nine days, and then giving it to the drunkard in a pulverized form, who will turn away from drinking as a Jew would from pork.”

1525

First Evidence of Laudanum Paracelsus (1490–1541) introduces laudanum, or tincture of opium, into the practice of medicine.

1552

The Catholic Church Comes Out Against Coca The Catholic Church’s First Council of Lima denounces the use of the coca leaf, commonly chewed by the Indians of the Andes for its stimulant properties: “The plant is the work of the Devil, and appears to give strength only by a deception of the Evil One; it possesses no virtue but shortens the life of many Indians who at most escape from the forests with ruined health . . . it is a useless object liable to promote the practices and superstitions of the Indians.”

1588

First Smoking Ban The Catholic Church in a later Council of Lima meeting attempt to impose the world’s first smoking ban, ordering its priests to abstain from smoking

Chronology: Significant Events in Drug and Alcohol Use through History  xxxix

during church: “It is forbidden under penalty of eternal damnation for priests, about to administer the sacraments, either to take the smoke of . . . tobacco into the mouth, or the powder of tobacco into the nose, even under the guise of medicine, before the service of the mass.” 1600

Tobacco Usage Becomes Widespread At the end of the 16th century, tobacco smoking, originally a tradition of Native Americans becomes widespread in England.

1600

Shakespeare on Addiction In the second part of King Henry the IV, Shakespeare writes: “Falstaff . . . If I had a thousand sons, the first human principle I would teach them should be, to foreswear thin portion and to addict themselves to sack.” Note: The term sack is an obsolete term for sweet wine like sherry.

1600

Coffee Drinkers Condemned The prince of the petty state of Waldeck pays 10 thalers to anyone who denounces a coffee drinker.

1600

Tobacco Users Condemned In Russia, Czar Michael Federovitch executes anyone on whom tobacco is found. Then Czar Alexei Mikhailovitch rules that anyone caught with tobacco should be tortured until he gave up the name of the supplier.

1604

James I Opposes Smoking England’s King James I opposes his subjects’ growing smoking habit and publishes a treatise in England titled A Counterblaste to Tobacco. In it he writes, “And now Good Countrymen, let us (I pray you) consider, what honour or policy can move us to imitate the barbarous and beastly manners of the wild, Godless and slavish Indians, especially in so vile and stinking a custom?”

1607 Jamestown England’s Virginia Company establishes the first permanent English colony in North America at Jamestown in Virginia. Nearly two-thirds of the initial 144 colonists die within the year. 1612

First Tobacco Crop Early Virginia colonist John Rolfe (perhaps best known as the husband of Pocahontas) plants the first tobacco crop in Jamestown.

1613

First Tobacco Shipment From the Jamestown settlement, the Virginia Company sends its first shipment of tobacco back to London for a significant profit.

1617

Tobacco Saves Jamestown Captain John Smith, early leader of English settlement in Virginia, describes Jamestown a decade after its founding as a town with “only five or six houses,

xl   Chronology: Significant Events in Drug and Alcohol Use through History

the Church downe, the palisades broken, the Bridge in pieces, the Well of fresh water spoiled,” but “the market-place, the streets, and all other spare places planted with Tobacco.” Tobacco, which is Virginia’s first viable cash crop, saves the colony from collapse. 1619

First Slaves in America The first African slaves arrive in North America, as the Jamestown colonists purchase the first 20 slaves to work in their tobacco fields. Tobacco and slavery would end up dominating Virginia society for the next 240 years.

1619

Tobacco as Currency Jamestown enthusiastically welcomes the arrival of a ship from England carrying “young maids to make wives.” The colonists happily pay the price to buy women—“one hundred and twenty pounds of the best leaf tobacco” each. The English population in North America soon begins to grow through natural reproduction.

1619

Tobacco Price Floor The Virginia Colonists establish the first colonial government and the first law passed by the assembly is related to tobacco. The law is a measure to control the prices of tobacco by mandating that no farmer can sell their tobacco for less than three cents on the pound.

1632

Massachusetts Bans Public Smoking The Massachusetts Colony becomes the first to ban smoking in public.

1633

Charles Taxes Tobacco England’s King Charles I justifies increased taxes on tobacco by condemning tobacco’s impact on English society: “The plant or drug called tobacco scarce known to this nation in former times, was in this age first brought into this realm in small quantity, as medicine, and so used . . . but in the process of time, to satisfy the inordinate appetites of men and women it hath been brought in great quantity, and taken for wantonness and excess, provoking them to drinking and other incontinence, to the great impairing of their heaths and depraving them of their manners, so that the care which His Majesty hath of his people hath enforced him to think of some means of preventing of the evil consequences of this immoderate use thereof.”

1650

First British Coffeehouse The first coffeehouse opens in the university town of Oxford, England.

1650

Early European Bans of Tobacco The use of tobacco is prohibited in the countries of Bavaria, Saxony, and in Zurich, but the prohibitions are wholly ineffective. The Ottoman Empire’s Sultan Murad IV decrees the death penalty for smoking tobacco: “Wherever their Sultan went on his travels or on a military expedition his halting-places were always distinguished by a terrible rise in executions. Even on the battlefield he was fond of surprising men in the act of smoking, when he would

Chronology: Significant Events in Drug and Alcohol Use through History  xli

punish them by beheading, hanging, quartering or crushing their hands and feet. . . . Nevertheless, in spite of all the horrors and persecution . . . the passion for smoking still persisted.” 1651

First Rum Produced The spirit rum makes its first appearance in the historical record when a visitor to the English colony of Barbados describes the island’s favorite drink as “Rumbullion, alias Kill-Devil, and this is made of sugar canes distilled, a hot, hellish and terrible liquor.” The name of the drink, “rumbullion,” is eventually shortened to “rum.”

1655

Rum for Sailors The English Royal Navy begins giving its sailors a daily ration of rum.

1656

Pubs in Massachusetts The Massachusetts General Court passes a law requiring every town in the colony to have a pub, which became the center of commerce and local governance.

1661

Rum Is a Menace In Massachusetts, the colonial court issues a ruling that declares that the overproduction of rum has a deleterious effect on society and must cease.

1669

First Usage of Tea in England England receives its first shipment of tea (which is caffeinated) from the British East India Company. At first the cost of tea is so high only the rich and elite can afford to drink tea.

1675

Coffeehouses Condemned In England, coffeehouse establishments are condemned by King Charles II, for he argues that they create idleness and promote disaffection with government.

1676

Coffeehouses Return King Charles II of England reestablishes the right of coffeehouses to exist after a public backlash over his earlier proclamation.

1680

Opium as Medicine Thomas Syndenham (1625–1680) writes, “Among the remedies which it has pleased the Almighty God to give to man to relieve his sufferings, none is so universal and efficacious as opium.”

1682

Cotton Mather Objects to Quakers Cotton Mather, a Puritan minister, objects to the arrival in Massachusetts of a ship carrying “a hundred or more of the heretics and malignants called Quakers”—members of a different group of English religious dissenters, led by William Penn. Mather suggests that the Puritans should capture the Quakers and sell them into slavery in Barbados, where they will “fetch good prices in rum and sugar.”

xlii   Chronology: Significant Events in Drug and Alcohol Use through History

1686

Increase Mather Against Rum In Massachusetts, the Puritan minister Increase Mather complains, “It is an unhappy thing that in later years a Kind of Drink called Rum has been common among us. They that are poor, and wicked too, can for a penny or twopence make themselves drunk.”

1690

England’s Use of Corn Alcohol The Act for the Encouraging of the Distillation of Brandy and Spirits from Corn is enacted in England.

1691

Death Penalty for Tobacco Usage In Lüneberg, Germany, the penalty for smoking tobacco is death.

1717

Twining’s Tea Opens Thomas Twining establishes one of the first tea shops in London, England, the same company that remains in existence today. At the time, however, tea is very expensive, and his clientele is mostly rich and elite women.

1717

The Politics of Alcohol Liquor licenses in Middlesex, England, are granted only to those who “would take oaths of allegiance and of belief in the King’s supremacy over the Church.”

1733

Molasses Tax England’s Parliament passes the Molasses Act of 1733, imposing an import tax on molasses coming into the American Colonies in order to protect the sale of molasses from within the colonies. The act simply creates a black market for molasses, contributes to smuggling, and further exacerbates the issue of piracy.

1734

Saint-Domingue Grows Coffee Coffee is first grown in the French Colony of Saint-Domingue, what is today the independent country of Haiti.

1736

Gin Act The British Parliament passes the Gin Act which intends to make spirits “come so dear to the consumer that the poor will not be able to launch into excessive use of them.” This effort results in widespread crime and fails to halt the continuing rise of the consumption of the new spirit.

1745

Attacks on the Catholic Church for Communion Wine The magistrates of one London division demand that “publicans and winemerchants should swear that they anathematized the doctrine of Transubstantiation.” The goal is to prevent alcohol becoming used for Catholic Communion.

1750

Tobacco Export Booms By the mid-18th century, tobacco is 50 percent of all of the colonies’ exports.

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1762

Dover’s Powder Thomas Dover, an English physician, introduces his prescription for a diaphoretic powder, which he recommends mainly for the treatment of gout. The compound, which is soon named Dover’s Powder, becomes the most widely used opium preparation over the next 150 years.

1770

Rum Consumption Increases A British census determines that rum has become so popular in the American Colonies that every person, on average, drinks over four gallons per year.

1770

Rum Exports Boom Over 140 rum distilleries exist in the American Colonies. The rum is made from molasses that is delivered to the colonies, especially New England, where it is then distilled into rum. That coming out of New England alone accounts for four-fifths of its exports.

1773

Saint-Pierre Notes Ironies of Coffee A French aristocrat and author, J. H. B. de Saint-Pierre, notes the impact of slaves growing coffee and sugar: “I do not know if coffee and sugar are essential to the happiness of Europe, but I know well that these two products have accounted for the unhappiness of two great regions of the world: America has been depopulated so as to have land on which to plant them; Africa has been depopulated so as to have the people to cultivate them.”

1773

Boston Tea Party Inspires Coffee The famous Boston Tea Party, instigated by the Sons of Liberty who were disgruntled over the excessive tax on tea in the American Colonies, contributes to the boycotting of tea and inspires American consumption of coffee.

1785

Distilled Spirits as a Disease The famous Philadelphian, Dr. Benjamin Rush, publishes Inquiry into the Effects of Ardent Spirits on the Human Body and Mind, in which he calls the use of alcohol a “disease,” and estimates that over 4,000 people die every year from the illness.

1788

Haiti Produces Half of World’s Coffee The French Caribbean colony of Saint-Domingue (modern-day Haiti) comes to such a high production of coffee it accounts for half the coffee grown in the world.

1789

First Temperance Society The first American temperance society is formed in Litchfield, Connecticut.

1790

Request for Duties on Distilled Spirits At a meeting of the Philadelphia College of Physicians, Dr. Benjamin Rush convinces his colleagues to address a letter to the U.S. Congress, asking them to “impose such heavy duties upon all distilled spirits as shall be effective to restrain their intemperate use in the country.”

xliv   Chronology: Significant Events in Drug and Alcohol Use through History

1791

Haitian Uprising War breaks out in Saint-Domingue when the slaves producing half of the world’s coffee revolt. The war lasts for 13 years, kills Saint-Domingue’s production of coffee, and ultimately creates the independent country of Haiti.

1791

Whiskey Excise Tax The United States imposes a federal tax on the production of whiskey and requires all stills to be registered. Because whiskey is often the only product that turned a profit for American farmers, they begin to revolt against the tax, which leads to the Whiskey Rebellion of 1794.

1792

First Opium Laws The first prohibitory laws against opium in China are promulgated. The punishment decreed for keepers of opium shops is death by strangulation.

1792

The Whiskey Rebellion Begins The Whiskey Rebellion, a protest by farmers in western Pennsylvania against a federal tax on liquor, breaks out and is put down by overwhelming force sent to the area by George Washington.

1792

“Kubla Khan” and Opium The poet Samuel Taylor Coleridge writes the famous poem “Kubla Khan,” allegedly under the influence of opium.

1800

Napoleon and Cannabis Napoleon bans cannabis usage among his troops occupying Egypt. It is the first widely recorded drug prohibition of the modern era. Despite the ban, Napoleon’s soldiers still manage to bring cannabis back to France. Its usage becomes quite popular among the avant-garde.

1801

Duty on Liquor Abolished The third president of the United States, Thomas Jefferson, makes the recommendation that the federal duty on liquor be abolished. The U.S. Congress complies.

1803

Active Ingredient of Opium Discovered The German Friedrich Sertürner discovers the active ingredient of opium by isolating the first plant alkaloid, helping to perfect the amount of opium and morphine in a given dose.

1804

Alcohol as Disease Edinburgh physician Thomas Trotter publishes An Essay, Medical, Philosophical, and Chemical on Drunkenness and Its Effects on the Human Body: “In medical language, I consider drunkenness, strictly speaking, to be a disease, produced by a remote cause, and giving birth to actions and movements in the living body that disorder the functions of health.  .  .  . The habit of drunkenness is a disease of the mind.”

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1804/1805

Morphine Discovered Friedrich Sertürner, a German chemist, isolates morphine from opium and describes morphine to the scientific community.

1812

War Helps Coffee The War of 1812 cuts off American access to English tea, which furthers Americans’ consumption of coffee. The war causes the cheaper Brazilian coffee to become the caffeinated beverage of choice in the United States.

1822

The English Opium Eaters Thomas De Quincey publishes Confessions of an English Opium Eater. He notes that the opium habit, like any other habit, must be learned. “Making allowance for constitutional differences, I should say that in less than 120 days no habit of opium-eating could be formed strong enough to call for any extraordinary self-conquest in renouncing it, even suddenly renouncing it. On Saturday you are an opium eater, on Sunday no longer such.”

1826

The American Society for the Promotion of Temperance The American Society for the Promotion of Temperance is founded in Boston. Although not the first temperance group, it is one that has more visibility and more staying power. By 1833, there are 6,000 local Temperance societies, with more than 1 million members.

1827

Morphine Production E. Merck & Company of Darmstadt, Germany, begins commercial manufacturing of morphine.

1833

First Commercial Coffee Roaster The first commercial coffee roaster in the United States begins operation in New York City.

1839–42

The First Opium War The British force upon China the trade in opium, a trade the Chinese had declared illegal, thus launching the first Opium War.

1840

Alcohol and Its Associated Diseases Benjamin Parsons, an English clergyman, declares, “Alcohol stands preeminent as a destroyer. . . . I never knew a person become insane who was not in the habit of taking a portion of alcohol every day.” Parsons lists 42 distinct diseases caused by alcohol, among them inflammation of the brain, scrofula, mania, dropsy, nephritis, and gout.

1841

Hashish Treatment Dr. Jacques Joseph Moreau uses hashish in the treatment of mental patients at the Bicetre Hospital.

1842

Lincoln’s Temperance Address Abraham Lincoln in his Temperance Address notes, “In my judgment, such of us as have never fallen victims, have been spared more from the absence of

xlvi   Chronology: Significant Events in Drug and Alcohol Use through History

appetite, than from any mental or moral superiority over those who have. Indeed, I believe, if we take habitual drunkards as a class, their heads and their hearts will bear an advantageous comparison with those of any other class.” 1844

Cocaine Isolated Chemists are able to isolate cocaine to its purest form.

1845

New Yorkers Love Coffee In New York City alone, the commercial coffee roasters alone account for more coffee than is consumed in all of Great Britain.

1845

Alcohol Prohibition A law prohibiting the public sale of liquor is enacted in New York State.

1847

Alcohol Prohibition Repealed The New York State law that prohibited the public sale of liquor is repealed.

1847

American Medical Association Founded Delegates of a national medical convention vote to create the American Medical Association (AMA).

1848

Drug Importation Act The Drug Importation Act of 1848 requires all medications (as defined by the newly established pharmacopeia) entering U.S. ports to be inspected and analyzed for “quality, purity, and fitness for medical purposes.”

1852

First Women’s Temperance Society Famed women’s rights leader Susan B. Anthony establishes the Women’s State Temperance Society of New York, the first society formed by and for women. Many of the early women’s rights leaders, such as Elizabeth Cady Stanton, Lucretia Mott, and Abby Kelly, are also ardent prohibitionists.

1852

American Pharmaceutical Association Formed The American Pharmaceutical Association is founded in 1852, and its constitution lists one of its goals as being “to as much as possible restrict the dispensing and sale of medicines to regularly educated druggists and apothecaries.

1853

Hypodermic Needle The first hypodermic needle is invented, changing the primary method for delivering many drugs into the bloodstream almost overnight.

1856

Second Opium War The British, this time with help from the French, extend their powers to distribute opium in China, thus launching the second Opium War.

1860

Convention of Peking The Convention of Peking marks the end of the Second Opium War. Among other trade-related conditions imposed by the British, the opium trade is

Chronology: Significant Events in Drug and Alcohol Use through History  xlvii

legalized after many years of British smuggling of Indian-grown opium into China. 1861

Morphine in Civil War Morphine, a derivative of opium, is widely used to relieve the suffering of wounded soldiers during the Civil War. Union Army doctors issued nearly 10 million opium pills to Union soldiers over the next four years. Morphine and opium addiction became so common among Civil War veterans that for the rest of the 19th century it is simply known as “the army disease.”

1861

No Coffee for South During the Civil War, the Union Army blockades all Confederate ports in the South, depriving the Confederacy of access to coffee. Southern soldiers are forced to drink chicory, a bitter brew made from the chicory root that looks like coffee but tastes worse and lacks caffeine. Black-market coffee in wartorn Virginia costs five dollars a pound, significantly up from the 10 cents it cost before the war.

1861

Coffee Fuels North While the South lacks for coffee, the caffeinated brew helps to fuel the Union Army through the Civil War. Every Union soldier receives a ration of onetenth of a pound of coffee grounds per day (a total of 36 pounds per year), making the boiling coffeepot a universal presence in Union military camps.

1862

Internal Revenue Act The Internal Revenue Act of 1862 is created to collect federal taxes to help pay for the war. The Act imposes a license fee of 20 dollars on retail liquor dealers, and a tax of one dollar a barrel on beer and 20 cents a gallon on spirits. The Department of the Treasury is given the responsibility for enforcing the taxes on distilled spirits.

1864

First Barbiturates Adolf von Baeyer synthesizes barbituric acid, the first known barbiturate, on December 4, and names it for Saint Barbara, as it was her feast day in the Catholic calendar of saints.

1865

Prepackaged Coffee Pittsburgh grocer John Arbuckle sells the first prepackaged coffee which he calls Arbuckle’s Ariosa Coffee, causing consumption of coffee to dramatically increase over the next several decades.

1868

Pharmacological Effect of Opium University of Pennsylvania professor Dr. George Wood writes a treatise which describes how opium effects people, noting, “A sensation of fullness is felt in the head, soon to be followed by a universal feeling of delicious ease and comfort, with an elevation and expansion of the whole moral and intellectual nature, which is, I think, the most characteristic of its effects. . . . It

xlviii   Chronology: Significant Events in Drug and Alcohol Use through History

seems to make the individual, for the time, a better and greater man. . . . The hallucinations, the delirious imaginations of alcoholic intoxication, are, in general, quite wanting. Along with this emotional and intellectual elevation, there is also increased muscular energy; and the capacity to act, and to bear fatigue, is greatly augmented.” 1868

Pharmacy Act (U.K.) In the United Kingdom, the Pharmacy Act passes Parliament. It is intended to regulate the purchase of poisons such as arsenic, cyanide, and prussic acid. Opium is also added to the list. Substances must be purchased from a registered chemist who must record the buyer’s name and the details of the transaction.

1868

Pharmacy Act of 1868 (U.S.) The U.S. Congress passes the Pharmacy Act. The act requires testing and registration by those who dispense drugs including morphine, cocaine, and barbiturates. It does not, however, regulate patent medicines, which often include the same list of drugs as primary ingredients.

1869

Prohibition Party The Prohibition Party is formed. Gerrit Smith, a two-time Abolitionist candidate for president, an associate of John Brown, and a crusading prohibitionist, declares, “Our involuntary slaves are set free, but our millions of voluntary slaves still clang their chains. The lot of the literal slave, of him whom others have enslaved, is indeed a hard one; nevertheless, it is a paradise compared with the lot of him who has enslaved himself to alcohol.”

1870

American Association for the Cure of Inebriety (AACI) Dr. Joseph Parrish and Dr. Willard Parker bring in 14 other physicians to meet at the New York City YMCA to found the American Association for the Cure of Inebriety.

1872

Coffee Declared Essential to Commerce Harper’s Magazine observes that “The proud son of the highest civilization can no longer live happily without coffee. . . . The whole social life of many nations is based upon the insignificant bean; it is an essential element in the vast commerce of great nations.”

1873

Women’s Christian Temperance Union Forms Feminists in Hillsboro, Ohio, form the Women’s Christian Temperance Union, which will become not only one of the largest women’s organizations, but also one of the largest prohibitionist organizations in American history.

1874

Woman’s Christian Temperance Union Convention The Women’s Christian Temperance Union holds its first annual convention in Cleveland, Ohio, and officially forms.

Chronology: Significant Events in Drug and Alcohol Use through History  xlix

1874

Heroin Synthesized English researcher C. R. Wright is the first person to synthesize heroin, or diacetylmorphine, by boiling morphine over a stove.

1875

Opium Dens Targeted San Francisco passes the first U.S. ordinance against smoking opium in opium dens. The primary motivation is to keep white women (and men) from visiting the Chinese opium dens. Other cities and states follow in the next few years.

1876

Coffee Imports in 1876 The United States imports 340 million pounds of coffee a year, buying almost one-third of all the world’s exported coffee.

1876

First Journal Dedicated to Addiction Published The American Association for the Cure of Inebriety (AACI) begins publishing the Quarterly Journal of Inebriety, the first journal dedicated to the issue of addiction.

1880

Smoking in America Smoking in America becomes more widespread as Americans are found to be smoking 500 million cigarettes a year, up from 42 million just five years earlier.

1882

Personal Liberty League The Personal Liberty League of the United States is founded to oppose the increasing momentum of the temperance movements attempting to implement prohibition.

1883

New York Times Comes Out Against Smoking New York Times editors come out against Americans’ growing taste for smoking cigarettes, which are considered to be feminine instead of the more manly pipes and cigars: “The decadence of Spain began when the Spaniards adopted cigarettes and if this pernicious practice obtains among adult Americans the ruin of the Republic is close at hand.”

1883

World’s Woman’s Christian Temperance Union Frances Willard, a leader of the Women’s Christian Temperance Union, at their annual convention announces the formation of the World’s Woman’s Christian Temperance Union.

1883

Cocaine for Soldiers German physician Dr. Theodor Aschenbrandt obtains a large supply of cocaine from Merck to test on German soldiers, which he reports has great success in regard to combat readiness.

1884

Freud and Cocaine Sigmund Freud personally treats his own case of depression with cocaine, and reports feeling “exhilaration and lasting euphoria, which in no way

l   Chronology: Significant Events in Drug and Alcohol Use through History

differs from the normal euphoria of the healthy person. . . . You perceive an increase in self-control and possess more vitality and capacity for work . . . In other words, you are simply more normal, and it is soon hard to believe that you are under the influence of a drug.” 1884

Compulsory Anti-Alcohol Education In New York, laws are enacted to make anti-alcohol teaching compulsory in public schools. The following year similar laws are passed in Pennsylvania, and other states soon follow suit.

1884

Cigarette Machine Debuts The first cigarette machine appears in America allowing for greater consumption, increased production, and larger profits.

1884

Cocaine Praised as Miracle Cure The American medical community embraces cocaine as a miracle cure for a variety of ailments, including—ironically—addiction to morphine and alcohol. The New York Times reports on the American medical community’s praise of cocaine when it writes, “The new uses to which cocaine has been applied with success in New York . . . include hay fever, catarrh and toothache and it is now being experimented with in cases of sea-sickness. . . . All will be given to understand that cocaine will cure the worst cold in the head ever heard of.”

1885

Opium Compared to Liquor The Report of the Royal Commission on Opium concludes that opium is more like the Westerner’s liquor than a substance to be feared and abhorred.

1886

Coca-Cola Invented from Two Stimulants Atlanta chemist John Pemberton invents Coca-Cola by combining ingredients from the coca leaf (cocaine) for the “Coca” and the African kola nut (caffeine) for the “Cola.”

1886

Temperance Education In 1886, Congress makes temperance education mandatory in the District of Columbia, in its territories, military bases, and naval schools. By 1900, all of the states have similar laws.

1887

Oregon Bans Cocaine Oregon becomes the first state to ban the sale of cocaine without a prescription.

1887

Amphetamine First Synthesized German chemist Lazar Edeleanu synthesizes amphetamines, although no drug is developed from the discovery until well into the 20th century.

1888

AACI Changes Its Name In 1888, the American Association for the Cure of Inebriety (AACI) changes its name to the American Association for the Study and Cure of Inebriety.

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1889

Johns Hopkins Hospital The Johns Hopkins Hospital, in Baltimore, Maryland, is opened. One of the founders of the hospital is Dr. William Stewart Halsted, who had become addicted to morphine. He continues to feed his addiction to morphine by taking large doses throughout his highly successful surgical career until his death in 1922.

1893

Anti-Saloon League Formed In Oberlin, Ohio, the Anti-Saloon League is formed to fight against the liquor trade and to call for statewide prohibition. The organization begins as a state organization, but within three years would develop into a national organization.

1894

Report of the Indian Hemp Drug Commission The Report of the Indian Hemp Drug Commission is published. The report runs over 3,000 pages and has to be published in seven volumes. Commissioned by the British government, the report concludes: “There is no evidence of any weight regarding the mental and moral injuries from the moderate use of these drugs. . . . Moderation does not lead to excess in hemp any more than it does in alcohol. Regular, moderate use of ganja or bhang produces the same effects as moderate and regular doses of whiskey.” The commission’s proposal to tax bhang is never put into effect, in part, perhaps, because one of the commissioners, an Indian, cautions that Moslem law and Hindu custom forbid “taxing anything that gives pleasure to the poor.”

1894

Norman Kerr Norman Kerr, an English physician and president of the British Society for the Study of Inebriety, declares in 1894: “Drunkenness has generally been regarded as . . . a sin, a vice, or a crime. . . . [But] there is now a consensus of intelligent opinion that habitual and periodic drunkenness is often either a symptom or sequel of disease. . . . The victim can no more resist [alcohol] than a man with ague can resist shivering.”

1895

Charley Post’s Opposition to Caffeine Charley Post, the inventor of Grape-Nuts cereal and a health-food fanatic, begins selling Postum, a grain-based noncaffeinated alternative to coffee. Post, who is a pioneer in modern advertising, sells Postum under the catchy slogan, “If Coffee Don’t Agree, Use Postum Food Coffee.” Post sells Postum by attacking coffee as a “poisonous drug—caffeine, which belongs in the same class of alkaloids with cocaine, morphine, nicotine, and strychnine.” Of note, however, is the fact that Charley Post, who makes millions of dollars selling Postum, never kicked his own coffee habit.

1895

Coca-Cola Marketed as Refreshing Drink Coca-Cola stops marketing itself as a medicine, launching new advertisements—“Drink Coca-Cola: Delicious and Refreshing.” The new advertising

lii   Chronology: Significant Events in Drug and Alcohol Use through History

positions Coca-Cola as a thirst quencher rather than a healthy drug. The sales of the soda skyrocket. 1897

Tea Importation Act The U.S. Congress passes the Tea Importation Act. A board of tea experts is created to regulate the standards of tea quality. The law also authorizes customs inspections of all tea entering U.S. ports with the power to refuse entry to substandard tea. This is the first U.S. law to regulate food products. The act is not repealed until 1996.

1898

Bayer Sells Heroin The German drug company Bayer begins selling heroin as an over-the-counter cough suppressant.

1898

Heroin Is Synthesized Diacetylmorphine (heroin) is synthesized in Germany. It is widely lauded as a “safe preparation free from addiction-forming properties.”

1900

Rev. Crafts Speaks on Prohibition In an address to the Ecumenical Missionary Conference, Rev. Wilbur F. Crafts declares, “No Christian celebration of the completion of nineteen Christian centuries has yet been arranged. Could there be a fitter one than the general adoption, by separate and joint action of the great nations of the world, of the new policy of civilization, in which Great Britain is leading, the policy of prohibition for the native races, in the interest of commerce as well as conscience, since the liquor traffic among child races, even more manifestly than in civilized lands, injures all other trades by producing poverty, disease, and death. Our object, more profoundly viewed, is to create a more favorable environment for the child races that civilized nations are essaying to civilize and Christianize.”

1900

Dr. Daly Praises Heroin Dr. James R. L. Daly, writing in the Boston Medical and Surgical Journal, declares: “It [heroin] possesses many advantages over morphine. . . . It is not hypnotic; and there is no danger of acquiring the habit.”

1901

Senate Resolution Banning Sale of Alcohol to Native Americans The Senate adopts a resolution, introduced by Henry Cabot Lodge, to forbid the sale by American traders of opium and alcohol “to aboriginal tribes and uncivilized races.” These provisions are later extended to include “uncivilized elements in America itself and in its territories, such as Indians, Alaskans, the inhabitants of Hawaii, railroad workers, and immigrants at ports of entry.”

1902

Chinese Exclusion The American Pharmaceutical Association’s Committee on the Acquirement of the Drug Habit declares, “If the Chinaman cannot get along without his ‘dope,’ we can get along without him.”

Chronology: Significant Events in Drug and Alcohol Use through History  liii

1902

Dr. Petty on Heroin Dr. George E. Petty, writing in the Alabama Medical Journal, observes, “Many articles have appeared in the medical literature during the last two years lauding this new agent. . . . When we consider the fact that heroin is a morphine derivative . . . it does not seem reasonable that such a claim could be well founded. It is strange that such a claim should mislead anyone or that there should be found among the members of our profession those who would reiterate and accentuate it without first subjecting it to the most critical tests, but such is the fact.”

1902

American Federation of Labor Pamphlet Scapegoats Chinese Opium Smokers The American Federation of Labor publishes a pamphlet which speaks of Chinese smokers who have spread the “deathly habit” to “hundreds, aye thousands, of our American boys and girls.”

1903

Cocaine Is Removed from Coca-Cola The formula of Coca-Cola is changed with caffeine replacing the cocaine it contained until this time.

1904

Lyman and Opium Traffic Charles Lyman, the president of the International Reform Bureau, petitions the president of the United States “to induce Great Britain to release China from the enforced opium traffic. . . . We need not recall in detail that China prohibited the sale of opium except as a medicine, until the sale was forced upon that country by Great Britain in the opium war of 1840.”

1905

Senator Blair on the Temperance Movement Senator Henry W. Blair in a letter to Rev. Wilbur F. Crafts, the superinten­ dent of the International Reform Bureau, writes, “The temperance movement must include all poisonous substances which create unnatural appetite, and international prohibition is the goal.”

1906

Pure Food and Drug Act The U.S. Congress passes the first Pure Food and Drug Act. Prior to its enactment, it was possible to buy, in stores or by mail order, medicines containing morphine, cocaine, or heroin, without having their ingredients labeled. The law requires truth in labeling and bans adulterated food products and poisonous medicines.

1906

Heroin as an Alternative to Morphine Squibb’s Material Medical lists heroin as “a remedy of much value . . . is also used as a mild anodyne and as a substitute for morphine in combatting the morphine habit.”

1906

Compulsory Anti-Alcohol Education Laws are passed in New York making it mandatory that school teachers instruct their students on the dangers of alcohol.

liv   Chronology: Significant Events in Drug and Alcohol Use through History

1906

Opium Trade Treaty China and England enact a treaty that restricts the Sino-Indian opium trade.

1907

Smith Act New York State bans the nonmedicinal use of cocaine.

1909

Shanghai Opium Commission The Shanghai Opium Commission lays the groundwork for the first international drug control treaty, the International Opium Convention of The Hague, 1912.

1909

Opium Exclusion Act Prompted by the U.S. participation in the international Shanghai Opium Commission of 1909, the United States passes the first federal drug prohibition law when Congress outlaws the importation of opium. This marks the start of a century of drug prohibition. The Exclusion Act bans the importation, possession, and use of “smoking opium.”

1910

Dr. Wright on Blacks and Cocaine Dr. Hamilton Wright, considered by many to be the father of U.S. antinarcotics laws, reports that “American contractors give cocaine to their Negro employees to get more work out of them.”

1910

Coffee Drunkards Dr. Harvey Wiley, the chief chemist of the U.S. Department of Agriculture and the enforcer of the Pure Food and Drug Act, declares that “coffee drunkenness is a commoner failing than the whiskey habit.  .  .  . This country is full of tea and coffee drunkards. The most common drug in this country is caffeine.”

1910

First Instant Coffee A Belgian entrepreneur with the most ironic name of George Washington begins selling the first instant coffee. He calls it G. Washington’s Refined Coffee, which most believe is named for the first president, not the owner of the company. It is initially less popular than traditional roasted coffee because there is agreement that it tastes worse than the real thing, but all instant coffee soon becomes a mainstay for American soldiers serving in the trenches of World War I.

1910

India–China Opium Trade Ends After 150 years of failed attempts to rid their country of opium, the Chinese convince the British to dismantle the India–China opium trade.

1911

U.S. Government Sues Coca-Cola The U.S. government sues Coca-Cola for violations of the 1906 Pure Food and Drug Act, charging that the drink has been adulterated through the unnatural addition of caffeine to the formula. Coca-Cola fights the case and ultimately wins.

Chronology: Significant Events in Drug and Alcohol Use through History  lv

1911

Cocaine Linked with Prostitution The New York Times warns that cocaine leads young girls into prostitution when the editors write, “There is no doubt that this drug, perhaps more than any other, is used by those concerned in the white slave traffic to corrupt young girls, and that when the habit of using the drug has been established, it is but a short time before such girls fall to the ranks of prostitution.”

1912

U.S. Food and Drug Administration Comes Out Against Caffeine Dr. Harvey Wiley, the lead enforcer of the Pure Food and Drug Act, declares to a stunned audience of coffee executives that Coca-Cola is “a first artificial cousin of coffee, because the dope that men put in Coca-Cola is the dope the Lord puts in coffee-caffeine. . . . I would not give my child coffee or tea any more than I would give him poison.”

1912

Criticism of Cigarettes Surfaces A writer in Century magazine proclaims, “The relation of tobacco, especially in the form of cigarettes, and alcohol and opium is a very close one. . . . Morphine is the legitimate consequence of alcohol, and alcohol is the legitimate consequence of tobacco. Cigarettes, drink, opium, is the logical and regular series.” Further, a physician warns: “[There is] no energy more destructive of soul, mind, and body, or more subversive of good morals than the cigarette. The fight against the cigarette is a fight for civilization.”

1912

International Opium Convention The first international Opium Convention meets in The Hague, and recommends various measures for the international control of the trade in opium. Additional Opium Conventions are held in 1913 and 1914. This first international drug control treaty is signed in The Hague during the First International Opium Conference. It requires that signatories ban the use of opiates for nonmedical purposes, penalize their unauthorized possession, and prohibit their sale to unauthorized persons.

1912

Phenobarbital Introduced Phenobarbital is introduced into therapeutics under the trade name of Luminal.

1913

Sixteenth Amendment The Sixteenth Amendment to the U.S. Constitution gives Congress the legal authority to enact a federal income tax. This shifts the taxation of liquor by the U.S. government, which amounts to half of its total revenue, to the taxation of people’s income. With the replaced stream of funding, prohibition could now go into effect without damaging the government’s source of funding.

1914

Towns-Boylan Act The State of New York Legislature passes the Towns-Boylan Act, which is an antinarcotic law. The New York law, which becomes effective July 1, 1914,

lvi   Chronology: Significant Events in Drug and Alcohol Use through History

is aimed at eliminating all nonmedicinal drug trafficking and usage, and it includes substantial criminal penalties for violations. 1914

Negro Cocaine Craze Dr. Edward H. Williams quotes another doctor, Dr. Christopher Kochs, saying, “Most of the attacks upon white women of the South are the direct result of the cocaine-crazed Negro brain.” Dr. Williams thus concludes that “Negro cocaine fiends are now a known Southern menace.”

1914

Harrison Narcotic Act The U.S. Congress passes the Harrison Narcotic Act which controls the sale of opium, opium derivatives, and cocaine. The Act requires doctors, pharmacists, and others who prescribe opium or coca leaves and their derivatives to register and pay a tax.

1914

Congressman Hobson Calls for a Prohibition Amendment Congressman Richard P. Hobson, a Democrat from Alabama, urges the passage of a prohibition amendment to the U.S. Constitution, because, as he asserts, “Liquor will actually make a brute out of a Negro, causing him to commit unnatural crimes. The effect is the same on the white man, though the white man being further evolved it takes longer time to reduce him to the same level.”

1914

Ford Condemns Cigarettes as Gateway Drug Auto magnate Henry Ford condemns cigarettes, writing in a pamphlet called The Case Against the Little White Slaver that warns American adolescents of the ruinous effects of smoking. “Morphine,” writes Ford, “is the legitimate consequence of alcohol, and alcohol is the legitimate consequence of tobacco. Cigarettes, drink, opium, is the logical and regular series.”

1914

Drugs and Race The New York Times publishes an article warning against a new peril at the intersection of drugs and race; “Negro Cocaine ‘Fiends’ Are a New Southern Menace,” reads the headline. The newspaper begins to echo the sentiments of Congressman Hobson from Alabama.

1915

Utah Passes the First State Antimarijuana Law Utah becomes the first state to pass laws making marijuana illegal primarily for the fact that it is prohibited by the Church of Jesus Christ of Latter-Day Saints. Mormons, who had gone to Mexico in 1910, returned smoking marijuana. It was outlawed at a result of the Utah legislature enacting all Mormon religion prohibitions as criminal laws.

1915

U.S. Coast Guard Created On January 28, 1915, President Woodrow Wilson signs into law the “Act to Create the Coast Guard,” which had been passed by Congress on January 20. The act combines the Life-Saving Service and Revenue Cutter Service to

Chronology: Significant Events in Drug and Alcohol Use through History  lvii

form the Coast Guard, which would come to play an instrumental role in the enforcement of drug laws. 1915

California Bans Marijuana California becomes the first state to ban cannabis consumption for nonmedicinal purposes.

1916

Whiskey and Brandy Dropped from List of Drugs The Pharmacopoeia of the United States drops whiskey and brandy from its list of drugs. Four years later, American physicians begin prescribing these “drugs” in quantities never before prescribed by doctors.

1917

American Medical Association Endorses National Prohibition The American Medical Association supports passage of the Eighteenth Amendment in a resolution which resolves, “The American Medical Association opposes the use of alcohol as a beverage; and be it further Resolved, that the use of alcohol as a therapeutic agent should be discouraged.”

1917

AMA on Syphilis and Alcohol The American Medical Association passes a resolution declaring that “sexual continence is compatible with health and is the best prevention of venereal infections,” and that one of the best methods for controlling syphilis is controlling the consumption of alcohol.

1917

Military Control of Alcohol The U.S. Congress passes laws setting up “dry and decent zones” around military camps. It is found that “Many barkeepers are fined for selling liquor to men in uniform. Only at Coney Island could soldiers and sailors change into the grateful anonymity of bathing suits and drink without molestation from patriotic passers-by.”

1917

WWI Coffee American troops in World War I consume 75 million pounds of coffee.

1918

Liquor Traffic Un-American The Anti-Saloon League says that the “liquor traffic is un-American, proGerman, crime-producing, food-wasting, youth-corrupting, home-wrecking, [and] treasonable.”

1919

Eighteenth Amendment On January 16, 1919, the Eighteenth Amendment is ratified and becomes part of the U.S. Constitution. In one year’s time, it will ban the manufacture, sale, importation, exportation, and transportation of intoxicating liquors.

1919

Webb et al. v. United States The U.S. Supreme Court issues its decision in the case of Webb et al. v. United States, 249 U.S. 96 (1919). The Court holds that prescriptions of narcotics for maintenance treatment are not within the discretion of physicians and, as a result, not privileged under the Harrison Narcotics Act of 1914.

lviii   Chronology: Significant Events in Drug and Alcohol Use through History

1919

U.S. v. Doremus The U.S. Supreme Court issues its decision in the case of United States v. Doremus (249 U.S. 86 [1919]). The federal government, trying to regulate drugs via the Harrison Act of 1914, had been imposing a tax on drug sales. Its constitutionality challenged, the U.S. Supreme Court upholds the Harrison Act on the basis that it did not exceed Congress’s taxing powers.

1920

Prohibition Era Begins On January 16, 1920, Prohibition goes into effect, making it illegal for Americans to drink alcohol. Contrary to the hopes and expectations of the Temperance Movement supporters, the law does not end alcohol consumption in the United States. In fact, it exacerbates it as millions of citizens obtain liquor illegally through bootleggers or speakeasies.

1920

Maxwell House Grows Coffee grows in popularity during the “Roaring Twenties,” partly due to the fact that alcohol is banned by Prohibition. The decade sees the rise of the famous Maxwell House brand, which quickly becomes the country’s favorite brand, popular from coast to coast. Maxwell House’s famous advertising slogan, “Good to the last drop,” continues to be used today.

1920

Dangerous Drugs Act (U.K.) The Dangerous Drugs Act implements the Hague Convention in Great Britain. It bans opium and cocaine following stories of ‘crazed soldiers’ from World War I. It also creates the offense of being an “occupier of premises permitting the smoking of prepared opium.” The Dangerous Drugs Act represents Britain’s first formal drug legislation, and establishes the Home Office as having primary responsibility for the drug issue, including over the Ministry of Health.

1920

Marlboro Begins as Woman’s Cigarette Philip Morris, one of the leading tobacco companies, introduces the Marlboro brand, which is marketed to women. The cigarettes are made with a special tip so as not to stick to women’s lipstick. Marlboros are advertised with the slogan “Mild as May.” The first advertising copy reads, “Women—when they smoke at all—quickly develop discerning taste. That is why Marlboros now ride in so many limousines, attend so many bridge parties, and repose in so many handbags.” The rugged-looking Marlboro cowboy is nowhere to be seen in the ads.

1920

U.S. Department of Agriculture Encourages Growing Marijuana The U.S. Department of Agriculture publishes a pamphlet urging Americans to grow cannabis (marijuana) as a profitable undertaking.

1920

Prohibition Unit Formed as a unit of the Bureau of Internal Revenue in 1920, the Prohibition Unit becomes the federal law enforcement agency to enforce the National Prohibition Act of 1919.

Chronology: Significant Events in Drug and Alcohol Use through History  lix

1921

U.S. Treasury Issues Treatment Regulations The U.S. government’s Treasury Department issues regulations for what treatments for drug addiction are legal and in accord with the Harrison Act.

1921

Peyote as a Drug Pennsylvania doctor Thomas S. Blair writes of the Indian use of peyote, but notes that peyote is a drug and Congress should pass a law prohibiting its use.

1921

Criminalization of Cigarettes By 1921, cigarettes are illegal in 14 states. In the peak year of 1921, there are 28 states which have 92 anticigarette bills pending. The primary focus of many of these bills is to “protect” young women. College campuses all across America begin expelling young women from college for smoking cigarettes. There is little evidence men received the same treatment.

1921

Alcohol for Medicinal Purposes Only The Council of the American Medical Association refuses to confirm the Association’s 1917 Resolution on alcohol. In the first six months after the enactment of the Volstead Act, more than 15,000 physicians and 57,000 druggists and drug manufacturers apply for licenses to prescribe and sell liquor for medicinal purposes.

1921

The Problem of the Narcotic Drug Addict Dr. Alfred C. Prentice, M.D., a member of the Committee on Narcotic Drugs of the American Medical Association, declares in an article in the Journal of the American Medical Association, “Public opinion regarding the vice of drug addiction has been deliberately and consistently corrupted through propaganda in both the medical and lay press. . . . The shallow pretense that drug addiction is a ‘disease’ . . . has been asserted and urged in volumes of ‘literature’ by self-styled ‘specialists.’”

1924

Heroin Act The manufacture of heroin is prohibited in the United States with the passage of the Heroin Act. It prohibits the manufacture, importation, and possession of heroin—even for medicinal use.

1925

Linder v. United States Decriminalizes Doctors Prescribing Drugs for Addicts In 1924 Dr. Charles O. Linder, completing a lifetime of honorable practice in Spokane, WA, is induced by a plant from the U.S. Treasury Department to write a prescription for four tablets of cocaine and morphine. Several treasury agents then descend on his office one afternoon, rampage through his waiting room crowded with patients, and break in on him in the midst of a medical examination. He is indicted, convicted, and sentenced to prison. He appeals and loses in the Circuit Court of Appeals, but he appeals to the U.S. Supreme Court. On April 13, 1925, the U.S. Supreme Court issues their

lx   Chronology: Significant Events in Drug and Alcohol Use through History

decision in Linder v. United States, and in an unanimous decision, his conviction is reversed and he is completely vindicated. 1925

The Drug Addict Robert A. Schless, writing in the American Mercury, argues, “I believe that most drug addiction today is due directly to the Harrison Anti-Narcotic Act, which forbids the sale of narcotics without a physician’s prescription.  .  .  . Addicts who are broke act as agents provocateurs for the peddlers, being rewarded by gifts of heroin or credit for supplies. The Harrison Act made the drug peddler, and the drug peddler makes drug addicts.”

1927

Bureau of Prohibition Becomes Independent Agency The Prohibition Unit, which was the federal law enforcement agency tasked with enforcing the National Prohibition Act of 1919, was originally under the Bureau of Internal Revenue. On April 1, 1927, it becomes an independent agency within the U.S. Department of the Treasury.

1928

Drug Addiction as the American Disease In a nationwide radio broadcast entitled The Struggle of Mankind Against Its Deadliest Foe, celebrating the second annual Narcotic Education Week, Richmond P. Hobson, a prohibition crusader and antinarcotics propagandist, declares, “Suppose it were announced that there were more than a million lepers among our people. Think what a shock the announcement would produce! Yet drug addiction is far more incurable than leprosy, far more tragic to its victims, and is spreading like a moral and physical scourge. . . . Most of the daylight robberies, daring holdups, cruel murders, and similar crimes of violence are now known to be committed chiefly by drug addicts, who constitute the primary cause of our alarming crime wave. Drug addiction is more communicable and less curable than leprosy. . . . Upon the issue hangs the perpetuation of civilization, the destiny of the world, and the future of the human race.”

1928

Germany Morphine Addiction It is estimated that in Germany, one out of every hundred physicians is a morphine addict, consuming 0.1 grams of the alkaloid or more per day.

1928

Amendment to Dangerous Drugs Act 1920 (U.K.) The Amendment to the Dangerous Drugs Act in the United Kingdom adds cannabis (plant material, resin, and oil) to the list of banned substances and makes simple possession of the drug an offense.

1929

Denatured Alcohol as Bootlegged Liquor One-tenth of industrial denatured alcohol is diverted into bootleg li­ quor. Approximately 40 Americans for every million die each year from drinking bootleg liquor, the majority as a result of methyl (wood) alcohol poisoning.

Chronology: Significant Events in Drug and Alcohol Use through History  lxi

1929

Porter Narcotic Farm Act The U.S. Congress passes the Porter Narcotic Farm Act on January 19, 1929. The act creates two facilities for the incarceration and treatment of drug addicts, the majority of them for either heroin or morphine. Most of those admitted to the two treatment centers come from federal prisons and are admitted involuntarily. The two facilities are located in Lexington, Kentucky (opened in 1935), and Fort Worth, Texas (opened in 1938). They serve as part prison, part rehabilitation center.

1930

Federal Bureau of Narcotics The Federal Bureau of Narcotics is formed under the U.S. Department of Justice. Many of its agents, including its first commissioner, Harry J. Anslinger, transferred from the Federal Bureau of Prohibition. Anslinger, upon taking charge, says, “Jail offenders, then throw away the key.” Harry J. Anslinger is considered to have been the first U.S. “drug czar.”

1930

History of Tobacco Count Corti writes in his History of Tobacco: “A glance at the statistics proves convincingly that the non-smokers are a feeble and ever dwindling minority. The hopeless nature of their struggle becomes plain when we remember that all countries, whatever their form of government, now encourage and facilitate the passion for smoking in every conceivable way.”

1931

Convention for Limiting the Manufacture and Regulating the Distribution of Narcotic Drugs The Convention requires signatory countries to produce detailed drug consumption statistics, and requires that each country limit production of narcotics to quantities only necessary for medicine and research. The detailed stipulations found in the Convention are nearly identical to the grouping of drugs found in the Schedule System that is still widely used to this day.

1932

Repeal Prohibition Democrat Franklin Roosevelt runs for president of the United States in 1932, promising repeal of federal laws pertaining to the prohibition of alcohol.

1932

Prohibition Crimes Evidence of the criminal effects of Prohibition are beginning to be realized in the United States. In 1932 alone, approximately 45,000 persons receive jail sentences for alcohol offenses. During the first 11 years of the Volstead Act, 17,971 people are hired as agents for the Prohibition Bureau. Of these agents, 11,982 are terminated “without prejudice,” and 1,604 are dismissed for bribery, extortion, theft, falsification of records, conspiracy, forgery, and perjury.

1933

First Female Narcotics Agent Elizabeth Bass becomes the first female agent with the Federal Bureau of Narcotics.

lxii   Chronology: Significant Events in Drug and Alcohol Use through History

1933

Twenty-First Amendment Ratified The U.S. Congress ratifies the Twenty-First Amendment, repealing Prohibition. America’s noble experiment, banning one of its most widely used drugs—alcohol—ends in abject failure. It is the only amendment to ever repeal another amendment and is the only one to have ever been ratified using the state ratifying convention.

1935

Medicalization of Alcoholism The American Medical Association passes a resolution declaring that “alcoholics are valid patients.”

1935

Alcoholics Anonymous Is Founded Alcoholics Anonymous (AA) begins in Akron, Ohio. It is the outcome of a meeting between Bill Wilson, a New York stockbroker, and Dr. Bob Smith, an Akron surgeon, both of whom had been hopeless alcoholics most of their lives.

1935

Federal Alcohol Administration Act The Federal Alcohol Administration Act is passed by the U.S. Congress and becomes part of the U.S. Code. It creates the Federal Alcohol Administration under the U.S. Department of Justice. The new administration’s purpose is to regulate the alcohol industry after the repeal of Prohibition, replacing the former Federal Alcohol Control Administration

1935

U.S. Public Health Service Program for Drug Abuse Research In Lexington, Kentucky, a small research unit is created to treat and study heroin addiction. The research unit would later become the National Institute on Drug Abuse, a branch of the National Institutes of Health.

1936

Increased Coffee Consumption The Pan-American Coffee Bureau is organized to promote coffee use in the United States. Between the years 1938 and 1941, coffee consumption increases by 20 percent.

1936

Reefer Madness The film Reefer Madness warns the United States that its youth face extreme danger in smoking marijuana. Intended as a means of scaring people, the effects of smoking marijuana are grossly overexaggerated. In the film, smoking pot leads directly to car wrecks, suicide, rape, and insanity. The propaganda film tells the story of a group of “beatniks” who become “hooked” on the “devil’s weed” and their subsequent decline. The film was a little-known failure until 1970 when the pro-marijuana organization National Organization for the Reform of Marijuana Laws (NORML) began showing the film at its rallies, which ultimately turned it into a humorous cult classic.

1937

Anslinger Pushes for Marijuana Drug Laws Commissioner Harry J. Anslinger, advocating for federal marijuana drug laws, writes, “How many murders, suicides, robberies, criminal assaults,

Chronology: Significant Events in Drug and Alcohol Use through History  lxiii

hold-ups, burglaries, and deeds of maniacal insanity it [marijuana] causes each year, especially among the young, can only be conjectured.” 1937

Marihuana Tax Act In August 1937, the U.S. Congress passes the Marihuana Tax Act, the first step toward criminalizing marijuana in the United States. This act had been recommended to members of the U.S. Congress by “Drug Czar” Harry Anslinger, then commissioner of the Federal Bureau of Narcotics. The act did not itself criminalize the possession or usage of cannabis, but levied a tax equaling roughly one dollar on anyone who dealt commercially in marijuana. Under the provisions of the act even minor procedural violations could result in a fine of up to $2,000 and five years’ imprisonment. The impact of the Act was to make it far too onerous and legally risky for anyone to deal in the substance. The Act itself is later found to be unconstitutional and is superseded by the Controlled Substances Act of 1970. It is largely believed that the law was primarily the federal government’s response to political pressure from enforcement agencies and other alarmed groups who feared the use and spread of marijuana by “Mexicans.”

1937

First Marihuana Tax Act Arrest On October 8, 1937, Mr. Samuel Caldwell becomes the first person arrested for violation of the new federal Marihuana Tax Act. He is sentenced to four years for selling two joints.

1938

Coca-Cola as the Sublimated Essence of America Journalist William Allen White calls Coca-Cola “a sublimated essence of all that America stands for, a decent thing honestly made, universally distributed, conscientiously improved with the years.”

1938

Harrison Act Arrests Tick Upward At least 25,000 physicians have been arraigned on narcotics charges since the passage of the Harrison Act in 1914, and another 3,000 have served penitentiary sentences.

1938

LSD Synthesized Dr. Albert Hofmann, a chemist at Sandoz Laboratories in Basle, Switzerland, synthesizes LSD. Five years later he accidentally ingests a small amount of it, and observes and reports effects on himself.

1938

Federal Food, Drug, and Cosmetic Act The law is considered in the early 1930s, but Congress is reluctant to pass the law until a tragedy strikes in 1937. That year a Tennessee drug company markets a form of the new sulfa wonder drug for pediatric patients. The new version of the drug is not tested in advance and proves to be highly toxic to children, and over 100 people die from the injections. The public outcry motivates Congress to revisit the drugs laws, quickly moving the bill to the president’s desk. The act brings cosmetics and medical devices under

lxiv   Chronology: Significant Events in Drug and Alcohol Use through History

regulatory control, and it requires that drugs be labeled with adequate directions for safe use. It also mandates premarket approval of all new drugs, requiring certification from the Federal Drug Administration that a drug is safe. The act also attempts to control common abuses in food packaging and quality, and it mandates legally enforceable food standards. 1939

Nazis Link Tobacco and Lung Cancer In Germany, Nazi scientists conduct the first successful epidemiological study that links tobacco smoking with lung cancer.

1941

China Suppresses the Poppy Generalissimo Chiang Kai-shek orders the complete suppression of the poppy. Numerous laws are enacted that provide the death penalty for anyone guilty of cultivating the poppy, manufacturing opium, or offering it for sale.

1942

Opium Poppy Control Act The U.S. Congress passes the Opium Poppy Control Act, which prohibits the possession or growing of the opium poppy without a license. It is common in America at this time to grow ornamental poppy plants in the United States, typically given special attention when poppies are given away on Armistice Day (November 11), later known as Veteran’s Day.

1943

Dangers of Marijuana Colonel J. M. Phalen, the editor of the journal Military Surgeon, writes in The Marijuana Bugaboo, “The smoking of the leaves, flowers, and seeds of Cannabis sativa is no more harmful than the smoking of tobacco. . . . It is hoped that no witch hunt will be instituted in the military service over a problem that does not exist.”

1943

School of Alcohol Studies is Founded at Yale University Yale University creates a School of Alcohol Studies to treat and study alcohol addiction.

1944

National Committee for Education on Alcoholism (NCEA) Founded Marty Mann becomes the first woman to be successfully treated through the Alcoholics Anonymous program and creates her own program called the National Committee for Education on Alcoholism, which later becomes the National Council on Alcoholism and Drug Dependence.

1946

Chinese Opium Usage at an All-Time High According to some estimates there were 40 million opium smokers in China in 1946.

1947

First Coffee Vending Machine Instant coffee becomes more popular in America with the invention of the “Kwik Kafe” vending machine. It is the first coffee vending machine allowing a paper cup to drop into a chute and fill up with hot instant coffee in just five seconds. By 1955, the United States will be home to over 60,000 coffee vending machines.

Chronology: Significant Events in Drug and Alcohol Use through History  lxv

1947

Methadone Is Distributed in the United States Methadone was first synthesized in Germany in 1937 and the drug was later distributed in the United States as a long-lasting analgesic. Starting in 1947, it begins to be used as a method of treating heroin addicts by weaning them off heroin and on to methadone, and then slowly weaning them off methadone. The primary reason is that methadone is not associated with the severe withdrawal symptoms of heroin.

1947

Narcotics Anonymous Created Narcotics Anonymous (NA) is created and describes its mission as a “nonprofit fellowship or society of men and women for whom drugs had become a major problem.” Narcotics Anonymous uses a 12-step model to end drug addiction. It is still in existence today.

1948

Paris Protocol The Paris Protocol of 1948 introduces what is known as the “similarity concept” into international drug legislation in order to prevent drug manu­ facturers being able to evade legislation by producing analogues of illicit drugs.

1949

Hollywood Promotes Cigarette Smoking The Hollywood of the era reaches an all-time high of promoting cigarette smoking in its films. In the John Wayne film The Sands of Iwo Jima, Wayne’s character celebrates the defeat of the Japanese Army by saying, “I never felt so good in my life. How about a cigarette?”

1949

Von Mises on the Danger of Allowing Government to Enforce Drug Laws The leading free-market economist and social philosopher, Ludwig von Mises, in the journal Human Action observes, “Opium and morphine are certainly dangerous, habit-forming drugs. But once the principle is admitted that it is the duty of government to protect the individual against his own foolishness, no serious objections can be advanced against further encroachments. A good case could be made out in favor of the prohibition of alcohol and nicotine. And why limit the government’s benevolent providence to the protection of the individual’s body only? Is not the harm a man can inflect on his mind and soul even more disastrous than any bodily evils? Why not prevent him from reading bad books and seeing bad plays, from looking at bad paintings and statues and listening to bad music? The mischief done by bad ideologies, surely, is much more pernicious, both for the individual and for the whole society, than that done by narcotic drugs.”

1949

Hazelden Centers Started in a farmhouse called the Old Lodge in Center City, Minnesota, the center is a nonprofit organization dedicated to treating alcohol and drug abuse. Other centers would later be created throughout the United States.

lxvi   Chronology: Significant Events in Drug and Alcohol Use through History

1950

AMA Links Smoking and Cancer for the First Time The American Medical Association publishes the first U.S. study that confirms the correlation between smoking and lung cancer.

1951

Marijuana Use on the Rise In 1951, according to United Nations estimates, there are approximately 200 million marijuana users in the world. The majority of users are found in India, Egypt, North Africa, Mexico, and the United States.

1951

China Crackdown on Drugs China begins a crackdown on drugs and makes mass arrests and seizures of drugs. Twenty thousand pounds of opium, 300 pounds of heroin, and various opium-smoking devices are gathered in a pile and publicly burned in Canton, China. Thirty-seven opium addicts are tried, sentenced, and executed in the southwest of China. It is wryly noted that China no longer has a drug problem after this crackdown.

1951

Boggs Act The Boggs Act of 1951 imposes mandatory minimum sentences for those convicted of violating the Narcotic Drug Import and Export Act or the Marihuana Tax Act. These minimums are repealed in 1970.

1951

Al-Anon Founded Al-Anon breaks away from Alcoholics Anonymous as an alternative to treating alcohol abuse. Today, it is an international organization that is focused on “fellowship of relatives and friends of alcoholics who share their experience, strength, and hope in order to solve their common problems.”

1952

The Coffee Break The Pan American Coffee Bureau (an association of South American coffee exporters) invents the coffee break. The Bureau spends over $2 million on an advertising campaign that says, “Give Yourself a Coffee-Break—And Get What Coffee Gives to You.” In less than a year, over 75 percent of all American companies report they allow their employees to take coffee breaks during business hours.

1953

Marlboro Man Marlboro, which was originally introduced in the 1920s as a cigarette for ladies, is rebranded to appeal to manly men. They find a model to portray the epitome of manhood—the Marlboro Man. He is featured in advertisements as a rugged cowboy and takes the cigarette from an almost unknown brand to become the most popular brand of choice among Americans.

1954

Tobacco Companies Deny Their Products Cause Lung Cancer In response to the American Medical Association’s study that found a connection between cigarette smoking and lung cancer, the major American tobacco companies band together to place a large advertisement in nearly

Chronology: Significant Events in Drug and Alcohol Use through History  lxvii

450 American newspapers. Their ad, titled “A Frank Statement to Cigarette Smokers,” challenges the emerging scientific consensus “that cigarette smoking is in some way linked with lung cancer in human beings. Although conducted by doctors of professional standing,” the statement argues, “these experiments are not regarded as conclusive in the field of cancer research. . . . Distinguished authorities point out: That medical research of recent years indicates many possible causes of lung cancer. That there is no agreement among the authorities regarding what the cause is. That there is no proof that cigarette smoking is one of the causes. That statistics purporting to link cigarette smoking with the disease could apply with equal force to any one of many other aspects of modern life. . . . We believe the products we make are not injurious to health.” 1955

The World Health Organization on Treating Drug Addicts The Präsidium des Deutschen Ärztetages, a German group, declares: “Treatment of the drug addict should be effected in the closed sector of a psychiatric institution. Ambulatory treatment is useless and in conflict, moreover, with principles of medical ethics.” This view on treating drug addicts is echoed by the World Health Organization in 1962 as being the most representative opinion of “most of the authors recommending commitment to an institution.”

1955

Iran Bans Opium The shah of Iran prohibits the cultivation and use of opium, despite the fact that opium had been used in the country for thousands of years. This new prohibition creates a black market in opium that becomes very lucrative. The prohibition is later lifted in 1969, and opium growing is resumed under state inspection. More than 110,000 persons register as addicts with the government in order to receive opium from physicians and pharmacies.

1956

Narcotics Control Act The Narcotics Control Act is enacted, authorizing the use of the death penalty for the sale of heroin to a person under 18 by someone over the age of 18 and increases the amount of time served for various drug offenses.

1957

Bogart Dies of Esophageal Cancer at 57 in ’57 On January 14, 1957, one of Hollywood’s most famous stars, long associated with smoking on screen and in real life, Humphrey Bogart, dies from esophageal cancer at the age of 57. Bogart starred in numerous films, including one of Hollywood’s most famous films, Casablanca.

1957

Alateen Formed Alateen, a part of the Al-Anon Group, is created to focus on treating teenagers in alcoholic families.

1960

Addiction on the Rise in the United States The United States reports to the UN Commission on Narcotic Drugs for 1960 that “there were 44,906 addicts in the United States on December 31, 1960.”

lxviii   Chronology: Significant Events in Drug and Alcohol Use through History

1960

Richard Alpert (Ram Dass) Advocates the Use of Psilocybin Richard Alpert, a Harvard professor, advocates his students experiment with psilocybin. He later visits India, meets a guru, and becomes a spiritual counselor, calling himself Ram Dass.

1961

UN Single Convention on Narcotic Drugs The United Nation’s Single Convention on Narcotic Drugs is ratified. The convention consolidates and broadens previous drug treaties into a coherent whole, which becomes the basis for the global response to the problems of drugs. The convention marks a turning point in global prohibition, for it becomes part of domestic law worldwide.

1963

Tobacco Sales at an All-Time High By the end of 1963, tobacco sales totaled $8.08 billion in America, for which $3.3 billion go to federal, state, and local taxes. A news release from the tobacco industry proudly announces, “Tobacco products pass across sales counters more frequently than anything else—except money.”

1963

National Advisory Commission on Narcotics and Drug Abuse President John F. Kennedy, responding to the rising use of narcotics and other drugs in the United States, creates the National Advisory Commission on Narcotics and Drug Abuse to develop policy solutions for the problem America faces.

1964

Compulsory Commitments for Alcoholism Encouraged in Great Britain In a Memorandum of Evidence to the Standing Medical Advisory Committee’s Special Sub-committee on Alcoholism, the British Medical Association states, “We feel that in some very bad cases, compulsory detention in hospital offers the only hope of successful treatment. . . . We believe that some alcoholics would welcome compulsory removal and detention in hospital until treatment is completed.”

1964

Federal Government Subsidies for Tobacco Growers An editorial in the New York Times calls attention to the fact that “the Government continues to be the tobacco industry’s biggest booster. The Department of Agriculture lost $16 million in supporting the price of tobacco in the last fiscal year, and stands to lose even more because it has just raised the subsidy that tobacco growers will get on their 1964 crop. At the same time, the Food for Peace program is getting rid of surplus stocks of tobacco abroad.”

1965

Illicit Drug Use Sees Dramatic Increases Recreational illegal drug use, particularly of marijuana, becomes much more common among middle-class, white young people, especially on college campuses, in the first half of the 1960s.

1966

Warning Label Required The U.S. Cigarette Labeling and Advertising Act takes effect, forcing cigarettes to be sold with the following warning label: “Cigarette smoking may

Chronology: Significant Events in Drug and Alcohol Use through History  lxix

be hazardous to your health.” The vague language of the warning is a result of heavy lobbying by the tobacco industry, which defeats competing proposals for a much stronger warning. 1966

Peet’s Coffee Opens First Store Peet’s Coffee and Tea opens its first store in Berkeley, California, challenging the market dominance of weak, poor-quality instant coffee by selling highquality, fresh-roasted beans.

1966

Subsidies for Increasing Foreign Tobacco Consumption Senator Warren G. Magnuson (D-WA) makes public a program which was sponsored by the U.S. Agriculture Department to subsidize “attempts to increase cigarette consumption abroad. . . . The Department is paying to stimulate cigarette smoking in a travelogue for $210,000 to subsidize cigarette commercials in Japan, Thailand, and Austria.” A U.S. Department of Agriculture spokesperson corroborates that “the two programs were prepared under a congressional authorization to expand overseas markets for U.S. farm commodities.”

1966

Narcotics Addict Rehabilitation Act The U.S. Congress enacts the Narcotics Addict Rehabilitation Act, inaugurating a federal civil commitment program for addicts.

1966

LSD Declared a Threat C. W. Sandman Jr., chairman of the New Jersey Narcotic Drug Study Commission, declares that LSD is “the greatest threat facing the country today . . . more dangerous than the Vietnam War.”

1966

LSD Prohibited in the United Kingdom The measure comes after LSD usage moves from being used in therapy to being used for recreational purposes, and then reaches levels thought to be problematic, fueled in part by the emerging psychedelic music scene and hysterical media coverage. The use of LSD in therapy continued until the early 1970s, before it was ended altogether.

1967

Dangerous Drugs Act 1967 (United Kingdom) Following a sharp rise in the number of heroin addicts and reports of overprescribing by doctors, the second Brain Report is commissioned and concludes that tighter restrictions are needed. This marks the beginning of the end of the British system of opiate prescribing. In addition, a clause is appended to the legislation that allows the police to “stop and search.”

1967

New York State’s Narcotics Addiction Control Program New York State’s Narcotics Addiction Control Program goes into effect. It is estimated to cost $400 million over the next three years, and is hailed by Governor Rockefeller as the “start of an unending war.” Under the new law, judges are empowered to commit addicts for compulsory treatment for up to five years. It is the beginning of what is often believed to have been the most draconian drug laws in America.

lxx   Chronology: Significant Events in Drug and Alcohol Use through History

1967

Phoenix House Founded In 1967, six heroin addicts who met at a New York City hospital band together to overcome their addiction together. The idea develops into the Phoenix House, which develops facilities across the United States.

1967

Tobacco Advertising The tobacco industry in the United States spends an estimated $250 million on advertising smoking. The advertising dollars appear to have an effect as the number of young smokers continues to rise.

1967

Legalize Marijuana Rally in Hyde Park A rally is held in Hyde Park, London, to legalize marijuana. The rally campaign literature states, “The law against marijuana is immoral in principle and unworkable in practice.” There are 65 signatories to the petition who include The Beatles, Nobel laureate Francis Crick, R. D. Laing, and Graham Greene.

1967

American Medical Association Adopts the Concept That Alcohol Is a Disease The American Medical Association passes a resolution identifying alcoholism as a “complex disease,” and a “disease that merits the serious concern of all members of the health professions.”

1968

Tobacco Sales and Users Reach Another All-Time High The U.S. tobacco industry posts gross sales of $8 billion in 1968. Americans smoke 544 billion cigarettes that year.

1968

Canada Forms a Drug Habit Canadians buy almost 3 billion aspirin tablets and approximately 56 million doses of amphetamines from the United States for nonmedicinal purposes. About 556 doses of barbiturates are also produced or imported for consumption in Canada.

1968

Barbiturate Use on the Rise in the United Kingdom It is estimated that about 500,000 British are regular users, and that 6 to 7 percent of all prescriptions written under the British National Health Service are for barbiturates.

1968

U.S. Bureau of Narcotics and Dangerous Drugs Founded The Johnson administration consolidates several drug agencies into the Department of Justice’s Bureau of Narcotics and Dangerous Drugs (BNDD). The move is intended to diminish turf wars between the various agencies that enforce drug laws in America, but tensions between the BNDD and U.S. Customs continue.

1969

Operation Intercept Operation Intercept is initiated by the Nixon administration, aimed at decreasing the amount of marijuana entering the United States. The Mexican

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government takes offense, and after international condemnation, the Nixon administration ceases its efforts. 1969

Drug Production Increases Dramatically by Decade’s End The U.S. production and value of various medical chemicals includes: barbiturates, 800,000 pounds, $2.5 million; aspirin (exclusive of salicylic acid) 37 million pounds, value “withheld to avoid disclosing figures for individual producers”; salicylic acid, 13 million pounds, $13 million; tranquilizers, 1.5 million pounds, $7 million.

1969

Drug Testing Students in New Jersey The parents of 6,000 secondary-level students in Clifton, New Jersey, are sent letters by the Board of Education asking their permission to conduct saliva tests on their children in order to determine if they have been smoking marijuana.

1969

Link Found Between Crime and Heroin Addicts Psychiatrist Dr. Robert DuPont conducts urinalysis tests of everyone entering the Washington, DC, jail system in August of 1969. He finds that 44 percent test positive for heroin. He discovers that the primary reason for their arrest was committing crimes associated with their heroin addiction or to obtain money to buy heroin. He later convinces the mayor of Washington to allow him to supply methadone to dependent heroin users.

1970

NORML Founded The National Organization for the Reform of Marijuana Laws (NORML) is founded by Keith Stroup. The group lobbies for decriminalization of marijuana.

1970

Drug Abuse Prevention and Control Act The U.S. Congress passes the Comprehensive Drug Abuse Prevention and Control Act, which reduces the penalty for marijuana possession but gives law enforcement new powers to conduct drug-related searches. The act consolidates previous drug laws, reduces penalties for marijuana possession, and establishes five categories (“schedules”) for regulating drugs based on their medicinal value and potential for addiction.

1971

Drug Use in Vietnam Drug abuse becomes a significant problem among U.S. soldiers fighting the war in Vietnam. While marijuana is the most common illegal drug used by U.S. servicemen, heroin creates the most difficult addiction problems.

1971

Nixon Begins War on Drugs President Nixon revamps his drug policies after the failure of Operation Intercept. President Nixon then coins the phrase “War on Drugs,” promising in a major speech to defeat “public enemy number one in the United States. . . . If we cannot destroy the drug menace, then it will destroy us.” President

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Nixon declares that “America’s Public Enemy No. 1 is drug abuse.” In a message to Congress, the president calls for the creation of a Special Action Office of Drug Abuse Prevention. 1971

Cigarette Ads Banned from U.S. Television and Radio The U.S. Congress passes a law that bans cigarette advertisements from U.S. television and radio.

1971

Starbucks Opens in Seattle The first Starbucks Coffee opens in Seattle, initially selling only bulk coffee beans bought from Peet’s Coffee in California.

1971

BNDD Becomes First Federal Law Enforcement Agency to Hire Female Special Agents The Bureau of Narcotics and Dangerous Drugs becomes the first federal agency to implement a program for hiring female special agents.

1971

Turkey Bans Poppy Cultivation On June 30, 1971, President Cevdet Sunay of Turkey decrees that all poppy cultivation and opium production will be forbidden beginning in the fall of 1972.

1971

UN Convention on Psychotropic Substances In light of rampant experimentation with many new drugs such as LSD, MDMA, and amphetamines in the 1960s, the United Nations broadens the scope of previous UN drug legislation, facilitating the inclusion of almost any drug imaginable.

1971

Misuse of Drugs Act (United Kingdom) The Misuse of Drugs Act implements a schedule system, in accordance with the judgment of the UN Commission on Narcotic Drugs, as to the potential for abuse and the therapeutic value of each drug included.

1972

U.S. Drug Addicts on the Rise Special assistant attorney general of the United States Myles J. Ambrose claims, “As of 1960, the Bureau of Narcotics estimated that we had somewhere in the neighborhood of 55,000 addicts . . . they estimate now (1972) the figure is 560,000.”

1972

BNDD Proposes Restricting Barbiturates The Bureau of Narcotics and Dangerous Drugs proposes restricting the use of barbiturates on the ground that they “are more dangerous than heroin.”

1972

Financing the War on Drugs The U.S. House of Representatives votes 366 to 0 to authorize “a $1 billion, three-year federal attack on drug abuse.”

1972

The French Connection A New York City Police detective, through a tenacious investigation of drug dealing in New York City, helps to expose what becomes known as the French

Chronology: Significant Events in Drug and Alcohol Use through History  lxxiii

Connection—where France is discovered to be a transshipment location for heroin. The exposure significantly damages the amount of heroin entering the United States. 1972

Drugs Used to Control Prisoners At the Bronx house of corrections, out of a total of 780 inmates, approximately 400 are given tranquilizers such as Valium, Elavil, Thorazine, and Librium. “I think they [the inmates] would be doing better without some of the medication,” says Capt. Robert Brown, a correctional officer. He says that in a way the medications make his job harder. Rather than becoming calm, he says, an inmate who had become addicted to his medication “will do anything when he can’t get it.”

1972

Office of Drug Abuse Law Enforcement Founded The Nixon administration creates the Office of Drug Abuse Law Enforcement (ODALE) to establish joint federal/local task forces to fight the drug trade at the street level. Myles Ambrose is appointed director.

1972

National Commission on Marijuana and Drug Abuse Created The National Commission on Marijuana and Drug Abuse is created by the Controlled Substances Act to study marijuana abuse in the United States. On March 22, 1972, the commission’s chairman, Raymond P. Shafer, presents a report to Congress and the public entitled Marihuana, A Signal of Misunderstanding, which favors ending marijuana prohibition and adopting other methods to discourage use.

1972

Mr. Coffee Brewer The first drip coffee maker, created by the company Mr. Coffee, goes on sale, allowing Americans to brew better coffee at home, thus increasing the consumption of coffee dramatically in the United States.

1973

Drug Enforcement Administration Created The Nixon administration creates the Drug Enforcement Agency. The new agency is supposed to be a super agency, overseeing America’s drug policy enforcement. It absorbs resources from the Bureau of Narcotics and Dangerous Drugs and the Office of Drug Abuse Law Enforcement.

1973

Fetal Alcohol Syndrome The term fetal alcohol syndrome is used for the first time to describe the condition that results from alcohol exposure during pregnancy. Problems that may be caused by fetal alcohol syndrome include physical deformities, mental retardation, learning disorders, vision difficulties, and behavioral problems.

1973

First Female DEA Graduate Mary Turner becomes the first female Drug Enforcement Administration special agent to graduate from the DEA’s training program. She finishes first in her class.

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1973

Support for Life Imprisonment of Drug Dealers A nationwide Gallup poll reveals that 67 percent of the adults interviewed “support the proposal of New York Governor Nelson Rockefeller that all sellers of hard drugs be given life imprisonment without possibility of parole.”

1973

Drug Abuse Industrial Complex Michael R. Sonnenreich, executive director of the National Commission on Marijuana and Drug Abuse, states, “About four years ago we spent a total of $66.4 million for the entire federal effort in the drug abuse area. . . . This year we have spent $796.3 million and the budget estimates that have been submitted indicate that we will exceed the $1 billion mark. When we do so, we become, for want of a better term, a drug abuse industrial complex.”

1973

Graduation of the First DEA Special Agents The Drug Enforcement Administration graduates its first class consisting of 40 men and women.

1974

Collapse of the DEA Miami Office Building On August 5, the Miami Office Building of the Drug Enforcement Administration collapses, killing seven agents and injuring dozens of people.

1974

President Nixon Resigns Under pressure from Congress because of the Watergate scandal, President Nixon becomes the first president to ever resign from office. The DEA remains one of the lasting legacies of Nixon’s war on drugs.

1974

DEA Female Agents in the Field The Drug Enforcement Administration fields 23 female special agents.

1974

Drug Abuse Warning Network The Drug Abuse Warning Network (DAWN) is created by the Drug Enforcement Administration in order to gain some idea as to how widespread drug abuse is in America.

1974

Office of Juvenile Justice and Delinquency Prevention Created The Office of Juvenile Justice and Delinquency Prevention (OJJDP) is created by the U.S. government in order to address the problems of juvenile delinquency, with a special focus on drug addiction and treatment.

1975

Minnesota Limits Public Smoking Minnesota becomes the first state to limit smoking in public spaces, passing the Clean Indoor Air Act to protect “the public health and comfort and the environment by prohibiting smoking in public places and at public meetings, except in designated smoking areas.”

1975

Ford Administration Releases White Paper on Drug Abuse The Domestic Council Drug Abuse Task Force releases a report that recommends that “priority in Federal efforts in both supply and demand reduction

Chronology: Significant Events in Drug and Alcohol Use through History  lxxv

be directed toward those drugs which inherently pose a greater risk to the individual and to society.” The white paper names marijuana a “low priority drug” in contrast to heroin, amphetamines, and mixed barbiturates. 1976

Presidential Candidate Jimmy Carter Campaigns on the Decriminalization of Marijuana Following the lead of several states that have already introduced similar policies, Carter proposes decriminalizing the possession of up to one ounce of marijuana. There is a quick public backlash over the proposal with many thinking it meant that marijuana would be legal. Carter backs away from the policy.

1976

Soft Drinks Beat Coffee Soft drinks surpass coffee to become America’s most widely consumed beverage other than water.

1976

Women for Sobriety Founded Sociologist Jean Kirkpatrick creates an alternative to the 12-step recovery groups such as Alcoholics Anonymous called Women for Sobriety. Only women are allowed in the program, which addresses the particular needs of women and their addictions.

1976

Parents’ Antidrug Movement Forms Troubled by the presence of marijuana at her 13-year-old daughter’s birthday party, Marsha “Keith” Schuchard and her neighbor Sue Rusche form Families in Action. This interest group becomes the first parents’ organization designed to fight teenage drug abuse. Schuchard writes a letter to Dr. Robert DuPont, then head of the National Institute of Drug Abuse, which leads DuPont to abandon his support for the decriminalization of marijuana.

1977

Rockefeller Drug Laws Called Failure The Joint Committee of the New York Bar Association concludes that the Rockefeller drug laws, considered the toughest in the nation, had no effect in reducing drug use but clogged the courts and the criminal justice system to the point of gridlock.

1977

Media Glamorizes Cocaine Use A May Newsweek story on cocaine is accused of glamorizing the drug’s effects and underestimating its dangers. The story reports, “Among hostesses in the smart sets of Los Angeles and New York, a little cocaine, like Dom Perignon and Beluga caviar, is now de rigueur at dinners. Some partygivers pass it around along with the canapes on silver trays. . . . the user experiences a feeling of potency, of confidence, of energy.”

1978

Asset Forfeiture Introduced The Comprehensive Drug Abuse Prevention and Control Act is amended to allow law enforcement to seize all money and/or “other things of value

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furnished or intended to be furnished by any person in exchange for a controlled substance [and] all proceeds traceable to such an exchange.” 1979

American Drug Use at an All-Time High Illicit drug use in the United States peaks when 25 million of Americans used an illegal drug within the 30 days prior to the annual survey on drug abuse.

1980

Trafficking a Threat A Presidential commission on drugs finds that illegal drug trafficking presents a threat to American national security, declaring, “The violence and corruption that are integral parts of organized criminal drug trafficking take the lives of American and foreign officials and private citizens, undermine drug control efforts and threaten entire governments to the extent that the stability of friendly nations is threatened, particularly in this hemisphere. Our national security is jeopardized.”

1980

Richard Pryor Ignites Self While Freebasing Comedian Richard Pryor sets himself on fire while freebasing cocaine. The event becomes part of American popular culture.

1980

Freeway Ricky Ross Freeway Ricky Ross, as he is known, becomes a popular cocaine dealer in Los Angeles, selling what he calls “Ready Rock” which later becomes known as “Crack Cocaine.”

1981

Kicking the Coffee Habit Author Charles Wetherall publishes Kicking the Coffee Habit, a book that highlights the dangers of coffee as a drug.

1981

Medellín Cartel Pablo Escobar’s Medellín Cartel rises to dominate the Colombian cocaine trafficking industry. Escobar becomes the primary target for the Colombian and U.S. governments in the war on drugs.

1981

U.S.-Colombia Extradition Treaty Ratified The Colombian and U.S. governments sign a treaty in order to increase the ability of both countries to target the drug cartels, especially the Medellín.

1981

Students Against Drunk Driving Students Against Drunk Driving (SADD) is started in 1981 in response to the organizational movement of Mothers Against Drunk Driving. It later changes its name to Students Against Destructive Decisions (SADD) and purports to be the nation’s largest peer organization. The group’s mission includes preventing drunk driving, but it also intends to provide students “with the best prevention and intervention tools possible to deal with the issues of underage drinking, other drug use, impaired driving, and other destructive decisions.”

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1981

Posse Comitatus Act Amended The U.S. Congress amends the 1878 Posse Comitatus Act, which forbids the armed forces to enforce civil law, so that the military could provide surveillance planes and ships for interdiction purposes.

1982

Pablo Escobar Granted Immunity Pablo Escobar, the kingpin of Colombia’s Medellín Cartel, is elected to the Colombian Congress, granting him immunity from prosecution in Colombian courts.

1982

Betty Ford Center Founded Mrs. Ford, the wife of former president Gerald Ford, and Leonard Firestone are co-chairs and founders of the Betty Ford Center at Eisenhower, located in Rancho Mirage, California, opening in October 1982. The center’s treatment program assists women, men, and their families in starting the process of recovery from alcoholism and other drug dependency.

1982

Organized Crime Drug Enforcement Task Force The Organized Crime Drug Enforcement Task Force is created in 1982 and would ultimately employ over 2,500 agents. It is a federal drug enforcement program in the United States, overseen by the attorney general and the Department of Justice. Its primarily concerns is the disruption of major drug trafficking operations and related crimes, including money laundering, tax and weapon violations, and violent crime.

1982

Koop Named Surgeon General C. Everett Koop is named the thirteenth surgeon general by President Ronald Reagan. Koop is the first surgeon general to ever become a household name.

1982

John Belushi Dies from Drug Overdose Actor and comedian John Belushi of Animal House fame dies of a heroincocaine-speedball overdose.

1982

Deal between Escobar and Noriega Allows Cocaine Transport through Panama Panamanian general Manuel Noriega and Pablo Escobar cut a deal that allows the Medellín Cartel to ship cocaine through Panama for $100,000 per load. The two had met in 1981 when Noriega mediated negotiations for the release of Marta Ochoa.

1982

Pablo Escobar Elected to the Colombian Congress Using his drug money to help the poor in Colombia, Pablo Escobar, the head of the Medellín Cartel, is elected by popular vote to the Colombian Congress.

1982

South Florida Drug Task Force Created President Reagan places Vice President George H. W. Bush in charge of a federal task force aimed at interdicting the drug trade in southern Florida.

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1982

Cocaine Anonymous Founded On November 18, 1982, the organization Cocaine Anonymous is founded. The organization uses the traditional 12-step program for people who seek recovery from drug addiction. The organization is patterned very closely after Alcoholics Anonymous, although they have no association.

1983

Drug Abuse Resistance Education (D.A.R.E.) Program Founded Drug Abuse Resistance Education (D.A.R.E.) is founded in 1983 in Los Angeles and proves to be so popular that it spreads to well over 75 percent of our nation’s school districts and in more than 43 countries around the world. D.A.R.E. is a police officer–led series of classroom lessons that teaches children from kindergarten through 12th grade how to resist peer pressure and live productive drug- and violence-free lives. Research on D.A.R.E. has demonstrated the program is not successful in keeping kids from doing drugs.

1983

Sylvester Stallone Agrees to Smoke in Films The Brown & Williamson Company—manufacturer of many cigarette brands, including Pall Mall, Lucky Strike, and Kool—signs an agreement to pay Hollywood star Sylvester Stallone half a million dollars to smoke Brown & Williamson cigarettes on screen across his next five films, which included Rambo and Rocky IV.

1984

Minimum Drinking Age in the United States is 21 The U.S. Congress passes a law that ties federal highway funding to moving the legal drinking age to 21. Most states move quickly to adopt the new age requirement, but those that hold out lose millions in federal highway dollars before moving to the 21 minimum age.

1984

Aviation Drug-Trafficking Control Act On October 19, 1984, the Aviation Drug-Trafficking Control Act is signed into law by President Ronald Reagan. The act authorizes the Federal Aviation Administration (FAA) to participate in the enforcement of drug trafficking laws in two ways: (1) the certification of airmen, and (2) the registration of aircraft. The FAA is not, however, authorized any law enforcement powers.

1984

Colombian Cocaine Destroyed Colombian government forces working in collaboration with American anti­ drug officials destroy more than $1 billion worth of cocaine in a series of raids against cocaine production facilities hidden deep in the jungles of Colombia.

1984

The Pizza Connection In 1984, after nearly a 10-year investigation, arrests are made in what became known as the Pizza Connection. The case is focused on a Mafia-run enterprise that distributed vast quantities of heroin and cocaine in the United States and then laundered the cash through pizza restaurants before sending it back to the suppliers in Sicily. The Pizza Connection Trial begins the following year on September 30, 1985, and would end up being the longest

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criminal jury trial in the federal courts in U.S. history. The trial ends with the conviction of all but one of the 22 defendants on March 2, 1987. 1984

Pablo Escobar Has Justice Minister Murdered The Medellín Cartel, run by Pablo Escobar, has Colombian minister of justice Rodrigo Lara Bonilla murdered.

1984

Starbucks Begins Selling Coffee To Go The famous Starbucks Coffee Company begins to sell coffee to go.

1984

U.S. Eradication of Marijuana in Mexico The United States busts 10,000 pounds of marijuana on farms in Mexico. The seizures, made on five farms in an isolated section of Chihuahua, suggest a 70 percent increase in estimates that total U.S. consumption was 13,000 to 14,000 tons in 1982.

1984

Crime Control Act The U.S. Congress passes the Crime Control Act of 1984, aimed at creating new laws and tougher sentences for drug offenses.

1985

Military Drug Interdiction The U.S. military spends $40 million on drug interdiction in 1985. By 1990, the General Accounting Office will report that the military’s efforts have had no discernible impact on the flow of drugs.

1985

Crack Cocaine Common in New York Crack cocaine, a potent form of cocaine that is smoked and developed in the early 1980s, begins to flourish in the New York region. It is cheap, highly addictive, and is quickly associated with blacks and violent crime.

1985

Passage of the Controlled Drugs Act (U.K.) The U.K. Parliament passes the Controlled Drugs Act, which increases the maximum penalties for importing, producing, and supplying—or possessing with intent to supply—Class A drugs from 14 years to life imprisonment.

1985

Medellín Cartel Murders Supreme Court Medellín Cartel guerillas attack Colombia’s Palace of Justice, killing nearly 100 people—including 11 supreme court justices—in the course of a daylong siege. Many fear that the cartel has become more powerful than the government of Colombia.

1985

DEA Agent Enrique Camarena Kidnapped and Murdered in Mexico DEA special agent Enrique Camarena disappears and is later found to have been killed on the Mexican border in revenge for the American intervention in the drug trade.

1986

Len Bias Dies at University of Maryland University of Maryland basketball star Len Bias dies from a cocaine overdose, creating a nationwide media sensation, a moral panic, and the introduction of legislation in Congress.

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1986

Media Hype of Crack Cocaine In response to the Len Bias overdose, Dan Rather of CBS News does a twohour special on crack cocaine, helping to fuel the moral panic.

1986

Just Say No First Lady Nancy Reagan, with the support of her husband, President Ronald Reagan, launches a public service announcement campaign to keep kids off of drugs, now famous for its slogan, “Just Say No.”

1986

Reagan Signs the Anti–Drug Abuse Act of 1986 Congress passes and the president signs the Anti–Drug Abuse Act of 1986, creating new mandatory minimums for federal drug offenses and including the higher sentencing for crack cocaine over powder cocaine.

1986

Medellín Indictment Leaders of the Medellín Cartel, extradited to the United States to stand trial, are indicted on racketeering charges.

1986

Partnership for Drug-Free America Founded The organization Partnership for a Drug-Free America is founded to conduct research and promote educational service announcements about the dangers of drugs.

1986

Iran-Contra Affair Exposed The U.S. press reports that the Reagan administration has been engaging in illegal dealings in drugs, arms, and paramilitary support.

1987

Starbucks Stores Under new ownership, Starbucks Coffee transforms its core business from the sale of whole beans for home consumption to the in-store sale of espresso drinks.

1987

Starbucks in Chicago Starbucks Coffee opens its first store outside of the Seattle area, in Chicago. Chicagoans initially dislike the strong Starbucks coffee, and the store loses money.

1988

Anti–Drug Abuse Act of 1988 The Anti–Drug Abuse Act of 1988 is signed into law creating new federal offenses for drugs and increasing the penalties of pre-existing drug laws. The new piece of legislation also creates the White House Office of National Drug Control Policy (ONDCP) for which the director becomes known popularly as America’s drug czar.

1988

Tobacco Industry Lawsuit The tobacco industry loses its first major lawsuit when a jury awards the family of Rose Cipollone, a lung cancer victim, a $400,000 verdict for having caused her cancer.

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1988

Noriega Indicted in United States A federal grand jury in Miami issues an indictment against Panamanian general Manuel Noriega for drug trafficking. Noriega had allowed the Medellín Cartel to launder money and build cocaine laboratories in Panama.

1989

Crack Cocaine Epidemic According to the media the United States is suffering a crack cocaine epidemic. While there is debate over the realities, in 1989, 46 percent of all arrests made in New York City are for possession or distribution of crack cocaine.

1989

Medellín Cartel Declares War on Colombian Government On August 18, 1989, the Medellín Cartel declares “total and absolute war” against the Colombian government, seeking to stop potential extradition of its members. The strategy consisted of hundreds of terrorist attacks against civilian and governmental targets.

1989

International Narcotics Control Act President George H. W. Bush signs the International Narcotics Control Act into law on December 13, 1989. The act authorizes Fiscal Year 1990 appropriations of $115 million for international narcotics control assistance and an additional $125 million for military and law enforcement assistance to Colombia, Peru, and Bolivia, in order to address the problem of cocaine at its source. The goal of the budgetary allocation is the disruption and dismantling of the criminal organizations that support the international production, processing, and trafficking of drugs, becoming essential components of our national drug control strategy.

1989

First Drug Court America’s first drug court is created in Miami, Florida, which was implemented in 1989 with the assistance of Attorney General Janet Reno. It is the first of its kind and introduces the basic philosophy that characterizes all subsequently developed programs.

1989

National Treasury Employees Union v. Von Raab The U.S. Supreme Court issues its decision in Treasury Employees Union v. Von Raab 489 U.S. 656 (1989), a case involving the Fourth Amendment and its implication on drug testing programs. The majority of the court upholds the legality of the federal drug testing program requiring employees in the U.S. Customs Service to submit to random drug testing as a condition of employment.

1989

Pablo Escobar on Forbes List of Richest in the World Pablo Escobar, the Medellín Cartel drug lord, is listed as the seventh-richest man in the world by Forbes magazine in its annual compilation of the richest people in the world.

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1989

Office of National Drug Control Policy is Created President George H. W. Bush appoints William Bennett to lead the new Office of National Drug Control Policy (ONDCP). As drug czar he campaigns to make drug abuse socially unacceptable, an approach he calls “denormalization.” Federal spending on treatment and law enforcement increase under Bennett’s tenure, but treatment remains less than one-third of the total budget.

1989

John Kerry Releases Congressional Report on Contra Drug Connection A congressional subcommittee on Narcotics, Law Enforcement and Foreign Policy, chaired by Senator John Kerry (D-MA), finds that U.S. efforts to combat drug trafficking were undermined by the Reagan administration’s fear of jeopardizing its objectives in the Nicaraguan civil war. The report concludes that the administration ignored evidence of drug trafficking by the Contras and continued to provide them with aid.

1989

U.S. Invades Panama The U.S. military invades Panama to secure President Manuel Noriega for extradition to the United States to stand trial. For 22 days, General Manuel Noriega eludes capture by the U.S. military. After seeking asylum in the Vatican embassy, he eventually surrenders to the DEA on January 3, 1990, in Panama and is brought to Miami the next day. On July 10, 1992, Noriega is convicted on eight counts of drug trafficking, money laundering, and racketeering, and sentenced to 40 years in federal prison.

1990

Anabolic Steroid Control Act The Anabolic Steroid Control Act of 1990 adds anabolic steroids to the federal schedule of controlled substances. As a result, it criminalizes the nonmedical use by those seeking muscle growth for athletic or cosmetic enhancement. It places steroids in the same legal class as barbiturates, ketamine, and LSD precursors.

1990

President Bush Proposes a 50 Percent Increase in War on Drugs Spending President Bush proposes adding an additional $1.2 billion to the funds for drug law enforcement in order to “face this evil as a nation united.”

1992

NIDA Becomes Part of NIH The National Institute on Drug Abuse (NIDA) becomes part of the National Institutes of Health (NIH). In collaboration with the NIH, NIDA conducts research with new methodologies in molecular biology, neuroscience, and brain imaging in order to accelerate the pace of scientific discoveries about drug abuse.

1992

First National Alcohol and Drug Addiction Recovery Month in September The first National Alcohol and Drug Recovery Month is recognized. Every September, thousands of treatment programs around the country annually celebrate their successes and share them with their neighbors, friends, and colleagues in an effort to educate the public about treatment, how it works, for whom, and why.

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1992

Presidential Candidate Bill Clinton Admits to Having Smoked Marijuana During the campaign of 1992, presidential candidate Bill Clinton admits to having smoked marijuana, but qualifies it by saying he didn’t inhale. Both of the following U.S. presidents—George W. Bush and Barack Obama—also admit to using marijuana in the past.

1993

Pablo Escobar Killed Medellín Cartel kingpin Pablo Escobar is killed by Colombian police with the aid of U.S. technology. The technology could recognize Escobar’s voice on a cell phone and give police an estimated location of where he was. They find his safe house and kill Escobar as he attempts to flee with one of his bodyguards.

1993

Actor River Phoenix Dead from Overdose Twenty-three-year-old actor River Phoenix dies of a heroin-cocaine overdose.

1993

Surgeon General on Legalizing Drugs Joycelyn Elders, the surgeon general of the United States, says that the legalization of drugs “should be studied,” causing a public controversy.

1993

NAFTA Passed and Signed into Law President Bill Clinton signs the North American Free Trade Agreement (NAFTA) into law. The bill allows for increased trade across the U.S.Mexican-Canadian border. The volume of trade makes it more difficult for U.S. Customs officials to find narcotics hidden within legitimate goods.

1994

Singer Kurt Cobain Commits Suicide Kurt Cobain, the lead singer of the Seattle-based alternative rock band Nirvana, dies of heroin-induced suicide.

1995

Sentencing Commission Recommends Mandatory Minimum Sentence Revisions The U.S. Sentencing Commission releases a report noting the racial disparities in powder vs. crack cocaine sentencing and calls for changes in mandatory minimum sentences. For the first time in history, the U.S. Congress rejects the recommendations of the commission.

1996

Clinton Names Gen. Barry McCaffrey as Drug Czar In his State of the Union address, President Bill Clinton nominates Army general Barry McCaffrey, a veteran of Vietnam and Desert Storm, as director of the Office of National Drug Control Policy. Two days later, the appointment is confirmed by the U.S. Senate.

1997

Drug-Free Schools and Communities Act On June 27, 1997, the Drug-Free Communities Act of 1997 becomes law. The White House Office of National Drug Control Policy (ONDCP) directs the Drug-Free Communities Support Program in partnership with the Substance Abuse and Mental Health Services Administration. This anti-drug

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program provides grants of up to $100,000 to community coalitions that mobilize their communities to prevent youth alcohol, tobacco, illicit drug, and inhalant abuse. 1998

Tobacco Settlement The American tobacco industry and 46 states sign the Master Settlement Agreement, in which tobacco companies agree to pay $246 billion over 25 years to offset the states’ costs of treating smoking-related illness.

1998

Public Letter to UN Secretary General Kofi Annan Appearing in the New York Times, a public letter is signed by more than 500 prominent academics, scientists, and political leaders and appeals to the UN secretary general “to initiate a truly open and honest dialogue regarding the future of global drug control policies—one in which fear, prejudice and punitive prohibitions yield to common sense, science, public health and human rights.”

1998

UN Special Session on Drugs 10-Year Strategy The UN General Assembly holds a special session on drugs and develops a 10-year strategy toward creating a “drug-free world” by 2008. The 10-year plan is unsuccessful.

1998

Operation Casablanca Operation Casablanca is the largest money-laundering probe in U.S. history to date, leading to the indictment of three Mexican and four Venezuelan banks and 167 individual arrests. Mexico and Venezuela are outraged over the undercover operation and consider it a threat to their national sovereignty.

1998

U.S. and Mexican Attorneys General Sign Brownsville Agreement As a result of Mexico’s anger about U.S. actions in Operation Casablanca, U.S. attorney general Janet Reno and Mexican attorney general Jorge Madrazo Cuellar draft the Brownsville Agreement. The United States and Mexico pledge to inform each other about sensitive cross-border law enforcement operations.

2001

September 11, 2001, Terrorist Attack on United States On September 11, 2001, 19 members of Al-Qaeda hijack four passenger jets. Two are flown into the World Trade Center Towers in New York City, one is flown into the Pentagon, and the fourth crashes into a field in Pennsylvania after the passengers tried to take back control of the airplane. The terrorist operation is believed to have been backed in part by the illicit drug trade.

2001

U.S. Invasion of Afghanistan The United States invades Afghanistan in retaliation for the September 11, 2001, attacks on American soil. The terrorist group Al Qaeda has taken control of the Taliban in Afghanistan, so by taking out the Taliban, it removes Afghanistan from their control, thus undercutting Al Qaeda. Part of the operation includes counterinsurgency and counternarcotics operations.

Chronology: Significant Events in Drug and Alcohol Use through History  lxxxv

2001

Portugal Decriminalizes Drug Possession Portugal becomes the first European country to decriminalize the acquisition, possession, and use of recreational drugs for personal use—defined as quantities up to a 10-day supply.

2002

No Child Left Behind Act The No Child Left Behind Act (NCLB) of 2001, Public Law 107-110, which reauthorizes the Elementary and Secondary Education Act of 1965 (ESEA), is signed. The Safe and Drug-Free Schools and Communities Act (SDFSCA) (Title IV, Part A of the ESEA) authorizes a variety of activities designed to prevent school violence and youth drug use. The purpose of the SDFSCA is to support programs that: (1) prevent violence in and around schools; (2) prevent the illegal use of alcohol, tobacco, and drugs; (3) involve parents and communities; and (4) are coordinated with related federal, state, school, and community efforts and resources to foster a safe and drug-free learning environment that promotes student academic achievement.

2002

Home Affairs Select Committee Report (U.K.) In the United Kingdom, the Home Affairs Select Committee issues their report entitled The Government’s Drugs Policy: Is It Working? The report recommends that “the Government initiates a discussion within the Commission on Narcotic Drugs on alternative ways—including the possibility of legalization and regulation—to tackle the global drugs dilemma.”

2003

Illicit Drug Anti-Proliferation Act of 2003 The Illicit Drug Anti-Proliferation Act, sponsored by then-senator Joe Biden, is aimed at educating and legislating against the drug Ecstasy and similar drugs. It also, however, makes it easier for prosecutors to charge, convict, and imprison property owners, business owners, and managers who fail to prevent drug-related offenses committed by customers, employees, tenants, or other persons on their property. This legislation also adds a civil liability clause to the existing criminal code.

2009

Drug Czar to No Longer Use “War on Drugs” Gil Kerlikowske, the director of the Office of National Drug Control Policy, states that the Obama administration would not use the term “War on Drugs.” He claims that the phrase is counterproductive and is contrary to the policy favoring treatment over incarceration in trying to reduce drug use. He explains, “Being smart about drugs means working to treat people who go to jail with a drug problem so when they get out and return to the communities you protect, you will be less likely to re-arrest them.”

2010

Fair Sentencing Act The Fair Sentencing Act of 2010 (Public Law 111-220) is passed by Congress and signed into law by President Barack Obama on August 3, 2010. The focus of the bill is to reduce the sentencing disparity between the amount of crack

lxxxvi   Chronology: Significant Events in Drug and Alcohol Use through History

cocaine and powder cocaine, and it eliminates the five-year mandatory minimum sentence for simple possession of crack cocaine, among other provisions. 2010

California Proposition 19 California Proposition 19, known as the Regulate, Control & Tax Cannabis Act, is defeated, with 53.5 percent of California voters voting “No” and 46.5 percent voting “Yes.”

2010

The Czech Republic Joins Portugal in Decriminalizing All Drugs The Czech Republic joins Portugal in decriminalizing the possession of all drugs for personal use within a set quantity.

2011

Mexican Drug War Death Toll Mexico, fighting a renewed drug war, finds many of the local drug cartels and gangs retaliating with drug war–related deaths increasing significantly. From December 2006 to 2010, the number of deaths reached 50,000, which moves the drug policy debate forward as a failure of President Calderon’s hard-line approach to drugs.

2012

States Legalize Marijuana Colorado and Washington State pass laws to legalize the consumption, possession, and sale of marijuana.

2012

The Netherlands Moves to Control Drugs The Netherlands begins to control its coffee shop system where drugs may be purchased for personal consumption. On May 1, 2012, in three areas they move to exclude foreigners (except Belgians and Germans) from buying marijuana in shops, and they introduce a Weed Pass allowing only 2,000 Dutch customers per establishment.

2012

Russia Sees Drugs as a Threat to International Security Russia appeals to the UN Security Council to treat drugs as a threat to international peace and security. Later in the year, the International Institute for Strategic Studies also assesses the war on drugs as a threat to international security.

2012

Latin American Leaders Call for Reform Twelve Latin American countries including Colombia, Guatemala, Mexico, Costa Rica, El Salvador, Panama, Nicaragua, Belize, Honduras, and the Dominican Republic support the calls for exploring the legal regulation of drugs.

2012

United Nations to Review Drug Policy in 2016 The United Nations agrees to a 2016 General Assembly Special Session in order to review global drug policy.

2012

Progress at the UN Commission on Narcotic Drugs For the first time, several member states, including the Czech Republic, break with the prohibitionist line in the UN Commission on Narcotic Drugs, which publicly backs the Global Commission on Drug Policy’s report.

Chronology: Significant Events in Drug and Alcohol Use through History  lxxxvii

2013

Traditional Coca Leaf Chewing Legal in Bolivia In Bolivia, a tradition among the indigenous population is the chewing of coca leaves, which has a drug-inducing effect. Bolivia has had a long history with the legalities of this tradition. After daring to withdraw from the 1961 UN Convention on Narcotic Drugs, Bolivia rejoins the convention with a qualification that allows the growing of coca leaf. This, however, was not supported by the United States and 17 other countries.

2013

United Kingdom Bans Khat The U.K. Parliament votes, against the recommendations of its own drugs experts, to ban the use of Khat. The substance known as Khat is a natural flowering plant that grows in South Africa (and the Middle East), where the indigenous populations have chewed it for well over a thousand years. The British people picked up the custom from its colonial days, and many South Africans who move to England continue the practice. The ban on Khat is motivated by fears of a link between the Khat trade and terrorism.

2013

United States Changes to Mandatory Minimums U.S. attorney general Eric Holder announces changes to mandatory minimum sentences, motivated in part by disparities in drug sentencing.

2013

Hazelden and Betty Ford Centers Merge On September 24, 2013, it is announced that the renowned addiction treatment providers Hazelden and Betty Ford Center had voted to merge together. In a joint statement, it is noted, “The integration of these two industry leaders will expand our geographic reach to help more people. It will position us well to respond to the challenges and opportunities presented by health care reform and the rapidly changing marketplace. The merger will help us achieve scale so we’re able to invest in state-of-the-art facilities and research and development.”

Bibliography Abadinsky, Howard. 2010. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Cengage. Belenko, Steven. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Publishing. Courtwright, David T. 2001. Forces of Habit: Drugs and the Making of the Modern World. Cambridge, MA: Harvard University Press. Davenport-Hines, Richard. 2002. Pursuit of Oblivion: A Global History of Narcotics. New York: W. W. Norton. Drug Enforcement Administration. 2014. “DEA History in Depth.” http://www.justice.gov/dea/ about/history.shtml. Durrant, Russil, and Jo Thakker. 2003. Substance Use & Abuse: Cultural and Historical Perspectives. Thousand Oaks, CA: Sage.

lxxxviii   Chronology: Significant Events in Drug and Alcohol Use through History Escohotado, Antonio. 1999. A Brief History of Drugs: From the Stone Age to the Stoned Age. Rochester, VT: Park Street Press. Friedman, Lawrence M. 1993. Crime and Punishment in American History. New York: Basic Books. Gahlinger, Paul. 2004. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use, and Abuse. New York: Plume Books. The Guardian. 2014. “100 Years of Altered States.” The Observer. http://observer.theguardian .com/drugs/story/0,,686503,00.html. Jonnes, Jill. 1996. Hep-Cats, Narcs, and Pipe Dreams: A History of America’s Romance with Illegal Drugs. Baltimore: Johns Hopkins University Press. Musto, David. 1999. The American Disease: Origins of Narcotic Control, 3rd ed. New York: Oxford University Press. Musto, David, ed. 2002. Drugs in America: A Documentary History. New York: New York University Press. National Public Radio. 2014. “Timeline: America’s War on Drugs.” The Forgotten War on Drugs. http://www.npr.org/templates/story/story.php?storyId=9252490. Oliver, Willard M., and James F. Hilgenberg Jr. 2010. A History of Crime and Criminal Justice in America, 2nd ed. Durham, NC: Carolina Academic Press. Porter, Roy, and Mikulas Teich. 1996. Drugs and Narcotics in History. New York: Cambridge University Press. Public Broadcasting System. 2014. “Thirty Years of America’s Drug War: A Chronology.” Frontline. http://www.pbs.org/wgbh/pages/frontline/shows/drugs/cron/. Roth, Mitchel P. 2010. Crime and Punishment: A History of the Criminal Justice System. Stamford, CT: Cengage. Schaeffer Library of Drug Policy. 2014. “Historical Research.” Schaeffer Library of Drug Policy. http://www.druglibrary.org/schaffer/History/HISTORY.HTM. White, William. 1998. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chestnut Health Systems.

A Over the past 30 to 40 years, scientific advances have shown that addiction is rooted in the neurochemical changes that take over a critical chemical pathway in the brain’s mesolimbic dopamine system. This area is known as the reward pathway and is programmed to respond to stimuli like sex or food with neurotransmitters such as dopamine that produce a pleasurable sensation. Scientists believe that this pleasure explains how organisms learn to repeat behaviors, such as eating and procreation, necessary for survival. This mechanism can backfire, however, when addictive substances are used. When an individual takes an addictive substance or undertakes addictive behavior, the impacted neurons become overstimulated, thus producing a surplus of dopamine. This creates a pleasurable experience that is significantly higher than the pleasure derived from life’s natural rewards. With each repeated exposure to the psychoactive stimulus, the brain reacts by reducing the neurotransmitter output, which results in decreased production of cellular receptors to receive and transmit dopamine along the reward pathway. The development of tolerance begins when individuals require more of the drug stimulus to attain the initial effect. Gradually, their behavior or use acquires a compulsive quality as individuals find themselves forced to indulge on a more frequent basis. This is not driven by a desire to feel good: it is a way to avoid feeling bad. Despite this, the affected individual is apt to deny the existence of the problem and claim that their usage or behavior is normal. An obvious signal that the person’s judgment

Addiction Addiction is a complex disorder that is marked by repeated compulsions to use substances or indulge in certain behaviors despite the potential negative consequences. As addicted individuals increasingly become reliant upon the object of addiction for emotional gratification, physical gratification, or both, they tend to neglect the other, more healthy aspects of their lives. There is general agreement that there are two types of addiction: physical, and psychological or behavioral. Physical addiction occurs when individuals become addicted to legal or illegal substances such as drugs or alcohol. Psychological or behavioral addiction occurs when individuals become addicted to activities such as shopping or gambling. Additionally, behavioral addiction is often referred to as “process” addiction. There is disagreement, however, as to whether behaviors can be truly considered addictions, with some choosing to refer to them as disorders (e.g., impulse control or obsessive-compulsion). Others argue that an addict’s compulsion to indulge in these behaviors regardless of the negative consequences makes them addictions. Addicts suffering from either type of addiction initially derive some sort of excitement, pleasure, gratification, or a combination of all three. The degrees of addiction often range from mild to severe. Those who are mildly addicted may have quicker response rates to treatment and a somewhat easier time refraining from the substance or behavior. On the other hand, recovery for those who are severely addicted may be difficult to impossible. 1

2  Addiction

abrupt withdrawal may lead to upsetting symptoms, these medications are not addictive because they do not produce compulsive use and loss of control. The signs of substance and behavioral addictions include, but are not limited to the following:

Heroin addict injects the drug into his arm. Addicts must use the drug several times a day to fend off symptoms of withdrawal. They will often inject into their arms, legs, or even between their toes. (powerofforever/ iStockphoto.com)

is impaired is that this denial practically becomes an automatic reflex with which one warrants pathological use or behavior. In instances when an individual is unable to indulge, they may begin withdrawal, which is the physical and psychological distress that arises as the brain attempts to compensate for the absence of drugs. Even though behavioral addictions usually do not produce the more severe physical symptoms of withdrawal that are associated with substance addictions, individuals may still experience certain levels of restlessness, agitation, and depression if they are unable to satisfy their needs. Medications, such as certain types of antidepressants, can cause a physical dependence in that they rebalance the brain’s neurotransmitters. While their

• Increased excitement associated with the anticipation of the substance or behavior • Feelings of irritability or restlessness when prevented from the gratification of the substance or behavior • Increasing amounts of time devoted to preparing for using the substance, engaging in the activity, or recovering from their respective effects • Neglecting responsibilities at home, school, or work • Relying upon the substance or behavior to manage emotions • Obsessively thinking about the activity • Seeking out the substance or activity regardless of the harm it causes (e.g., deteriorating health) • Denying the problem to oneself and to others in spite of the clearly negative effects • Concealing the use or behavior from others • Experiencing blackouts—losses of memory while under the influence of a substance or when sober, an inability to recall behavior that happened when under the influence • Developing depression, which, while often a contributory factor in the development of an addiction, is also a result • Having a personal history of either anxiety or other mental disorders; being subjected to psychological or physical abuse; or suffering from low self-esteem • Developing some form of sexual dysfunction

Addiction  3

• Feeling remorse or shame over the use of substance(s) or engaging in activities associated with use

Causes One of the most puzzling aspects of addiction is why some people become addicted and others do not; what is clear is that no one can become addicted to a drug unless he or she tries it first. A child who takes a few sips of a parent’s beer may like the pleasurable feelings that result, but the overwhelming reason most young people indulge in drugs or alcohol for the first time is peer pressure. Friends urge them to “just try it.” Despite adverse reactions like nausea or dizziness that many first-time users experience, the disinhibitory and euphoric effects of the drugs encourage adolescents struggling with emotional or peer issues to experiment with them again and again. Some substances are more addictive than others—heroin, more addicting than alcohol, triggers a greater flood of pleasure-giving neurotransmitters. Age and gender are factors—teens and young adults aged 15 to 25, as well as males, are more susceptible. A child or teen is statistically much more likely to escalate usage into addiction. In fact, according to the National Institute on Drug Abuse (NIDA), it is rare for anyone over the age of 30 to become addicted to alcohol; an alcoholic over age 30 is most likely to have acquired the disease as a young person, even if primary symptoms do not become apparent until the addict is older. Although young brains are still developing and therefore able to recover more readily if the disease is not too advanced, they are also more vulnerable to the effect of drugs and more likely to develop an addiction. The tendency of addictions like alcoholism to run in families gave rise to theories for a genetic basis for the disorder, and subsequent studies have borne these out. In fact, although

vulnerability to addiction varies among individuals, a multigenerational history of addiction can increase someone’s risk 4 to 5 times that of the general population. The ability of modern science to map the human genome has allowed researchers to pinpoint “candidate genes” with genetic variations that are implicated in the disorder. How they are switched on or triggered by environmental stimuli is not yet clear, but isolating them could allow scientists to develop drugs that modify their activity and mitigate their contribution to the disease. These findings show that, far from earlier explanations for the origin of addiction that focused on moral weakness and deficient will power, biology seems to account for at least half of a person’s predisposition to addiction, and environmental influences largely account for the rest. The latter, particularly among teenagers struggling with social status and self-image, include peer pressure, family dysfunction, issues with school or work, social demands, and a permissive culture. As many as 40 percent of addicts suffer from concurring mental illnesses such as anxiety disorders, depression, or posttraumatic stress syndrome. Affected individuals tend to self-medicate with substances like alcohol to relieve distressing symptoms or, in more severe cases, to function at all. Individuals who are compelled to use psychoactive drugs as medicine have a higher risk of developing an addiction than are those who use them solely for recreational purposes. Besides those with mental disorders, scientists have been able to determine that certain personality types are more susceptible to addiction—most likely those with antisocial personality disorders or conduct disorders. In addition, it has been shown that the more quickly a given substance enters the bloodstream, the greater its initial effect; the greater its effect, the lower the low that follows, and the sooner the addict is using again.

4  Addiction

Many of the factors that lead to substance abuse and addiction take root in childhood and erupt during adolescence when puberty and access present opportunities for teens to experiment with mood-altering substances. After decades of failed attempts to deal with this fact through morality-based approaches based on punishment and ostracism, researchers began to develop what are called science-validated programs that are producing positive results. Such programs work to balance preventive factors against risk factors for drug use by educating and working with young people, both those who use psychoactive drugs and those who have not yet begun to experiment with them. Designed to target various age groups in the school and in the home, science-validated programs have proved to be effective in reducing teen drug use and consequently are being adopted throughout the United States. The NIDA reports that adolescent use of illicit drugs declined by 23.2 percent from 2001 to 2006, due in part to these educational approaches. As the perceived risk rose, use tended to decline. Since teens sometimes feel that drugs and alcohol are their only coping mechanisms, the NIDA states that it is essential to find ways to prevent them from abusing the very substances that will warp brain development and derail their ability to mature physically and emotionally. Protective factors that can reduce the risk of addiction include parental supervision and support, academic success, and local prevention policies. Early intervention is critical; by the time most addicts enter treatment, they have been sick for 20 years. Not only is it tragic for addicts to lose years of emotional and intellectual growth to their addictions, but it also allows the disease to progress. In a person with a multigenerational history of drug and alcohol abuse, vigilance and a sensible lifestyle are the best preventive

measures. Such individuals should avoid addictive substances just as someone with diabetes should avoid sugar.

Treatments Since addiction is a chronic disease, it requires lifelong management. Treatment is approached in various ways both in methods and philosophy. This is largely due to the age-old debate about whether addiction constitutes a disease or a choice. In spite of this, the majority of treatment specialists agree that the best approach is a combination of medical, behavioral, and motivational techniques that are tailored to the individual addict’s specific needs and profile. Participating actively in groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous helps some addicts prevent relapse and aid life-long recovery. In cases of severe substance addiction, the initial detoxification and withdrawal often must be achieved under medical supervision. Maintenance medications like methadone or antianxiety drugs (anxiolytics) may be useful in helping to ease the symptoms of withdrawal and craving; studies have shown that an addict’s potential for relapse increases when withdrawal is painful. Drugs such as naltrexone and disulfiram can be useful since they obstruct the brain’s receptors from responding to addictive substances or even make the addict very ill if they use drugs. Typically, behavioral therapy is rendered as cognitive behavioral therapy (CBT). Unlike psychological therapies that focus on the long-term causes of addiction, CBT helps addicts develop practical, everyday tools to help the addict improve immediate functioning. The treatment may involve the use of medication, counseling, and training as motivational mechanisms allowing the addict to change their behavior and to solve problems through the use of coping strategies. These strategies help addicts to iden-

Addiction  5

tify harmful patterns of behavior and cope with situations that may trigger addictive use or behaviors. Twelve-step programs offer a less formalized approach to CBT. Alcoholics Anonymous applies these same strategies but, like other 12-step programs, tends to employ a greater spiritual focus. Treatment experts point out that therapies require a minimum of 90 days of treatment before showing significantly positive results. The NIDA suggests that addicts can start seeking treatment from their family physician; psychologists or psychiatrists who specialize in addiction; members of the clergy; employee assistance programs; 12-step programs; or local mental health centers. Kathryn H. Hollen See also: Long-Term Potentiation; Jellinek, E. Morton; Recovery; Risk Factors for Drug Use; Rush, Benjamin

Further Reading American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision. Washington, DC: American Psychiatric Association. Califano, Joseph A. 2007. Jr. High Society: How Substance Abuse Ravages America and What to Do About It. New York: Perseus Books. Carter, Adrian. 2012. Addiction Neuroethics: The Promises and Perils of Neuroscience Research on Addiction. New York: Cambridge University Press. Carter, Adrian, Wayne Hall, and Judy Illes. 2012. Addiction Neuroethics: The Ethics of Addiction Neuroscience Research and Treatment. London: Academic Press.

Grant, Jon E., and S. W. Kim. 2003. Stop Me Because I Can’t Stop Myself: Taking Control of Impulsive Behavior. New York: McGraw-Hill. Halpern, John H. 2002. “Addiction Is a Disease.” Psychiatric Time 19, no. 10 (October): 54–55. Hanson, Glen R. July 2007. Utah Addiction Center (University of Utah Health Center). http://uuhsc.utah.edu/uac. Heyman, Gene M. 2011. Addiction: A Disorder of Choice. Gainesville: University of Florida Press. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Hyman, S. E., and R. C. Malenka. 2001. “Addiction and the Brain: The Neurobiology of Compulsion and Its Persistence.” Nature Reviews Neuroscience 2 (10): 695–703. Kalivas, Peter, and Nora Volkow. 2005. “The Neural Basis of Addiction: A Pathology of Motivation and Choice.” American Journal of Psychiatry 162, no. 8 (August): 1403–13. Kauer, Julie A. 2003. “Addictive Drugs and Stress Trigger a Common Change at VTA Synapses.” Neuron 37, no. 4 (February): 549–50. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Lemanski, Michael. 2001. A History of Addiction and Recovery in the United States. Tucson, AZ: See Sharp Press.

Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton.

Miller, Shannon C. 2006. “Language and Addiction.” American Journal of Psychiatry 163: 2015.

Gerdes, Louise L, ed. 2005. Addiction: Opposing Viewpoints. San Diego: Greenhaven Press.

Moyers, William Cope. 2006. Broken: The Story of Addiction and Redemption. New York: Penguin Group.

6  Addiction National Institute on Drug Abuse. 2007. The Science of Addiction: Drugs, Brains, and Behavior. NIH Publication No. 07-5605, February. Nestler, Eric, and Robert Malenka. 2007. “The Addicted Brain.” Scientific American, September. http://www.health.harvard.edu/ newsweek/The_addicted_brain.htm.

U.S. Department of Health and Human Services. 2007. “Results from the 2006 National Survey on Drug Use and Health: National Findings.” Substance Abuse and Mental Health Services Administration, Office of Applied Studies. DHHS Publication No. SMA 07-4293.

Nurnberger, John I., Jr., and Laura Jean Bierut. 2007. “Seeking the Connections: Alcoholism and Our Genes.” Scientific American 296 (4): 46–53.

U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research (NIDCR). http:// www.nidcr.nih.gov.

Ozelli, Kristin Leutwyler. 2007. “This Is Your Brain on Food.” Scientific American 297, no. 3 (September): 84–85.

U.S. Department of Health and Human Services, National Institute of Mental Health (NIMH). http://www.nimh.nih.gov.

Peele, Stanton. 2001. “Is Gambling an Addiction Like Drug and Alcohol Addiction?” Journal of Gambling Issues, February. http: //www.camh.net/egambling/issue3/feature/ index.html.

U.S. Department of Health and Human Services, National Institute on Alcohol Abuse and Alcoholism (NIAAA). http://www .niaaa.nih.gov.

Peele, Stanton. 2004. 7 Tools to Beat Addiction. New York: Three Rivers Press. Potenza, Marc N. 2006. “Should Addictive Disorders Include Non-Substance-Related Conditions?” Addiction 101 (s1): 142–51. Schaler, Jeffrey A. 2002. “Addiction Is a Choice.” Psychiatric Times 19, no. 10 (October): 54, 62. Sutton, Amy L. 2007. Alcoholism Sourcebook: Basic Consumer Health Information About Alcohol Use, Abuse, and Dependence. Detroit: Omnigraphics. Teitelbaum, Scott A. 2011. Addiction: A Family Affair. Gainesville: University of Florida Department of Psychiatry. Tracy, Sarah, and Caroline Jean Acker, eds. 2004. Altering American Consciousness: The History of Alcohol and Drug Use in the United States, 1800–2000. Amherst and Boston: University of Massachusetts Press. U.S. Department of Health and Human Services. 2005. “Morbidity and Mortality Weekly Report: Surveillance Summaries.” Centers for Disease Control and Prevention, Youth Risk Behavior Surveillance–United States.

U.S. Department of Health and Human Services, National Institute on Drug Abuse (NIDA). http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). http: //www.samhsa.gov. U.S. Department of Justice Drug Enforcement Administration (DEA), March 2008. Retrieved from http://www.usdoj.gov/dea. White, William. 2000. “Addiction as a Disease: Birth of a Concept.” Counselor 1, no. 1 (October): 46–51, 73. White, William. 2001. “Addiction Disease Concept: Advocates and Critics.” Counselor 2, no. 1 (February): 42–46. White, William. 2001. “A Disease Concept for the 21st Century.” Counselor 2, no. 4 (April). White, William. 1998. Slaying the Dragon: The History of Addiction Treatment. Bloomington, IL: Chestnut Health Systems. Winters, Ken. 2008. Adolescent Brain Development and Drug Abuse. Philadelphia: Treatment Research Institute.

Addiction Medications  7

Addiction Liability Addiction liability describes the likelihood that any given substance has the potential to create chemical dependence: higher addiction liability leads to a greater likelihood of addiction. However, this may vary with each individual since they bring unique variables of genetics, environment, and behavior into the mix. Even though heroin, for example, has on average a higher addiction liability than marijuana, its potential to become addictive may be much higher than average for people with a genetic predisposition and environmental risks, yet be significantly lower than average for a mature person with no genetic predispositions and who comes from a stable socioeconomic background. When combined with individual susceptibility, addiction liability can help to explain why some people, at their first exposure, develop instant onset addiction while others do not become addicted after repeated experimentation. The complex nature of addiction and the presence of many variables that lead to it warn against inflexible assessments of a drug’s inherent addictive potential. Most experts, however, agree that, all things being equal, the most addictive drugs are amphetamines, cocaine, nicotine, and opiates such as heroin; second are alcohol, benzodiazepines, and barbiturates; third are marijuana and hashish; and the least addicting are caffeine and hallucinogens. There are also differences within each of these categories; for example, some tranquilizers are more powerful than others. Kathryn H. Hollen See also: Addiction

Further Reading Carter, Adrian. 2012. Addiction Neuroethics: The Promises and Perils of Neuroscience

Research on Addiction. New York: Cambridge University Press. Carter, Adrian, Wayne Hall, and Judy Illes. 2012. Addiction Neuroethics: The Ethics of Addiction Neuroscience Research and Treatment. London: Academic Press. Edwards, Scott, and George F. Koob. 2013. “Escalation of Drug Self-Administration as a Hallmark of Persistent Addiction Liability.” Behavioral Pharmacology 24 (5–6): 356–62. Hall, W. D., C. E. Gartner, and A. Carter. 2008. “The Genetics of Nicotine Addiction Liability: Ethical and Social Policy Implications.” Addiction 103 (3): 350–59. Nielsen, D. A., and M. J. Kreek. 2012. “Common and Specific Liability to Addiction: Approaches to Association Studies of Opioid Addiction.” Drug and Alcohol Depen­ dence 123: S33–S41. Sutton, Amy L. 2007. Alcoholism Sourcebook: Basic Consumer Health Information About Alcohol Use, Abuse, and Dependence. Detroit: Omnigraphics. Twerski, Abraham, and Craig Nakken. 1999. Addictive Thinking and the Addictive Personality. New York: MJF Books. Vanyukov, Michael, and Ty A. Ridenour. 2012. “Common Liability to Drug Addictions: Theory, Research, Practice.” Drug and Alcohol Dependence 123.

Addiction Medications Despite the unavailability of medications that prevent or cure addiction, many can help in the reduction of the cravings, obsessive thoughts, anxiety, and withdrawal symptoms that further the use of abusive drugs. Researchers are becoming excited about the promise of vaccines and drugs that might help mediate the controlling functions in the prefrontal cortex of the brain that impact

8   Addiction Medications

judgment, behavior, and self-control. A vaccine to prevent cocaine addiction has been in the human clinical trial phase since 2008. Vaccines for other addictive drugs—methamphetamines, nicotine, and heroin—are also in development. These vaccines will stimulate the immune system to identify and cut off the activity of the drugs. Rather than preventing receptors in the brain from reacting to the addictive stimuli like other medications, vaccines operate by blocking the addictive drug’s molecules from reaching the brain. In addition to aiding in the treatment of addiction in new and important ways, vaccines have the potential to prevent addiction in the first place. For behavioral addictions, there is currently no vaccine therapy under consideration. Among other recent developments is Prometa, a medication that when combined with nutritional supplements and therapy has been promoted by the manufacturer as an effective treatment in eliminating the cravings associated with methamphetamine, alcohol, and cocaine addiction. Prometa is not a suitable treatment for addiction to opiates or benzodiazepines, but it has been used to address methamphetamine abuse by some private treatment centers and criminal justice systems. The medication, however, is still under investigation, and some therapists have significant reservations about its safety and effectiveness with some being highly critical of the inadequate number of controlled studies to evaluate Prometa’s benefit. Many of the newer drugs that have been granted approval by the Food and Drug Administration to treat specific conditions are frequently prescribed off-label. This occurs when physicians use their own discretion to prescribe medications to treat disorders for which they were not initially formulated. The medications that are specifically designed or prescribed off-label to treat or

prevent various types and stages of addiction usually fall into one of several categories: Antidepressant/antiobsessional drugs Atypical neuroleptics (antipsychotics) Mood stabilizers (anticonvulsants) Opioid antagonists Opioid partial agonists Vaccines Other medications occasionally prescribed off-label in the treatment of addictions include disulfiram (Antabuse), which interferes with alcohol metabolism but may alleviate cocaine addiction, and methylphenidate (Ritalin), which is an addictive stimulant that can be safely used to treat some impulse control disorders if they accompanied with attention-deficit disorders. Researchers are continually discovering that many new drugs formulated to treat one type of addiction have the capability to treat others. Since all addictions are, to some degree, seated in the same mesolimbic area of the brain, drugs that affect this region of the brain are likely to have a widespread effect. Antidepressants have shown to be effective in the treatment of both behavioral and substance addictions because they modulate serotonin levels and other types of neurotransmitter activity. Antidepressants are typically prescribed to treat depression and other mood disorders as well as obsessive-compulsive disorders by aiding the mediation of impulses, dysfunctional behaviors, and cravings associated with addiction. In instances of impulse control disorders, therapists have found the combination of antidepressants and mood stabilizers (neuroleptics) to be the most effective treatment. Commonly prescribed antidepressants include: Bupropion (Wellbutrin) Citalopram (Celexa)

Addiction Medications  9

Clomipramine (Anafranil) Escitalopram oxalate (Lexapro) Fluoxetine (Prozac) Fluvoxamine (Luvox) Nefazodone (generic versions only available in the United States) Paroxetine (Paxil) Sertraline (Zoloft) Venlafaxine (Effexor)

Medicating Impulse Control Disorders Therapists have also found that other drugs, in addition to antidepressants, can be especially effective in the reduction or elimination of impulsive urges seen with behavioral addictions when used alone or in combination with other medications. Since responses to these medications vary from patient to patient, positive results may not be attained until after several weeks of therapy and many adjustments to the drug formulations or combinations. The results, however, can be dramatic. For the first time in years, numerous patients can gain freedom from their impulsive urges and, with the addition of counseling, can resume a normal life. Medicating Substance Addictions As with symptoms of impulse control disorders, many symptoms of substance addictions respond to antidepressants, but they can also be remedied with uniquely formulated medications. In many instances, these types of drugs have proven to be effective in the treatment of addiction. For example, Topiramate has been efficacious in the treatment of alcoholism as well as addictions to nicotine and other stimulants. In most situations, these medications are used in combination with behavioral therapy, which is considered an essential component. Without behavioral therapy, the factors that set off the addiction remain in place, which increases

the odds of a relapse once the medication is stopped. Otherwise, if the motivating factors that fueled the drug addiction in the first place are not removed, the behavior is likely to re-emerge when the medication is discontinued.

Addiction Vaccines Vaccines are currently being developed for those who are addicted to some drugs, particularly cocaine and tobacco, that will prevent the user from experiencing the effects of these drugs. They work by inserting antibodies into the bloodstream that work to bind to the substance and prevent it from acting as an antagonist for the brain receptor. They may also alter the user’s immune system so it produces these antibodies on its own. The vaccines will prevent the body from experiencing a chemically induced sensation of pleasure that typically occurs after use. Medications That Treat Impulse Control Disorders (drug trade names are shown in parentheses) Opioid Antagonists Nalmefene (Revex) Naltrexone (Depade and ReVia are oral formulations; Vivitrol is injectable) Mood Stabilizers Carbamazepine (Tegretol) Divalproex [Sodium Valproate and Val­ proic Acid] (Depakene, Depakote) Lamotrigine (Lamictal) Lithium (Eskalith, Lithobid) Atypical Neuroleptics Clozapine (Clozaril) Olanzapine (Zyprexa) Quetiapine (Seroquel) Risperidone (Risperdal) Ziprasidone (Geodon)

10   Addiction Medications

Stimulants Methylphenidate (Ritalin) Medications That Treat Substance Addictions (drug trade names are shown in parentheses) Cannabis None Depressants Alcohol Acamprosate (Campral) Anxiolytics Baclofen (Kemstro, Lioresal) Disulfiram (Antabuse) Memantine (Namenda) Nalmefene (Revex) Naltrexone (Depade and ReVia are oral formulations; Vivitrol is injectable) Ondansetron (Zofran) Prometa Rimonabant (Acomplia) Topiramate (Topamax) Varenicline (Chantix) Benzodiazepines None Hallucinogens None (vaccines are in clinical trials) Inhalants None Opiates (Narcotics) Partial Agonists Buprenorphine (Buprenex, Suboxone, Subutex) Methadone (Dolophine) Antagonists Nalmefene (Revex)

Naloxone (Narcan) Naltrexone (Depade and ReVia are oral formulations; Vivitrol is injectable)

Vaccine (in development for heroin addiction) Stimulants Cocaine Baclofen (Kemstro, Lioresal) Diltiazem Disulfiram (Antabuse) Gabapentin (Neurontin) Modafinil (Provigil) Prometa Topiramate (Topamax) Vaccines (in clinical trials) Methamphetamine Prometa Vaccine (in development) Other Stimulants Vaccine (in development) Nicotine Bupropion (Zyban) Nicotine replacements Rimonabant (Acomplia) Topiramate (Topamax) Vaccines (in development) Varenicline (Chantix) Kathryn H. Hollen See also: Addiction; Addiction Liability; Depressants; Hallucinogens; Methamphetamine; Nicotine; Opiates; Stimulants

Further Reading Addiction Recovery Guide, “Your Online Guide to Drug and Alcohol Addiction Recovery” http://www.addictionrecovery guide.org/medication/. Bart, Gavin. 2012. “Maintenance Medication for Opiate Addiction: The Foundation of

Addictive Personality  11 Recovery.” Journal of Addictive Diseases 31 (3): 207–25. Carter, Adrian. 2012. Addiction Neuroethics: The Promises and Perils of Neuroscience Research on Addiction. New York: Cambridge University Press. Carter, Adrian, Wayne Hall, and Judy Illes. 2012. Addiction Neuroethics: The Ethics of Addiction Neuroscience Research and Treatment. London: Academic Press. Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton. Grant, Jon E., and S. W. Kim. 2003. Stop Me Because I Can’t Stop Myself: Taking Control of Impulsive Behavior. New York: McGraw-Hill. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. National Institute on Drug Abuse, 2009. “DrugFacts: Treatment Approaches for Drug Addiction.” http://www.drugabuse .gov/publications/drugfacts/treatment -approaches-drug-addiction. White, W. L. 2012. “Medication-Assisted Recovery from Opioid Addiction: Historical and Contemporary Perspectives” Journal of Addictive Diseases 31 (3): 199–206.

Addictive Personality Experts do not generally use the term “addictive personality”; it is a vague, nonscientific term in popular usage intended to describe someone who overindulges in different substances or has traits that makes him or her more predisposed to becoming addicted to a substance. For example, a person who smokes, drinks, and eats sugary foods to excess, even if he or she does not suffer from a diagnosable alcohol addiction or eating disorder, may be regarded by friends and as-

sociates as having an addictive personality. According to this concept, those who abuse drugs have a particular set of personality traits or characteristics (biological, psychological, or social) that predisposes them to such activities. In other words, drug addicts are people who have a combination of biological, genetic, and environmental factors that are associated with an increased vulnerability to addiction. Not everyone who uses a drug for recreation becomes addicted or abuses that substance. In fact, most people who try cigarettes or some other drug do not continue to use them, or use them to excess. Many people can consume drugs or drink heavily without become addicted. However, others become reliant on drugs relatively quickly. This may mean that drugs are not wholly addictive and that the explanations for drug abuse must be found elsewhere—not with the drug itself. While many may become addicted to drugs or alcohol, they may also become addicted to other risky behaviors such as gambling, pornography, exercise, work, or food. Some believe that those individuals who are in families with parents who abuse drugs or alcohol will be more inclined to develop their own problems with drug abuse. But does this happen because of a genetic quality, or because they were exposed to it while young and therefore find it more acceptable? Are they simply more prone to addiction or addictive behaviors? Some scientists acknowledge that the term can refer to someone with a collection of certain diagnosable mental disorders that predispose him or her to addiction. An example is a person suffering from an anxiety disorder who would be more likely to use alcohol or other drugs to self-medicate in an attempt to alleviate his or her emotional and psychic discomfort. There is also evidence

12   Addictive Personality

that people with antisocial or conduct disorders are more likely to become alcoholics or abuse other drugs to such a degree that addiction could easily develop. Nevertheless, the scientific community prefers to describe them as vulnerable to addiction or at higher risk for addiction than to claim that such people have addictive personalities. If a person has an addiction to one thing, they could be more easily addicted to another behavior. So, for example, if a person is addicted to drugs, they may then be more susceptible to a food addiction or a gambling problem. There are many factors that may help to explain addictive personalities. Biological factors, such as a decreased level of dopamine, may cause a person to use drugs or be involved in other behaviors as a way to get a “dopamine high.” Other studies have indicated that psychological characteristics may also explain addictive personalities. Those who feel a sense of social alienation or lack of coping skills may be more likely to abuse drugs or other substances. Other factors such as childhood sexual or physical abuse may also elevate the risk of addictive behavior. Recent research seems to indicate that those who have addictive personalities share similar traits. For example, they seem to display more impulsive behaviors and have more difficulty in delaying gratification and are not committed to the goals generally supported in society. Many seem to have an antisocial personality and tend toward more nonconforming behaviors. Those addicted to substances also seemed to share a heightened sense of general or overall stress in their daily lives. Researchers say this helps to explain why teenagers, who often feel more stress as they grow into adulthood, tend to have more severe drug and alcohol problems. Those researchers who believe there is a psychological basis for addiction also be-

lieve that addictions could be avoided and more effective treatment methods could be developed for those who are considered to be at risk for abusing illicit substances. In fact, those individuals with addictive personalities could be identified before the behavior becomes a serious threat and break the cycle of addiction. The concept of an addictive personality remains popular among many in the scientific community and the general public. However, there is little research to support the concept. In fact, recent research has proven that many of the early studies were flawed. No research has successfully discovered a single characteristic that can lead to addiction behaviors. Instead, doctors have identified multiple characteristics that can predispose an individual to addiction, but they make it clear that these characteristics do not cause the addictive behaviors. Some of these characteristics include low selfesteem, child abuse, poor grades in school, and a higher need for stimulation. Research is continuing into the possible connection between personality correlates and substance abuse. Kathryn H. Hollen See also: Addiction; Addictive Personality; Alcohol Use; Alcoholism

Further Reading The Addictive Personality. 2009. Information Television Network. New York: Films Media Group. (Electronic Resource) Berglund, K., E. Roman, J. Balldin, U. Berggren, M. Eriksson, P. Gustavsson, and C. Fahlke. 2011. “Do Men with Excessive Alcohol Consumption and Social Stability Have an Addictive Personality?” Scandinavian Journal of Psychology 42 (3): 257–60. Borchard, T. (2012). “The Addictive Personality: Why Recovery Is a Lifetime Thing.”

Adolescent Tobacco Use  Psych Central. http://psychcentral.com/blog/ archives/2012/02/26/the-addictive-personality -why-recovery-is-a-lifetime-thing/. Breen, Gerome. 2007. Cocaine and Amphetamine Addiction Genetics. London: Henry Stewart Talks. (Electronic Resource) Marlatt, G. Alan, Mary E. Larimer, and Katie Witkiewitz. 2012. Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors. New York: Guilford Press. Mason, Stephen, 2009. “TheAddictive Personality.” Psychology Today. http://www.psychol ogytoday.com/blog/look-it-way/200903/ the-addictive-personality. Nelson, Bryce. 1983. “The Addictive Personality: Common Traits are Found.” New York Times. http://www.nytimes .com/1983/01/18/science/the-addictivepersonality-common-traits-are-found.html. Sutton, Amy L. 2007. Alcoholism Sourcebook: Basic Consumer Health Information About Alcohol Use, Abuse, and Dependence. Detroit: Omnigraphics. Twerski, Abraham, and Craig Nakken. 1999. Addictive Thinking and the Addictive Personality. New York: MJF Books. Walker, Ida.2013. Addiction in America: Society, Psychology and Heredity. Broomall, PA: Mason Crest.

Adolescent Tobacco Use According to the U.S. Centers for Disease Control (CDC) more than 3,200 people aged 18 and under try their first cigarette every day in the United States (Centers for Disease Control 2014). In 2012, 6.6 percent of adolescents aged 12 to 17 smoked in the United States, a drop of 6.4 percent since 2002 (Substance Abuse Mental Health Services Administration 2013). Young people grossly underestimate the addictiveness of nicotine. Of daily smokers

who think that they will not smoke in five years, almost 75 percent are still smoking five to six years later. Data show the following: • Approximately 23 percent of high school students are current (used in past 30 days) smokers as are 6.7 percent of middle school students. • Smoking is more prevalent among male high school students (16.3 percent) than among girls (11.7 percent). • The overall use of smokeless tobacco among high school students is 6.4 percent. • Nearly 11 percent of high school males currently use smokeless tobacco. (Cen­ ters for Disease Control 2014) The Centers for Disease Control and Prevention (2014) has stated that among young people, the short-term health consequences of smoking include damage to the respiratory system, addiction to nicotine, and the associated risk of other drug use. According to the 2013 American Legacy Foundation 57.6 percent of teenage tobacco users also used illicit drugs while only 6.1 percent of teenage nonsmokers use illicit drugs (American Legacy Foundation 2013). Long-term health consequences of youth smoking are reinforced by the fact that most young people who smoke regularly continue to smoke throughout adulthood. Among the effects are the following: • Smoking harms the physical fitness of adolescents both in terms of performance and endurance. This occurs even among young people trained in competitive running. • Smoking among adolescents can impede lung growth and lung function. • Young adult smokers have resting heart rates that are between two and three

13

14   Adolescent Tobacco Use

Three young teenage girls smoking cigarettes. While it is illegal for teens to purchase cigarettes, they often steal them from adults, have others purchase them, or purchase them illegally. (Will and Deni McIntyre/Getty Images)

beats faster per minute when compared to nonsmokers. • Aside from being associated with poor overall health and a variety of shortterm adverse health effects in young people, smoking may also be a marker for underlying mental health problems such as depression among adolescents. • People who start smoking cigarettes at a younger age are more likely to become strongly addicted to nicotine. Worldwide, 14 percent of the youths aged 13 to 15 smoke, and one-quarter of all children who do smoke started by age 10. In June 1995, a group of 22 international organizations and individuals met at the Rockefeller Foundation’s Bellagio Study and Conference Center in Italy to examine the implications of the current global trend

in tobacco production and consumption, especially in developing countries, for sustainable development. Regarding children and youth, it was reported that 300 million will eventually be killed by tobacco use based on current smoking patterns. In a report issued by the WHO focused on Europe, Hazardous Harmonization in Smoking by European Youth (2002), it was reported that while there are decreasing rates by adults in some countries, no country has shown a significant decrease in smoking by young people since 1997. Around 30 percent of 15- to 18-yearolds in Europe are smokers. Since the mid1990s, smoking among youths in Eastern Europe has risen only slightly, while rates among Western European teenagers have remained stable over the same period. Furthermore, it was reported that there are no significant differences in tobacco consump-

Adolescent Tobacco Use 

tion among young people between countries and subregions. Smoking by teens is particularly dangerous and can result in long-term health effects which many teens feel are too “far away” to worry about. Many of the youth who begin smoking will die prematurely because of a tobacco-related disease or illness. Most people recognize that smoking increases the risk of respiratory problems (wheezing, coughing), emphysema, lung cancer, oral cancer, asthma, stroke, and cardiac arrest. It can shorten a person’s life by 10 years or more. But many youth do not recognize other dangers of smoking, such as bad skin (and more wrinkles in the skin as smokers age), and yellowish tints to their teeth and nails. Smokers also lose bone density, which can lead to osteoporosis. Other problems include fertility problems, bad breath, bad odors to their clothes and hair, and increased risk of illness. Despite education programs that teach children the dangers of smoking, teens continue to use tobacco products. Some place the blame for this on the tobacco companies who advertise to young people. Advertising campaigns such as Joe Camel portray glamorous images of smoking, sending the message that smoking makes sometimes awkward teens cool and accepted by others. Tobacco use is also portrayed as cool in movies and on television. Teenagers often begin smoking because their parents or other adults in their lives smoke, or because they are trying to emulate celebrities who smoke. Some teens are trying different forms of tobacco and nicotine because they have the impression that these other methods of ingesting the drugs are safer than cigarettes. Some teens use hookahs to experiment with tobacco. Hookahs are water pipes that can be used to smoke tobacco through a hose

with a tapered mouthpiece. Many teens argue that using a hookah to smoke tobacco is safe because the smoke is cooled as it passes through the water before entering the lungs. But this is not true. Most doctors agree that hookahs are no safer than cigarettes. In fact, because hookahs do not have filters, the health risks might be even greater than cigarettes. Moreover, since hookahs are often shared with other users, there is an additional risk of becoming sick from germs on the pipe. Some teens are also using electronic cigarettes (e-cigarettes) instead of traditional cigarettes with the thought that they are safer. However, e-cigarettes use a cartridge filled with nicotine and other chemicals that are mixed with a vapor then inhaled by the user. The vapor contains cancer-causing chemicals and other toxins. The safety of e-cigarettes has not yet been determined by the Food and Drug Administration (FDA), so they do not have the same health warnings on the labels as do cigarette packaging. But this does not mean they do not pose a health risk to teenagers who are using them. Richard E. Isralowitz See also: Nicotine; Tobacco

Further Reading American Legacy Foundation. 2013. “Tobacco Fact Sheet.” http://www.legacyfor health.org/content/download/568/6824/file/ LEG-FactSheet-Youth_and_Tobacco-AU GUST2013.pdf. American Legacy Foundation and the National Center on Addiction and Substance Abuse. 2003. “Reducing Teen Smoking Can Cut Marijuana Use Significantly.” http://www .teensarenotadisease.com/CASA_smoking_ pot_link.htm. Campaign for Tobacco-Free Kids. 2003. “Health Groups Say Tobacco Prevention

15

16   Advisory Commission on Narcotic and Drug Abuse Programs Can Save States Money And Cuts Are ‘Penny-Wise, Pound-Foolish.’” January 22. http://tobaccofreekids.org/Script/ DisplayPressRelease.php3?Display=591. Centers for Disease Control and Prevention. 2014. “Smoking & Tobacco Use.” http:// www.cdc. gov/tobacco/data_statistics/fact _sheets/youth_data/tobacco_use/. Centers for Disease Control and Prevention. 2013. “Tobacco Use Prevention Through Schools.” http://www.cdc.gov/Healthy Youth/tobacco/index.htm. Lapointe, Martin M. 2008. Adolescent Smoking and Health Research. New York: Nova Biomedical Books. Lazarus, David. 2002. “U.S. Pushed by Philip Morris, Stalling Global Ban on Tobacco Ads.” Join Together On Line. http:// www.jointogether.org/sa/news/features/ reader/0,1854,555463,00.html. Marlatt, G. Alan, Mary E. Larimer, and Katie Witkiewitz. 2012. Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors. New York: Guilford Press. Perry, Cheryl L., and Michael J. Staufacker. 1996. “Tobacco Use.” In Ralph J. DiClemente, William B. Hansen and Lynn E. Ponton, eds. Handbook of Adolescent Health Risk Behavior. New York: Plenum Press, pp. 115–60. Schapiro, M. 2002. “Big Tobacco.” Nation (May 6). http://www.thenation.com/doc.mh tml?i=20020506&s=schapiro. Strasburger, Victor C., Robert T. Brown, Paula K. Braverman, Peter D. Rogers, Cynthia Holland-Hall, and Susan M. Coupey. 2006. Adolescent Medicine: A Handbook for Primary Care. Philadelphia: Lippincott Williams and Wilkins. Substance Abuse and Mental Health Services Administration. 2013. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” http://www.samhsa.gov/data/NSDUH

/2012SummNatFindDetTables/National Findings/NSDUHresults2012.htm#ch4. Switzerland Addiction Research Institute. 2003. “Tobacco, Alcohol, Drugs Killing 7 Million a Year.” http://www.abc .net.au/science/news/health/HealthRepub lish_792982.htm. University of Michigan News and Information Services. 2002. “Teen Smoking Declines Sharply in 2002, More than Offsetting Large Increases in the Early 1990s.” Ann Arbor: University of Michigan News and Information Services. http://www.monitor ingthefuture.org. U.S. Department of Health and Human Services and SAMHSA’s National Clearinghouse for Alcohol and Drug Information. “Prevention Primer.” http://store.health.org. Watkins, Tom. 2013. “Emerging Tobacco Products Gaining Traction among Young, CDC Survey Finds.” CNN. http://www.cnn .com/2013/11/14/health/tobacco-emerging -products/index.html. World Health Organization. 2001. Women and the Tobacco Epidemic—Challenges for the 21st Century. Geneva: WHO. World Health Organization. 2002. Hazardous Harmonization in Smoking by European Youth. http://www.who.dk/document/cma/ PB032002e.pdf.

Advisory Commission on Narcotic and Drug Abuse Established by President John F. Kennedy’s Executive Order 11076, on January 15, 1963, the President’s Advisory Commission on Narcotic and Drug Abuse was given the task of recommending “new legislation to prevent misuse of both narcotics and non-narcotics (chiefly barbiturates and amphetamines) and to provide improved rehabilitation for habitual misusers” (Fed-

African Americans and Drug Use  17

eral Register 1963; Congress and the Nation, 1965, 1194; President’s Drug Advisory Council, Executive Office of the President of the United States, 1963). The commission, which featured Federal Circuit Court Judge E. Barrett Prettyman as chair and Dean Markham as executive secretary, was established with an organizational philosophy of three principles: that “the illegal traffic in drugs should be attacked with the full power of the Federal Government; the individual drug abuser should be rehabilitated; and drug users who violate the law by small purchases or sales should be made to recognize what society demands of them” (Congress and the Nation, 1965, 1194; President’s Drug Advisory Council, Executive Office of the President of the United States, 1963). The Advisory Commission on Narcotic and Drug Abuse submitted its last report on November 1, 1963; President Lyndon B. Johnson released the final report to the public on January 25, 1964. Among its various findings, the commission called for “major revisions in the enforcement of narcotics laws, including dismantling of the Treasury Department’s Federal Bureau of Narcotics. It said the Bureau’s responsibilities over illicit and legitimate uses of narcotics should be divided, respectively, between the Departments of Justice and Health, Education and Welfare” (Congress and the Nation, 1965). The final report also proposed new federal legislation over drugs with “habitforming potential,” new controls to limit black-market drug sales by pharmacists and retail pharmacies, and the granting of discretion to federal courts in the sentencing of narcotics offenders (Congress and the Nation, 1965). On July 15, 1964, President Johnson designated Lee White of the White House Staff to act as a liaison between the many federal agencies charged with implementation of the many recommendations

made by the Advisory Commission (Johnson 1964). Nancy E. Marion See also: Drug Abuse; Johnson, Lyndon B.; Kennedy, John F.; Narcotics

Further Reading “Executive Orders Disposition Tables John. F. Kennedy—1963.” National Archives. Federal Register. 28 FR 477. http://www .archives.gov/federal-register/executive -orders/1963-kennedy.html. “President’s Advisory Commission on Narcotic and Drug Abuse: Final Report.” 1963. President’s Drug Advisory Council, Executive Office of the President of the United States of America. National Criminal Justice Reference Service. https://www.ncjrs.gov/App/ Publications/abstract.aspx?ID=164685. “Narcotics, 1945–1964 Legislative Overview.” 1965. Congress and the Nation, 1945–1964, vol. 1, 1193–94. Washington, DC: CQ Press, 1965. http://library.cqpress.com/catn/catn 45–4-18126–975530. Johnson, Lyndon B. 1964. “Statement by the President on Narcotic and Drug Abuse.” Online by Gerhard T. Peters and John T. Wooley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=26374.

African Americans and Drug Use The 2012 National Survey on Drug Use and Health indicates that the rate of African Americans using illicit drugs within the past month was higher among blacks aged 12 and over (11.3 percent) than for whites (9.2 percent). Research also shows that African Americans tend to have longer drinking “careers” and higher rates of alcohol-related problems than whites. Moreover, it appears that co-occurring alcohol disorders and drug

18   African Americans and Drug Use

dependence (especially cocaine) is more common in African Americans than Caucasians. Blacks are also more likely to use crack cocaine than whites. Although the exact patterns of drug use among ethnic groups remains unclear, it is evident that African Americans are disproportionately represented in drug arrests and prison sentences across the nation. African Americans are more likely to be stopped by police, arrested, prosecuted, convicted, and sentenced for drug offenses than are white Americans. The advocacy group Human Rights Watch reported that blacks are arrested for possession of drugs more than three times as often as white Americans. Moreover, blacks compose 45 percent of the people serving time in state facilities for drug offenses, whereas whites compose 30 percent of that population. However, this trend could be changing. In 2000, statistics indicated that black Americans were eight times as likely as whites to be arrested on marijuana possession charges. Recent studies show that the rate has dropped to four times as likely. These high imprisonment rates are considered to be an unintended consequence of the U.S. War on Drugs that began in the 1970s. At this time, many American leaders, including African American leaders, supported tough drug laws that would put drug dealers in prison for lengthy terms, if not for life. In fact, members of the Congressional Black Caucus met with President Richard Nixon during the 1970s and urged him to support tougher drug laws. Over the years, however, the tough sentencing structures imposed by the nation’s war on crime resulted in unfair treatment of minorities. The disparity in arrest rates may also be caused by police departments that are under pressure to increase their drug arrest statistics. These departments may choose to con-

centrate their attention on minority or poor neighborhoods and low-level offenses that are easier, quicker, and cheaper to investigate and solve than are more complicated and detailed felony offenses. It is thought that socioeconomic factors influence or determine the prevalence of drug use by African Americans. Specifically, circumstances such as poverty, employment, and education impact the likelihood of drug use. Other factors that may lead to drug use include easy availability of drugs and stresses resulting from an urban lifestyle. Other research shows that blacks are more likely to abuse alcohol and illegal drugs if they feel they have been treated unfairly, discriminated against, or both (i.e., they have been treated with less courtesy than others, have been turned down for a job). Those individuals perceive that they are treated unfairly by strangers so they use alcohol and drugs to cope with emotional pain. In short, discrimination can play a role in the health of these individuals. Treatment options for black Americans who abuse illicit drugs are not as readily available as they are for whites. The discrepancy between the number of individuals who are in need of treatment and those receiving it is called a “treatment gap.” There is a larger treatment gap in the African American community than among Caucasian. Thus, fewer African Americans are receiving the treatment they need to overcome their drug addictions. Effective treatment for drug abuse is critical for African Americans because they experience a greater risk of related health problems such as cirrhosis. Moreover, they are more likely to have higher rates of fatal drug overdoses. There is some evidence to show that the treatment programs currently available to minority groups may not be appropriate, and

African Americans and Drug Use  19

are therefore not effective. Many agree that African Americans are more successful in treatment if the program includes more culturally sensitive treatment that is targeted for this population. Some say that more emphasis must be placed on sociocultural factors including spirituality. It is also crucial that primary prevention programs that describe the harmful effects of drugs be established to change perceptions and attitudes of African Americans about drugs. A new treatment program that has been effective, particularly for women, includes motivational counseling. The program, called Motivational Enhancement Therapy, seeks to determine an individual’s readiness to live a substance-free life. When the effectiveness of this type of therapy was tested against traditional counseling, it was determined that participants had higher retention rates among women but not males. Because of the disparity between use and arrest between blacks and whites, there has been a push to make policy changes geared toward reducing these differences. New York governor David Paterson, the state’s first black governor, signed legislation that would modify strict mandatory minimum sentences for drug offenders, called the Rockefeller laws, that result in high imprisonment of black males. Not long after, U.S. attorney general Eric Holder also argued that similar laws that exist on the federal level should also be repealed. Many states have decriminalized drug use, even legalizing marijuana, which results in fewer arrests. One organization working for more effective and fair drug laws is the National African American Drug Policy Coalition (NAADPC). Composed of leaders from nine major African American professional organizations, the NAADPC first met in Washington, DC, and since then has established

affiliate chapters in major cities across the country. The members of this organization seek to address the phenomenon of drug abuse in the African American community in order to eradicate the negative effects of drug abuse. They support laws that reduce crime while enhancing public health and protecting children. Among other things, the group has as an objective to monitor federal and state drug laws and to make recommendations for more effective laws that focus on education, prevention, treatment, and research. They also seek to train and educate policymakers, judges and community members of more effective programs such as diversion and therapy. Nancy E. Marion See also: Rockefeller Drug Laws

Further Reading Britt, Alice B. 2004. “African Americans, Substance Abuse and Spirituality.” Minority Nurse.com. http://www.minoritynurse .com/article/african-americans-substance -abuse-and-spirituality. Hunt, Haslyn E. R. 2012. “Study: Unkindness Linked to Alcohol, Drug Abuse in Black Populations.” Purdue University News, November 14. http://www.purdue .edu/newsroom/releases/2012/Q4/study -unkindness-linked-to-alcohol,-drug-abuse -in-black-populations.html. Knafosaki, Saki. 2013. “When It Comes to Illegal Drug Use, White America Does the Crime, Black America Gets the Time.” Huffington Post. September 17. http://www .huffingtonpost.com/2013/09/17/racial disparity-drug-use_n_3941346.html. Levinthal, Charles F. 2012. Drugs, Behavior and Modern Society. Boston: Allyn and Bacon. Marlatt, G. Alan, Mary E. Larimer, and Katie Witkiewitz. 2012. Harm Reduction: Prag-

20  Al-Anon matic Strategies for Managing High-Risk Behaviors. New York: Guilford Press. McWhorter, John. 2011. “How the War on Drugs Is Destroying Black America.” Cato’s Letter 9, no. 1, pp. 2–6. National Institutes of Health, National Institute on Drug Abuse. 2003. Drug Abuse Among Racial/Ethnic Minorities (Maryland). http:// archives.drugabuse.gov/pdf/minorities03 .pdf. National Survey on Drug Use and Health. 2010. SAMHSA.gov, Office of Behavioral Health Equity. http://www.samhsa.gov/ obhe/african-american.aspx. Nauert, R. 2011. “New Approach for Substance Abuse among African-Americans.” PsychCentral. http://psychcentral.com/news/ 2011/10/18/new-approach-for-substance -abuse-among-african-americans/30441 .html. Substance Abuse and Mental Health Services Administration. 2013. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” http://www.samhsa.gov/data/NSDUH/2012 SummNatFindDetTables/NationalFindings/ NSDUHresults2012.htm#ch4. Urbina, Ian. 2013. “Blacks Are Singled Out for Marijuana Arrests, Federal Data Suggests.” New York Times, June 3. http:// nytimes.com/2013/06/04/us/marijuana -arrests-four-times-as-likely. Venugopal, Arun, 2013. “The Shift in Black Views of the War on Drugs.” National Public Radio, August 16. http://www.npr.org/ blogs/codeswitch/2013/08/16/212620886/ the-shift-in-black-views.

Al-Anon Al-Anon is a mutual aid group for relatives and friends of alcoholics. Formally separate from, but born out of, Alcoholics

Anonymous (AA) in the 1940s, Al-Anon similarly follows AA’s famous Twelve Steps and Twelve Traditions in an attempt to help relatives deal with alcoholism, which it considers a family disease. Apolitical, nondenominational, and volunteer based, Al-Anon grew out of the informal gathering of family members with alcoholic loved ones into an international organization with tens of thousands of local chapters. The creation of Al-Anon is inextricably intertwined with the history of AA, which began in 1935 with the encounter of two alcoholics who formed a mutual aid society based upon members standing in front of the group to make personal declarations or tell their stories. Over time, AA developed a 12-step program and 12 traditions as guiding components, but in general it has remained an open organization predicated on abstinence, avoiding advancing hard and fast answers to alcoholism and recovery, and organizing into local mutual-support groups. While helpful for many alcoholics, AA did not, at least at first, offer much for their families and loved ones. In AA’s first years, spouses and relatives of AA members often waited together for their alcoholic loved ones to finish their mutual aid meetings. These moments together led to the realization that alcohol had a profound impact not just upon the alcoholics in their families, but upon their own lives as well. Discussions about their experiences with alcohol and alcoholics, which often took place in ad hoc locations such as church kitchens, led to the creation of informal family groups that gathered to share their members’ experiences and provide mutual support and encouragement. Some of the earliest of these group meetings took place in Long Beach, California; Chicago; Richmond; Austin; and Toronto in the mid-1940s. A group in Rochester, New York, was among the first to

Al-Anon  21

adapt the Twelve Steps for use by the husbands and wives of alcoholics, and formal groups for family members of alcoholics began to spread across the country by the end of the decade. The growth of group meetings for relatives of AA members represented a bit of a problem for AA itself. While AA was not unsupportive of this development, it was not eager to admit family members of alcoholics into AA proper, and it continued to define itself as an organization strictly dedicated to, and composed of, alcoholics. To provide family members and friends of alcoholics a place to share their experiences, the AA Board of Trustees took the names of interested family members and listed them at General Ser­vices so that they might meet on their own, independently of AA. By 1948, approximately 90 unofficial groups had applied for listing within AA’s official directory, signaling the demand for either an institutional change to allow for family members to attend AA meetings, or for the creation of an AA-like group for family members of alcoholics. Soon thereafter, a Clearing House Committee of relatives of AA members in the New York City area was formed. It initially met in a member’s home before moving into what was known as the Old 24th Street AA Club House. From that location, and with the help of Lois, the wife of AA cofounder Bill W., the Clearing House Committee recruited volunteers, answered the questions of interested individuals, created a Family Group leaflet, and undertook a survey of all known groups that met to provide support for relatives of AA members. As a result of this poll, in 1951 they adopted the name of Al-Anon Family Groups. The use of “Al-Anon,” rather than “AA,” in their official name signaled their organizational independence from AA. Yet the mission of the new group was intimately tied to that of

AA. When Al-Anon began, the group’s publicly stated goals were to foster cooperation and understanding of the AA program in the home, to help members live by the Twelve Steps and grow spiritually along with their alcoholic loved ones, and to welcome and give comfort to families of new AA members. In 1951, Al-Anon adopted, with only minor alterations, AA’s Twelve Steps, and the Al-Anon Family Group Headquarters, Inc. (as it was incorporated in 1954) similarly approved the Twelve Concepts in 1970. Much like AA, Al-Anon grew in large part thanks to articles about it in major publications such as Time and Life, and being featured on television programs during the 1950s. This exposure, together with the growth of AA itself, helped Al-Anon grow exponentially in the mid-twentieth century, as the group exploded from a small organization of just 145 registered groups in 1951 to 500 in 1954 and 1,500 in 1963. Officially, Al-Anon is autonomous from AA, but the Sixth Tradition of Al-Anon states that there should always be cooperation between the two organizations. In this regard, the relationship between AA and AlAnon is akin to that between AA and Narcotics Anonymous. Weekly Al-Anon meetings resemble those that take place among AA members, with Al-Anon members gathering in support of one another’s difficulties in dealing with alcoholic relatives. The Twelve Steps and Twelve Traditions of AA guide the meetings, with Al-Anon members importantly abiding by the First Step, which involves relatives of alcoholics admitting that they, too, are powerless over alcohol. This is not a profession of Al-Anon members’ own alcoholism, but rather a recognition that alcohol can have a powerful impact on the whole family, with its effects not limited to the alcoholic alone. Thus believing alcoholism to be a kind of family disease, the group

22  Alateen

considers the Twelve Steps an important recovery tool that should not be limited to those with drinking problems. With the conception that an individual’s alcoholism is a family disease that can make relatives sick, Al-Anon tries to get its members to focus on their own issues rather than those of their alcoholic relatives. Particular attention is paid to the emotional complications that result from being unable to bring about their loved ones’ sobriety, and another common issue worked on in Al-Anon meetings is the sense of shame, inadequacy, or personal failure that can emerge when AA meetings help the relative achieve an abstinence from alcohol that family members were unable to bring about in spite of their best efforts. In keeping with its emphasis that alcoholism is a family disease, Al-Anon has formed an alliance with Alateen, a similar mutual aid group for children and teens with alcoholic relatives or friends. Alateen began in 1957 when a teenager, whose father was in AA and whose mother was in Al-Anon, founded a kind of teen version of Al-Anon that has grown to around 3,500 worldwide groups today. Al-Anon Family Group Headquarters officially coordinates Alateen, and a local Al-Anon member sponsors most local Alateen groups. Including Alateen gatherings, Al-Anon claims to currently hold 24,000 meetings spread across 115 countries. Al-Anon also maintains a Web site, http://www.al-anon .alateen.org, which connects members and provides information to prospective members. Al-Anon’s monthly magazine, The Forum, is available from the Web site, as are additional Al-Anon publications. Howard Padwa and Jacob A. Cunningham See also: Alateen; Alcohol Mutual Aid Societies; Alcoholics Anonymous; Narcotics Anonymous

Further Reading Al-Anon. “Al-Anon’s Twelve Suggested Steps.” http://www.al-anon-alateen-msp.org/ pages/12steps.html. Al-Anon. “Sixty Years of Hope.” http://www .alanon.org.za/. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior, 2nd ed. New York: Macmillan Reference USA. How Al-Anon Works for Families and Friends of Alcoholics. 1995. New York: Al-Anon Family Groups. One Day at a Time in Al-Anon. 2000. Virginia Beach, VA: Al-Anon Family Group Headquarters. Roth, Jeffrey D., and Emjay M. Tan. 2007. “Analysis of an Online Al-anon Meeting.” Journal of Groups in Addiction and Recovery 2 (1): 5–39. Timco, C., R. Cronkite, L. A. Kaskutas, A. Laudet, J. Roth, and R. H. Moos. 2013. “Al-Anon Family Groups: Newcomers and Members.” Journal of Studies on Alcohol and Drugs 74 (6): 965–76. Zajdow, Grazyna. 2002. Al-Anon Narratives: Women, Self-Stories, and Mutual Aid. Westport, CT: Greenwood Press.

Alateen Alateen is a mutual aid group for children and teenagers with alcoholic relatives or friends. Created in 1957 in California by a teenager whose father was in Alcoholics Anonymous (AA) and whose mother was in Al-Anon, Alateen is a version of Al-Anon designed for the children of families with an alcoholic member. It is coordinated by Al-Anon Family Group Headquarters, Inc., and it currently claims to have around 3,500 groups worldwide.

Alateen  23

The origins of Alateen are to be found in Al-Anon, which itself emerged out of Alcoholics Anonymous (AA). AA began with the encounter of two alcoholics in 1935 who formed a mutual aid society based upon members standing in front of the group to make personal declarations or tell their life stories. Over time, AA developed its TwelveStep Program and Twelve Traditions as guiding components, and became composed of local mutual support groups instead of a top-heavy, national bureaucracy. Alateen’s immediate forbearer, Al-Anon, grew out of the shared plight of spouses and relatives of AA members who, in the early years of AA’s development, often waited together for their alcoholic loved ones to finish their mutual aid meetings. These moments together led to the realization that alcohol had a profound impact not just upon the alcoholics in their families, but upon their own lives as well. Discussions about their experiences with alcohol and alcoholics led to the creation of informal family groups that gathered to share their members’ experiences and provide mutual support and encouragement. This eventually led to the official founding of Al-Anon Family Groups in 1951. In what would become the basis for Alateen meetings, weekly Al-Anon meetings used the Twelve Steps and Twelve Traditions to help relatives of AA members cope with the broader impact of their loved ones’ alcoholism. Al-Anon members worked at focusing on their own issues rather than those of their alcoholic relatives, and particular attention was paid to the emotional complications that resulted from being unable to bring about their loved ones’ sobriety. Another issue commonly worked on in Al-Anon meetings (as well as in later Alateen gatherings) was the sense of shame, inadequacy, or personal failure that could emerge when AA meetings helped relatives achieve an abstinence from alcohol

that alcoholics’ family members themselves were unable to bring about. While Al-Anon was helpful for many family members of alcoholics, some children of AA members felt that the group did not meet their needs. To address these shortcomings, a 17-year-old son of an AA member in California founded a new organization—Alateen—in 1957. In order to bring together other teens with relatives attending AA or Al-Anon meetings, the anonymous teenager, with his mother’s support, envisioned Alateen as a group that could serve as a teen version of Al-Anon, focusing on the needs of family members of alcoholics who were between 12 and 20 years old. The initial group was composed of the founding young man and five other teens, and it met in a room downstairs from the room in which their parents met. The idea of a group for young adults caught on quickly, as by 1963, there were over 200 Alateen groups, and the group continued to grow as it was featured in national publications such as Time and Seventeen. Today, Alateen has developed into an organization with thousands of groups meeting worldwide. Many Alateen meetings are held at community centers, churches, and schools, which are all convenient and nonthreatening places for young people to meet. There they often find support from others who may be in similar situations or experiencing similar problems. During the meetings, friends and others can provide support and tips to teens who are recovering from alcohol problems, or whose family members are recovering from abuse issues. It is a place where teens can share experiences and learn how to cope with some of the problems they may be experiencing. In the meetings, professionals help children and teens understand that they are not the cause of anyone else’s behavior, and they

24   Alcohol Bootlegging and Smuggling

should not feel responsible for anyone else’s choices regarding alcohol use or the behaviors that result from the alcohol abuse. They also help children and teens understand that they cannot make choices for their family members nor can they control the behavior of those family members. Instead, they learn to separate their feelings of anger toward the family members who are drinking but at the same time continue to express love for those people. In the end, the children and teens need to know that they can continue to have successful lives and positive experiences despite the alcohol abuse by others in their families, and not feel guilty about it. Despite this impressive growth, Alateen is not an independent organization, and it is officially coordinated by Al-Anon Family Group Headquarters. Al-Anon’s influence extends to the local level as well, with an active, adult member of Al-Anon required to serve as the sponsor of Alateen weekly meetings. Similarly, Alateen members’ personal sponsors can come from the ranks of Al-Anon, though they are also free to have a sponsor who comes from within Alateen. Weekly Alateen meetings operate very much like Al-Anon meetings. Importantly, Alateen meetings feature members abiding by Al-Anon’s First Step, which involves admitting powerlessness over alcoholism. By declaring an inability to control or cure a relative’s alcoholism, Alateen members are encouraged to focus on their own wellbeing regardless of whether the loved one’s drinking stops or not. They are likewise taught to emotionally detach themselves from the drinker’s problems while continuing to love the person. Alateen does slightly alter AA’s and Al-Anon’s Twelfth Step, which is modified to state the organization’s goal of carrying their message to other youths with alcoholic relatives or friends. Alateen maintains a Web site, http://www

.al-anon.alateen.org/alateen.html, containing information about Alateen meetings and published Alateen material. Alateen’s newsletter, Alateen Talk, is also available from the Web site. Howard Padwa and Jacob A. Cunningham See also: Al-Anon; Alateen; Alcohol Mutual Aid Societies; Alcoholics Anonymous; Narcotics Anonymous

Further Reading “About Alateen.” http://www.al-anon.alateen .org/alaabout.html. Alanon/Alateen. “The 12 Steps of Alateen” http://www.al-anon.ab.ca/alateen/asteps .html. Al-Anon Family Groups. 2007. “Member Survey Results, Al-Anon Family Groups, Fall 2006.” http://www.al-anon.alateen.org. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. “Twelve Traditions of Alateen.” http://www .al-anon.alateen.org/alatraditions.html.

Alcohol Bootlegging and Smuggling Bootlegging and smuggling, the acts of illegally producing and transporting alcohol, became nationwide phenomena after the implementation of national prohibition as federal law in 1920. Despite the efforts of the Prohibition Unit, which was created to enforce the Volstead Act, bootleggers and smugglers found means of providing Americans with the alcoholic beverages they still craved. In some cases, bootleggers and smugglers became popular figures as a result of crimes that fascinated those members of the public who were opposed to the Eigh­

Alcohol Bootlegging and Smuggling  25

During Prohibition, thousands of barrels of alcohol were destroyed at the hands of law enforcement officials. It was often done publicly to impress upon the citizens the dangers of alcohol and to display the efficiency of law enforcement in carrying out the law. (General Photographic Agency/ Getty Images)

teenth Amendment, which was repealed in 1933. When the Volstead Act, and thereby national prohibition, became federal law on January 20, 1920, alcohol did not disappear from American life. Despite a ban on most alcoholic beverages, there was still a considerable demand for drink that was catered to by bootleggers and smugglers. The illegal beverages they provided could be clandestinely bought in places like drugstores, barbershops, and hotels, but the most popular place to purchase and consume this alcohol was the speakeasy—a kind of underground bar that emerged during national prohibition. The most successful and famous speakeasies served those affluent members of

society who longed for a drink despite the illegality and high price of alcohol. Cocktails, in particular, became features of the speakeasy experience, as prohibition generally had the unintended consequence of elevating consumption rates for hard alcohol. Speakeasies themselves flourished, especially in places like New York City, which effectively abandoned its enforcement of prohibition after 1924. Evidencing the great thirst that existed for illegal liquor, New York’s police commissioner estimated that there were 32,000 speakeasies operating within the city in 1929. Such a figure was over twice as great as the number of legal drinking establishments that existed in the city before prohibition.

26   Alcohol Bootlegging and Smuggling

The Prohibition Unit—the federal agency created in 1920 in order to enforce national prohibition and the Volstead Act—was largely unsuccessful in policing speakeasies and stopping the bootlegging and smuggling of alcohol. This result was surprising to those in power who reasoned that enforcement would not be an enormous task because, after all, enough Americans supported national prohibition to pass a constitutional amendment. The mistaken belief that a modestly endowed Prohibition Unit would be sufficient to police the liquor ban thus gave enterprising bootleggers and smugglers, who risked a first-offense fine of $1,000 and six months in jail, ample opportunity to devise means of providing Americans with illicit alcohol. One particularly effective method of smuggling alcohol was to bribe agents within the Prohibition Unit. This practice was so popular that one out of every 12 agents of the Prohibition Unit was fired for acts of corruption (e.g., accepting bribes or conspiring to sell illegal liquor) within the first six years of prohibition. The underfunding of the Prohibition Unit, which in part led to so much corruption within its ranks, also meant that the agency as a whole could not afford to protect the nation’s lengthy borders from extensive and sophisticated smuggling efforts like the one devised by the infamous Bill McCoy. His first smuggling ventures involved loading his ship in the Caribbean with cases of liquor and simply sneaking his cargo back to U.S. docks. What distinguished McCoy from other smugglers engaging in similar activities, however, was his origination of “Rum Row,” which referred to the lining up of alcohol-carrying ships just beyond U.S. waters. These boats were within the safety of international waters, but close enough to the shore that other boats could sail out to meet them and purchase high-quality liquor.

This novel setup was so successful that, after upgrading ships, McCoy’s boat was described as a high-end “floating liquor store.” And consumer demand was particularly strong because McCoy’s goods were noted for being undiluted and unadulterated, unlike much bootleg liquor in America, which could be downright dangerous to consume. As a result, the term “the real McCoy” was born to describe the quality of McCoy’s smuggled liquor, which was brought to shore in the boats of customers who were generally successful in outracing and evading the thinly stretched Coast Guard patrols. In fact, the setup was so difficult for the Coast Guard to combat that Rum Rows sprang up across the Atlantic seaboard, with outposts along every state and nearly every city from Maine to Florida. Similar Rum Rows existed in the Gulf of Mexico and along the Pacific. McCoy’s signature business model, which quickly brought him a great deal of wealth and fame before his arrest in 1923, helps explain why the Prohibition Unit admitted that in 1925 it had stopped just 5 percent of the liquor being smuggled into the United States. The bootlegging of alcohol inside of the country was tough to halt as well. Beyond the challenges involved in finding illegal stills and permanently shutting down bootlegging operations, the Prohibition Unit had difficulties prosecuting violators of the Volstead Act. With national prohibition growing increasingly unpopular, the court system often became jammed with alcohol-related cases. For example, in southern Alabama, the center of moonshine production, as high as 90 percent of all cases in the system resulted from alleged violations of the Volstead Act. And with the general public becoming increasingly resentful of national prohibition, some prosecutors found juries to be quite sympathetic to bootleggers and smug-

Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (1992)  27

glers and consequently reluctant to convict. Heightened penalties for violations of the Volstead Act were introduced in 1929 in an attempt to curb bootlegging and smuggling, but these modifications were ineffective in creating greater compliance with the law. Ultimately, the pervasive bootlegging and smuggling efforts that persisted throughout national prohibition spoke to the public’s dissatisfaction with the Volstead Act. The occasional championing of notorious smugglers also reflected a substantial opposition to the government’s ban on the commercial manufacture and sale of liquor. With the passage of the Twenty-First Amendment in 1933, alcohol became legal and effectively ended drinking Americans’ reliance upon, and fascination with, alcohol bootleggers and smugglers. Howard Padwa and Jacob A. Cunningham See also: McCoy, Bill; Prohibition Unit; Volstead Act

Further Reading Blumenthal, Karen, 2011. Bootleg: Murder, Moonshine, and the Lawless Years of Prohibition. Chicago: Flashpoint. Burns, Eric. 2004. The Spirits of America: A Social History of America. Philadelphia: Temple University Press. Clark, Norman H. 1976. Deliver Us from Evil: An Interpretation of American Prohibition. New York: W. W. Norton. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee. Wood, Steve. 2013. “Prohibition-Era Moon­ shine Is on the Rise” USA Today. http:// w w w. u s a t o d a y. c o m / s t o r y / m o n e y / business/2013/10/14/moonshine-bar -menus/2983957/.

Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (1992) President George H. W. Bush signed the Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (PL 102-321) on July 10, 1992. By signing the new act, Bush restructured the existing federal alcohol, drug abuse, and mental health research and services programs as a way to both increase research about substance abuse and mental health and to provide more services to those directly affected by these diseases. Specifically, the 1992 law rearranged the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) that was originally established by President Nixon in 1974 and housed with the Department of Health and Human Services. The ADAMHA Act integrated three research institutes into the National Institutes of Health: the National Institute on Alcohol Abuse and Alcoholism; the National Institute on Drug Abuse; and the National Institute of Mental Health. The bill reorganized the way the federal government underwrote mental health and substance abuse research and services. Bush announced that by bringing these research agencies into the NIH, there would be a greater exchange of information and sharing of expertise within the research community, which would, in turn, increase the quality of research designed to address the needs of these populations. Bush sought to bring research on mental illness and addictive disorders into the mainstream of biomedical and behavioral research. The second goal of the reorganization was to provide more effective services to those who suffer from mental illness and addictive disorders. Bush strove to target treatment programs to those people who were in need of help. He believed the reorganization would

28   Alcohol Mutual Aid Societies

enhance federal leadership that would, in turn, help state and local organizations provide improved services to address these important public health problems. By reorganizing these agencies, Bush sought to enhance the quality of mental health and substance abuse services to those who suffer from, or are vulnerable to, mental illness and addictive disorders. Under the reorganization, the service components became part of a new agency, the Substance Abuse and Mental Health Services Administration (SAMHSA). Congress directed SAMHSA to provide substance abuse and mental health services to the people most in need and to translate research findings in these areas into the general health care system. The general mission of SAMHSA was to reduce the impact of substance abuse and mental illness on U.S. communities. The act, as signed by Bush, included other provisions that would address other goals that the Bush administration supported. One of those was to reduce the number of newborn children exposed to drugs and alcohol. He also sought to establish a federal grant program that was intended to increase the number of people who could receive substance abuse treatment. Under this grant program, states would be asked to assess their existing programs to reduce drug and alcohol abuse and to create new statewide treatment and prevention strategies. The grant program was necessary because Bush had concerns about the costs of certain mandates in the bill and the effect they would have on the ability of the states to provide substance abuse treatment services to those in need. Additionally, the bill continued the prohibition on using federal funds for needle exchange programs. Bush argued that there was no evidence that needle exchange programs reduced the prevalence of HIV infection. Instead, according Bush administration

officials, distributing free needles to drug users only encouraged more drug use. The new law passed by Congress required states to enforce laws that would bar the sale of tobacco products to minors. Although most states had laws to prohibit such sales, many were not enforcing them. Nancy E. Marion See also: Bush, George Herbert Walker; National Drug Control Strategy; Needle Exchange Programs

Further Reading Bush, George. 1992a. “Statement on Signing the ADAMHA Reorganization Act.” July 10. Gerhard Peters and John T. Woolley, The American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=21218. Bush, George. 1992b. “Proclamation 6482— Mental Illness Awareness Week, 1992,” October 1. Gerhard Peters and John T. Woolley, The American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=47409. National Institute of Mental Health. “Important Events in NIMH History.” http:// www.nih.gov/about/almanac/organization/ NIMH.htm.

Alcohol Mutual Aid Societies Abstinence-based mutual aid societies are composed of individuals with drinking problems who seek to curb alcohol use and abuse. These initially emerged among Native American tribes in the 18th century with non–Native Americans developing their own mutual aid societies later in the century. By the 19th century, alcohol mutual aid societies had multiplied in number and orientation, but faded away in the early 20th century. Today, groups like Alcoholics Anonymous (AA) have taken up the mantle of alcohol mutual aid societies.

Alcohol Mutual Aid Societies  29

Alcohol mutual aid societies originated with “recovery circles,” the cultural revival efforts of various Native American leaders in the mid-18th century. Perhaps most prominent amongst a number of Native American “seers,” the Delaware Prophet (Neolin) formulated a mission of religious and cultural revitalization obtainable only by abstaining from alcohol and returning to Native traditions. The Delaware Prophet, along with other important Native prophetic leaders, used the story of his own recovery from alcohol abuse to demonstrate how a Native American community could recapture its vitality if it abstained from alcohol, which was believed to be an instrument of foreign oppression and exploitation. About a century after the emergence of Native American recovery circles, alcohol mutual aid societies became prominent among non–Native American communities. The first significant temperance organization of this type was the Washingtonian movement (or the Washingtonians). Founded in 1840 by six Baltimore drinkers, the Washingtonians differed from previous temperance figures in that they were not led by teetotalers, elites, or religious figures. Instead, the Washingtonians, composed of lower-middle- and working-class alcoholics, democratized temperance activity. They also succeeded in gaining members where other temperance figures had failed, in large part because they focused on saving individual alcoholics rather than advocating greater social reform and pushing for tighter legal restrictions on alcohol. The Washingtonians blossomed into a national organization as a result of large rallies and powerful orators, but the group’s lifeblood was the weekly meeting of local Washingtonian societies, which stressed support, encouragement, advice, and solidarity. At these regular gatherings, members often told sobering tales about the harmful effects that alcohol had on

their lives, the benefits of their newfound sobriety, and the importance of remaining free of drink. When members relapsed into drinking, other members would rally around in support, providing the emotional, financial, and medical support to help them through the crisis. In this regard, Washingtonian methods prefigured the techniques that would later be employed by 20th-century alcohol mutual aid societies like Alcoholics Anonymous. When, in the late 1840s, the Washingtonians disappeared as a result of irreparable divisions over issues of membership, religious ties, political aims, as well as the general difficulty of members remaining sober, fraternal temperance societies like the Sons of Temperance, the Order of Good Templars, the Independent Order of Rechabites, the Order of the Friends of Temperance, and the Independent Order of Good Samaritans rose in prominence. These groups generally opened their doors to anyone who signed a pledge of abstinence and met other membership requirements, but they eventually declined in importance as a result of divided views on the direction these alcohol mutual aid societies should take—to focus on rehabilitating the alcoholics, or to work towards legally prohibiting alcohol. Ribbon Reform Clubs originated in the early 1870s and represented a new wave in the history of alcohol mutual aid groups. The Royal Ribbon Reform Club, the Blue Ribbon Reform Club, and the Red Ribbon Reform Club sought to avoid the divisions that befell previous alcohol mutual aid societies by banning political discussions at all group events. In general, members were expected to meet regularly for mutual support, engage in rescue work for the sake of other alcoholics, and sign pledges of abstinence. In addition, members wore ribbons on their lapels (in the color of their particular reform club), both as a symbol of their fight against alco-

30   Alcohol to Subdue Victims

hol abuse and so that members could find one another while traveling. Another significant alcohol mutual aid society was the Keeley Clubs, a group organized by recovering alcoholics affiliated with Leslie Keeley’s institutes for inebriates, which extended across the country beginning in the mid-1890s. Keeley argued that alcoholism was a disease, and that, consequently, through a combination of his (pharmacologically spurious) injections, behavior modification techniques, and a supportive therapeutic environment, alcoholics could be cured. Keeley Clubs employed morning meetings filled with speeches, discussions, and mutual support. Keeley Clubs, like most of the alcohol mutual aid societies and treatment institutions of the 19th century, slid towards obsolescence in the early 20th century. Alcohol mutual aid societies reemerged in the 1930s with the founding of AA. From its first meeting—the encounter of two alcoholics in 1935—until today, AA has been centered on members standing in front of the group to make personal declarations or tell their life stories. Over time, AA developed its Twelve-Step Program and Twelve Traditions as guiding components, but in general it has remained an open organization predicated on abstinence, avoiding advancing hard and fast answers to alcoholism and recovery, and organizing into local mutual support groups instead of a top-heavy, national bureaucracy. In AA, advice is thus offered not by professionals, but rather via other alcoholic members who relate stories of their own experiences as a means of suggesting to others how they might best deal with their own alcoholism. As a result of these approaches, AA has grown into the world’s largest alcohol recovery group and most successful alcohol mutual aid society. In recent decades, mutual aid groups like Al-Anon and Alateen have borrowed aspects of AA’s model to fashion

alternative alcohol mutual aid societies for relatives of alcoholics. Another recent alcohol mutual aid society, LifeRing, has diverged significantly from AA’s model by eliminating AA’s spiritual components and empowering individuals, in a secular manner, to take the lead in their fights against addiction. Howard Padwa and Jacob A. Cunningham See also: Al-Anon; Alcoholics Anonymous; Alateen; LifeRing; Recovery Circles; Ribbon Reform Clubs

Further Reading Betty Ford Center. 2011. “Significant Events in the History ofAddiction Treatment and Recovery In America.” http://www.bettyfordcenter .org/recovery/article.php?category=methods techniques&post=significant-events-in-the -history-of-addiction-treatment-and-recov ery-in-america. Blocker, Jack S. Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. National Council on Alcoholism and Drug Dependence, Inc. “Mutual Aid/Self Help Support Groups.” http://www.ncadd.org/index .php/get-help/mutual-aid-support-groups. O’Brien, Suzanne J. Crawford, ed. 2008. Religion and Healing in Native America: Pathways for Renewal. Westport, CT: Praeger. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee. White, William. 2003. “Alcoholic Mutual Aid Societies.” In J. Blocker and I. Tyrell, eds., Alcohol and Temperance in Modern History, 24–27. Santa Barbara, CA: ABC-CLIO.

Alcohol to Subdue Victims Sexual violence can be perpetrated in several ways. Perpetrators can use physical force to

Alcohol to Subdue Victims  31

engage in a sexual act against another person’s will or touch someone’s private body parts in an abusive way. Perpetrators may also attempt or complete a sexual act with a person who is incapacitated (due to alcohol, disabilities, etc.). This entry will focus on how perpetrators use alcohol as a tactic to subdue a victim. Alcohol/Drug Facilitated Sexual Assault refers to situations in which alcohol or other types of drugs are used by an offender as a way to subdue a potential victim in order to carry out a sexual attack of some kind. Offenders have used many different types of drugs as a way to subdue their victims. These include Rohypnol, GHB, and Ketamine. In most cases, alcohol is the most common substance that is used to subdue potential victims. There is extensive research on alcoholfacilitated sexual assaults, primarily within college populations. One in four college students will be sexually assaulted while in college (Karjane, Fisher, and Cullen 2005); half of acquaintance rapes have occurred after the victim, perpetrator, or, in most cases, both have been drinking (Davis et al. 2009). Alcohol has been identified as a factor for increased risk for sexual victimization. In the college environment there are many social events for students that often involve alcohol consumption. Students attend parties or go on dates to meet new people, hang out with friends, and have a good time. While the majority of the students socialize just to have fun, some students view these events as an opportunity to take advantage of and sexually assault women. Perpetrators primarily use alcohol to subdue their victims (Abbey and Guy Ortiz 2008). If a perpetrator uses another drug to subdue his victim, such as marijuana or cocaine, it is usually used in conjunction with alcohol (Abbey and Guy Ortiz 2008). Most victims know their attacker and may feel comfortable with the person, be more in-

clined to drink, and less likely to think about the risk of a sexual assault occurring. A perpetrator may use this familiarity as a way to encourage the victim to drink and be less resistant during the assault. Often, date-rape drugs such as Ecstasy are mixed with an alcoholic drink as a way to subdue a victim. The victim in these cases quickly becomes helpless and easy victims for assault. To make matters worse, the victim often has no memory of what happened, making it more difficult to charge an offender with wrongdoing. Another aspect of the social scene on college campuses is binge drinking. Binge drinking for men is having five or more drinks; for women it is having four or more drinks. In order to be considered binge drinking, drinks need to be consumed within a two-hour period. Regular binge drinking resulted in more sexual assaults where the victim was incapacitated than assaults that utilized force. Drinking large amounts of alcohol can prevent an individual from being able to respond to unwanted sexual contact. Individuals who engage in binge drinking on a monthly basis have an increased risk for all forms of sexual assault, particularly assaults where the victim is incapacitated (McCauley, Calhoun, and Gidycz 2010). Alcohol may make an individual more vulnerable to an assault and possible injury. The severity of the injury depends on how much alcohol is in the victim’s system. If a victim has only a small or moderate amount of alcohol, she may be better equipped to recognize the assault and fight back. By fighting the perpetrator, she may face more injuries. However, if a victim has high amounts of alcohol in the body, she may be incapacitated and physically and mentally unable to defend herself. In this case, the perpetrator may use less force since the victim is not fighting back.

32   Alcohol Use

Research shows that offenders who use alcohol or drugs as a way to subdue women often demonstrate a hostility toward women. They also appear to be very confident but in reality lack self-esteem. They have an unrealistic need for power and to control others. Perpetrators may use alcohol to subdue their victims for different reasons. Consuming alcohol can help lessen feelings of anxiety and tension, reducing victims’ ability to appropriately interpret cues. Additionally, victims’ defensive response may be weakened after drinking alcohol, compared to when they are sober. Drinking alcohol also makes social and relational cues harder to read for the victim (Davis et al. 2009). Researchers have described how women assess risk and divide relevant cues into two types, clear or ambiguous. Clear cues show forceful intent to sexually engage with the victim. Ambiguous cues are behaviors that are more socially acceptable in a social setting, like flirting. Finally, perpetrators may view victims’ drinking as a sign of interest in sex when in reality there is no interest. It is important to note that alcohol use is not a sufficient cause or trigger of violence. Similarly, it is important to remember victims are not at fault for being assaulted because they were drinking. Perpetrators purposefully take advantage of women in environments where it can be hard for women to understand the true intention of behaviors. In many situations, young girls are considered to be “at fault” or somehow deserving of the sexual assault because they were drunk when it occurred. Allegations of rape are often discounted if the victim had been drinking alcohol or was otherwise under the influence of a drug. Legally, the victim’s consent is not implied even if she agrees to a sexual advance if she is under the influence of drugs or alcohol. Melanie Lowe Hoffman

See also: Alcohol-Facilitated Sexual Assault; Domestic Abuse and Alcohol; Ecstasy; Ketamine

Further Reading Abbey, A., and L. Guy Ortiz. 2008. “Alcohol and Sexual Violence Perpetration.” Applied Research Forum 5: 1–15. Brecklin, R. L., and E. S. Ullman. 2010. “The Roles of Victim and Offender Substance Use in Sexual Assault Outcomes.” Journal of Interpersonal Violence 25 (8): 1503–22. Centers for Disease Control and Prevention. (n.d.). “Definition of Sexual Violence.” http://www.cdc.gov/ViolencePrevention/ sexualviolence/definitions.html. Davis, C. K., A. S. Stoner, J. Norris, H. G. George, and N. T. Masters. 2009. “Women’s Awareness of and Discomfort with Sexual Assault Cues.” Violence Against Women 15 (9): 1106–25. Karjane, H. M., B. S. Fisher, and F. T. Cullen. 2005. Sexual Assault on Campus: What Colleges and Universities Are Doing about It. Washington, DC: U.S. Department of Justice. McCauley J. L., S. K. Calhoun, and A. C. Gidycz. 2010. “Binge Drinking and Rape: A Prospective Examination of College Women with a History of Previous Sexual Victimization.” Journal of Interpersonal Violence 25 (9): 1655–68. Testa, M. 2004. “The Role of Substance Use in Male-to-Female Physical and Sexual Violence.” Journal of Interpersonal Violence 19 (12): 1494–505.

Alcohol Use People have been making and using fermented drinks since prehistoric times. In the United States today, over half of all Ameri-

Alcohol Use  33

cans aged 12 or older report that they drink alcohol. In the latest National Survey on Drug Use and Health, 52.1 percent of those surveyed said they used alcohol, which is about 135.5 million people. Once ingested, alcohol is absorbed into the bloodstream quickly. Just how quickly that occurs depends partly on the amount and type of food that is in the user’s stomach. High-fat foods and carbohydrates lessen the absorption rates of alcohol. An alcoholic drink mixed with a carbonated beverage will be absorbed more quickly. Alcohol remains in the bloodstream until it is broken down by the liver. When a person consumes alcohol at a faster rate than it can be broken down in the body, the blood alcohol content rises. The blood alcohol content, or BAC (also referred to as the blood alcohol concentration) is the percentage of alcohol in the person’s bloodstream. A BAC of .10 indicates that .10 percent of the person’s blood is alcohol. The BAC is often used for legal or medical purposes, to quantify the extent to which a person was intoxicated. Once absorbed, the effects of alcohol may appear within 10 minutes and peak at approximately 40 to 60 minutes. At a blood alcohol level of .05, the person will experience reduced inhibitions. At .10, there may be slurred speech. The user will experience euphoria and motor impairment at a .20 blood alcohol. Confusion is common in those with a blood alcohol of .30. A rise in a blood alcohol level to a .40 leads to stupor. A coma can occur at a .5 BAC, and respiratory paralysis and death occurring at .60. A person using alcohol may experience many different, sometime serious, symptoms. Alcohol is a depressant and acts as a sedative. Common effects of alcohol use are a depressed breathing rate, heart rate, and control mechanisms in the brain. Alcohol

use may also affect a person’s ability to drive an automobile or perform other complex tasks. A user may have reduced inhibitions (which may lead to embarrassing behavior), a reduced attention span, an impaired shortterm memory, impaired motor coordination, a longer thought process, and effects on judgment. Greater alcohol use may result in memory loss, hangovers, and blackouts. Such long-term use of alcohol does not only affect the user, but may also affect others, including family members, relatives, friends, or even strangers in the case of an automobile accident. If the alcohol user is pregnant, the unborn baby may suffer lifelong consequences. Most doctors recommend that women who are pregnant should avoid alcohol use. Although state laws require that consumers must be at least 21 years old to consume alcohol, most high school seniors in America have consumed alcohol within the past month. Whether someone chooses to use alcohol partly depends on the attitudes developed during childhood and teenage years. It is also impacted by parental attitudes and behaviors toward drinking; family relationships also matter. Many teens that use alcohol risk becoming an alcoholic later in life. Those teens that suffer from low self-esteem or depression are more likely to begin drinking early. In recent years, scientists have determined that moderate use of alcohol may have beneficial health effects for the consumer. A “moderate” use has been defined as 12 fluid ounces of beer, 5 fluid ounces of wine, or 1.5 fluid ounces of distilled spirits. Those using alcohol within these limits may experience heart benefits. Specifically, moderate use may reduce the risk of developing heart disease and thus reduce the risk of dying from a heart attack. It may also reduce the chance of a stroke. Other possible benefits from mod-

34   Alcohol Use

erate use include a lower a risk of gallstones and diabetes. These possible health benefits are not certain at this time. Despite the potential benefits of moderate use, some users are unable to control their consumption of alcohol. Abuse can become dependence for some. These people are determined to be suffering from alcoholism, or a dependence on alcohol. These individuals have lost control of their alcohol use. It doesn’t matter what kind of alcohol they drink or how much or when. But they are unable to stop drinking once they start. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1 in 12 American adults abuse alcohol. Additionally, young adults, ages 18 to 29, are most likely to have alcohol problems. According to the NIAAA (2005), about one in 13 adults in the United States suffer from alcoholism. They offer four questions to determine if someone has a drinking problem:  1. Have you ever felt you should curb your drinking?   2. Have people irritated you by criticizing your drinking?   3. Have you ever felt guilty or bad about your drinking?   4. Have you ever had a drink first thing in the morning to calm your nerves or to cure a hangover? Continued, long-term alcohol use can result in health problems including stomach ailments (inflammation of the stomach lining), heart problems (cardiovascular problems including weakened muscle damage leading to heart failure, stroke, or high blood pressure), cancer (particularly breast cancer and cancer of the mouth, pharynx, larynx, and esophagus), brain damage, and cirrhosis

(an irreversible scarring) of the liver. It can also lead to nonhealth consequences including driving citations or accidents, decreased interest or performance in school and work, increased absenteeism in school or at work, increased social isolation, an increased tolerance to alcohol, the inability to decrease or stop drinking, tremors, secretive alcohol use, lying, neglected appearance, neglected nutrition, and increased violence. Long-term use can also result in suicide, or accidental serious injury or death. Symptoms of alcohol dependence include waking up in the morning thinking about getting a drink, and thinking about it during the day. The inability to stop drinking after one drink is a clear indicator of a problem. Most alcoholics do not, and cannot, stop after having just one drink. Additionally, there is a physical dependence on alcohol. If an alcoholic does not use alcohol, they may suffer withdrawal symptoms that include nausea, sweating, shakiness, restlessness, irritability, tremors, anxiety, hallucinations, and convulsions. Problem drinking can be caused by genetic, physiological, psychological, and social factors. They all play a role. Some individuals drink to cope with emotional problems or peer pressure; poverty and physical or sexual abuse also increases the odds of alcohol dependence. Research indicates that there may be a genetic foundation for alcoholism, but at this time there has been no direct genetic link identified for alcoholism. A family history of alcoholism may increase the chance of a person becoming an alcoholic or suffering from a drinking problem. At the same time, that risk may increase depending upon the situational environment. If alcohol is present, the chance of developing alcoholism multiplies. Many people “binge drink,” which is defined as having four or five drinks in the

Alcohol Use  35

space of a few hours. It is estimated that 23 percent of people aged 12 and over indulge in binge drinking. Binge drinking typically begins around age 13 and then increases with adolescence. People binge drink more often during their young adulthood. It decreases as people age. Treatment for those who abuse alcohol or have been diagnosed as suffering from alcoholism can receive treatment, although there is no treatment for alcoholism. Treatment can include counseling by a psychologist and/or behavior therapy. Psychologists who have been trained in treating patients with alcohol problems can assess the motive or reason why the patient is alcohol dependent and then develop cognitivebehavioral coping skills. They also help family members. Many abusers go to rehab or join support groups as a way to treat their illness. A common program is Alcoholics Anonymous, a 12-step program. There are some medications that have been developed to help alcoholics refrain from drinking. One of those, Antabuse, will make a user sick if they consume any alcohol while taking the drug. Another drug, Naltrexone, reduces the effects of alcohol in the brain and any cravings for it. Another drug is Acamprosate, which helps to relieve the symptoms associated with alcohol withdrawal. In 1995 in the United States, the cost of alcohol use and alcoholism-related treatment services, medical consequences, lost earnings due to illness, lost earnings due to crime and victimization, crashes, fires, criminal justice, and so on was estimated to be $167 billion. The comparable cost related to illegal drug use for that same year was about $110 billion. The total cost to society of alcohol is on order of 30 times what the United States spends on its treatment—about $6 billion in 1997.

The magnitude of alcohol problems has been overshadowed in recent years by the preoccupation with the widespread use of illicit drugs, including heroin, cocaine, crack, and Ecstasy, and the threat of AIDS. According to the Switzerland Addiction Research Institute, annually 1.8 million deaths worldwide are the result of alcohol use while illegal drugs caused 223,000. The WHO claims more than 55,000 people aged 15 to 29 across Europe die each year as a result of alcohol-related road accidents, poisoning, suicide, and murders. The American Medical Association estimates that alcohol contributes to more than 100,000 deaths annually in the United States from drunk driving, cancer, stroke, cirrhosis of the liver, falls, and other adverse effects. These results lead to the conclusion that when added together, the deaths or costs caused by alcohol are greater than the deaths from every abused illegal drug combined. Drinking patterns in the United States show the following facts for lifetime, pastyear, and past-month alcohol use: • Adult males drink more than females. • An estimated 135.5 million Americans aged 12 or older (52.1 percent of the population in this age group) report being current (within the past 30 days) drinkers of alcohol. • Nearly one-quarter (23 percent) of the persons aged 12 or older participated in binge drinking (five or more drinks on the same occasion) at least once in the past 30 days prior to the survey. • Those with a high school education or less and those with some college were more likely than college graduates to report heavy alcohol use. • White people tend to drink more than black and Hispanic people.

36   Alcohol Use

• Adults who graduate from college drink more than those who do not graduate from college. Heavy alcohol use, however, is more prevalent among those without college education. • People who are employed drink more than those who are unemployed. (Substance Abuse Mental Health Services Administration 2012) Richard E. Isralowitz See also: Al-Anon; Alateen; Alcoholics Anonymous; Twelve-Step Programs

Further Reading Alcohol and Drug Information Clearinghouse. 2003. “A Parenting Perspective: Children of Alcoholics.” http://www.prevlink.org /getthefacts/facts/coa.html. Alcohol Policies Project, Center for Science in the Public Interest. 2000. “Alcohol Use” 2006. New York Times. http://www.nytimes.com/health/guides/ specialtopic/alcohol-use/overview.html? inline=nyt-classifier. American Legacy Foundation and the National Center on Addiction and Substance Abuse. 2003. “Reducing Teen Smoking Can Cut Marijuana Use Significantly.” September 16. http://www.teensarenotadisease.com/ CASA_smoking_pot_link.htm. American Psychological Association. 2012. “Understanding Alcohol Use Disorders and Their Treatment.” http://www.apa.org/. Centers for Disease Control and Prevention (CDC). 2001. CDC Fact Book 2000/2001. Washington, DC: U.S. Public Health Ser­ vice, Office of the Surgeon General.

www.hsph.harvard.edu/cas/Documents/ trends/. Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press. Magill, M., and L. A. Ray. 2009. “CognitiveBehavioral Treatment with Adult Alcohol and Illicit Drug Users: A Meta-analysis of Ran­domized Controlled Trials.” Journal of Studies on Alcohol and Drugs 70 (4): 516–27. Mayo Clinic. 2014. “Alcohol Use: If You Drink, Keep it Moderate.” http://www.may oclinic.com/health/alcohol/SC00024. National Center for Biotechnology Information. 2012. “Alcohol Use and Safe Drinking.” http://www.ncbi.nlm.nih.gov/ pubmedhealth/PMH0002669/. National Institute of Health. 2011. “Alcohol Use and Safe Drinking.” http://www.nlm.nih.gov /medlineplus/ency/article/001944.htm. National Institute on Alcohol Abuse and Alcoholism (NIAAA). “FAQs for the General Public.” http://www.niaaa.nih.gov/faqs/ general. National Institute on Alcohol Abuse and Alcoholism (NIAAA). 2005. “Screening for Alcohol Use and Alcohol Related Problems.” http://pubs.niaaa.nih.gov/publications/aa65/ aa65.htm. National Institute on Drug Abuse. 2012. “Alcohol.” http://www.drugabuse.gov/drugs -abuse/alcohol. Peterson, J. Vincent. 2003. A Nation Under the Influence: America’s Addiction to Alcohol. Boston: Allyn and Bacon.

Centers for Disease Control and Prevention (CDC). 2013. “Fast Stats: Alcohol Use.” http:// www.cdc.gov/nchs/fastats/alcohol.htm.

Schoenborn, Charlotte A. 2001. Alcohol Use Among Adults: United States, 1997–98. Hyattsville, MD: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.

Harvard School of Public Health, College of Alcohol Studies Surveys. 1993–2001. http://

Substance Abuse and Mental Health Services Administration. 2011. “Results from the

Alcohol-Facilitated Sexual Assault  2010 National Survey on Drug Use and Health: Summary of National Findings” NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Substance Abuse and Mental Health Services Administration. 2013. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” http://www.samhsa. gov/data/NSDUH/2012 SummNatFindDetTables/NationalFindings/ NSDUHresults2012.htm#ch4. Sutton, Amy L. 2007. Alcoholism Sourcebook: Basic Consumer Health Information About Alcohol Use, Abuse, and Dependence. Detroit: Omnigraphics. Switzerland Addiction Research Institute. 2003. “Tobacco, Alcohol, Drugs Killing 7 Million a Year.” http://www.abc.net.au/ science/news/health/HealthRepublish_ 792982.htm. U.S. Department of Health and Human Ser­ vices and SAMHSA’s National Clearinghouse for Alcohol and Drug Information. “Prevention Primer.” http://store.health.org. Yoon, Y., H. Yi, B. Grant, F. Stinson, and M. Dufor. 2002. Surveillance Report #60: Liver Cirrhosis Mortality in the United States, 1970–99. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism, Division of Biometry and Epidemiology.

Alcohol-Facilitated Sexual Assault The increased risk factors for a potential rape victim when under the influence of alcohol and other drugs make it easy to understand why a perpetrator would use these substances as a weapon in completing a rape. A perpetrator knows the effects that alcohol has on a victim, and therefore will use it to his or her advantage. Some perpetrators may choose to take advantage of a victim’s voluntary con-

sumption of a particular substance. However, other perpetrators deliberately use drugs or alcohol to incapacitate a potential victim in order to complete a sexual assault. While the use of “date rape drugs” is discussed elsewhere in this encyclopedia, it is important to acknowledge alcohol as the most widely used date rape drug. Perpetrators often seek out victims in places where alcohol is being consumed (e.g., parties, bars, clubs) because intoxication can lead to a victim’s diminished ability to determine risk and to physically resist the perpetrator’s advances. Alcohol is a legal drug that depresses the central nervous system and therefore is commonly present in instances of sexual assault. It can cloud judgment and make people less self-conscious, so they might do something they would not do when sober. Alcohol can also cause a person to become unconscious or lose physical control of his or her body. It is common knowledge that alcohol is used in a variety of social situations, making it difficult to differentiate between someone who uses alcohol as a weapon in committing sexual assault and someone who has seemingly consensual, though drunken, sex with a partner. A perpetrator of alcohol-facilitated sexual assault may rely on the fact that often the victim is voluntarily under the influence of alcohol, making the crime of sexual assault much harder to prove. Because alcohol is legal in the United States, it is more difficult to prove that the perpetrator did something wrong by providing alcohol to a potential victim, unlike if they provided the potential victim with illegal narcotics. One theory on sexual violence prevention on a college campus suggests that reducing binge drinking (and therefore its negative consequences such as sexual violence) may reduce sexual risk behaviors and sexual victimization (Testa, Hoffman, and Livingston 2010). It should be noted, however, that the

37

38   Alcohol-Facilitated Sexual Assault

dangers that rest with this assertion are vast. Colleges and universities that rely on a study such as this in planning sexual violence prevention programs will address only the alcohol piece of the puzzle. Even though heavy episodic drinking may lead to risky behaviors by both victims and perpetrators, it does not cause a person to commit an act of sexual violence. Indeed, previously victimized women attending a college or university are a high-risk group, as they are already more likely to be engaging in risky behaviors (such as binge drinking or drug use) (Testa, Hoffman, and Livingston 2010). We must closely examine the concept of “misperception” when considering alcoholfacilitated sexual assault. There is some documentation that alcohol use and misuse lead to people’s misperception of social cues, and therefore may lead to sexual assault. Whether or not this is intentional remains to be proven. A person who regularly consumes alcohol has a higher likelihood of misreading another person’s sexual interest, which could then lead to sexual violence perpetration. Perpetrators who are under the influence of alcohol may falsely believe that alcohol increases their own sex drive and that it signals a woman’s interest in sex. A combination of these beliefs could lead a perpetrator to use alcohol to his advantage in sexual situations. There are additional schools of thought that sexual assault perpetrators intentionally try to get women drunk in order to have sex with them, and that these perpetrators think of women who drink alcohol as being sexually available to them. A perpetrator may strategically try to have sex with a person who is already intoxicated because she is seen as an easy target, especially if the targeted victim is sick from alcohol or is in and out of consciousness. Being voluntarily drunk does not come with an automatic consent to engaging in sexual

activity; however, a predator may rely on the fact that the victim is very drunk to reduce the odds that he will get caught. Due to the nature of alcohol intoxication, a victim who was drunk may question her own actions even more than a victim who was sober at the time of the assault. This could lead to the victim questioning whether or not she said no, led on the perpetrator, or a variety of other things that should not matter, but often do in instances of sexual violence. A perpetrator of alcohol-facilitated sexual assault may try to use his or her state of drunkenness as an excuse for the assault. If he is drunk too, how could someone accuse him of rape? However, according to the National District Attorney’s Association, there are a number of things to look for to determine the predatory nature of the perpetrator of alcohol-facilitated sexual assault. Some things to consider are: • Did the rapist use force or threaten the victim? • Did the victim say “no”? • Was the rapist sober enough to participate in other activities? • Did the rapist isolate or lie to the victim? • Has the rapist been accused of this type of behavior before? Alcohol, while being a socially acceptable and legal substance, is still a drug and is often used as such. Some of the inherent danger of alcohol as it relates to sexual assault is linked to how readily available alcohol is in most places. While this makes it difficult to prove that someone has used alcohol as a weapon, it is important to remember that alcohol does not cause sexual assault. It serves as a catalyst or contributing factor, and should be regarded with caution by both perpetrators and victims alike. Sharon Zucker

Alcoholics Anonymous (AA)  See also: Alcohol Use; Date Rape Drugs; Domestic Abuse and Alcohol

Further Reading LeBeau, Marc A., and Ashraf Mozayani. 2001. Drug-Facilitated Sexual Assault: A Forensic Handbook. San Diego: Academic Press. Olszewski, Deborah. 2009. “Sexual Assaults Facilitated by Drugs or Alcohol.” Drugs: Education, Prevention and Policy 16(2): 39–52. Scalzo, Theresa, P. 2007. “Prosecuting Alcohol-Facilitated Sexual Assault.” National District Attorney’s Association, American Prosecutors Research Institute Special Topics Series. http://www.vaw.umn.edu/ documents/prosecutingalcoholsa/prosecut ingalcoholsa.pdf. Testa, M., J. Hoffman, and J. Livingston. 2010. “Alcohol and Sexual Risk Behaviors as Mediators of the Sexual Victimization-Revictimization Relationship.” Journal of Consulting and Clinical Psychology 78(2): 249–59. World Health Organization. 2005. “Alcohol Use and Sexual Risk Behavior: A CrossCultural Study in Eight Countries.” Geneva: World Health Organization. Zawacki, T., A. Abbey, P. O. Buck, P. McAuslan, and A. M. Clinton-Sherrod. 2003. “Perpetrators of Alcohol-Involved Sexual Assaults: How Do They Differ from Other Sexual Assault Perpetrators and Non-perpetrators?” Aggressive Behavior 29: 366–80.

Alcoholics Anonymous (AA) Alcoholics Anonymous (AA) is the largest alcohol recovery group in the world, with the sole requirement for membership being the desire to stop drinking. AA is an international organization, but its central unit is local meetings in which members share their stories of alcoholism and recovery as

a means of helping other members either become or remain sober. Alcoholics Anonymous (AA) began in 1935 with “Bill W.,” a temporarily sober alcoholic, seeking the support of an alcoholic surgeon, “Dr. Bob,” in Akron, Ohio. With the meeting of these two men, AA was effectively founded. Bill W. (1895–1971) and Dr. Bob (1879–1950) initially met through the efforts of a local Oxford Group network. The Oxford Group began in 1921 under the name of the “First Century Christian Movement” as a network of groups whose meetings featured participants standing up and publicly confessing their shortcomings. Members would also proselytize to new recruits by talking about salvation through the Oxford Group, which was founded on a Protestant ideology that espoused surrendering one’s self and one’s pride to God, accepting divine guidance, recovering through a process of spiritual growth, and a belief in the ability of individuals to reform and improve themselves without the aid of clergy. Some members who had alcohol problems strove to achieve sobriety via their involvement with the Oxford Group, but the organization was not exclusively devoted to the aid and rehabilitation of alcoholics. Bill W., a traveling stock-market analyst based out of New York, came to the Oxford Group through the proselytizing efforts of a friend who hoped to save him from his drinking habit. After a spiritual awakening in 1934, Bill W. headed to Akron with the idea of using the Oxford Group as a means of saving other alcoholics. Bill W.’s meeting with Dr. Bob constituted the first meeting of the nascent AA. The Oxford Group was displeased, however, with meetings exclusively held for alcoholics, and by 1939 the breakaway group officially took the title “Alcoholics Anonymous.” This name was derived from the practice of members referring to themselves as “a nameless bunch of drunks.”

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40   Alcoholics Anonymous (AA)

Reflecting their origins within the Oxford Group, AA meetings, from the beginning, featured members standing in front of the group to make personal declarations or tell their life stories. And though AA published a guide in 1939 that would come to be known as the Big Book, it remained an open organization that avoided advancing hard and fast answers to alcoholism and recovery. It put forth a generic and unscientific notion of members being “allergic” to alcohol, thus suggesting the need for total abstinence. And AA essentially remained an organization of local mutual-support groups instead of a top-heavy, national bureaucracy. Advice was thus offered not by professionals, but rather via other alcoholic members who related stories of their own experiences as a means of suggesting to others how they might best deal with alcoholism. What united AA groups was their now famous Twelve Step model for recovery from alcoholism, which was laid out in the Big Book. The steps for individuals who want to work the AA program are:  1. Admitting that they are powerless over alcohol and that their lives have become unmanageable.  2. Coming to believe that a power greater than themselves could restore sanity to their lives.   3. Deciding to turn their wills and lives over to the care of God, however they understand him (their personal “higher power”).  4. Making a moral inventory of them­­­ selves.  5. Admitting to their higher power, themselves, and to other people the exact nature of their wrongs.  6. Being ready to have their higher power remove these defects of character.

 7. Asking the higher power to remove their shortcomings.   8. Making a list of all persons they have harmed, and becoming willing to make amends to them.   9. Making amends to such people wherever possible, unless doing so would cause harm to them or to others. 10. Continuing to take personal inventory and admitting when they are wrong. 11. Through prayer and meditation, working to improve conscious contact with their higher power. 12. Having had a spiritual awakening through these steps, trying to carry the message to other alcoholics, and to practice these principles in all aspects of their daily lives. (Alcoholics Anonymous 2001) During World War II, AA started publication of the AA Grapevine, a journal that began as a way of keeping in touch with servicemen abroad, but became, and continues to be to this day, a means of addressing and encouraging alcoholics of various backgrounds and attachments to alcohol to attend AA meetings. It featured members testifying to their personal experiences with alcohol and recovery, and it also included discussions of the effects of drugs other than alcohol. Thanks in large part to this publication, AA had 12,986 members spread across 556 local groups by the end of the war. In 1950, the group culled member correspondence to create its “Twelve Traditions of Alcoholics Anonymous”—a series of basic guidelines for structuring AA groups, including calls for anonymity, unity, acceptance of a broadly defined higher power, economic self-sufficiency, and being apolitical. The publication of the Twelve Traditions spurred a new, dramatic growth in AA as an organization, as by the end of that year, member-

Alcoholics Anonymous (AA) 

ship exceeded 96,000, and more than 3,500 local groups were in existence. The fact that “a desire to stop drinking” was the only requirement for membership within AA allowed local groups great freedom to deal as they saw fit with the issues specifically facing its local members, further increasing AA’s significance within U.S. life. And with endorsements ranging from the likes of President Eisenhower to advice columnist Dear Abby, AA became the predominant self-help organization for alcoholics in the country during the 1950s. Though AA had long worked to encourage alcoholics to stop drinking, as the middle of the 20th century progressed, AA became more involved in institutional efforts to help alcoholics. Members helped create AA “farms,” “retreats,” and “Twelve-Step houses,” many of which enjoyed the support of the National Council on Alcoholism. The “Minnesota Model,” a chemical dependency treatment that is most often associated with the Hazelden Institute but has become one of the primary methods of treatment in the United States, employs AA’s Twelve Steps. Through these efforts and others, AA membership grew from 311,450 in 1970 to 907,575 in 1980. By 1990, AA counted around 2 million members—a precipitous increase from its initial group of Bill W. and Dr. Bob in 1935. With this veritable explosion in membership numbers also came an increasing diversification of AA in terms of its programs and members. Some local groups moved away from AA’s original emphasis on God and spirituality and towards a more secularized version of AA. Similarly, local meetings have become more specialized in recent years, with some meeting groups limited to specific demographics. For example, there are now AA groups organized by gender, age, language, sexual orientation, and cooccurring problems.

AA’s diversification is paralleled by the emergence of other treatment and recovery groups that offer alcoholic-related support. For instance, Al-Anon (which was founded by Bill W.’s wife, Lois Wilson) and Alateen are voluntary organizations that cater to the spouses and children of alcoholics, respectively. Other alternatives to AA include Women for Sobriety, Rational Recovery, Moderation Management, and LifeRing. Additionally, the success of AA’s approach to alcohol abuse spawned 12-step programs for other addiction problems. Prominent examples include Gamblers Anonymous, Narcotics Anonymous, Cocaine Anonymous, and Sexaholics Anonymous. Howard Padwa and Jacob A. Cunningham See also: Al-Anon; Alcohol Mutual Aid Societies; Hazelden Foundation; LifeRing; Narcotics Anonymous

Further Reading Alcoholics Anonymous. 2001. Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism. New York: Alcoholics Anonymous World Services. Alcoholics Anonymous. 2007. Big Book. S.I.: Works Publishing. B., Mel. 2007. 101 Meeting Starters: A Guide to Better Twelve Step Discussions. Center City, MN: Hazelden. Blocker, Jack S. Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Edwards, Griffith. 2000. Alcohol: The Ambiguous Molecule. London: Penguin Books. Kurtz, Ernest. 1979. Not—God: A History of Alcoholics Anonymous. Center City, MN: Hazelden Educational Services.

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42  Alcoholism Mendelson, Jack H., and Nancy K. Mello. 1985. Alcohol: Use and Abuse in America. Boston: Little, Brown and Company. White, William L. 1998. Slaying The Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chesnut Health Systems. Witbrodt, Jane, Lee Kaskutas, Jason Bond, and Kevin Delucchi. 2012. “Does Sponsorship Improve Outcomes above Alcoholics Anonymous Attendance? A Latent Class Growth Curve Analysis.” Addiction 107: 301–11.

Alcoholism Alcoholism is an addiction to ethanol, which is the intoxicant in alcoholic beverages. Ethanol, also known as ethyl alcohol, is the byproduct of fermentation, a chemical interaction between yeast and sugar. It is estimated that 10 to 15 percent of people who drink alcohol become addicted to the drug. Moderate (social) drinking (1 to 2 drinks a day for men, 1 for women) is not considered harmful for most adults and may benefit cardiovascular function. Drinks are defined as: 5 ounces of wine, 12 ounces of beer, or 1 to 3 ounces of distilled spirits. Due to their significantly greater vulnerability to addiction and the permanent changes in brain function that alcohol can cause, people who are underage—ages 12 to 20—should refrain from using alcohol at all. There are two types of alcoholism: acute and chronic. Acute alcoholism is characterized by episodic bursts of intoxication while chronic alcoholism manifests itself in a deteriorating pattern of long-term use. While there is continuing disagreement about whether alcoholism is a behavioral problem, a symptom of mental disorders such as depression or anxiety, or a primary disease that arises on its own, it is widely regarded as a progressive disorder character-

ized by stages (early, middle, and late) that can ultimately destroy the drinker’s life. In its advanced state, untreated alcoholics can die from the immediate effects of intoxication or from related complications such as dementia, heart failure, or cirrhosis of the liver. Despite ongoing controversies about the exact nature of alcoholism, it is considered to be a disease of the brain by both the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the National Institute on Drug Abuse (NIDA). In their view, anyone can become an alcoholic, but those with a genetic predisposition or those who drink heavily for a long time are at considerably greater risk. Teenagers are also at greater risk because their developing brains are more vulnerable to alcohol’s effects. As the brain’s circuitry becomes distorted in service to the addiction, one’s judgment, memory, learning, and control over deteriorating behavior become increasingly impaired, which causes the alcoholic to pursue the illogicality of continued drinking. Chemically, alcohol is a depressant that inhibits the activity of the central nervous system. Upon entering the stomach, most of the alcohol goes to the small intestine, but some enters the bloodstream where it finds its way to the brain. Once it reaches the brain, the alcohol triggers the release of the neurotransmitters dopamine, serotonin, and norepinephrine, which activate the brain’s reward pathway to produce pleasant sensations. Alcohol also releases gammaaminobutyric acid (GABA) that inhibits the brain’s stimulative responses and permits feelings of relaxation and calm to prevail. Coordination and reflexes slow and speech may become slurred as the amount of alcohol in the body increases, thereby depressing the central nervous system even further. Additional toxicity results in vomiting and can be complicated by choking or suffocation if the

Alcoholism  43

drinker aspirates their own vomit. In more serious instances, alcohol poisoning will result in respiratory depression, coma, and death. Twelve to 48 hours after alcoholics stop drinking they can experience a wide range of withdrawal symptoms. The exact symptoms are dependent upon the stage of the disease. In milder forms these symptoms include sleep disturbances, headache, sweating, thirst, and anxiety, while hallucinations, seizures, and even death are seen in the more severe form of withdrawal. Increasing evidence indicates that the brain’s glutamate system plays a role in producing some of these symptoms. There is some promise in drug therapies that target this system and reduce the symptoms of withdrawal.

Incidence The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2012 an estimated 17.7 million Americans either have an alcohol dependency or abuse alcohol. Of those, a reported 1.4 million Americans received treatment. Since alcohol is legal and its use is socially acceptable, alcohol is the drug of choice among adolescents, particularly high school seniors; the average age at which a teenager takes a first drink is 14 or younger. Of the adolescents between the ages of 12 and 17, 12.9 percent were current consumers of alcohol. In 2012, the rate of alcohol use by full-time college students (60.3 percent) was higher overall compared to part-time students (51.9 percent). Some college students engage in extreme drinking during which they consume more than double the amount of alcohol they would consume if binging. The availability of alcohol is a continuing problem: underage drinkers can easily obtain beverages containing alcohol. In Europe, distilled spirits are appearing in flavored beverages that appeal to younger palates.

The patterns of alcoholism and alcohol abuse differ across the major ethnic groups in the United States. Factors such as age, gender, socioeconomic background, marital status, education level, religion, and community demographics, as well as ease of access to various treatments, distort drinking patterns and make statistical analysis more difficult. Further, different nationalities within ethnic groups exhibit different patterns, e.g. Mexican Americans consume more alcohol than Hispanic Americans. Statistics indicate that Caucasians—especially those of Northern European derivation—have higher overall rates of alcoholism than other ethnic groups, and, of these, men are at higher risk than women. Trends also indicate that among high school students, Caucasian and Hispanic adolescents use alcohol at a higher rate than their African American cohorts. Meanwhile, women become addicted to drugs and alcohol more easily than men, and experience greater ill effects. This is due to the complex differences in the physiology and emotional makeup of women, which makes them more sensitive to drugs. On average, there is a gap of eight to 10 years from the time a person begins to abuse alcohol to the time they seek treatment. For teenagers who drink, this is a particularly critical issue: since their young brains are more susceptible to the highly damaging effects of ethanol, they may develop an earlier and quickly crippling form of the disorder. Research shows that the volume of the hippocampus is reduced 10 to 35 percent in teens who abuse alcohol extensively. Since the hippocampus is the seat of memory, this could cause serious deficiencies. The NIDA has reported that fewer individuals are developing the disease past the age of 30. This indicates that alcoholism almost always starts at a younger age even though clear symptoms may not surface until a later age.

44  Alcoholism

In 2007, citing statistics showing that the risk of developing serious alcohol problems later in life is five times higher for teenagers who drink, the acting surgeon general of the United States issued a Call to Action. The appeal called for renewed efforts to identify the causes and extent of underage drinking, conduct further research studying how alcohol affects developing brains, and adopt improved surveillance strategies for preventing alcohol use among the nation’s youth.

Diagnosis How to characterize alcoholism—the consequence of an impaired sense of personal responsibility, a deficit of willpower, a vice, a symptom of another disorder, or a primary disease—has been debated for centuries and has complicated attempts to diagnose it. In the 1970s, three criteria emerged that most experts agreed could be used to diagnose alcoholism: (1) large quantities of alcohol had been consumed over a period of years, (2) alcohol use had led to diminished health or social status, and (3) a loss of control over the amount and frequency of use had become evident. These criteria have changed since then. Now only a loss of control is regarded as a definitive symptom, although tolerance and withdrawal are considered by some to be classic signs. The U.S. medical community usually bases formal diagnosis on the criteria published by the American Psychiatric Association (APA) in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). Other countries generally rely on the criteria laid out in the World Health Organization’s International Classification of Diseases, 10th Revision (ICD-10), which are similar to those of the DSM. Although the NIDA reports that heavy drinking is a risk factor for developing alcoholism, the disease is not defined by the amount someone drinks. Each

person metabolizes alcohol differently, so what may be an excessive amount for one is not too much for another. Women, in general, are more affected by alcohol than men; what would be a moderate amount for a man could be an intoxicating or even dangerous amount for a woman, especially if she is pregnant. A problem many experts have with the DSM criteria is that they describe a late stage of alcoholism when the disease is advanced and the alcoholic is very ill. Many sufferers die from complications before they reach end-stage disease. Since most experts agree that alcoholism is progressive, they seek ways to identify the early stage of the disorder and intervene to prevent its continued development. This can be difficult because early warning signs are not always easy to detect; if they do appear, the alcoholic—or friends and family—can easily deny their significance. Other critics worry that too many high-functioning alcoholics— those whose ability to function normally at home, work, and school has not yet begun to deteriorate in apparent ways—evade diagnosis even though their drinking patterns meet the appropriate criteria.

DSM Criteria for Diagnosing Alcohol Dependence The following criteria used for diagnosing alcohol dependence have been adapted from the 4th edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for diagnosis of substance addiction and abuse. The manual’s editors use the word dependence in this edition as a synonym for addiction. Mounting pressure is on the APA to revert to addiction in the next edition. The person should exhibit three or more of the following symptoms arising out of an abusive pattern of alcohol use within a 12-month period:

Alcoholism  45

  1. Developing tolerance, manifested by (a) the need for more alcohol to obtain the desired effect, or (b) a noticeably diminished effect with continued use of the same amount of alcohol;   2. Undergoing withdrawal, (a) by showing classic symptoms of restlessness, tremor, sleeplessness, and anxiety, or (b) by needing to drink to relieve those symptoms;  3. Drinking more frequently or in greater quantities than was originally intended;   4. Making frequent but unsuccessful attempts to control alcohol use;  5. Spending more time to obtain alcohol, to drink, or to recover from hangovers;  6. Neglecting social, academic, occupational, or recreational activities or responsibilities;   7. Continuing to use alcohol in spite of negative consequences associated with its use, such as the development of physical or psychological problems.

Stages of Alcoholism The initial stage of alcoholism can be difficult to recognize because the symptoms resemble the patterns associated with normal drinking. Some alcoholics report a subjective contrast between themselves and normal drinkers in the increased pleasure that they derive from drinking from the start. They often develop a greater tolerance for alcohol than their counterparts and arrange opportunities to drink or continue to drink after everyone else has stopped. Additional danger signs are concealing the amount of alcohol consumed, keeping extra supplies of alcohol hidden, or becoming agitated or preoccupied when alcohol is unavailable. The middle stage is marked by an increased frequency and severity of hangovers

that may include shakiness, agitation, excessive perspiration, gastrointestinal distress, and feelings of guilt and shame. Drinkers may begin to experience increased duration of memory lapses and find they regret impulsive behaviors that they engaged in while inebriated. Withdrawal symptoms also become worse, restlessness or vivid dreams may disrupt an individual’s sleep, and they will increasingly find themselves drinking or using other substances to remedy the effects of prior excesses. Complaints from family or friends, psychological or nutritional problems, and difficulties at school or work start to pile up. In late stages, the alcoholic’s behavior and social structure deteriorates, and seri-

A young Asian man uses alcohol as a coping mechanism. Many people use alcohol to deal with depression and other personal and mental problems. It can lead to alcoholism and other diseases of the body. (quavondo/ iStockphoto.com)

46  Alcoholism

ous physical symptoms from the accumulated attacks to the body and brain also arise. Withdrawal process can induce anguishing craving and intense psychological discomfort; irritation of both the stomach and intestines can provoke nausea and diarrhea; imbalances of the neurochemicals can manifest in mental confusion, hallucinations, and in some instances seizures. Life-threatening withdrawal symptoms include an elevated heart rate, rapid breathing, disorientation, and blackouts. Death can result if severe delirium tremens develop. Many alcoholics who stop drinking before that point can regain their health provided they receive the appropriate medical treatment and abstain from alcohol for the remainder of their lives. Kathryn H. Hollen See also: Al-Anon; Alateen; Alcohol Use; Alcoholics Anonymous

Further Reading American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision. Washington, DC: American Psychiatric Association. Fingarette, Herbert. 1988. Heavy Drinking: The Myth of Alcoholism as a Disease. London: University of California Press. Gifford, Maria. 2011. Alcoholism. Santa Barbara, CA: Greenwood Press. Hanson, David J. August 2007. Alcohol Problems and Solutions. http://www.alcoholin formation.org. Jellinek, E. M. 1960. The Disease Concept of Alcoholism. New Haven, CT: Hillhouse Press. Johnson, Vernon E. 1980. I’ll Quit Tomorrow. Rev. ed. New York: HarperCollins. Ketcham, Katherine, and William Asbury. 2000. Beyond the Influence: Understanding and Defeating Alcoholism. New York: Bantam Books.

Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Knapp, Caroline. 1996. Drinking: A Love Story. New York: Dial Press. McGovern, George. 1997. Terry: My Daughter’s Life-and-Death Struggle with Alcoholism. New York: Penguin Books. Milam, James, and Katherine Ketcham. 1983. Under the Influence: A Guide to the Myths and Realities of Alcoholism. New York: Bantam Books. Nurnberger, John I. Jr., and Laura Jean Bierut. April 2007. “Seeking the Connections: Alcoholism and Our Genes.” Scientific American 296 (4): 46–53. Paton, Alex, and Robin Touquet, eds. 2005. ABC of Alcohol. Malden, MA: Blackwell Publishing. Powter, Susan. 1997. Sober .  .  . and Staying That Way. New York: Simon & Schuster. Quertemont, Etienne, and Vincent Didone. 2006. “Role of Acetaldehyde in Mediating the Pharmacological and Behavioral Effects of Alcohol.” Alcohol Research & Health 29(4): 258–65. Substance Abuse and Mental Health Services Administration. 2013. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” http://www.samhsa.gov/data/NSDUH/2012 SummNatFindDetTables/NationalFindings/ NSDUHresults2012.htm#ch4. Sutton, Amy L. 2007. Alcoholism Sourcebook: Basic Consumer Health Information About Alcohol Use, Abuse, and Dependence. Detroit: Omnigraphics. Teitelbaum, Scott A. 2011. Addiction: A Family Affair. Gainesville: University of Florida. Tracy, Sarah, and Caroline Jean Acker, eds. 2004. Altering American Consciousness: The History of Alcohol and Drug Use in

Alpert, Richard (Ram Dass; 1931– )  47 the United States, 1800–2000. Amherst and Boston: University of Massachusetts Press. U.S. Department of Health and Human Ser­ vices. 2007. Results from the 2006 National Survey on Drug Use and Health: National Findings. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. DHHS Publication No. SMA 07–4293. U.S. Department of Health and Human Ser­ vices, Centers for Disease Control and Prevention (CDC). 2007. http://www.cdc.gov. U.S. Department of Health and Human Ser­ vices, National Institute of Mental Health (NIMH). 2008. http://www.nimh.nih.gov. U.S. Department of Health and Human Ser­ vices, National Institute on Alcohol Abuse and Alcoholism (NIAAA). 2007. http:// www.niaaa.nih.gov. U.S. Department of Health and Human Ser­ vices, National Institute on Drug Abuse (NIDA). 2007. http://www.nida.gov. U.S. Department of Health and Human Ser­ vices, Substance Abuse and Mental Health Services Administration (SAMHSA). 2007. http://www.samhsa.gov. Vaillant, George. 1995. The Natural History of Alcoholism Revisited. Cambridge, MA: Harvard University Press. White, William. December 2000. “The Rebirth of the Disease Concept of Alcoholism in the 20th Century.” Counselor 1(2): 62–66.

Alpert, Richard (Ram Dass; 1931– ) During the 1960s, Richard Alpert was involved in research on psychoactive substances at Harvard University, along with his good friend and colleague, Dr. Timothy Leary. He later spent time studying spiritualism in India and devoted the greatest part of his life

to studying and teaching about this subject in the United States. He became a beloved spiritual teacher to many around the world. Richard Alpert was born on April 6, 1931, in Newton, Massachusetts. His father was a prominent attorney, president of the New York, New Haven, and Hartford railroad, and a founder of Brandeis University and the Albert Einstein College of Medicine in New York City. Alpert received his BA from Tufts University, his MA in motivation psychology from Wesleyan University, and his PhD in human development from Stanford University. He then accepted a teaching and research post in the Department of Social Relations and the Graduate School of Education at Harvard University. While at Harvard, he met Timothy Leary, from whom he learned about the psychoactive effects of a number of substances. Between 1960 and 1961, Al­ pert and Leary began to question human consciousness and began a series of experiments with psilocybin, LSD-25, and other psychedelic chemicals. They sometimes used graduate students as their subjects. The direction of these experiments was sufficiently troubling to Harvard administrators that both men were dismissed from their academic positions in 1963. That move was of little concern to Alpert, who later said that he had already become disillusioned with academics as a “meaningless pursuit.” In a recent interview, Dass said of the time: “When I was leaving the academic world, the President of Harvard called me into his office to fire me. I looked at him and I saw that he was in a box that he couldn’t get out of, and that I was free.” In 1967, Alpert went to India, where he met his spiritual teacher, Neem Karoli Baba, and studied yoga and meditation. He received his new name, Ram Dass, or “servant of God.” He has spent the rest of his life studying a variety of spiritualistic philosophies, including Hinduism, karma, yoga, and Sufism. He is proba-

48   Alpert, Richard (Ram Dass; 1931– )

bly best known today not for his early studies of psychoactive substances, but for his 1971 spiritual book, Be Here Now. His other publications include The Psychedelic Experience: A Manual Based on the Tibetan Book of the Dead (with Leary and Ralph Metzner); Doing Your Own Being (1973); The Only Dance There Is (1974); Journey of Awakening: A Meditator’s Guidebook (1978); Compassion in Action: Setting Out on the Path of Service (with Mirabai Bush; 1991); Still Here: Embracing Aging, Changing and Dying (2000); and Paths to God: Living the Bhagavad Gita (2004). In 1996, Ram Dass was planning a talk radio program that would have the title “Here and Now with Ram Dass.” Seven pilot programs were aired in the Los Angeles and San Francisco Bay Area, and they were well received by the public and plans were made to launch the show nationally. However, in 1997, Alpert suffered a stroke that paralyzed the right side of his body and left him with Broca’s aphasia, a brain condition that makes speech difficult. Nonetheless, he continues to write, teach, and lecture, as his condition permits. He also serves on the faculty of the Metta Institute. In 1974, Ram Dass established the Hanuman Foundation, a nonprofit educational and service organization that concentrates on the spiritual well-being of society. It seeks to provide education and service to the community. The Hanuman Foundation also established the Prison Ashram Project, which is a way to assist inmates in prisons grow spiritually throughout their incarceration. Another outlet is the Dying Project, a spiritual support group for those facing death. Dass also works with the Social Venture Network, composed of groups of businesses that have the goal of bringing social consciousness into business practices. Ram Dass then created, along with many others, the Seva Foundation, an international

health organization, in 1978. The organization provides cataract surgeries to people suffering with their eyesight. Dass continues to be an honorary lifetime member of the foundation. In 2013, Dass wrote his memoir entitled Polishing the Mirror: How to Live from Your Spiritual Heart. He works now with the Love Serve Remember Foundation that seeks to continue the work of Neem Karoli Baba and Ram Dass. They also assist Dass in his current research and teaching endeavors. Through his foundation’s Web site (http:// www.ramdass.org/), Dass provides weekly teachings by a featured teacher, a blog, web­ casts, online courses, e-books, and other ways to continue to spread his messages. His interests include the further research into psychedelics, international development, environmental awareness, and political action. Some quotes from Ram Dass: “The quieter you become, the more you can hear.” “Be here now.” “Let’s trade in all our judging for appreciating. Let’s lay down our righteousness and just be together.” “Treat everyone you meet like God in drag.” “The spiritual journey is individual, highly personal. It can’t be organized or regulated. It isn’t true that everyone should follow one path. Listen to your own truth.” “If you think you’re free, there’s no escape possible.” “Every religion is the product of the conceptual mind attempting to describe the mystery.” “The game is not about becoming somebody, it’s about becoming nobody.” “Information is just bits of data. Knowledge is putting them together. Wisdom is transcending them.”

Alternative Addiction Treatment 

“The Ego is an exquisite instrument. Enjoy it, use it—just don’t get lost in it.” David E. Newton See also: Leary, Timothy; Psychedelic Drugs

Further Reading Be Here Now, Be Here Now, Be Here Now, Be Here Now: Remember. 1971. San Cristobal, NM: Lama Foundation, Distributed by Crown Publishers (New York). Dass, Ram, and Mirabai Bush. 1992. Compassion in Action: Setting Out on the Path of Service. New York: Bell Tower. Dass, Ram, with Stephen Levine. 1976. Grist for the Mill. New York: Bantam Books. Davidson, Sara. 1973. “The Metamorphic Journey of Richard Alpert.” Ramparts Magazine 11(8). Lattin, Don. 2010. The Harvard Psychedelic Club: How Timothy Leary, Ram Dass, Huston Smith and Andrew Weil Killed the Fifties and Ushered in a New Age for America. New York: HarperOne. Schnall, Marianne. 2013. “Exclusive Interview with Ram Dass.” Huffington Post, August 21. http://www.huffingtonpost.com/mar ianne-schnall/exclusive-interview-with -_13_b_3790005.html. Seva Foundation. http://www.seva.org/site/ PageServer?pagename=about. Wark, C., and J. F. Gallliher. 2010. “Timothy Leary, Richard Alpert (Ram Dass) and the Changing Definition of Psilocybin.” International Journal of Drug Policy 21 (3): 234–39.

Alternative Addiction Treatment Many alcoholics and drug addicts reject the spiritually centered approach that Alcoholics Anonymous (AA) and the Minnesota model utilize. They instead seek support through groups that meet their unique needs, or they

prefer treatment options that emphasize the development of self-reliance and emotional maturity that leads to independence from support groups. For this group of alcoholics and drug addicts—plus those who find total abstinence impossible or unacceptable—alternative treatments have been developed. This includes harm-reduction strategies that focus on the negative consequences of alcohol and drug addiction rather than on their use. Strategies like this are also referred to as tertiary levels of prevention and treatment and can be controversial. Other examples of such strategies include less-than-total abstinence, the use of medical marijuana, or needle-sharing programs to prevent HIV and other diseases. Other alternative approaches that represent primary prevention efforts (i.e., discourage the use of drugs entirely) or secondary strategies, which involve identifying and addressing the underlying psychological or sociological causes of addiction, include the following.

Moderation Management (MM) MM was founded in 1993 by Audrey Kishline and is dedicated to helping alcoholics moderate their drinking. Designed primarily for those with early-stage alcoholism, it has been heavily criticized by mainstream treatment professionals who insist that total abstinence is the only suitable treatment for any stage of alcoholism. Bolstering their argument is the fact that Kishline was driving drunk and caused a fatal accident in March of 2000 that killed two people. MM’s supporters claim that Kishline was already severely alcoholic when she founded the program, and therefore was not a good candidate for the program’s approach; Kishline’s relapse proves that while MM can help problem drinkers control their drinking, it is not recommended for alcoholics. Like similar programs, MM proposes several steps to recovery that include attending meetings, examining the reasons for and pat-

49

50   Alternative Addiction Treatment

terns of drinking, establishing goals and priorities, and periodically reviewing progress. Specific limitations that are placed on drinking behavior include:   1. Never drink and drive.   2. Never drink when it would endanger oneself or others.   3. Avoid drinking every day.  4. Limit the amount of alcohol consumed per week.

Rational Recovery (RR) RR is a self-recovery movement that was founded in 1986 and has undergone substantive changes in the years since it began. The organization grew rapidly at first, but then found that its central principles began to diverge. One group broke off to form a new entity called Self-Management and Recovery Training (SMART). The original RR group now places its emphasis on what it calls an “addictive voice recognition technique” (AVRT). Members believe that by learning to recognize one’s addictive voice—any thinking that supports or suggests the use of alcohol or drugs— an addict can identify the triggers driving their addiction, thereby gaining power over it. RR does not involve meetings or traditional forms of therapy, one-day-at-a-time abstinence measures, or the use of medications such as naltrexone to help treat addiction. Proponents believe such methods keep the addictive voice alive, and they spurn addiction scientists who they claim are employed or funded by the for-profit treatment industry. The organization’s Web site offers a crash course in self-treatment. Secular Organizations for Sobriety (SOS) SOS is another organization founded in 1986 and is also known as Save Our Selves. It is a network of groups that focuses on personal

responsibility for addressing and recovering from addiction while relying on the support and assistance of one’s SOS group of choice. The SOS Web site posts a clearinghouse that offers links to the entire network. Meetings are offered in many cities throughout the United States and in other countries. The organization’s principles are embodied in its proposed steps to recovery:  1. Acknowledge one’s alcoholism/addiction.   2. Reaffirm the presence of the disease and recommit to the knowledge that, no matter what, it is not possible to drink or use again.   3. Take whichever steps are necessary to maintain sobriety.  4. Recognize that life’s uncertainties cannot be used as an excuse to use drugs or drink, and that life can be good without drugs.  5. As clean and sober individuals, be able to share thoughts and feelings with one another.  6. Maintaining sobriety should be the top priority.

Self-Management and Recovery Training (SMART) An outgrowth of the RR movement, SMART began operations in 1994 with the goal of helping addicts gain the maturity and selfreliance needed to identify and eliminate self-destructive attitudes and behaviors that result from them. Encouraging addicts to practice abstinence, develop emotional independence, and reduce their need for support groups are its three principal goals. The fundamental belief that addicts need to gain maturity and self-reliance underlies its program. SMART meetings can be found throughout the United States and around the world

American Association for the Study and Cure of Inebriety (AASCI)  51

and can help addicts benefit from the latest scientific approaches to addiction treatment and learn techniques for self-directed change in their lives.

Women for Sobriety (WFS) In 1975, WFS was founded, based on the perceived need for a group that addressed the unique perspectives and problems of women suffering from alcoholism. Although its principles are similar to those of AA, it defines its approach to recovery somewhat differently:   1. Accept responsibility for the disease and take charge of one’s own life.   2. Remove negative thinking from one’s life.   3. Develop a happy state of mind rather than waiting for it to just happen.   4. Understand problems so they do not become overwhelming.   5. Believe in oneself as a capable, compassionate, and caring woman.  6. Make one’s life a great experience through conscious effort.  7. Embrace caring and love to change the world.   8. Focus on keeping one’s priorities in order.  9. By viewing oneself as renewed, re­ fuse to be submerged in the past. 10. Understand that love given is also returned. 11. Work to develop an enthusiasm for life. 12. Appreciate one’s own competence. 13. Focus on being responsible for one’s life and thoughts. The WFS program views the treatment of alcoholism as proceeding in 6 stages, each focusing on some of the 13 principles. Level 4 of recovery, for example, embraces the concepts embedded in principles number 3, 6, and 11.

WFS groups originated in the United States, but there are also groups in Canada, Europe, Australia, and New Zealand. Kathryn H. Hollen See also: Twelve-Step Programs

Further Reading Horvath, Tom. 2012. “If Not AA, Then What? SMART Recovery and the AA Alternatives.” Huffington Post. http://www .huffingtonpost.com/tom-horvath-phd/ad diction-treatment_b_1663494.html. Lemanski, Michael. 2001. A History of Addiction and Recovery in the United States. Tucson, AZ: See Sharp Press. Marlatt, G. Alan, ed. 1998. Harm Reduction: Pragmatic Strategies for Managing HighRisk Behaviors. New York: Guilford Press. Peele, Stanton. 2004. 7 Tools to Beat Addiction. New York: Three Rivers Press. Rehab Centers. 2013. “Alternative Addiction Treatment for Drugs and Alcohol.” http://therehabcenters.com/alternative -addiction-treatment/. Schaler, Jeffrey A. October 2002. “Addiction Is a Choice.” Psychiatric Times 19(10): 54, 62. Stop Your Addiction. “Alternative Addiction Treatment.” http://www.stopyouraddiction .com/addiction-treatment/alternative -addiction-treatment/. Trimpey, Jack. 1996. Rational Recovery: The New Cure for Substance Addiction. New York: Pocket Books.

American Association for the Study and Cure of Inebriety (AASCI) The American Association for the Study and Cure of Inebriety (AASCI), which was founded in 1870, broke new ground as an organization dedicated to the study of alcohol

52   American Association for the Study and Cure of Inebriety (AASCI)

and drug addiction. The AASCI, which was composed of doctors, reformers, and superintendents of inebriety treatment centers, was a pioneer in casting alcoholism and drug addiction not as moral failings on the part of the individual, but rather as medically treatable conditions. This view, as well as the AASCI itself, began to fall out of favor as the prohibitionist cause gained steam around the turn of the century, but the AASCI’s ideas took on a new life elsewhere with the passage of the Twenty-First Amendment and the repeal of prohibition in 1933. The AASCI began in 1870 under the name of the American Association for the Cure of Inebriates. The group had three main purposes—to facilitate the exchange of information among professionals in the fields of alcoholism and addiction treatment, to provide political advocacy for legislation to establish and support the work of inebriate asylums, and to publish a professional journal and treatises on addiction treatment. The AASCI was founded by Dr. Joseph Parrish, who served as the medical director and chair of the board of directors of the Pennsylvania Inebriate Asylum in Media, Pennsylvania. Much of the association’s leadership consisted of leading professionals within the world of late-19th-century inebriety treatment. For example, one of the group’s leading members, Dr. Nathan S. Davis, was not only involved with AASCI but also helped found the American Medical Association and the Chicago Washingtonian Home, a facility dedicated to the treatment of alcoholics. In his work with the Washingtonians, Davis helped advance the belief that individuals could overcome alcoholism through moral example, testimonials, and support groups. Another of the AASCI’s leading members, Dr. Thomas Crothers, contributed to the organization’s understanding of alcoholism

as a medically treatable condition. Crothers was a physician who devoted much of his professional life towards treating inebriety and gaining recognition of it as a disease. In doing so, he went beyond traditional moral conceptions of alcohol abuse and furthered existing theories about alcoholism being an illness (and not a sin) by giving the concept of inebriety greater scientific footing. Over many years working at inebriate asylums, Crothers gathered a body of evidence that he felt validated his disease conception of alcohol addiction. When he joined the AASCI in 1873, Crothers worked to popularize his notion of alcoholism as the longtime editor of the AASCI’s Quarterly Journal of Inebriety. Under Crothers’s editorship, the Quarterly Journal of Inebriety attracted contributions from many of the most innovative medical theorists of the 19th century, such as neurologist George M. Beard. The AASCI worked to keep controversial papers and articles that were mere advertisements for certain facilities or doctors out of its journal, thus using it as a tool to further the professional credibility of the study of inebriety. The AASCI had some success with this, as by 1891, over 2,000 physicians across the country subscribed to the Quarterly Journal of Inebriety. The leaders of the AASCI challenged conventional thinking about alcohol abuse by arguing that inebriety was a disease, and not a moral failing. Given that it was a disease, they believed that the best way to help alcoholics was to give them medical treatment. With this claim, the AASCI differed from other contemporary conceptions of drunkenness, which often viewed inebriety as a vice or a moral failing. Though these more moralistic ideas were actually held by some AASCI members in the early days of the organization, the idea that inebriety was a disease that could be passed down hereditarily, warranted medical attention, and required

American Society of Addiction Medicine (ASAM)  53

treatment nevertheless became the main line of thinking for the organization. Though most AASCI members believed that inebriety was a disease, the group’s publications put forward many different theories about what kind of disease alcoholism was. Some within the AASCI believed that anyone who became drunk could be classified as an “inebriate,” while other AASCI members argued that drinkers were diseased only when they chronically turned to alcohol. Despite these inconsistencies, the AASCI helped popularize some key concepts about inebriety. For example, the AASCI often published articles that discussed “chronic poisoning,” a term invoked to describe the physiological basis of opium abuse. Similarly, Beard was influential within the AASCI with his definition of alcoholism as a form of neurasthenia, a neurological disorder that many 19th-century physicians believed was responsible for a variety of physical and mental illnesses. Notwithstanding the diversity of theories about inebriety within its membership ranks, the AASCI grew from its initial coalition of all six inebriety institutions that existed in 1870 into an organization of 32 inebriety facilities by 1878. The organization’s rapid growth spoke to the popularity of the AASCI’s theories about inebriety, and as its influence grew, more and more physicians and alcohol reform organizations began to adopt the group’s medical understanding of inebriety as a disease. But by 1904, the AASCI had receded in prominence to the point of being united with the American Medical Temperance Association (AMTA), another organization that was founded by Davis. After it joined forces with the AMTA, the organization changed its name, becoming the American Medical Society for the Study of Alcohol and Other Narcotics. Though Crothers continued to defend the AASCI’s work

and wanted to further the understanding of inebriety as a medical problem, proponents of alcohol prohibition eventually came to dominate the organization. Consequently, the Quarterly Journal of Inebriety ceased publication in 1914, and the AASCI faded into obscurity. The AASCI may have existed until the 1920s, but if so, it must have been as a faint shadow of its former self. Howard Padwa and Jacob A. Cunningham See also: Alcohol Use; Alcoholism

Further Reading Blocker, Jack S. Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Blumberg, L. 1978. “The American Association for the Study and Cure of Inebriety.” Alcoholism, Clinical and Experimental Research 2 (3): 235–40. Edwards, Griffith. 2000. Alcohol: The Ambiguous Molecule. London: Penguin Books. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. Murdock, Catherine Gilbert. 1998. Domesticating Drink: Women, Men, and Alcohol in America, 1870–1940. Baltimore: Johns Hopkins University Press. White, William L. 1998. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chestnut Health Systems.

American Society of Addiction Medicine (ASAM) The American Society of Addiction Medicine (ASAM) is a nonprofit organization made up of physicians who treat patients

54   American Society of Addiction Medicine (ASAM)

with addiction problems. ASAM’s mission is to increase the accessibility of—and improve the quality of—addiction treatment, educate physicians and health care providers on addiction, support research and prevention of addiction, promote the role of the physician in the care of addicted patients, and to establish addiction medicine as a specialty within the medical field. Today there is both a national organization as well as state organizations that help further the agency’s goals in those states. According to ASAM, the term “addiction” refers to a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death. ASAM’s roots date back to the 1950s, when physician Ruth Fox worked to establish the New York City Medical Committee on Alcoholism, a group of physicians interested in the study of alcoholism and its treatment that met at the New York Academy of Medicine. The Medical Committee met regularly, and in 1954 it convened

its first scientific meeting and established the New York City Medical Society on Alcoholism, with Dr. Fox as its president. In 1967, this group changed its name to the American Medical Society on Alcoholism (AMSA). In the early 1980s, the organization incorporated similar groups, such as the American Academy of Addictionology and the California Society for the Treatment of Alcoholism and Other Drug Dependencies, into its membership. In 1986, AMSA began offering a national certification examination for doctors in the field of addiction medicine. The organization achieved one of its major goals—to get addiction treatment recognized as a subfield within medicine— in 1988, when it was approved and given membership by the House of Delegates of the American Medical Association. To reflect its interest in all addictions, not just alcoholism, the society changed its name to the American Society of Addiction Medicine (ASAM), in 1989. In 1990, ASAM achieved a major success when the American Medical Association gave addiction medicine a separate code as a self-designated specialty, officially recognizing addiction as a specialty within the medical field. In the 1990s, ASAM continued its work in establishing addictionology as a subfield within medicine, coming up with a set of guidelines for training programs in addiction medicine in 1990, and publishing editions of its Principles of Addiction Medicine, a reference guide that documented the scientific and clinical foundations of addictionology, in 1994, 1998, and 2003. More recently, ASAM established its Medical Specialty Action Group in order to further the group’s goal of establishing addiction medicine as a primary specialty within the medical field, and to develop standards for training on addictive disorders for use in residency training programs.

American Society of Addiction Medicine (ASAM)  55

Today, ASAM continues to advocate for addiction medicine to be recognized as a medical disorder by physicians, health insurers, health care organizations, and policymakers. By partnering with government and private-sector organizations, the group sponsors programs and creates educational materials to help physicians, health professionals, and government officials understand both the medical and societal aspects of substance abuse. The group is concerned with policies on the federal and state levels that would change the access that patients with substance abuse disorders have to treatment options. This includes changes in treatment programs for veterans, education programs for youth, or changes in federal allocations to different agencies that provide treatment, prevention, and recovery programs. Their advocacy program relies on grassroots networks to reach out to state and federal legislatures. They organize “lobby days” on Capitol Hill and issue “Action Alerts” to activate members to act on a particular policy. To keep federal legislators aware of the potential health, economic, and legal implications of pro-addiction treatment policies, they publish briefings for the members of Congress that describe these concerns. To further their success, ASAM contracts with professional lobby consultants to represent addiction coalitions on proposed legislative action. ASAM also keeps their members informed on the progress of their actions through their Web site. For those members who are interested, ASAM provides an “advocacy toolkit” to assist them in their advocacy work. Through its publications, ASAM News, Journal of Addiction Medicine, Principles of Addiction Medicine, and ASAM Patient Placement Criteria, the organization disseminates information about addiction and its treatment.

The group is also a strong advocate for addiction treatment, pushing for addiction medicine specialists to be paid by insurance companies the same way that other medical specialists are, and also working to secure funding to study the efficacy of different addiction treatments. They have developed criteria to help professionals determine the most appropriate treatment settings for those seeking treatment for their addictions. The criteria include characteristics of the patient and other outside factors. The criteria can be used to determine the appropriate intensity of the treatment (i.e., outpatient, intensive outpatient, partial hospitalization, medically monitored intensive inpatient, or medically managed intensive inpatient). ASAM holds a yearly conference for those in the treatment/addiction fields as a way to advance knowledge about patterns of diagnosis, treatment, and on-going research. They also offer multiple training and education courses to professionals on a variety of topics. Some of those include Risk Evaluation and Mitigation Strategies (REMS), Toxicology Testing and the Physicians’ Role in the Prevention and Treatment of Substance Abuse, Opioid REMS, online Buprenorphine training, and review courses. More information on ASAM and its activities are available at the group’s Web site: http://www.asam.org/. David E. Newton See also: Addictive Medications; Addictive Personality; Alcoholism

Further Reading American Society of Addiction Medicine. “The American Society of Addiction Medicine Strategic Plan 2006–2010.” http:// www.asam.org/CMS/images/PDF/General/ Strategic%20Plan.pdf.

56   American Temperance Society (ATS) American Society of Addiction Medicine. “ASAM Historical Timeline.” http://www .asam.org/Timelines.html. American Society of Addiction Medicine. “ASAM Mission.” http://www.asam.org/ about.html. American Society of Addiction Medicine. 1996. “Patient Placement Criteria for the Treatment of Substance-Related Disorders.” Chevy Chase, MD: American Society of Addiction Medicine. California Society of Addiction Medicine. “About CSAM.” http://www.csam-asam .org/about_csam.vp.html. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA.

American Temperance Society (ATS) The American Temperance Society (ATS) (also known as the American Society for the Promotion of Temperance) was the first national temperance organization in the United States. After a national trend toward increased consumption of alcoholic beverages, ATS members sought to limit drinking of these beverages as a way to improve family life. Buoyed by a Protestant revival and led by media-savvy directors, the ATS grew into an organization of approximately 1.5 million Americans by 1835. Though it did not operate as a prohibitionist organization, the ATS was significant in helping pave the way to national prohibition, as the temperance organization’s initial notions of moderate drinking being acceptable eventually gave way to the ideal of complete abstinence from alcohol. The origins of the ATS are to be found in an 1826 state convention brought together by Boston reverend Dr. Justin Edwards. At this

assembly, Massachusetts clergymen took the lead in establishing a group they named the American Society for the Promotion of Temperance. Edwards, along with Lyman Beecher, became one of the cofounders of the ATS. Beecher was a Presbyterian minister from Litchfield, Connecticut, and father to Harriet Beecher Stowe. His speeches on the temperance movement were published in the United States and became popular across Europe. This new organization differed from its closest predecessor, the Massachusetts Society for the Suppression of Intemperance (MSSI), which was founded in 1813 by elite figures in the state and whose main tactics in combating intemperance were to pressure local officials to lock up public drunks and advocate restricting licenses for the sale of liquor. Since the elitist MSSI did not believe in prohibition, they favored the idea of suppressing intemperance by means of allowing only the most upstanding local citizens to possess alcohol sales licenses. The ATS’s innovations as a temperance organization were multiple. Unlike the MSSI and other previous temperance groups, the ATS cast their opposition to intemperance in religious terms, often invoking a divine inspiration for their efforts. Similarly, the ATS utilized missionary tactics to convert the drinker to temperance. Since 14 of 16 directors of the American Temperance Society were members of the American Tract Society, the group used many of the American Tract Society’s propaganda tactics, distributing millions of temperance pamphlets throughout the country. These temperance tracts built upon the writings of temperance advocates like Dr. Benjamin Rush by utilizing (sometimes spurious) statistics to emphasize the broad threat that they believed drunkenness posed to the vitality of the nation. Another new

American Temperance Society (ATS)  57

ATS development was the uncompromising nature of their stance on temperance. Instead of working towards moderate consumption as the ideal, the ATS fixed complete abstinence from distilled drinks as the definition of temperance. The structure that the ATS took as an organization also represented a new stage in the development of temperance activity in the United States. The ATS was significant since it was the first national temperance organization, but just as importantly, it also granted local chapters a great deal of initiative and power. As a result, unlike its more centralized predecessor, the MSSI, the ATS functioned as a fairly democratic institution with a broad public membership base spread across the country. Money, tracts, and speakers flowed from the national body to its local chapters, while the local associations were responsible for the work of rallying their particular communities to temperance in specialized ways. Thus the strength of the national temperance organization emerged from the diversity of its local specialization, as it had vibrant local branches that catered to temperance-minded African Americans, artisans, business groups, or women. Women, in particular, played an important role in the ATS, which became one of the first American voluntary organizations of any type to attract large numbers of women to its ranks. Women were especially active in spreading petitions and fundraising for local temperance societies. Though men remained the leaders of the ATS, women often outnumbered men in the rank and file of the organization. In the mid-1830s, the ATS changed both its stance on alcohol and the nature of the orga­nization itself. By 1835, the ATS had approximately 1.5 million members spread across some 8,000 auxiliaries; their ranks thus constituted about 12 percent of the

nation’s free population. Despite these impressive numbers, the ATS concluded that a new approach to temperance was needed to win the national fight against alcohol. As such, in 1836 the ATS adopted teetotalism and reorganized itself as the American Temperance Union. The teetotal pledge differed from other pledges since the teetotaler pledged to give up all alcohol, and not just distilled spirits. Fermented drinks such as wine, cider, and beer were thus no longer acceptable beverages for the newly defined temperate person, who viewed wine as equally dangerous as whiskey. With this embrace of teetotalism, the ATS changed not only its name, but also its constituency. Members who preferred to abstain simply from distilled spirits found themselves at often harsh odds with teetotalling members, and some tepid supporters of the ATS withdrew their assistance. The end result of the ATS’s reorganization into the American Temperance Union was the radicalization of mainstream temperance agitation and political activity, which would gain momentum in the late 19th and early 20th centuries. Howard Padwa and Jacob A. Cunningham See also: Eighteenth Amendment; Prohibition; Prohibition Party; Rush, Benjamin; Volstead Act; Women’s Christian Temperance Union

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. Mendelson, Jack H. and Nancy K. Mello. 1985. Alcohol: Use and Abuse in America. Boston: Little, Brown and Company.

58  Amphetamines Pegram, Thomas R. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee. Rorabaugh, William J. 1979. The Alcoholic Republic: An American Tradition. New York: Oxford University Press. Tyrell, Ian R. 1979. Sobering Up: From Temperance to Prohibition in Antebellum America, 1800–1860. Westport, CT: Greenwood Press.

Amphetamines Amphetamines are a group of addictive central nervous system stimulants that imitate the effects of adrenalin in the body. Amphetamines are frequently prescribed to suppress appetite and treat obesity, improve concentration and focus in people with attentiondeficit hyperactivity disorders, or boost wakefulness in narcoleptics, patients who are subject to uncontrollable sleeping patterns. Amphetamines are also known as “speed” or “uppers” and are listed on Schedule II of the Controlled Substances Act (CSA) because of the high potential for abuse. This group of drugs is one of the most abused classes of drugs, and 16 to 51 million people between the ages of 15–64 years old reportedly used an amphetamine substance at least once in 2007 (Castiglioni et al. 2011). In the brain, amphetamines act somewhat differently from cocaine, another potent stimulant, because they prevent the reuptake of dopamine significantly longer and thus have a prolonged effect. They produce a feeling of energy and alertness, and provide the user with a state of arousal and sense of confidence. One of the earliest forms of amphetamines was Benzedrine, which was given to pilots in World War II as a way to help them stay awake during long missions. It was also

used to clear bronchial passages because it would shrink enlarged nasal mucosa. Later they were used as diet pills known as “black beauties.” Eventually, these drugs were replaced with safer drugs, but they have remained available on the black market. One of the most notorious amphetamines is methamphetamine (Methedrine), a highly addictive and destructive drug that can be easily manufactured in basement or garage laboratories. The drug is now produced in clandestine “meth labs” that use chemicals that are both toxic and highly flammable. Some meth is found in powder form and can be snorted, smoked, or injected. It is odorless, tasteless, and can dissolve in liquid.

An assortment of amphetamines confiscated by law enforcement. Amphetamines, also called uppers, have an energizing effect on the body. People rely on these drugs to keep them awake or to allow them to concentrate, but they can also be addictive and abused. (Centers for Disease Control and Prevention)

Amphetamines  59

This drug goes under the names crank, go, chalk, fire, and glass. A smokeable form of methamphetamine, called crystal meth, is popular because it is not injected. It is a concentrated form of methamphetamine that resembles small pieces of glass. It has a rapid onset and lasts about six to eight hours. Decongestants sold over the counter usually contain amphetamine-like drugs that contain pseudoephedrine, ephedrine, and phenylpropanolamine. Although these are less potent than the more addictive amphetamines that are often used in the manufacture of much more potent drugs such as methamphetamine, they are on List I of the CSA and are subject to controls mandated under the Combat Methamphetamine Epidemic Act of 2005 to supervise the availability and sale of products containing the drug. Other amphetamines are well-known pharmaceuticals such as methylphenidate (Ritalin) and dextroamphetamine (Adderall), both of which are prescribed to treat attention-deficit hyperactivity disorders, usually in children. These drugs work on the central nervous system in such a way that they lower the level of hyperactivity and attention deficit. They also appear to increase self-esteem, cognition, and social functioning. Ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is an illicit hallucinogen that is sometimes categorized as an amphetamine. Depending on the dosage and frequency of their use, drugs such as Ecstasy initially produce feelings of intimacy and liveliness that encourage social interaction and physical activity. It can give the user increased energy levels. As a type of hallucinogenic drug, it may also distort perception, memory, and sensation. Ecstasy is used in nightclubs, bars, and dance clubs called “raves,” sometimes mixed with other drugs such as alcohol or ketamine, marijuana, or LSD. While use of Ecstasy seemed to peak in 2000 and

2001, the 2011 Monitoring the Future Study showed that the drug is becoming popular among eighth and tenth graders. Moreover, the 2010 National Survey on Drug Use and Health found that in 2010, about 695,000 people in the United States over the age of 12 had used Ecstasy in the month prior to the survey (Miller 2013). In 2012, however, that number had increased to 900,000 (SAMHSA 2013). In addition to the typical rush of euphoria, alertness, and sense of well-being that the use of amphetamines produces, users may also display anxiety, aggressiveness, and repetitive behaviors. Excessive or protracted use can lead to paranoid or psychotic episodes involving confusion, delusions, violence, and hyperactivity or hypersexuality, which may encompass unsafe sexual practices resulting in the spread of illness. Physical consequences of amphetamine abuse include elevated blood pressure, irregular heartbeat, nausea and vomiting, respiratory depression, and, possibly, seizures, coma, or death. Withdrawal is associated with headaches, muscle cramps, fatigue, sleep disturbances and nightmares, and severe depression— sometimes of suicidal intensity. Users who binge for days continuously ingest amphetamines to both reexperience the rush and to avoid the certain torment of a crash and subsequent withdrawal. Kathryn H. Hollen See also: Controlled Substances Act; Ecstasy

Further Reading Califano, Joseph A. Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do About It. New York: Perseus Books. Castiglioni, Sara, Ettore Zuccato, and Roberto Fanelli. 2011. Illicit Drugs in the Environment. Hoboken, NJ: John Wiley and Sons.

60  Analgesics Cobb, Allan B. 2000. Speed and Your Brain: The Incredibly Disgusting Story. New York: Rosen Central.

U.S. Department of Health and Human Services, National Institute on Drug Abuse (NIDA). 2007. http://www.nida.gov.

Drugs.com. “Amphetamine.” http://www .drugs.com/amphetamine.html.

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). 2007. http://www.samhsa.gov.

Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Menhard, Francha Roffe. 2006. The Facts About Amphetamine. New York: Marshall Cavendish Benchmark. Miller, Malinda. 2013. Ecstasy: Dangerous Euphoria. Broomall, PA: Mason Crest. Moore, Elaine A. 2011. The Amphetamine Debate: The Use of Adderall, Ritalin, and Related Drugs for Behavior Modification, Neuroenhancement and Anti-Aging Purposes. Jefferson, NC: McFarland and Company. National Institutes of Health. “Methamphetamine.” MedlinePlus. http://www.nlm.nih .gov/medlineplus/methamphetamine.html. Pates, Richard, and Diane Riley. 2010. Interventions for Amphetamine Misuse. Ames, IA: Blacksell. Substance Abuse and Mental Health Services Administration (SAMHSA). 2013. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” http://www.samhsa.gov/data/NSDUH/2012 SummNatFindDetTables/NationalFindings/ NSDUHresults2012.htm#ch4. United Nations. Preventing Amphetamine-type Stimulant Use Among Young People: A Policy and Programming Guide. 2007. Vienna: United Nations Office on Drugs and Crime. U.S. Department of Health and Human Services, Amphetamine/Methamphetamine Reports. http://www.oas.samhsa.gov/amphetamines .htm.

U.S. Department of Justice, Drug Enforcement Administration (DEA). 2008. http://www .usdoj.gov/dea.

Analgesics Analgesics are the class of drugs that are used medically by patients to relieve pain without causing a loss of consciousness. The word comes from the Greek an (“without”) and algia (“pain”). Analgesic drugs work on the peripheral and central nervous systems. For users, these drugs can be highly addictive. The number of people addicted to analgesics, particularly pain pills such as Oxycodone, is increasing. In fact, more people are addicted to pain pills than to cocaine, heroin, and meth combined. Some mild forms of analgesics are available over the counter (OTC) without a physician’s prescription, but stronger analgesics are available only with a doctor’s script. They may be given orally (by mouth), through the rectum or nose, or injected, intravenously or topically. They can be taken on a regular schedule or as needed to manage pain. Every pain medicine carries some benefits as well as some risks. There are three types of OTC analgesics. One is salicylates, which includes aspirin, one of the most common analgesics. While aspirin is generally safe for most adults, use by children under 16 has been linked to Reye’s syndrome, a rare liver disorder. Long-term use in adults can cause damage to the stomach lining, causing abdominal

Analgesics  61

pain and bleeding. It can also prevent the blood to clot, making it useful for patients suffering from (or prone to) heart attacks and stroke. The second type of OTC analgesic is acetaminophen. This drug relieves fever and headaches and other common pains, but it does not reduce inflammation. For most people, acetaminophen does not cause stomach problems as does aspirin, and it is safer for children. But in large doses, it can cause liver damage. OTC brands include Tylenol and Panadol. Stronger forms can also be prescribed by a doctor if needed. The third is type of OTC analgesic is non­ steroidal anti-inflammatory drugs (NSAIDs). They work by inhibiting cyclooxygenases. These drugs reduce swelling and reduce pain, so they are often used for patients suffering from arthritis or muscle sprains. Examples of this type of drug include ibuprofen (Advil or Motrin) and naproxen (Aleve). These drugs have few side effects and are safe for most users, but long-term use could lead to kidney and/or liver damage. Other side effects of NSAIDs include peptic ulcers, renal failure, and hearing loss. Most of these medications have the same or similar pain-reducing effects. Many of these are available combined with other drugs, such as antihistamines, that serve to enhance the effects. When combined with other drugs, they are considered to be compound analgesics. When choosing one of the many types of analgesics, a doctor must consider not only the severity of the patient’s pain, but also the type of pain. Pain is categorized as acute, chronic nonmalignant, or chronic malignant. Acute pain is usually short term with an identified source and simple treatment. It can be caused by an injury, broken bones, or cuts. Chronic nonmalignant pain is ongoing and can be associated with progressive

diseases such as arthritis. Chronic malignant pain is associated with advanced, chronic diseases such as AIDS, cancer, or multiple sclerosis. For those suffering from such conditions, stronger prescription medications are needed. COX-2 inhibitors were derived from NSAIDs. These drugs inhibit another version of the cyclooxygenase enzyme. Some of these drugs are celecoxib and rofecoxib. In most people, these drugs are as effective as NSAIDs but may cause fewer gastrointestinal problems. However, it was found that some of these drugs increased the risk of cardiovascular problems in some patients, so their use is sometimes limited. The most common controlled analgesics are opiates and morphinomimetics such as morphine and codeine (also oxycodone). They are popularly used analgesics because of their effectiveness for reducing many types or levels of pain (from mild to severe). Some patients may have symptoms of nausea, vomiting, constipation, or itching when using these drugs. Long-term use can lead to confusion, respiratory concerns, and seizures. However, they are usually safe and effective when used correctly. If used frequently, the effectiveness of the drug may be diminished. In this case, the dosage should be increased. Some opioids are administered through patches, which allows for the drug to be released into the body over a long period of time. They can be effective for patients who are unable to take drugs orally. Some antidepressants have analgesic qualities. These medications appear to be most effective for pain associated with arthritis, nerve damage, some headaches (particularly migraines), fibromyalgia, lower back pain, and pelvic pain. While the exact reason why these drugs also reduce pain is unclear, it is thought that they may increase neurotransmitters in the spinal cord that reduce

62  Analgesics

pain signals to the body. One of the most effect group of antidepressants used for pain is called tricyclics. In some patients, these drugs cause blurred vision, drowsiness, dry mouth, weight gain, confusion, constipation, or heart problems. Topical analgesics have been developed for people suffering from painful joints. Capsaicin is an example of this kind of drug. With topical analgesics, the drug can be applied directly to the location of the pain. This way, there is less medicine throughout the body and a lower potential for causing side effects. Topical medicine can be applied by a cream, lotion, or spray. Marijuana (and specifically the THC, or tetrahydrocannabinol found in marijuana) has been identified as having analgesic effects for users. Although illegal in the United States under federal law, some individual states allow those suffering from certain diseases to use marijuana medically. Inhaled cannabis is effective in reducing pain for some patient suffering from multiple sclerosis and some injuries. Marijuana can also be ingested orally through baked goods or oils, but for some people, the effect can be different than when the marijuana is smoked. It is important that those taking pain medicines be watched for potential side effects. Patients should never take more than the recommended dosage, and they should read and be aware of all of the warnings and potential side effects of the drugs. Patients using opioids should be aware that it may affect their driving ability to perform other skilled tasks. Alcohol use should be stopped while a patient is using analgesics. Those who use the drugs can take it orally through a pill form, or can crush the pills and snort them, or melt them so they can be injected. Some users prefer to shoot pain medication instead of heroin because the drugs are made by pharmaceutical compa-

nies, so the purity of the drug is not in question. Moreover, pain pills are designed with slow release safety coatings to help prevent an overdose. Nonetheless, overdoses do happen. Patients who have overdosed on analgesic medicines may display pinpoint pupils, respiratory depression, hallucinations, tremors, shaking in the arms or legs, or even seizures. Some people may become extremely sleepy, or even lapse into a coma. In recent years, deaths by prescription painkillers have increased, especially by females. Between 1999 and 2010, almost 48,000 women died from an overdose of painkillers. This is an increase of over 400 percent (as compared to 265 percent for men). Almost 18 women die every day in the United States from an overdose of painkillers. The most vulnerable population is women between the ages of 45 and 54. It is thought that women, since they are more likely to suffer from chronic pain, are prescribed these drugs more often and at higher doses. They are also more likely to use them for longer time periods than men. Thus, they are more likely to become more dependent on them. Nancy E. Marion See also: Antidepressants; Cocaine and Crack; Codeine; Oxycodone/OxyContin

Further Reading Aronson, J. K., ed. 2010. Meyler’s Side Effects of Analgesics and Anti-inflammatory Drugs. Boston: Elselvier. Centers for Disease Control and Prevention. 2013. “Prescription Painkiller Overdoses: A Growing Epidemic, Especially Among Women.” http://www.cdc.gov/vitalsigns/ PrescriptionPainkillerOverdoses/index .html. Jacobs, Vivian, and Alexander Lang, eds. 2012. Analgesics: New Research. New York: Nova Science Publishers.

Andean Trade Preference Act (1991)  63 Jasmin, Luc. 2013. “Over-the-Counter Pain Relievers.” http://www.nim.nih.gov/medline plus/ency/article/002123.htm. Knott, Laurence, and Gurvinder Rull. 2013. “Opioid Analgesics.” http://www.patient.co .uk/print/513. Mayo Clinic. 2013. “Antidepressants Are a Mainstay in the Treatment of Many Chronic Pain Conditions—Even When Depression Isn’t a Factor.” http://www.mayoclinic .com/health/pain-medications/PN00044. O’Brien, Robert, and Sidney Cohen. 1984. The Encyclopedia of Drug Abuse. New York: Facts on File. Ogbru, Annette (Gbemudu), and William C. Chiel Jr. “OTC Pain Relievers and Fever Reducers.” http://www.medicinenet.com/ analgesics_antipyretics/page2.htm. Pates, Richard, and Diane Riley. 2010. Interventions for Amphetamine Misuse. Ames, IA: Blackwell.

Andean Trade Preference Act (1991) The influx of illicit drugs into the United States from Andean countries (Bolivia, Colombia, Peru) has been a concern to many U.S. presidents in recent years. President Ford sought to expand cooperation with the leaders of these countries to control the production and shipment of hard drugs. President Carter claimed to have received assurances from the president of Colombia that he was going to give the drug problem high priority. He also promised to establish a commission comprising government officials representing both countries that would coordinate their efforts to deal with international trafficking of cocaine. President Reagan earmarked $10 million from a military assistance program to purchase aircraft that would be used for interdiction and eradica-

tion efforts, some of which was specifically reserved to create a regional South American fleet in Colombia. Congress agreed with this approach. While considering a foreign aid authorization bill in 1985, Congress debated a provision that would have withheld all of Bolivia’s $21 million in economic development aid until it met certain conditions for reducing the production of coca, the basic component of cocaine. While some members wanted to suspend all aid to Bolivia until it showed more action on cracking down on the production of coca, the majority of members agreed to reserving only $10 million until antidrug efforts were proven. During his administration, President George H. W. Bush announced an all-out effort to reduce illegal drug use in America. He sought ways to develop more multilateral cooperative agreements and eliminate narco-trafficking organizations. In September 1989, President Bush announced $65 million in emergency assistance to the Colombian government to assist in their fight against cocaine cartels. In a televised speech, Bush explained that officials in Colombia had arrested suppliers, seized tons of cocaine, and confiscated homes of the drug lords. But there was more to be done. Bush’s plan at that time also included over a quarterbillion dollars for the following year for law enforcement assistance for the three Andean nations, which was part of a five-year, $2 billion plan to counter producers, traffickers, and smugglers. The Andean Trade Preference Act (ATPA) was enacted in December 1991 during the George H. W. Bush administration as a way to provide assistance to four Andean countries (Bolivia, Colombia, Ecuador, and Peru) to fight against drug production and trafficking. By expanding alternative means of production, it is hoped that these countries

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would rely less on drug production and trafficking. In 2001, Congress also passed the Andean Counterdrug Initiative, an effort to block narcotics shipments to the United States. The ATPA was succeeded by the Andean Trade Promotion and Drug Eradication Act (ATPDEA), which was enacted on August 6, 2002, during the George W. Bush administration. This new law renewed and amended the ATPA to provide duty-free opportunities to certain products that were not included in the original ATPA. The ATPA was a trade preference system by which the United States permitted a variety of exports from these countries to come into the United States with duty-free access. Under the new act, the number of Andean-produced items exempted from tariffs increased from approximately 5,600 to about 6,300. The exemptions in the ATPDEA were expected to expire on December 31, 2006, but Congress renewed the act for an additional six months, up to June 30, 2007. Congress passed an additional 8-month extension on June 28, 2007, which took the exemption to February 29, 2008. A third extension was passed by Congress on February 28, 2008, this time for 10 months. In November of 2008, President George W. Bush asked Congress to remove Bolivia from the agreement because they did not cooperate in counternarcotic efforts. On December 14, 2009, the House of Representatives approved a new extension for one year, but the Senate did not renew the plan. Despite this, a plan covering products from Ecuador was eventually approved. The ATPDEA has increased trade between the United States and the four Andean nations. It is reported that U.S. exports to the region increased from $6.5 billion in 2002 to $11.6 billion in 2006. During that same time, imports from the Andean countries

into the United States grew from $9.6 billion to $22.5 billion. The primary exports into the United States were oil, clothing, copper cathodes, flowers, gold jewelry, asparagus, and sugar. Most of the imports came from Ecuador, followed by Colombia, Peru, and Bolivia. Nancy E. Marion See also: Bush, George H. W.; Bush, George W.; Colombian Cartels; Drug Trafficking

Further Reading “Andean Trade Program.” http://export.gov/ peru/u.s.perutradepromotionagreement/an deantradepreferenceact/index.asp. Bauder, Julia. 2008. Drug Trafficking. Detroit: Thomson. “Congress Clears Foreign Aid Authorization Bill.” 1986. In CQ Almanac 1985, 41st ed., 41–61. Washington, DC: Congressional Quarterly. http://library.cqpress.com/ cqalmanac/cqal85–1147153. “Congress Clears Massive Anti-Drug Measure.” 1987. In CQ Almanac 1986, 42nd ed., 92–106. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqal manac/cqal86–1149752. Office of the U.S. Trade Representative, Executive Office of the President. “Andean Trade Preference Act.” http://www.ustr.gov/ trade-topics/trade-development/preference -programs/andean-trade-preference-act -atpa. “Presidential Address: Bush Anti-Drug Proposal Slated to Add $2.2 Billion.” 1990. In CQ Almanac 1989, 45th ed., 33-C-36-C. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqalmanac/ cqal89–851–25637–1136979. “Presidential Statement: Carter Proposes Drug Law Revision.” 1978. In CQ Almanac 1977, 33rd ed., 41-E-43-E. Washington, DC: Congressional Quarterly.

Anslinger, Harry J. (1892–1975)  65 http://library.cqpress.com/cqalmanac/ cqal77–863–26256–1200540. Steinberg, Michael K., Joseph J. Hobbs, and Kent Mathewson. 2004. Dangerous Harvest: Drug Plants and the Transformation of Indigenous Landscapes. New York: Oxford University Press. U.S. Customs and Border Protection. 2013. “Andean Trade Preference Act (ATPA)— Expiration of Duty-Free Treatment.” https://help.cbp.gov/app/answers/detail/ a_id/325/~/andean-trade-preference-act -%28atpa%29—-expiration-of-duty-free -treatment. U.S. International Trade Commission. 2011. Andean Trade Preference Act: Impact on U.S. Industries and Consumers and on Drug Crop Eradication and Crop Substitution, 2011. http://www.usitc.gov/publica tions/332/pub4352.pdf.

Anslinger, Harry J. (1892–1975) Harry J. Anslinger was one of the most influential figures in U.S. drug control policy during the 20th century. He was the first head of the Federal Bureau of Narcotics, and kept the position from 1930 through 1962. For the duration of his tenure, Anslinger advocated for the tough treatment of addicts and traffickers, and he also was a very public decrier of the dangers of habit-forming drugs and an outspoken critic of the maintenance treatment of addicts. Henry Jacob Anslinger was born in Altoona, Pennsylvania, in 1892, and became involved with law enforcement by compiling statistics and investigating arson cases. When the United States entered World War I in 1917, Anslinger was in the Ordinance Division of the War Department, where he worked as an overseer of government contracts. He was then sent to Holland to work

for the State Department, and when the war concluded he remained in Europe, where he gathered intelligence on Russia and drug smuggling from Germany to the United States. He was then transferred to Venezuela and the Bahamas, where he worked in intelligence gathering on rum smuggling in the Caribbean. There, he enjoyed his first major professional success, as he persuaded the British to establish a certificate system that would make it possible to keep records of all ship movements. This impressed officials in the Treasury Department, and he was soon appointed the chief of the Foreign Control Section of the Prohibition Unit. In 1929, he was appointed assistant commissioner of prohibition. Though it was becoming clear that alcohol prohibition was not working as he rose through the ranks of the Prohibition Unit, Anslinger remained an enthusiastic supporter of the cause, recommending that the United States try to limit alcohol smuggling through international agreements and by empowering the Justice Department, rather than the Treasury Department, to oversee enforcement. He also recommended expanding the reach of the Volstead Act to make illegal purchase of alcohol a crime with severe punishment. By toughening the law, he reasoned, people would be discouraged from temptation to break it. When Levi G. Nutt was compelled to resign from his post as the head of the Narcotic Division of the Prohibition Unit in 1930, Anslinger was named his replacement, and within a few months, he became the head of the Narcotic Division’s successor—the Federal Bureau of Narcotics (FBN). As the nation’s chief enforcer of narcotics control laws, Anslinger bought many of the attitudes he had during his work at the Prohibition Bureau—that high fines and mandatory prison sentences would be effective deterrents—to the task of narcotics control. However, he

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was also shrewd enough to adapt some of the lessons learned from the failure of alcohol prohibition to his campaigns against narcotics. Most importantly, he learned that an overly zealous enforcement campaign against widely used substances was doomed to failure, especially because federal judges were likely to let off ordinary citizens brought up on trifling charges. Taking this into consideration, Anslinger made an effort to bring drug law offenders to local courts, where judges were more likely to mete out punishment. He also instructed agents not to focus their enforcement efforts on individuals who were suffering from illness, or became addicted while ill, but rather to crack down on recreational users, who were seen as more delinquent than sick. Anslinger also tried to keep the FBN’s activities limited to drugs that were widely considered dangerous—opiates and cocaine—and he resisted suggestions that the FBN tackle other, more common addictive substances such as barbiturates and amphetamines. Another lesson Anslinger took from prohibition was that citizens groups, such as the Anti-Saloon League and the Woman’s Christian Temperance Union, were valuable allies in lobbying for both the passage and enforcement of tougher restrictions on habit-forming substances. Taking this into consideration, the FBN under Anslinger worked with citizens groups to help spread the word concerning habit-forming drugs and the dangers they could pose. He also allowed for supplies of narcotics to be available at times when the nation needed them, as he did when he provided assurances that there were adequate supplies of morphine for medical use during World War II. To help with public relations, Anslinger also discouraged his agents from focusing on local druggists and doctors, instead encouraging them to crack down on the individuals who were less likely to gain

public sympathy—smugglers and racketeers. Anslinger believed that together with the imprisonment and forced cure of addicts in the Public Health Service Narcotic Hospitals, attacking large-scale traffickers would be the most effective way to handle the drug menace. Though he wanted to maintain a low profile in some areas, Anslinger nonetheless became a very outspoken advocate of tighter controls. In the 1930s, Anslinger organized a propaganda campaign against the dangers of narcotics to drum up support for the Uniform State Narcotic Act of 1932. In spite of reluctance to complicate matters by policing a drug that was not included in the Harrison Narcotics Act, Anslinger came to play a critical role in adding a new substance— marijuana—to the list of federally controlled substances by supporting and helping push through the 1937 Marihuana Tax Act. As with the Uniform State Narcotic Act, Anslinger oversaw a rigorous campaign against marijuana to scare the public into supporting legislation aimed at the drug. Leading the way with an article titled “Marihuana—Assassin of Youth” that he published in 1937, Anslinger helped cement public fears about narcotics by telling tales of young people committing suicide, indulging in sexually deviant behavior, thieving, or becoming murderous when under the influence of drugs. Anslinger contributed to antidrug sentiment by making accusations (sometimes accurate, sometimes not) that enemies of the United States—such as the Mafia, the Japanese during World War II, and communist countries—were involved in drug trafficking, thus making a connection between narcotics use and national security concerns. He was particularly vigilant on this point when it came to the Chinese communists, as he repeatedly argued before both Congress and the press that the Chinese government was smuggling

Anslinger, Harry J. (1892–1975)  67

heroin into the United States in order to weaken the population so they could invade. When lobbying for the FBN to receive more funding from Congress, Anslinger continually repeated the dangers that drugs posed to youth and national security to make his case. In addition to linking narcotics with enemies of the United States, Anslinger also argued that all the drugs controlled by the FBN, ranging from marijuana to heroin, were equally dangerous, and that the government needed to crack down on both users and dealers in order to prevent the drug epidemic from spreading. Thanks in large part to Anslinger’s propaganda, attitudes towards both narcotics and narcotics users hardened between the 1930s and 1960s, as conceptions of addicts being criminals, rather than victims of a disease, became dominant in the United States. After World War II, Anslinger feared that smuggling would rise with the renormalization of global commerce, so he supported the creation of mandatory minimum sentences for drug offenders to discourage trafficking, a provision that became law in 1951 with the passage of the Boggs Act. When concern over the resurgence of heroin on American streets emerged in the 1950s, he argued that tougher laws and more effective enforcement, above all else, would be the solution to the problem. Anslinger’s line of argument held sway in Congress, and his vision of a tougher control regime was partially realized with the passage of the 1956 Narcotic Control Act. Anslinger was also a staunch opponent of outpatient maintenance treatments for addicts, as he claimed that such arrangements merely facilitated and spread addiction, rather than curing it. He also argued that maintenance was inappropriate, especially after World War II, since he believed that most addicts were criminals anyway, and as such, undeserving of care. He

often publicly debated Lawrence Kolb, who had become critical of the FBN’s antimaintenance policies, during the 1950s. In 1961, he coauthored a book, The Murderers: The Story of the Narcotic Gangs, to make the case that tougher enforcement was necessary since drug smuggling was being carried out by some very powerful organizations— the Mafia and the communists. Sometimes Anslinger used more unsavory methods to try to disprove his critics. For example, he tried to silence Alfred Lindesmith, an outspoken critic of the FBN, by supporting the writing of works that would have undermined Lindesmith’s research and his faculty position at the University of Indiana. In addition to Lindesmith, Anslinger also worked to undermine the credibility of researchers such as Marie Nyswander and Vincent Dole, who argued that addicts should not be treated as criminals and advocated the use of methadone treatments for opiate addicts. Anslinger retired from the FBN in 1962, and then served two years as the U.S. representative to the United Nations Narcotics Commission. He passed away at the age of 83, in 1975. Howard Padwa and Jacob A. Cunningham See also: Anti-Saloon League; Boggs Act; Dole, Vincent; Federal Bureau of Narcotics; Harrison Narcotics Act; Lindesmith, Alfred; Marihuana Tax Act; Narcotic Control Act; Nutt, Levi G.; Nyswander, Marie; Prohibition Unit; Women’s Christian Temperance Union

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press. Acker, Caroline Jean, and Sarah W. Tracy, eds. 2004. Altering American Consciousness: The History of Alcohol and Drug Use in the

68  Antidepressants United States, 1800–2000. Amherst: University of Massachusetts Press. Anslinger, Harry J., and Will Oursler. 1961. The Murderers: The Story of the Narcotic Gangs. New York: Farrar, Straus and Cudhay. Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Frydl, Kathleen J. 2013. The Drug Wars in America, 1940–1973. Cambridge: Cambridge University Press. Krebs, Albin. 1975. “Harry J. Anslinger Dies at 83; Hard-Hitting Foe of Narcotics.” New York Times, November 18: 40. McWilliams, John C. 1990. The Protectors: Harry J. Anslinger and the Federal Bureau of Narcotics. Newark: University of Delaware Press. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Antidepressants Antidepressants are a treatment for those suffering from the symptoms of moderate or severe depression. Depression can make it difficult for a person to carry on daily tasks and activities that bring pleasure. It is usually caused by an abnormal functioning of the brain, and can be brought on by stress, difficult life events (illnesses, death of family or friends), or other prescription drugs.

Antidepressants are not stimulants, but instead remove or reduce the symptoms associated with depression. They became popular as prescription drugs during the 1950s. It was thought at the time that the market for the drug was so small that few drug companies wanted part of it. During the 1960s, sales of antidepressants remained small. As more antidepressants were developed, the drugs became more popular. In 2005, it was estimated that 11 percent of females and 5 percent of males in the United States took antidepressant medication. The National Center for Health Statistics reports that 5 percent of 12–19 year olds in America use antidepressants. They are now used often for patients suffering from symptoms other than depression because of their analgesic (pain-relieving) and anti-inflammatory properties. They are also used for social anxiety, anxiety disorders, agitation, obsessive compulsive disorders, and posttraumatic stress disorder. Antidepressants are not a cure for depression, but instead help to reduce the symptoms of the disease. Scientists have discovered that certain brain chemicals (called neurotransmitters) are associated with depression, and these medications have an effect upon the neurotransmitters. Specifically, antidepressants can increase the concentration of one or more of the chemicals in the brains that are used by nerves to communicate with one another. Each type of antidepressant can affect the neurotransmitters in different ways, which means that the drugs have different effects and affect each patient differently. MAOIs (monoamine oxidase inhibitors) were the first class of antidepressants that were developed. They worked by increasing the levels of norepinephrine, serotonin, and dopamine by inhibiting an enzyme called monamine. Monamine typically breaks down norepinephrine, serotonin, and dopa-

Antidepressants  69

mine; so if monamine oxidase is inhibited, norepinephrine, serotonin, and dopamine are not broken down, thereby increasing the concentration in all three neurotransmitters in the brain. There were many concerns that they would cause dangerous interactions with certain foods and other drugs, so the use of these drugs declined. Since then, many new antidepressants have been developed that work well with fewer dangerous side effects. Nicotine is sometimes considered to be an antidepressant because it helps the body release dopamine and norepinephrine. It also may desensitize nicotinic receptors. Caffeine is also considered to be an antidepressant, especially at moderate doses (less than 6 cups of coffee per day or its equivalent). People who use caffeine in these amounts have fewer depressive symptoms and an overall reduced risk of suicide. However, for those suffering from panic disorders, caffeine (especially in excessive amounts) can bring on symptoms. Typically, the effects of antidepressants will begin to occur in the first few weeks of use. Usually the medication must be taken regularly. If there are no improvements by six to eight weeks, a doctor may choose to use another type of drug. The benefits typically do not continue if the patient stops using the drug. Some patients may only need to use a drug for a short time to learn to manage symptoms, whereas others may need to remain taking the drug indefinitely. While most antidepressants are safe for patients to use, some antidepressants cause side effects (sometimes temporary) for those who use them. Possible side effects include dizziness, anxiety, nausea, insomnia, restlessness, decreased sex drive, headaches, weight gain, tremors, sweating, sleepiness or fatigue, dry mouth, diarrhea, and constipation. Some antidepressants have a stimulating effect on users, whereas others have

a slightly sedating effect. It has been found that certain younger patients and young adults on these drugs may experience suicidal thoughts or behavior, especially when first beginning to take the medication. For patients over the age of 65, the risk of falling is increased. This also means a higher risk of fractures. For pregnant patients, antidepressant use can lead to withdrawal symptoms for their newborns. This typically includes tremors, restlessness, mild respiratory problems, and weak cry. Antidepressant use during pregnancy can lead to spontaneous abortion or other birth defects. In some cases, antidepressant use can lead to risk of suicide. In 1990, reports indicated that the use of the drugs (in particular Prozac) could lead to suicidality. Many years later, warning labels were put on antidepressants indicating that some patients, particularly those just beginning to take the drug, ceasing use of the drug, or changing the dosage of the drug, may suffer this effect. This is a particularly severe side effect if the patient is a young person. For that reason, any adolescent taking these drugs should be monitored closely. Since these drugs affect people differently, doctors need to choose a particular antidepressant based on the patient’s symptoms. The dosage may vary and depend on the age of the patient, and their age and weight. Usually a doctor will begin with a low dosage and raise it if needed. It is important to monitor the effects of the medications and have the flexibility to switch to another form of medication if needed. Some antidepressants may interact with medications for other conditions, so patients must be monitored for that as well. If a patient decides to discontinue the use of antidepressants, they may experience symptoms of withdrawal. These can include anger, anxiety, panic, confusion, crying, memory lapses, nightmares, tinnitus, shaking, balance problems, gastrointestinal

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problems, headaches, or sweating. To help prevent these symptoms, a patient should discontinue a drug slowly, over a period of several weeks or even months. Some recent studies have shown that the possible benefits of antidepressants have been exaggerated. In fact, some say that antidepressants are only somewhat more effective than placebos. At this point, researchers know little about what causes depression and how antidepressants work. Many doctors inform their patients that many times, medication is not enough to address the symptoms of depression. While medication may be helpful, changes in lifestyle may also help. Therapy, exercise, or other self-help treatments may be effective for some people. Below is a list of antidepressants that are commonly used to treat depression.

Serotonin reuptake inhibitors (SSRIs) Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac, Prozac Weekly, Sarafem) Fluvoxamine (Luvox, Luvox CR) Paroxetine (Paxil, Paxil CR, Pexeva) Sertaline (Zoloft) Serotonin and norepinephrine reuptake inhibitors (SNRIs) Venlafaxine (Effexor XR) Desvenlafaxine (Pristiq) Duloxetine (Cymbalta) Atypical antidepressants Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL) Trazodone (Oleptro) Mirtazapine (Remeron, Remeron SolTab) Nefazodone Tricyclic and tetracyclic antidepressants Amitriptyline

Clomipramine (Anafranil) Doxepin (Silenor, Zonalon) Imipramine (Tofranil, Tofranil-PM) Trimipramine (Surmontil) Desipramine (Norpramin) Nortriptyline (Pamelor, Aventyl) Protriptyline (Vivactil) Amoxapine Maprotiline

Monoamine oxidase inhibitors (MAOIs) Isocarboxazid (Marplan) Phenelzine (Nardil) Tranylcypromine (Parnate) Selegiline (Emsam, Eldepryl, Zelapar) Nancy E. Marion Further Reading “Depression: Dealing with Medicine Side Effects.” http:www.webmd.com/depression/ managing-the-side-effects-of-antidepres sants. “Depression Medications (Antidepressants).” http://webmd.com/depression/depression -medications-antidepressants. Dudley, William. 2008. Antidepressants. San Diego, CA: Daniel A. Leone. Glenmullen, Joseph. 2005. The Anti-depressant Solution: A Step-by-Step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “Addiction.” New York: Free Press. Hecht, Alan, and David J. Triggle. 2011. Antidepressants and Antianxiety Drugs. New York: Chelsea House. Hedaya, Robert J. 2000. The Anti-Depressant Survival Program: How to Beat the Side Effects and Enhance the Benefits of Your Medication. New York: Crown Publishers. National Institute for Mental Health. 2005. Medications for Mental Illness (NIH Publication No. 02-3929). Bethesda, MD: National

Anti–Drug Abuse Acts  Institute of Mental Health. http://www.nimh .nih.gov/health/publications/medications/ summary.shtml. Psych Central. 2006. “Antidepressant Medications.” http://psychcentral.com/lib/anti depressant-medications/000451. Sharpe, Katherine. 2012. “The Medication Generation.” Wall Street Journal, June 29. http://online.wsj.com/news/articles/SB100 0242405270230364950457749311261870 9108.

Anti–Drug Abuse Acts The Anti–Drug Abuse Acts were two pieces of federal legislation that toughened federal drug laws in the United States in the 1980s. Emphasizing law enforcement and social control as key elements in the fight against drug abuse in the United States, the acts marked a return to the punitive approaches towards drug abuse and drug trafficking that had taken place in the 1950s with the Boggs Act and the Narcotic Control Act. In the 1980s, drug abuse became a major social issue. Media coverage on drug abuse increased dramatically, especially with the rise of cocaine use and the widespread use of a new form of cocaine—crack—in America’s inner cities. Beginning in late 1984, the news media began reporting on the use of crack cocaine in poor neighborhoods of Los Angeles, and on the harmful effects it had on the health of youths who used the drug. By 1986, newspapers, magazines, and television news programs ran stories focusing on the dangers of the drug, spurring calls for the government to take more rigorous action against crack and those who dealt it. The cocaine-related deaths of college basketball star Len Bias and football player Don Rogers brought the dangers of

the drug into clearer relief. The rise in news coverage of the drug, not surprisingly, led increasing numbers of people to believe that it posed a grave social menace, and between 1985 and 1989, the number of Americans who believed that drugs posed the most serious problem in the United States rose from just 2 percent to 38 percent. Against the background of President Ronald Reagan’s War on Drugs, which had begun in the early 1980s, these concerns fueled public fears of crack and cocaine, so that by the middle of the decade, illicit drugs rose to the top of the social policy agenda. In September of 1986, Reagan gave a television address where he called for “zero tolerance” policies towards not only dealers, but also users, of illicit drugs. Consequently, drug abuse became a key issue in the 1986 congressional elections, and many politicians supported tougher measures against drug abuse and trafficking, either to gain votes, or to show that they were not “soft on drugs.” On October 27, 1986, this political pressure culminated in the passage of the Anti–Drug Abuse Act of 1986. The stated purpose of the act was to encourage foreign cooperation in eradicating drug crops, halt the international drug traffic, improve the enforcement of federal drug laws, provide strong federal leadership, establish effective drug abuse prevention and education programs, and expand federal support for drug treatment and rehabilitation centers. The actual focus of the act, however, leaned heavily towards the law enforcement side of drug control. The minimum sentence for selling or possessing large amounts of drugs (a kilogram or more of heroin, 1,000 kilograms of marijuana, five kilograms of cocaine) rose to 10 years with no maximum, meaning that major dealers could be sentenced to life in prison. If anyone suffered injury or death due to the sales of narcot-

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ics, the minimum penalty rose to 20 years. The fines for these offenses were also extremely harsh, as drug law offenders could be fined up to $4 million, and if dealers were working as part of a drug ring, the financial penalty could be up to $10 million. The penalties for repeat offenses of these provisions were doubled. The law also stipulated that there could be no possibility of probation or suspended sentences for these offenders. The act also allowed for the doubling of penalties for individuals who used minors to sell or distribute drugs, and increased penalties for selling drugs to minors and pregnant women. While extremely tough on dealers, the penalties for possession of small amounts of drugs for personal use were not as harsh. The maximum punishment for possession was one year in prison and a $5,000 fine, and double that for repeat offenders. In these cases, the courts had the right to place individuals on probation. If individuals already had two prior convictions for possession, they faced a minimum of 90 days in prison, but no more than three years. Aside from stiffening penalties, the act also authorized the federal government to issue grants to states for law enforcement programs and programs aimed at disrupting the drug trade. It also allowed for increased funding for international efforts to crack down on the global drug traffic. In addition to these provisions that were designed to help limit the availability of drugs, there were also sections of the act that aimed at preventing demand for illicit drugs. One section of the act authorized the creation of a presidential media commission on alcohol and drug abuse to organize media campaigns that spread public awareness about the dangers of drug abuse. It also called for a presidential conference, the White House Conference for a DrugFree America, which issued its final report

in 1988. The report highlighted the dangers that drugs posed to the United States, giving support to the harsh enforcement provisions of the Anti–Drug Abuse Act. Overall, of the $1.7 billion in additional money set aside for anti-drug efforts by the 1986 act, 86 percent of it went towards law enforcement efforts. Not surprisingly, the mandatory minimum sentences imposed by the act led the U.S. prison population to increase dramatically, as it almost doubled between 1980 and 1988. In spite of the measures of the 1986 act, politicians, the media, and the general public remained heavily concerned about the dangers drug addiction posed to the U.S. public. Even though there were tougher penalties for dealing, many Americans continued to use cocaine, crack, heroin, and marijuana. Instead of shifting course away from the punitive approach, which clearly had its shortcomings, Congress enacted another tough law, the Anti–Drug Abuse Act of 1988, in October of that year. The act increased many penalties, and allowed for the death penalty in murder cases that involved drug-trafficking organizations. It also created a special offense that targeted crack cocaine, allowing for possession of small amounts of the drug to be punishable by sentences of a minimum of five years, and a maximum of 20. In addition to these measures, the 1988 act also made some innovations. Most importantly, it authorized the creation of the Office of National Drug Control Policy to coordinate federal antidrug efforts. The 1988 act also had more provisions allowing for treatment, as it mandated that half of the $2.8 billion it allocated be spent on programs aimed at decreasing demand, such as educational and treatment programs. Due to budget problems, however, only $500 million of the $2.8 billion that was designated by the legislation was actually spent.

Anti-Saloon League (ASL)  73

Though provisions of the 1988 act called for spending to reduce demand for narcotics, the Anti–Drug Abuse Acts of 1986 and 1988 marked a new height in the federal government’s law-and-order campaign against narcotics use. Supported by both the media and the political establishment, these laws had tremendous consequences for drug dealers and users, as they toughened the punishments for both dealing and possessing controlled substances. Soon after the laws were enacted, many critics began to question the wisdom of using such draconian methods to address the drug problem. In response to the tremendous amounts of money spent on enforcing drug laws and the growing number of people put in prison because of them, some prominent commentators started to call for the legalization of narcotics, arguing that the damages caused by the campaign against drugs seemed to be greater than the damages caused by the drugs themselves. Nancy E. Marion See also: Crack Epidemic; Drug Addiction and Public Policy; Drug Policy Alliance Network; Office of National Drug Control Policy; Reagan, Ronald, and Nancy Reagan

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. H.R. 5854. http://thomas.loc.gov/cgi-bin/bd query/z?d099:HR05484:@@@L&summ2 =m&. Huggins, Laura E., ed. 2005. Drug War Deadlock: The Policy Battle Continues. Stanford, CA: Hoover Institution Press. Musto, David F., ed. 2002. Drugs in America: A Documentary History. New York: New York University Press. Padwa, Howard, and Jacob A. Cunningham. 2010. “Anti–Drug Abuse Acts.” In Addic-

tion: A Reference Encyclopedia. Santa Barbara, CA: ABC-CLIO. http://ebooks .abc-clio.com/reader.aspx?isbn=97815988 42302&id=A1857C-734. Select Committee on Narcotics Abuse and Control. 1988. “Implementation of the Anti–Drug Abuse Act of 1986: Report of the Select Committee on Narcotics Abuse and Control.” Washington, DC: U.S. Government Printing Office.

Anti-Saloon League (ASL) The Anti-Saloon League (ASL) was a prominent national temperance organization that played a central role in bringing about national prohibition in 1920. Organized as a highly efficient, nonpartisan lobby backed by powerful industrialists and religious figures, it pressured politicians into passing the Volstead Act, which it also played a key role in writing and pushing through Congress. Founded in 1893, the ASL emerged out of a local Ohio temperance society and became a national temperance organization that tried to generate mass support for measures that would have prohibited alcohol and at the same time pressured politicians into passing them. To do this, the ASL constructed itself as a highly professional and organized group dedicated to the single issue of temperance. Unlike other advocates of prohibition who formed their own, separate political parties, the ASL operated within the two-party political system, believing that success would be more difficult to achieve if they tried to advocate for prohibition from outside of the political establishment. Consequently, the ASL supported any candidate, whether Republican or Democrat, who was willing to back its temperance measures. The result was the creation of a powerful, nonpartisan

74   Anti-Saloon League (ASL)

political pressure group that played a vital role in bringing about national prohibition. The ASL was created by Howard H. Russell, a Congregationalist minister who, during his years as a divinity student at Oberlin College in the mid-1880s, worked to increase enforcement of local saloon laws. After graduating and preaching elsewhere, Russell returned to Oberlin in 1893, and in that year founded the Ohio Anti-Saloon League. In doing so, Russell enjoyed the support of Ohio Methodist institutions, and to help run this new league, he hired Wayne Wheeler, who would later become the general counsel and chief Washington lobbyist for the Anti-Saloon League of America, and the author of the Volstead Act. The ASL’s program was marked by practical political compromise and piecemeal progress, not a desire to institute national prohibition all at once. As a result, the ASL focused its efforts on local-option elections, which gave voters the choice of whether saloons should be licensed or not. This flexibility enabled the ASL to concentrate its campaigning on winnable elections, thus effectively extending prohibition, piece by piece, to parts of Ohio that had resisted going fully dry. Similarly, the ASL worked to elect local and state politicians sympathetic to prohibition so as to ultimately build a coalition of politicians and voters willing to draft and pass a constitutional amendment legislating national prohibition. Local successes based on this tactic of nonpartisan political pressuring quickly translated into national momentum, and in 1895 the Ohio Anti-Saloon League merged with other temperance associations to form the American Anti-Saloon League, which was renamed the Anti-Saloon League of America in 1905. By 1907 the ASL operated in 43 states and territories and had 300,000 subscriptions to its monthly journal, The

American Issue. The ASL’s publishing influence was even more expansive by 1909, when it became the primary publisher of temperance literature in the nation. The success of the ASL on a national level resulted from many innovations it brought to the temperance movement. Temperance work had previously been tied to Protestantism, but with the emergence of the ASL, this partnership was strengthened to a far greater degree. Russell’s work as a minister was but one component of this collaboration between temperance advocates and Protestants, for the overwhelming majority of ASL officials were also ordained ministers or active laymen. Through their efforts, the pulpit effectively became a springboard for the ASL and its temperance activities. The ASL’s deep connections with religious figures even extended into significant partnerships with prominent Catholics. Progressive “social gospel” priests often gave their public support to the ASL, and a number of priests even held state or national league offices. The ASL did not, however, limit itself to working within the religious community, as it also developed an impressive list of major financial donors from the industrial world. Millionaires such as Andrew Carnegie, Pierre du Pont, Henry Ford, and John D. Rockefeller, among others, contributed large sums of money to the ASL. Though the bulk of the ASL’s budget came from individual donations of less than $100 a year, the support of such notables gave the ASL an extremely impressive capital base and cachet within the temperance world. Perhaps the most integral ingredient for the ASL’s success was its highly efficient bureaucratic organization. Somewhat based upon a business model of vertical integration, the ASL was driven by a central leadership committee composed of paid, skilled, and well-educated clergymen and

Anti-Saloon League (ASL)  75

professionals. These leaders developed national campaigns, disseminated temperance literature, sent orators across the country, recruited volunteers, drafted legislation, and lobbied politicians. The figure most responsible for running this highly influential political pressure machine was Wheeler, ASL founder Rev. Russell’s protégé. Wheeler was so representative of the ASL’s tenacious and calculating approach that the league’s critics often dubbed its political pressure “Wheelerism.” A lawyer by trade, Wheeler became general counsel of the national league in 1916, and his power only became more pronounced in the years immediately thereafter. Applying his namesake brand of political pressure with great acumen after the passage of the 1913 WebbKenyon Act, which forbade the shipment of liquor from wet into dry areas, Wheeler became a powerful voice for national prohibition within Washington political circles. Working with fellow ASL leader Ernest Hurst Cherrington, Wheeler drafted the Prohibition Amendment and subsequently composed a major part of the bill that enabled its enforcement—the Volstead Act. Though Prohibition was undoubtedly the victory the ASL had long been working towards, the passage of the Eighteenth Amendment and the Volstead Act also sowed the seeds of discord that would eventually divide the organization. While Cherrington and the majority of the ASL wanted to shift their attention towards education now that liquor had been prohibited, Wheeler and a minority of ASL members argued that the league’s focus should be on improving enforcement of national prohibition. The result was a decidedly weakened organization that, coupled with the growing withdrawal of church support over the course of the 1920s, led to an ASL that could wield only a fraction of the tremendous power it once possessed.

The one great instance where the ASL’s past glory was evident occurred with the 1928 presidential election, when the group lent its support to the Republican Party and its candidate Herbert Hoover. Hoover’s subsequent victory demonstrated the impact the ASL could still have, but it spelled the end of its highly successful nonpartisan political pressure program. With the repeal of prohibition, the ASL was further marginalized, though it hung on for a number of years before reconstituting itself multiple times. It has lived on as the American Council on Alcohol Problems since 1964. Howard Padwa and Jacob A. Cunningham See also: Eighteenth Amendment; Prohibition Party; Volstead Act; Webb-Kenyon Act; Women’s Christian Temperance Union

Further Reading Blocker, Jack S., Jr. 1976. Retreat from Reform: The Prohibition Movement in the United States, 1890–1913. Westport, CT: Greenwood Press. Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Kerr, Kathel Austin. 1985. Organized for Prohibition: A New History of the Anti-Saloon League. New Haven, CT: Yale University Press. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. Mendelson, Jack H., and Nancy K Mello. 1985. Alcohol: Use and Abuse in America. Boston: Little, Brown and Company. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee.

76   Anxiety Disorders

Anxiety Disorders Anxiety is a normal reaction to stress that is a common emotion people experience in response to school, work, or family. It can be helpful in allowing someone to deal with a tense situation. However, for about 19 million Americans, anxiety becomes crippling and causes symptoms ranging from mild to extreme. These anxiety disorders are emotional states brought on by the anticipation of a real or imaginary threat. They are characterized by varying degrees of fear, tension, restlessness, and irritability. In more advanced cases, when extreme psychological discomfort and physical distress might include profuse sweating, heart palpitations, tremor, nausea and vomiting, diarrhea, and/ or panic, it is classified as a psychiatric condition. Untreated, such a disorder can rise to intolerably intense levels; in individuals prone to substance abuse, drug addiction frequently results from the individual’s need to self-medicate as a way to alleviate symptoms. Addiction worsens anxiety as the individual struggles to reduce the substance abuse, only to experience profound discomfort, which triggers increased abuse of the drug. People caught in these cycles of anxious despair and addiction are susceptible to suicide. In addition to generalized anxiety disorder, which is not restricted to specific fears, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) identifies other types of anxiety: panic disorder, posttraumatic stress disorder, social phobia (or social anxiety disorder), and specific phobias (such as a fear of heights or snakes). Those who experience panic disorders have feelings of intense fear. They also have fast heartbeats, sweating, dizziness, or stomach distress, among other symptoms. Posttraumatic stress disorder sometimes follows severe trauma or a life-

threatening event. It is sometimes characterized by vivid flashbacks, terror, nightmares, and, on occasion, violent behavior. Social phobias make it difficult for some to leave their homes or interact with other people in a normal way. Whatever the type of phobia, the disorder makes it difficult or even impossible for the sufferer to lead a normal life. Panic attacks may surface in the absence of any apparent triggers and can be overwhelming in their sudden and alarming symptoms, which include intense feelings of impending collapse or death, sweating, heart palpitations, jitteriness, tremor, restlessness, quivering voice, breathlessness, numbness, and feeling faint. While the symptoms are dramatic, panic attacks are not life threatening. Social phobia may be manifested by sweating, trembling, inability to speak, even dizziness and faintness. Anxiety disorders are often associated with other mental illnesses such as depression or obsessive-compulsive disorder. The likelihood of a dual diagnosis is so great that most mental health professionals automatically screen patients with anxiety disorders for co-occurring conditions. Such people respond best to treatment that combines medication and psychotherapy and, in some cases, relaxation techniques. Co-occurring conditions must be treated simultaneously if treatment is to be effective. In some cases, drug use can lead to anxiety attacks. At high doses, caffeine can cause many symptoms of anxiety such as heart palpitations, rapid/irregular pulse, insomnia, trembling, or breathlessness. Not surprisingly, users of khat also experienced these symptoms. On rare occasions, users of marijuana experience panic attacks during which they may experience strong feelings of anxiety. Users of Ecstasy and cocaine also report feelings of anxiety.

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Women are twice as likely to experience anxiety disorders than are men. They also occur earlier in women than in men. This may be because of differences in brain chemistry, or because men and women deal with stress differently. Those who experience anxiety disorders are sometimes prescribed tranquilizers as a treatment. At one time, physicians were likely to prescribe benzodiazepines (a tranquilizer) for anxiety, but these have been replaced with safer drugs. In small doses, barbiturates are also described for removing anxiety. If given too much, a user may become aggressive and violent. Some natural treatments for anxiety attacks include physical activity, a healthy diet, regular sleeping habits, relaxation techniques (deep breathing, stress relief activities), and volunteering with others. Kathryn H. Hollen See also: Ecstasy; Flashbacks; Khat; Marijuana

Further Reading Hina, Paul, and Sarah Hina. 2010. Anxiety Disorders. Farmington Hills: MI: Greenhaven Press. Horwitz, Allan V. 2013. Anxiety: A Short History. Baltimore: Johns Hopkins University Press. Hyman, Bruce. 2006. Anxiety Disorders. Minneapolis, MN: Twenty-First Century Books. Kahn, Jeffrey P. 2013. Angst: Origins of Anxiety and Depression. New York: Oxford University Press. Rachman, Stanley. 2013. Anxiety: Stanley Rachman. New York: Routledge. “Women and Anxiety Disorders.” Anxiety and Depression Association of America. http://www.adaa.org/living-with-anxiety/ women.

Zvolensky, Michael J., and Jasper A. J. Smits, eds. 2008. Anxiety in Health Behaviors and Physical Illness. New York: Springer.

Armstrong, Lance (1971– ) Lance Armstrong was born in 1971 in Plano, Texas. As a young boy he was a competitive swimmer, but dropped out of that activity to train for triathlons, quickly becoming a professional triathlete. In 1992 he chose to become a professional road racing cyclist, beginning his professional cycling career on the Motorola racing team. He won multiple races, setting records as he went. In the middle of his racing career, Armstrong was diagnosed with stage-three testicular cancer in 1996, at the age of 25. After discovering that the cancer had spread to his brain, abdomen, and lungs, he had extensive treatments that included both brain surgery and testicular surgery, along with chemotherapy. He was declared to be cancer free in February 1997. Armstrong returned to cycling and became a member of the U.S. Postal/Discovery team. He was a member of that team from 1998 to 2005, at which point he retired from racing. In 2009, he reentered racing, this time with the Astana team. From 2010–2011, he raced with the UCI Pro Team/Radio Shack. In one race, Armstrong crashed into a pileup, breaking his collarbone. He was forced to drop out of the race and return to Texas for surgery. He was riding again four days later. On February 16, 2011, Armstrong again announced his retirement from competitive cycling. At the time of his second retirement, Armstrong was being investigated for allegations of doping (using a substance such as an anabolic steroid or erythropoietin to improve athletic performance). In June 2012, the United States Anti-Doping Agency (USADA) for-

78   Armstrong, Lance (1971– )

Lance Armstrong, a competitive cyclist and seven-time winner of the Tour de France bicycle race. A survivor of testicular cancer, Armstrong raised millions of dollars for cancer research.   Armstrong admitted to abusing illicit performance-enhancing drugs and was forced to retire from the sport, being disqualified from all his winning races and prohibited from any futher competition. (Justforever/Dreamstime. com)

mally charged Armstrong with using illicit performance-enhancing drugs. After an investigation, the USADA concluded that Armstrong had been part of a successful doping program. On August 24, 2012, the USADA stripped Armstrong of his seven Tour de France titles and banned Armstrong from competitive cycling for his lifetime. In October of that year, the Union Cycliste Internationale (UCI), the organization that oversees cycling, accepted the findings of the USADA, and Armstrong did not appeal the decision. For many years, Armstrong had been accused of illicit drug use. He consistently

denied the allegations, pointing out that he never had a positive drug test, despite taking around 600 tests, both announced and unannounced. He attacked other cyclists who accused him of using drugs, even though many of them saw his trainer injecting Armstrong with steroids. Armstrong then stopped working with those trainers, who had been convicted of “sporting fraud,” claiming he had no tolerance for someone who would use performance-enhancing drugs. In 2004, two reporters, Pierre Ballester and David Walsh, published three books in which they accused Armstrong of using performance-enhancing drugs. One was L.A. Confidentiel—Les secrets de Lance Armstrong, in which another cyclist described how he and other members of the Motorola race team that included Armstrong used illegal substances. Armstrong and other members of the team denied the story. The authors also alleged that Armstrong would be provided with medical prescriptions for drugs that would explain traces of drugs in his urine. The other books were L.A. Official and Le Sale Tour (The Dirty Trick), in which the authors made similar claims. Some of the accusations made in the book were reprinted in the U.K. newspaper The Sunday Times in 2004. Armstrong sued the paper for libel, and the case was settled out of court. In 2005, L’Équipe, a French sports newspaper, reported that six of Armstrong’s urine samples from the 1999 Tour de France that had been frozen and stored at a lab had tested positive for steroids. Armstrong again denied all of the accusations that were then made. He was eventually cleared when a Dutch lawyer reported that the urine samples were conducted improperly. U.S. federal prosecutors investigated the allegations that Armstrong used illegal substances from 2010 to 2012. In early 2012, the federal prosecutors dropped their investigation

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without bringing charges. However, in June 2012, the USADA formally accused Armstrong of doping and trafficking of drugs. The charges were based on blood samples from 2009 and 2010, and from witnesses, including former teammates, who claimed to see Armstrong take the drug. He was also accused of pressuring teammates to use the drugs. In January 2013, after years of denying charges of drug use, Armstrong admitted doping in a televised interview conducted by talk show host Oprah Winfrey. While admitting in the interview to the things he did, he also said it was not true that he was doping as late as the 2009–2010 season, and that the last time he used illegal substances was in 2005. After the interview, all of Armstrong’s sponsors dropped him. He lost an estimated $75 million. In December 2012, The Sunday Times filed a lawsuit against Armstrong for $1.5 million. They sued for a return of the original settlement, plus interest and the court costs related to the case. In August 2013, Armstrong and the newspaper reached an undisclosed settlement. In 1997, Armstrong founded the Lance Armstrong Foundation, which supports people diagnosed with cancer. The foundation works to increase the public’s awareness of cancer. It has raised more than $325 million from the sale of yellow bracelets. He also founded, along with other professional athletes, Athletes for Hope, an organization that encourages professional athletes to become involved in charitable causes. In an interview in December 2013, Armstrong acknowledged that he made mistakes, but if he had the chance to do it over again, he would still dope because everyone else was doing it. He claims that he has been singled out because was the most famous of cyclers and because he fought back hard against those who made accusations against him. He

believed that because he was so adamant in his denials and too aggressive against those who accused him, he was targeted. What bothers him the most from these events is that he lost the trust of other cancer patients. Nancy E. Marion See also: Steroids, Anabolic; Steroids in Sports

Further Reading Ballester, Pierre, and David Walsh. 2004. L.A. Confidentiel: Les Secrets de Lance Armstrong. France: La Martiniere. ESPN.com. 2013. “Lance Armstrong Singled Out.” December 12. http://espn.go.com /sports/endurance/story/_/id/10124453/lance -armstrong-singled-nice. Ingle, Sean. 2013. “Memorable Moments of 2013: Lance Armstrong Admits that He Doped: Disgraced Cyclist Finally Comes Clean to Talk Show Host Oprah Winfrey on Prime-time U.S. Television.” The Guardian, December 27. Keel, Toby. 2013. “Shocks of the Year #3: Lance Armstrong Comes Clean about Being Dirty.” Eurosport | The Rundown, December 29. http://uk.eurosport.yahoo .com/blogs/the-rundown/shocks-3-lance -armstrong-comes-clean-being -dirty-081938548.html. Vinton, Nathaniel. 2013. “Cyclist Claims Lance Armstrong Bribed His Team with $100,000 to Throw 1993 Race.” New York Daily News, December 13. http://www .nydailynews.com/sports/more-sports/ cyclist-lance-bribed-team-100k-throw -race-article-1.1547409#ixzz2p0lCM5K5. Vinton, Nathaniel. 2013. “Lance Armstrong Accuses Former Cycling Chief Hein Verbruggen of Covering Up His Positive Drug Tests.” New York Daily News, November 19. http://www.nydailynews.com/sports/ i-team/armstrong-accuses-cycling-chief

80   Asset Forfeiture -covering-positive-drug-tests-article-1 .1521191#ixzz2p0ljamLF. Vinton, Nathaniel. 2013. “Lance Armstrong Returns Bronze Olympic Medal, Faces a Rough Road Ahead.” New York Daily News, September 12. http://www.nydailynews.com/ sports/more-sports/lance-surrenders-bronze -medal-faces-rough-ride-article-1.1454120 #ixzz2p0mnyD9J.

Asset Forfeiture The U.S. government has determined that an effective way to fight drug trafficking is to seize the assets used by drug traffickers to facilitate the trade, which can include houses, cars, money, planes, etc. Thus, if there is probable cause to believe that illicit drugs were transported in a certain automobile, airplane, or other mode of transportation, or if identifiable money was received from the sale of illicit drugs, or if drugs were stored at a specific house or location, or if jewelry or other items (televisions, stereos) were purchased with drug money, these assets could be seized by government officials. The law comes from the 1984 Comprehensive Crime Control Act. Congress inserted a section that allows for the civil forfeiture of a broad range of property, including residences, taverns, apartment and office buildings, undeveloped land, and improvements built on land. In 1985 the U.S. Department of Justice created the National Assets Seizure and Forfeiture Fund, which by 1990 had grown to $500 million. By that year, an additional $1.4 billion in real and personal property had been seized and was awaiting forfeiture. In the next five years, the department almost doubled this intake. To many, it is not fair that those who make a lot of money through illegal means should

be permitted to purchase goods and keep those, even after being charged and convicted of criminal offenses. Nor should they be allowed to save enough money so they do not need to be employed after released from prison (if that happens). By seizing any property purchased with profits from the drug trade, the offender is prevented from enjoying an “easy life” because of their illegal actions. The seized property helps the government pay for the costs associated with investigating and punishing those who choose to harm society through their drug dealing. Asset forfeiture, however, has raised questions about drug war tactics because it appears to be in conflict with the Fifth Amendment’s protection against seizing property without due process of law. It has also been criticized as a graphic example of how federal and state government power could be widely abused. To cite one example: In 1993 Richard Lyle Austin was convicted of cocaine possession with intent to distribute and sentenced to seven years in prison by a South Dakota court. Although the offense in South Dakota could lead to a fine of $10,000 maximum, the court assessed Austin a fine 40 to 50 times larger. Moreover, the federal government confiscated Austin’s mobile home and auto body shop, which were appraised at $400,000. The federal government has confiscated property even in cases in which the owner was ignorant of the illegal use to which the property was put and even when no criminal charges were filed. The U.S. House Judiciary Committee has noted that in more than 80 percent of the civic asset forfeiture cases the property owner is not charged with a crime. Nevertheless, the government can keep the seized property. In December 1993 the U.S. Supreme Court gave a ruling that guaranteed owners the right to protest the property seizure in court before it is confis-

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cated. In an editorial, the Christian Science Monitor noted that the closeness of the 5–4 decision indicates “both the reluctance to weaken an anti-crime measure that has been at least somewhat successful, and the acknowledgment that seizure by law enforcement agencies of assets even suspected to be contraband may have been carried out in some instances with too little regard for basic civil liberties” (“Drugs and Civil Rights” 1993). Another issue concerns the fact that the individuals from whom the property is seized often have the burden to prove that it was not used to facilitate the sale of drugs, or purchased with drug money. This implies that the property owners are presumed to be guilty, a violation of the Constitution. If the defendant successfully proves the property was not used for drug trafficking and the property is returned, the government is not obligated to pay any kind of interest nor is it responsible for any damage done to the property while it was in the government’s possession. By the mid-1990s, many federal and local government agencies had done well with the cash obtained from forfeiture, using it for staff, equipment, and sometimes even for basic operating expenses. A 1992 U.S. General Accounting Office study revealed that one police department relied on forfeiture for 10 percent of its budget. The U.S. Supreme Court has also ruled that the government’s right to forfeiture extends to drug assets needed or used by a defendant to pay attorneys’ fees. Thus, since the 1980s the government has used forfeiture laws to go after the lawyers of drug traffickers in an effort to destroy their criminal organizations. In 1996 the U.S. Supreme Court ruled that the government may prosecute drug dealers and seize their property without vio-

lating the Fifth Amendment ban on double jeopardy. The decision was viewed as a victory for federal prosecutors in the War on Drugs. Critics have charged that forfeiture may make it difficult for defendants in drug cases to pay fees to their attorneys, thus preventing them from receiving a fair trial. Many defendants in drug cases, moreover, have been able to negotiate lighter sentences by giving up hidden property or agreeing not to challenge forfeiture in court. Groups like the American Civil Liberties Union and the National Association of Criminal Defense lawyers have said that the practice favors the successful, powerful criminal over the lesser one and is injurious to the American legal system. In 2000, the U.S. Congress amended the original law to increase the standard from “probable cause” to “preponderance of the evidence.” It also prevented the government from using hearsay testimony for the basis of seizing property, and permitted claimants who successfully challenged the seizure of their property to recover the costs of any legal expenses incurred through the process. Ron Chepesiuk See also: Cocaine and Crack; Common Sense for Drug Policy; Crime Control Act

Further Reading Chambliss, William J. 2011. Key Issues in Crime and Punishment. Thousand Oaks, CA: Sage. Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. “Drugs and Civil Rights.” 1993. Christian Science Monitor, December 16. Gallagher, G. Patrick. 1992. “The Management and Disposition of Seized Assets.” Washington, DC: Police Executive Re-

82   Association Against the Prohibition Amendment (AAPA) search Forum, U.S. Department of Justice, Office of Justice Programs. Ivins, Molly. 1998. “War on Drugs Makes Some Cops Act Like Criminals.” Sacramento Bee, September 6. McMurry, Kelly. 1996. “Supreme Court Upholds Civil Forfeiture in Drug Cases.” Trial, August 4. U.S. General Accounting Office. 2000. “Seized Property and Forfeited Assets System Requirements.” Washington, DC: U.S. General Accounting Office.

Association Against the Prohibition Amendment (AAPA) The Association Against the Prohibition Amendment (AAPA) was a highly influential lobby and national organization that worked towards the repeal of the Eighteenth Amendment of the U.S. Constitution, which had instituted alcohol prohibition. With the backing of influential political, financial, and corporate figures, the AAPA played an important role in shaping and organizing the popular and political will behind the passage of the Twenty-First Amendment, which repealed Prohibition on December 5, 1933. Founded in 1918 by William H. Stayton, the AAPA was the first wet citizens’ lobby of any great stature in the United States. Working in Washington, D.C., for the Navy League of the United States during the first discussions of the nascent Eighteenth Amendment, Stayton created an organization of people committed to challenging National Prohibition even before the federal ban on alcohol went into effect in 1920. Early on, Stayton opposed the Eigh­ teenth Amendment on the grounds that it increased his taxes, spoiled his investments, and harmed the U.S. economy since it pre-

vented the international trade of valuable alcohol exports. As disregard for prohibition increased over the years, Stayton railed against prohibition, arguing that it was a symptom of a wider problem—the fanatical desire of reformers to meddle in the affairs of others and regulate the details of their lives. In general, Stayton and the AAPA viewed the prohibition of alcohol as the federal government overstepping its bounds by controlling the individual decisions of U.S. citizens. Though many disliked the Eighteenth Amendment for this and other reasons, Stayton attracted few followers in the early years of the AAPA. By 1921, despite widespread defiance of prohibition, the AAPA could only count around 100,000 members in its national organization, which was not nearly enough to overturn the Eighteenth Amendment. Financially, too, the AAPA was hardly primed to repeal the Eighteenth Amendment in 1921, as its treasury was mostly financed by Stayton himself up to that point. As the 1920s progressed, however, more Americans disgruntled with prohibition joined the AAPA, in large part because it was essentially the only group of its kind. By 1926, the AAPA’s national membership rose to 726,000, with members concentrated in New York, Ohio, Illinois, and California. As significant as the spike in membership numbers was the prestige of some of the newer members of the AAPA. As the alliance’s momentum grew, the AAPA attracted men of great prominence to its cause. Some notable members included author Irvin S. Cobb, ex-mayor of New York Seth Low, railroad tycoon Stuyvesant Fish, chemical giants Irene and Pierre du Pont, publisher Charles Scribner, financier John J. Raskob, and civic leader and philanthropist Marshall Field III. Pierre du Pont joined, he said, because he believed

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the prohibition movement had erred in failing to distinguish between the moderate use of alcohol and drinking to excess. Many new members joined, however, because they were persuaded by the AAPA’s argument that since so many citizens defied the increasingly unpopular Eighteenth Amendment, the federal government was breeding a dangerous disrespect for the U.S. Constitution by trying to enforce an unenforceable law. During the Great Depression, the AAPA pushed an economic argument against the Eighteenth Amendment. With many Americans financially suffering, the AAPA argued that prohibition was an unneeded economic burden upon the country. The AAPA claimed that enforcing prohibition cost taxpayers over $300 million, and that a ban on alcohol amounted to $11 billion in lost tax revenues by 1931. And with unemployment at high levels, the AAPA argued that prohibition cost the nation untold numbers of jobs in brewing, distilling, bottling, shipping, retail sales, and service. In essence, the AAPA suggested that repealing the Eighteenth Amendment could help America out of the Great Depression. The AAPA took this message, and others, to politicians and laypeople in a grassroots campaign to create a constitutional amendment that would repeal prohibition. The AAPA subsidized research studies that illustrated the failure of prohibition, and they published these findings in newspapers and magazines. On the political front, they supported every wet politician, regardless of the candidate’s party. However, the AAPA ultimately found greater political support from the Democratic Party, when in 1928, AAPA leader John J. Raskob was selected Democratic national chairman by the party’s candidate for president, Alfred Emanuel Smith, himself an opponent of prohibition.

Smith lost the presidential election to Herbert Hoover, a supporter of prohibition, but four years later, the AAPA convinced the Democratic Party to make repealing the Eighteenth Amendment a part of the party’s platform. Thus, when Franklin D. Roosevelt, the Democratic Party’s subsequent presidential candidate, won the election, the AAPA’s position gained the highest possible political backing. In addition to having the next president on their side, the AAPA also reaped the rewards of their years of political lobbying when Congress approved a bill to end prohibition even before Roosevelt entered the White House. In each house, the 72nd Congress passed a constitutional amendment to repeal the Eighteenth Amendment. In the subsequent drive for the amendment’s ratification at state conventions, AAPA members played significant roles. Nationwide, 73 percent of voters advocated repealing the Eighteenth Amendment, and among the 37 state conventions held in 1933, only South Carolina preferred maintaining prohibition. On December 5, 1933, the Twenty-First Amendment was ratified, ending both prohibition and the AAPA, which disbanded that very evening with a celebratory dinner in New York City’s Waldorf-Astoria Hotel. Howard Padwa and Jacob A. Cunningham See also: Eighteenth Amendment; Volstead Act; Women’s Organization for National Prohibition Reform

Further Reading Barr, Andrew. 1999. Drink: A Social History of America. New York: Carroll & Graf Publishers. Blocker, Jack S. Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An Interna-

84   Authors and Drug Use tional Encyclopedia. Santa Barbara, CA: ABC-CLIO. Burns, Eric. 2004. The Spirits of America: A Social History of America. Philadelphia: Temple University Press. Kyvig, David E. 2000. Repealing National Prohibition, 2nd ed. Kent, OH: Kent State University Press. Rose, Kenneth D. 1996. American Women and the Repeal of Prohibition. New York: New York University Press.

Authors and Drug Use Many famous authors have abused drugs over the years, many of whom claim that it helps them to be more creative. Below is a description of some famous authors and the drugs they allegedly used.

Edgar Allan Poe It is likely that Poe was an alcoholic, even though he drank alcohol only occasionally. He would drink for a few days, followed by months or even years of complete abstinence. Before 1841, there is little evidence of Poe’s alcohol use. Most of the evidence of his drinking comes from his recollections that were written long after the fact. It appears that his first bout with drinking was in 1826 when he attended the University of Virginia. At that time, he was away from home and his parents for the first time and Poe drank more than he should have, despite making a promise to himself to stay away from alcohol. It also seems that Poe’s father (David Poe Jr.) and brother (Henry Poe) were frequent alcohol users. Some people believe that Poe even used absinthe, a liqueur made from wormwood that has a very high alcohol content and contains thujone, a chemical similar in nature to tetrahydrocannabinol (THC). It is also believed by many that Poe passed out

in the streets of Baltimore because he was so drunk and froze to death.

Ernest Hemingway It was thought that during the last 20 years of his life, Hemingway drank a quart of whiskey a day. Hemingway enjoyed drinking and could ingest great amounts of alcohol without outwardly showing the effects. Toward the end of his life, when his health was deteriorating, his doctors told him to stop drinking. Hemingway listened to his doctors and did stop, but only temporarily. But the effect of alcohol use is not what killed Hemingway. He committed suicide by shooting himself in the head. Elizabeth Barrett Browning The English poet Elizabeth Barrett Browning took laudanum, a mixture that contains opium, to treat her spinal tuberculosis as a child. But she never stopped taking it and became a lifelong opium addict. For Browning, her use of the drug became an inspiration for her writing. The letters written by Elizabeth and her husband Robert Browning are full of images of scarlet poppies. Ayn Rand Rand was addicted to nicotine and was a chain smoker for many years. She also used amphetamines after she was prescribed Benzedrine for weight loss by a physician. This was a common medical practice at the time. Rand quickly discovered that the amphetamines gave her the energy and focus to finish the first of her two major novels, The Fountainhead. From then until around 1972, Rand continued to use amphetamines, especially Dexedrine and Dexamyl. There is some evidence that Rand used amphetamines heavily, enough so that her friends were very concerned.

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William S. Burroughs Burroughs became addicted to morphine while living in New York. But he seemed to be able to stop using it with little difficulty when he wanted. Sometimes he was addicted to the drug, but sometimes he would not use it at all. He wrote a book about his experiences with the drug, now known as Junkie. The book was first published as a sensationalistic novel entitled Confessions of an Unredeemed Drug Addict. Stephen King According to King’s memoir On Writing, he used multiple drugs and alcohol frequently during the 1980s. His addictions reportedly became so serious that he claims that he can only barely remember writing the book Cujo. After the book was published, King’s family and friends staged an intervention in which they dumped evidence of his addictions on the rug in front of him. The pile included beer cans, cigarette butts, cocaine, Xanax, Valium, Nyquil, dextromethorphan (cough medicine), and marijuana. King then sought treatment and was able to quit using all drugs and alcohol in the late 1980s. He has remained sober ever since. Robert Louis Stevenson It is reported that The Strange Case of Dr. Jekyll and Mr. Hyde (1886) was written by Stevenson during a six-day binge with cocaine. Stevenson’s wife Fanny said: “That an invalid in my husband’s condition of health should have been able to perform the manual labor alone of putting 60,000 words on paper in six days, seems almost incredible.” Ken Kesey Kesey often wrote his novels while he was under the influence of acid. He published One Flew Over the Cuckoo’s Nest in 1962

and the novel Sometimes a Great Notion in 1964. Both of his novels explore what Kesey saw as the conflict between modern industrial society and individuality, or an inherent struggle between conformity and freedom. This struggle was also a part of Kesey’s personal life, which caused him to use psychedelic drugs.

Jack Kerouac Kerouac died from cirrhosis of the liver due to his alcoholism. Aldous Huxley In The Doors of Perception, his famous 1954 book that inspired Jim Morrison’s band name “The Doors,” Huxley recounts his experience while using mescaline. Huxley found that the drug opened his mind and inspired him to write his book. Adam Stilgenbauer See also: Addiction; Alcohol Use; Amphetamines; Entertainers and Drug Use; Peyote

Further Reading Edgar Allan Poe Society of Baltimore. 2009. “Edgar Allan Poe: Drugs, and Alcohol.” http://www.eapoe.org/geninfo/poealchl .htm. Heroin Helper. 2011. “William S. Burroughs.” http://www.heroinhelper.com/bored/celeb rities/William_Burroughs.shtml. Miller, H. B. 2011. “Was Ayn Rand a Drug Addict?” The Rand Watch. http://randwatch .blogspot.com/2011/03/was-ayn-rand -drug-addict.html. Opiods.com. “Elizabeth Barrett Browning (1806–1861).” http://opioids.com/opium/ browning.html. RenewEveryDay.Com. “Author Stephen King Lived His Own Sort of Horror.” http:// www.reneweveryday.com/author-stephen -king-lived-his-own-sort-of-horror/.

86   Aviation Drug-Trafficking Control Act (1984) Timeless Hemingway. “Ernest Hemingway FAQ: Life.” http://www.timelessheming way.com/content/lifefaq. Townsend, M. 2008. “Drugs in Literature: A Brief History.” The Guardian: The Observer. http://www.theguardian.com/society/2008/ nov/16/drugs-history-literature.

Aviation Drug-Trafficking Control Act (1984) President Reagan had many different tactics for addressing the illicit drug problem in the United States. He sought new approaches to stop drug abuse. One of those was the Aviation Drug-Trafficking Control Act. Designed to provide a greater risk to persons involved in the smuggling of illicit objects and signed and approved by President Ronald Reagan on October 19, 1984, the act, officially known as An Act to Amend the Federal Aviation Act of 1958 to Provide for the Revocation of the Airman Certificates and for Additional Penalties for the Transportation by Aircraft of Controlled Substances, and for Other Purposes, states that a pilot whose aircraft is found to contain, transport, or attempt to transport illegal substances will be forced to be without license for five years before attempting to acquire a new license rather than the one-year penalty proclaimed by the previous act. In addition, the act granted the Federal Aviation Administration (FAA) the ability to strip an aircraft that has been used in or for the transportation of restricted substances of its certificate of registration. After the signing of the act, serving as an airman while not carrying proper documentation for or regarding the transportation of outlawed goods became a criminal offense. Introduced in February 1983, the Aviation Drug-Trafficking Act claimed its arguably biggest victory with the incarceration of

Jose Evaristo Linares Castillo, or “Don Evaristo.” While leading a drug trafficking ring out of Villavicencio, Colombia, and with help from the Fuerzas Armadas Re­ volucionarias de Colombia, Linares Castillo organized the transportation of thousands of kilograms of cocaine into the United States through Central America and Mexico. He was officially arrested May 25, 2012. A proposal was made to amend the law in 1988. A committee in the House of Representatives, the Public Works Committee, proposed that state and local law enforcement officials should be permitted to inspect registrations of all aircraft suspected of drug trafficking. No action was taken on the proposal. In 1988, Congress passed (and the president signed) a new law that authorized $2.7 billion for antidrug activities. Among the many provisions in that bill, there was one that directed the FAA to change the aircraft registration system to prevent the registration of private aircraft to a fictitious person. Changes were also required that would halt the ability of a person to use a false or nonexistent address when registering an aircraft, nor could they use a post office box to register an aircraft. Someone seeking to register an airplane could not use a name that was not identifiable, or make frequent legal changes in registration markings assigned to that plane. The new bill also required the FAA to establish a method for timely and adequate notice of any transfer of ownership of aircraft. Nancy E. Marion

Further Reading Aviation Drug-Trafficking Control Act of 1984. Public Law 98–499. http://www.gpo .gov/fdsys/pkg/STATUTE-98/pdf/STAT UTE-98-Pg2312.pdf. “Congress Clears Massive Anti-Drug Measure.” 1987. In CQ Almanac 1986, 42nd

Aviation Drug-Trafficking Control Act (1984)  87 ed., 92–106. Washington, DC: Congressional Quarterly. http://library.cqpress.com/ cqalmanac/cqal86–1149752. “Election-Year Anti-Drug Bill Enacted.” 1989. In CQ Almanac 1988, 44th ed., 85–111. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqalmanac/ cqal88–1141196. Reagan, Ronald. 1984. “Statement on Signing the Aviation Drug-Trafficking Control Act.”

October 19. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ws /?pid=39283. U.S. Department of the Treasury. 2013. “Treasury Designates Head of Aviation Drug Smuggling Operation.” http://www.treas ury.gov/press-center/press-releases/Pages/ tg1857.aspx.

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B Unbeknownst to Fouchet, the murders were witnessed by Max’s best friend Julie Mott (Téa Leoni). Julie had been in the suite’s upper balcony when the murders took place. Julie knows of Mike because of his relationship with Max and refuses to trust anyone but him, but he is not available when Julie first contacts the police regarding the murders. Since Julie never met Mike and does not know what he looks like, Captain Howard (Joe Pantoliano) persuades Marcus to impersonate Mike. To pull of the charade, Marcus switches lives with Mike. Telling his family that he has to go to Cleveland to work on a case, Marcus asks Mike to stay with them while he is gone. Marcus then moves into Mike’s apartment where Julie and her dogs are hiding. While in Julie’s presence, the two friends assume each other’s identity. As the investigation proceeds, Mike and Marcus touch base with their former infor­ mants such as a former chemist, Jojo (Michael Imperioli). In the meantime while looking through a book of mug shots, Julie identifies a man named Noah as one of Max’s murderers. With this information, Marcus and Mike go to one of Noah’s favorite hangouts, Club Hell. Julie—eager to avenge the death of her friend—follows Marcus and Mike to Club Hell where she is recognized by Noah’s associates. Noah leaves the club and is killed following a brief scuffle and car chase. While watching news coverage of the incident, Marcus’s family learns of his true whereabouts.

Bad Boys Bad Boys is an action-adventure comedy starring Martin Lawrence and Will Smith. The film was released in 1995 and marked the directorial debut of Michael Bay. Don Simpson and Jerry Bruckheimer were the producers. Based upon the success of Bad Boys, two sequels have been spawned: 2003’s Bad Boys II and the upcoming Bad Boys III that is scheduled for a July 2015 release. The plot revolves around detectives Marcus Burnett (Lawrence) and Mike Lowrey (Smith), who are best friends working in the Miami-Dade Police Department’s narcotics division. The story begins with the theft of $100 million of heroin that had been seized in a raid and stored in the department’s secure evidence vault. The drug represented the largest drug bust of Marcus and Mike’s careers and places their division in the crosshairs of the department’s Internal Affairs division. The department is given an ultimatum: the division will be shut down if the drugs are not recovered within five days. Marcus and Mike get their first lead when the body of a former cop, and one of the thieves responsible for the theft of the drugs, Eddie Dominguez (Emmanuel Xuereb), is found at a hotel suite. The body of an escort named Maxine “Max” Logan (Karen Alexander) is also discovered. Both had been killed by Dominguez’s boss Fouchet (Tchéky Karyo), a French drug lord. The case takes a twist when it is revealed that not only was Max one of Mike’s major informants, she was also an ex-girlfriend.

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Martin Lawrence and Will Smith in a scene from the film Bad Boys. The actors play detectives tracking down missing heroin in this action-comedy film. (Columbia Pictures/Moviepix/Getty Images)

Mike and Marcus pay another visit to Jojo, and after an intense interrogation in which Marcus and Mike play the proverbial good cop–bad cop, Jojo gives the detectives the location of the chemist responsible for cutting the stolen heroin. They stake out the chemist’s house and follow him to where Fouchet has hidden the heroin. After returning to Mike’s apartment with Julie, Marcus is confronted by his wife, thereby blowing their cover. Julie panics and tries to flee but is kidnapped by Fouchet and his men who have also arrived at Mike’s apartment. As a consequence, Internal Affairs essentially shuts down the division by reassigning all of its members. The order, however, is delayed by Captain Howard thus allowing Mike and Marcus the opportunity to retrieve both Julie and the heroin.

With the aid of two fellow members of the narcotics division, Marcus and Mike devise a plan to save Julie and reclaim the drugs. At an abandoned air field, the police and the drug dealers engage in a shoot-out. After saving Julie, Marcus is shot in the leg by Fouchet, who also shoots Mike as he is escaping a building that has been set ablaze. Mike is rescued by Marcus and Julie, who had recovered Mike’s car. The three pursue Fouchet. To run Fouchet’s car off the road, Marcus clips it with Mike’s car. The ploy works, but Fouchet extricates himself from the wreckage. Mike shoots Fouchet in the leg as he tries to escape. He tries to provoke Mike—who wants to exact revenge for Max—but is thwarted by Marcus who is able to keep his friend from committing murder. Undaunted, Fou-

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chet draws a weapon he had concealed and fixes it on Marcus. Mike is able to see a reflection of Fouchet on Marcus’s forehead and opens fire, killing Fouchet. The film ends as Marcus and Mike express their mutual admiration for each other and relief that they both survived the ordeal. Marcus proceeds to handcuff Mike and Julie to each other, then limps away. Bad Boys grossed $15,523,358 in its opening weekend (April 9, 1995). The total gross, both domestic and worldwide, was $140,800,000. Stacy O’Hara Leiter See also: Entertainers and Drug Use

Further Reading Internet Movie Database. 1995. Bad Boys. http://www.imdb.com/title/tt0112442/. Internet Movie Database. Bad Boys III. http:// www.imdb.com/title/tt1502397/. Movieclips. 1995. Bad Boys. http://movieclips .com/9epYh-bad-boys-movie-videos/.

Barbiturates Barbiturates are a group of central nervous system depressants that can have a wide variety of effects on the user. In a mild form, they can be used for mild sedation, but can also be used in a stronger form as anesthetics and anticonvulsants. Some have a high potential for abuse, both physical and psychological, and therefore fall into Schedule II of the Controlled Substances Act. Examples of these include phenobarbital (Nembutal) and secobarbital (Seconal). Others are less addictive, and have been placed in Schedule III or IV of the Controlled Substances Act. They are used for both medical and nonmedical reasons, legally and illegally.

Barbiturates were first created by German researcher Adolf von Baeyer in 1864. Since then, over 2,500 barbiturates have been created, but most have not been marketed for human use. Today, only a few are prescribed by physicians. They were used often as medicine in the early 1900s, and were used often in the 1930s as sedatives and sleep aids. They then became very popular in the 1960s and 1970s to treat patients with anxiety, insomnia, and seizures. However, barbiturates soon became popular as a recreational drug, and addiction to them quickly became rampant. Common street terms for barbiturates are barbs, reds, red birds, rainbows, phennies, tooies, blues, blue heaven, yellows, and yellow jackets. Commonly prescribed during the first half of the 1900s, barbiturates are used less frequently nowadays due to their high addiction liability. Of the hundreds of compounds that have been synthesized, most are still prescribed for insomnia and other sleep disorders. In smaller doses, they can produce slurred speech and impaired motor coordination, and in heavier doses they can cause coma. In combination with alcohol or other central nervous system depressants, barbiturate use can be fatal. Barbiturates can be categorized based on the length of time they are effective in a body. There are barbiturates that are short acting and are used in hospitals for anesthesia purposes because of their short duration and because they produce immediate unconsciousness in a patient. They take effect within a minute when injected into the body and have a duration of no more than three hours. The intermediate-acting barbiturates are used for anxiety and insomnia, but less frequently than before because of the potential dangers of these drugs (safer ones have been recently developed). These usually take around 15 to 45 minutes to take effect, and

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may work up to six hours. Examples of these drugs are Seconal and Amytal. Because these drugs last so long, they were often used by recreational users. Long-acting barbiturates are often used as anticonvulsants. They take about an hour to take effect, but they last about 16 hours. Because they take so long to affect the user, they are rarely used for recreational purposes. In very high doses, these forms of the drug can be used for physicianassisted suicide. Available legally only by prescription, barbiturates have effects ranging from very short to long, especially the compounds used for anesthetic purposes. Some newer central nervous system depressants on the market with barbiturate-like qualities are sedative-hypnotics. Examples are zolpidem (Ambien), zaleplon (Sonata), ethchlorvynol (Placidyl), eszopiclone (Lunesta), and ramelteon (Rozerem), which are approved for the short-term treatment of insomnia. These drugs have many properties in common with the benzodiazepines and, despite advertisements touting their safety, are subject to abuse. Barbiturates have been used illegally for recreational purposes because they give the user feelings of relaxation and euphoria. Some users have decreased anxiety and loss of inhibitions. Over time, a user can become physically and psychologically addicted to barbiturates and build up a tolerance. Someone addicted to barbiturates may experience withdrawal symptoms and must go through detox treatment in order to cleanse the body of the drug. The barbiturate Rohypnol is sometimes mixed with alcohol and given to a woman as a way to render her incapable of resisting sexual advances. This is referred to as the “date rape drug.” Because of the potential for criminal activity related to this drug, the penalties for its abuse have been increased.

Overuse of the drug can lead to an overdose. Symptoms of a barbiturate overdose include fatigue or sluggishness, loss of coordination, cloudy or fuzzy thinking, and shallow breathing. If enough of the drug is present, a user may go into a coma or even die. The risk of death becomes even higher if barbiturates are used in combination with other drugs such as alcohol or opiates. Celebrities who have passed away as a result of a barbiturate overdose include Marilyn Monroe, Judy Garland, and Jimi Hendrix. Barbiturates can be injected into a vein or muscle, or can be taken orally through a pill form. The development of benzodiazepines or minor tranquilizers in recent years has reduced the number of prescriptions written for barbiturates. They are seen as being safer (less addictive) than barbiturates. Kathryn H. Hollen See also: Addiction Liability; Controlled Substances Act

Further Reading Abadinsky, Howard. 2010. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Wadsworth. Califano, Joseph A. Jr. 2007. High Society: How Substance Abuse Ravages America And What to Do About It. New York: Perseus Books. Dryden-Edwards, Roxanne. 2012. “Barbiturate Abuse.” Emedicine health. http://www .emedicinehealth.com/barbiturate_abuse/ article_em.htm. Henn, Debra, Deborah de Eugenio, and David J. Triggle. 2007. Barbiturates. New York: Chelsea House. Hoffman, John, and Susan Froemke, eds.2007. Addiction: Why Can’t They Just Stop? New York: Rodale.

Barnes, Nicky (1933– )  93 Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. U.S. Department of Health and Human Ser­ vices, National Institute on Drug Abuse (NIDA). http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). http: //www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration (DEA). http://www.usdoj .gov/dea.

Barnes, Nicky (1933– ) Leroy Nicholas “Nicky” Barnes was born on October 15, 1933, in New York City. He would become one of New York City’s most notorious—and elusive—drug dealers, earning him the nickname “Mr. Untouchable” (“Nicky Barnes” 2014). In the 1970s he created The Council, which would become one of the city’s largest distributors of heroin. Barnes was finally arrested in March 1977, and entered the Witness Protection Program in 1998 after becoming an informant for federal prosecutors. Barnes claims to have begun dealing drugs while associating briefly with a street gang. It was during this period when Barnes developed a heroin addiction. While a teenager, he was arrested for numerous offenses including possession of a hypodermic needle, possession of burglary implements, and breaking into cars. The last arrest resulted in a three-year sentence at the Manhattan House of Corrections, also known as “The Tombs.” Upon his release in 1954, Barnes resumed his career as a drug dealer. He was arrested again five years later on a drug charge and

was given a five-year sentence, which was served at Green Haven State Prison where he became friends with Matty Madonna, a known mob figure. Since they both dealt drugs, the men allegedly exchanged information on their particular organizations. When Barnes was released in 1962, he used the knowledge he had gained from Madonna to expand his own illegal enterprise. In 1965, Barnes’s attempt at enlarging his drug empire was disrupted by yet another arrest. This time authorities had found Barnes in possession of narcotics estimated to be worth more than $500,000. A New York Times article on Barnes claimed that the New York Police Department regarded Barnes as “one of the biggest distributors of narcotics in Harlem and the Bronx.” Barnes has maintained his innocence regarding the 1965 charges, accusing the police of setting him up. Barnes began serving a lengthy sentence (between 15 and 20 years) in 1966. He returned to Green Haven where he made friends with another Mafia boss, “Crazy Joey” Gallo. He passed his sentence reading law journals and converting to Islam. At the time of his latest incarceration, Barnes’s organization employed approximately 50 people. After winning an appeal, Barnes was released from Green Haven in 1971. Once again he used the knowledge he had gained from a reported Mafia boss to grow his operation by creating The Council, which was comprised of African-American drug dealers. The Council served as the epicenter of Barnes’s drug distribution, handling the logistics of Barnes’s organization, e.g., deciding which suppliers to use, cash disbursement for the dealers, and conflict resolution. Among the members of The Council were Guy Fisher, Thomas “Gaps” Forman, Joseph “Jazz” Hayden, Ishmeel Muhammed, and

94   Barnes, Nicky (1933– )

Frank Jones. All decisions made by The Council, however, were subject to Barnes’s approval; he had veto power. To symbolize the cohesion of The Council a motto was adopted: “Treat my brother as I treat myself” (“Nicky Barnes” 2014). Now that Barnes had finally achieved his goal of establishing a drug empire, he began to enjoy the perks. He became a fixture at numerous nightclubs, often accompanied by many women (none of whom was his wife). He owned a few Mercedese and a Maserati that he drove while being followed by police surveillance units. His closets were filled with custom-made suits (approximately 300), shoes (about 100 pair), and several leather coats (estimates range from 27 to 50). In the early 1970s, Barnes had more runins with the authorities. His May 1974 arrest was related to the murder of Clifford Haynes. Haynes’s sister was the girlfriend of Guy Fisher and had stolen some money from The Council. Barnes claims that Haynes was killed while extracting information on the whereabouts of Haynes’s sister. A few months later Barnes was stopped by the police who, upon inspection, discovered approximately $130,000 in cash. Officers at the scene claimed Barnes attempted to use the money as a bribe to avoid arrest. Barnes continues to dispute this claim. In 1975, he was exonerated on both the murder and bribery charges. He was arrested again in late 1976 when policed pulled over the car in which he and some associates were travelling. This resulted in a possession of illegal weapons charge. In his capacity to escape punishment for the numerous crimes with which he was charged, Barnes earned the nickname “Mr. Untouchable.” Unfortunately for Barnes, the nickname did not apply for much longer. His downfall began in March 1977, when he and some of his associates were arrested and

charged with narcotics conspiracy. Barnes faced the additional charge of operating a criminal enterprise. Before the trial could begin, the New York Times Magazine published an article on Barnes titled “Mister Untouchable”; he also appeared on the issue’s cover. Some claim that President Jimmy Carter had seen the article and was angered. As a result, he placed pressure on federal prosecutors to secure a conviction against Barnes. The trial of Barnes and his associates began in September 1977. The prosecution, which was led by U.S. attorney Robert B. Fiske Jr., argued that the defendants had been running a drug ring that had averaged about $1 million in heroin sales each month from a location in Harlem. The prosecution’s evidence had been gathered as part of an extensive undercover operation. The trial lasted two months ending with convictions for Barnes and 10 of his associates. Guy Fisher was the sole acquittal. Barnes’s sentence was handed down on January 19, 1978: life in prison without parole. Unlike his earlier incarcerations, Barnes was sent to Marion Federal Penitentiary in Illinois. In the early 1980s, Barnes decided to become an informant and provide testimony against his former associates, especially Guy Fisher. In exchange for his cooperation, the sentence was reduced. Barnes explained his reasoning for turning against Fisher in a joint interview with another notorious drug kingpin, Frank Lucas: “When I went to the joint, I gave Guy Fisher a woman of mine and told him to look out for her, take care of her,” Barnes said. Fisher had crossed the line when he began having a romantic relationship with the woman, enraging Barnes. For his protection Barnes was transferred to another prison that had a special unit dedicated to protecting witnesses, allowing Barnes the chance to testify in several trials.

Barry, Marion S. (1936– )  95

Upon his release in 1998, Barnes entered the Federal Witness Protection Program. He was given a new identity and a new life. Barnes managed to remain hidden from his enemies until 2007 when the autobiography he cowrote with Tom Folsom, Mr. Untouchable, was released. In an interview for the New York Times Barnes discussed his new life and his reason for writing the book. When describing his new life, Barnes said: “I live within my paycheck. I want to get up every day . . . and go to work and be a respected member of my community. . . . I’m not looking in the rear view mirror to see if anyone is tailing me anymore” (Jacobson 2007). As to why he wrote the book, Barnes explained that he simply wanted to earn some money. The millions he had earned had been spent. Barnes did admit that he sometimes missed the perks that came with being a crime boss such as not having any financial worries. Aside from his autobiography, a documentary on his life (titled Mr. Untouchable) was also released in 2007. Movie audiences were able to see a dramatized version of his life in the film American Gangster, which starred Denzel Washington as Frank Lucas and Cuba Gooding Jr., as Barnes. Stacy O’Hara Leiter See also: Drug Trafficking

Further Reading Jacobson, Mark. 2007. “Lords of Dopetown.” New York Times Magazine, October 25. http:// nymag.com/guides/money/2007/39948/. “Nicky Barnes.” 2014. Biography.com. http://www.biography.com/people/nicky -barnes-481806. Roberts, Sam. 2007. “Crime’s ‘Mr. Untouchable’ Emerges from Shadows.” New York Times, March 4. http://www.ny

times.com/2007/03/04/nyregion/04nicky .html?_r=0.

Barry, Marion S. (1936– ) Marion Barry was born in 1936 in Itta Bena, Mississippi. He moved to Memphis, and was accepted to LeMoyne College to study, graduating as a chemistry major. He began graduate studies in chemistry at Fiske University, earning a master’s degree. In 1965, Barry was elected as the first chairman of the Student Nonviolent Coordinating Committee. In the 1970s, Barry served on the first elected school board in Washington, D.C., and then on the first elected city council. While serving as a city councilman in 1977, he was shot near his heart as he entered the elevator at the District Building by Hanafi Muslim extremists. Barry became the mayor of Washington, D.C., in 1978. He was only the second person ever elected to serve in that capacity. Four years later, he was reelected as mayor of the city. During his second term in office, stories emerged about Barry’s cocaine and alcohol use. In August of 1984, Barry, who was married, ran into legal trouble again. He admitted to “visiting” a woman, Karen K. Johnson, who had a reputation for selling cocaine and was eventually convicted of cocaine possession and contempt of court for not testifying against the mayor. Barry “visited” her for over a year. Barry’s third term as mayor began in 1986. He later admitted that his drug use was out of control by that time. His aides would only schedule afternoon meetings for him, and he would often fall asleep at his desk. In March of 1987, he admitted to visiting Grace Shell, a 23-year-old part-time model. Shell claimed that Barry had been harassing her. The

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Washington mayor Marion Barry is captured on an FBI videotape while lighting a crack cocaine pipe in a hotel room on January 18, 1990. Behind him stands Rasheeda Moore, a model who claimed to have used drugs with Barry over 100 times. The tape was later used as evidence in a trial in which Barry was prosecuted for drug possession and perjury. (AP Photo/Barry Thumma)

mayor, through his legal counsel, said that Barry had no romantic interest in Shell but was only trying to meet her three-year-old son. After an investigation that lasted several weeks, Barry was arrested by DEA agents in January 1990 at the Vista hotel after being videotaped smoking cocaine with his “longtime friend” Hazel Diane “Rasheeda” Moore. She had invited him to the hotel room where she wanted Barry to smoke freebase cocaine before having sex. It turns out that Moore had agreed to work with the FBI during the investigation after being arrested on narcotics charges. Upon his arrest, Barry argued that he had never smoked crack, he

didn’t know what he was smoking that night, and that he had been set up. There were 14 charges against Barry, including three felony counts of perjury and 10 counts of drug possession, and one misdemeanor count of conspiracy to possess cocaine. After the trial, the jury was divided and found Barry guilty of only one misdemeanor charge, and sentenced him to six months in federal prison and to pay a $5,000 fine for cocaine possession. Barry was required by law to serve the entire six months. In addition to Barry, ten of his top officials were also convicted, including his wife, who was charged with defrauding the government and selling cocaine. After serving his sentence, Barry reentered the political scene. He used his conviction and prison term as an illustration that he was no different than the “average person.” He admitted to making mistakes, but that he had learned from them and he was ready to move ahead. In 1992, Barry won a seat on the city council, and in 1994 he was reelected as mayor of the city, serving until 1999 when he decided not to run again. In 2002, Barry considered running for a seat on the D.C. council, but dropped out of the race when U.S. Park Police found traces of cocaine and marijuana in his car. Barry also had to pay a $35,000 fine to a woman as the result of a civil case in which he was accused of exposing himself in an airport bathroom. But in 2004, he chose to run for the council and won the campaign. He serves in this position today. Nancy E. Marion See also: Cocaine and Crack; Drug Enforcement Administration

Further Reading Agronsky, Jonathan I. Z. 1991. Marion Barry: The Politics of Race. Latham, NY: British American Publishing.

Bath Salts and Synthetic Cannabis (“K2” or “Spice”)  97 Barras, Jonetta Rose. 1998. The Last of the Black Emperors: The Hollow Comeback of Marion Barry in the New Age of Black Leaders. Baltimore, MD: Bancroft Press. Barry, Marion. 1979. “A Conversation with Mayor Marion Barry: Held on April 10, 1979 at the American Enterprise Institute for Public Policy Research.” Washington, DC: AEI. Colburn, David R., and Jeffrey S. Adler. 2001. African-American Mayors: Race, Politics and the American City. Urbana: University of Illinois Press. “D.C. Council Members: Marion Barry.” http://www.dccouncil.washington.dc.us/ council/marion-barry. “Marion Barry: Making of a Mayor.” 1998. Washington Post, May 21. http://www .washingtonpost.com/wp-srv/local /longterm/library/dc/barry/barry.htm. Marion, Nancy E. 2010. The Politics of Disgrace. Durham, NC: Carolina Academic Press.

Bath Salts and Synthetic Cannabis (“K2” or “Spice”) Within the past few years, in an effort to circumvent existing laws, a number of new, designer drugs packaged as harmless household products have hit the market via the Internet or sold in “head shops” and even in gas stations. One such drug, known as K2 or Spice, consists of dried leaves of various plants that have been sprayed with synthetic designer cannabinoids. The synthetics are chemically dissimilar enough to the main active ingredient in marijuana that existing law did not cover them. The synthetic cannabinoids consist of an alphabet soup of different drugs, any and all of which might be in a single packet of K2/Spice: HU-210, HU-211,

JWH-018, and JWH-073. The drugs are also sold under names such as Vanilla Sky, Cloud 9, Ivory Wave, or Purple Wave. Because they are not regulated by the DEA, these drugs can often be sold to anyone of any age in any store. They are marketed as potpourri or herbal incense. While some argue that these new drugs are harmless, others disagree and report that one hit can kill a user. One crime spree carried out by a man in Tampa, Florida, demonstrates the harmful effects that bath salts can have. The man, Charley “Chris” Bates, walked into an apartment complex around 11:00 one evening where some students were watching football. He tied up the four men and raped the four women who were there. He then went to another apartment complex where he approached a female while she was sitting on the front porch of her house. Bates forced her to go inside where he made her undress and kiss him. She began to pray and recite Bible verses with him. Bates apologized and left. Bates headed to another apartment complex where he stumbled across a party. There he forced about 25 people, at gunpoint, to go into a bedroom where he fired one round into the floor, then left. He ran into another man, fired several shots at him, and moved on. Police heard the gunshots and saw Bates run away. They had a description of him, and by the next morning had a full manhunt in progress, with 100 officers looking for him, including some in a helicopter. Two police were able to stop him, where they exchanged gunfire, killing Bates. An autopsy of Bates’s body showed that he had heavy amounts of illegal “bath salts” in his body when he died. In 2012, a man was shot and killed by police officers after he refused to stop eating the face of another homeless man. He had taken off his clothes and was eating the other

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man’s face, showing behavior that officials said was consistent with ingesting bath salts. In another story, a 48-year-old woman tried to kill her 71-year-old mother with a machete after taking bath salts. In most cases, the products known as “bath salts” are synthetic stimulants derived from cathinone, the active chemical and a mild stimulant found in khat, a flowering plant that grows in East Africa and the Arabian Peninsula. Cathinone is a Schedule I drug in the United States but is legal in some other countries. The DEA reports the most common synthetics found in products marketed as bath salts are Mephedrone and MDPV and believes that the drugs are manufactured in India and China. Mephedrone is an analog of cathinone and as such, is a Schedule I drug with use prohibited in the United States. But MDPV is currently not scheduled. To date, the DEA has not moved to temporarily ban MDPV. K2 and bath salts are marketed as fake and/or legal weed and are sold in small bags or foil packets, carefully labeled as not being for human consumption. The labeling is simply a ploy to get around existing drug laws, which do not regulate nonconsumable products. But the drugs are indeed consumed by humans. Humans consume these drugs by snorting them, smoking, or injecting them into the body. They have effects similar to cocaine, marijuana, or amphetamines. They are often white crystals that resemble Epsom salts, which is why they are called “bath salts.” They are snorted, smoked, or injected. The drug revs up the neurons in the brain and doesn’t let them be turned off. This results in a high that can last up to nine hours, including hyperaggressive behavior by the user. They can also result in seizures, tremors, and kidney failure. The manufacturers of these products continue to make them because they are

profitable. The makers circumvent laws by constantly manipulating the chemical structure of the product. They create substances that are similar pharmacologically to a Schedule I or Schedule II drug, but do not fit all the legal standards of a Schedule I or II drug. Additionally, the structure can be manipulated in endless variations. Because of this, it becomes almost impossible for a lab to determine the exact chemical composition of the product as well as its potential harm if consumed. However, because these drugs are unregulated, the composition and effects can vary. K2/Spice and bath salts can cause headaches, heart palpitations, and nausea. Unpredictable results in users include paranoia, panic attacks, and hallucinations. There are reports of users showing up with symptoms of violent agitation, similar to an amphetamine or PCP-induced psychosis. Some users have become violent towards others or themselves, but have no memory of their reactions once the drug wears off. Some users have committed suicide. Because of the violent reactions, there were 23,000 visits to hospital emergency rooms related to the use of bath salts in 2011. Additionally, 67 percent of those patients had also used another drug. On March 1, 2011, the DEA used emergency provisions of the Controlled Substances Act to place the most common synthetic cannabinoids in K2/Spice on Schedule I, making their use illegal for 12 months thereafter with the provision to extend the ban for an additional 6 months. Presently, 28 states have banned bath salts. Nancy E. Marion See also: Cannabis; Drug Enforcement Administration; Khat; United Nations International Day Against Drug Abuse and Illicit Trafficking

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Further Reading “America’s New Drug Problem: Snorting ‘Bath Salts.’” 2011. FoxNews.com, January 24. http://www.foxnews.com/health/2011/ 01/24/americas-new-drug-problem-snorting -bath-salts/. Anderson, David, Susan Beckerleg, Degol Hailu, and Axel Klein. 2007. The Khat Controversy. New York: Berg. “‘Bath Salts’ Led to 23,000 ER Visits in One Year.” 2013. WebMD. http://www.webmd .com/mental-health/news/20130917/bath -salts-drugs-led-to-23000-er-visits-in-one -year-us-report. “Face Eating Cannibal Attack May Be Latest in String of ‘Bath Salts’ Incident.” 2012. ABC News, June 1. http://abcnews.go.com/ Blotter/face-eating-cannibal-attack-latest -bath-salts-incident/story?id=16470389. Goodnough, Abby. 2011. “An Alarming New Stimulant, Legal in Many States.” New York Times, July 16. http://www.nytimes .com/2011/07/17/us/17salts.html?page wanted=all. “International Day Against Drug Abuse and Illicit Trafficking: June 26.” http:// www.un.org/en/events/drugabuseday/index .shtml. McMillen, Matt. 2011. “‘Bath Salts’ Drug Trend: Expert Q & A.” WebMD. http://www .webmd.com/mental-health/features/bath -salts-drug-dangers. Snyderman, Nancy. 2011. “Bath Salts Drugs Causing Alarm.” NBC Nightly News, October 19. New York: NBCUniversal Media LLC. Sullivan, Dan. 2013. “Test Finds Bath Salts Chemical in Tampa Rampage Suspect’s System.” Tampa Bay Times, December 6. http://www.tampabay.com/news/public safety/crime/medical-examiner-suspect-in -september-rampage-had-bath-salts-in-his -system/2155836.

Beatniks The term “beatniks” refers to young individuals who came of age in the 1950s and challenged the mainstream middle-class society and rejected its morals and values. They were part of the counterculture, a social subculture who rejected traditional rules of society. They sought to better their souls as opposed to collecting material possessions. Beatniks were often writers or other artists and would-be artists who expressed themselves through art. They experimented with drugs, particularly marijuana and cocaine, and influenced the counterculture that followed in the 1960s. Most beatniks supported liberal politics and supported desegregation and accepting other cultures. They were part of the jazz music scene. The word “beatnik” came from underworld slang for “beaten down.” Beatnik men had long hair, wore goatees and berets, and played bongos. Women wore black leotards and had long, straight hair (as a way to rebel against beauty salons). They encouraged communal living and were easily recognized by the use of slang terms such as “Daddy-O” and “Cool, man.” The beatnik culture captivated the American youth and shocked older Americans who were quickly labeled as “square.” Famous beatniks, or beats, included Allen Ginsberg, Neal Cassady, Lawrence Ferlin­ ghetti, and William Burroughs. Ron Chepesiuk See also: Alpert, Richard (Ram Dass); The Counterculture and Drugs; Ginsberg, Allen; Hippies

Further Reading Finbow, Steve. 2012. Allen Ginsberg. London: Reaktion Books. Heims, Neil. 2005. Allen Ginsberg. Philadelphia: Chelsea House.

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Two beatniks in Hollyood during the late 1950s. Beatniks were known for spending time in coffee houses while discussing art, literature, and life. (AP Photo/Ed Widdis) Jedick, Peter. 1998. Hippies. Rocky River, OH: Peter Jedick Enterprises. Kramer, Jane. 1970. Allen Ginsberg in America. New York: Vintage Books. Plummer, William. 1981. The Holy Goof: A Biography of Neal Cassady. New York: Thunder’s Mouth. Tyrell, John. 1976. Naked Angels: The Lives and Literature of the Beat Generation. New York: McGraw-Hill.

Behavioral Addictions Behavioral addictions are a type of impulse control disorder that becomes apparent when a person is unable to control the frequency or the extent of a particular behavior, or if they

have impulsive or uncontrollable urges that cause a behavior. Many do not believe that behavioral addictions are actually true addictions as, often, these behaviors do not result in pleasure or gratification that is often associated with substance addictions. In other words, there is no euphoric or out-of-body experience that results from the behavior. Examples of impulse control disorders that are most often labeled as addictions include compulsive computer use (also referred to as internet addiction), compulsive shopping (to the extent of putting a person in debt), selfinjury (such as cutting oneself), intermittent explosive disorder (most often known as rage addiction), kleptomania (stealing or shoplifting), pathological gambling (unable to stop even after going into debt), pyroma-

Behavioral Addictions 

nia (starting fires), sexual addiction, and trichotillomania (pulling out one’s hair for no apparent reason). Not all these listed disorders are categorized as impulse control disorders by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). However, more and more experts in the field of addictions are recognizing these behaviors as behavioral addictions and labeling them as such. The difference between these disorders and what is called a “compulsion” is very slight, leading to reluctance to label these behaviors as addictions. Generally speaking, an “impulse” involves urges within a person that result in a strong desire to act in a certain way that may feel good when it is done but in the long run may cause the person to be regretful. On the other hand, a compulsive behavior usually involves obsessive or unwanted thoughts that can only be quieted when a person carries out an act or series of acts that he or she knows to be excessive or unusual. These behaviors need much more analysis and research before people truly understand the causes and consequences. Some current studies show that people suffering from behavioral addictions can be grouped into three categories. The first is those who have uncontrollable urges to carry out the behavior. The second category is those people who do not have urges but yet engage in the behavior. Often this is done as a way for the person to escape bad feelings such as loneliness or depression. The third category is composed of those who have urges only when they have negative feelings. This means that the bad feelings act as a trigger event for the urges, or cause the urges, and then the behavior results. Some people have behavioral urges for no apparent reason, whereas others have the behaviors only after some kind of a trigger

event. For example, a pathological gambler’s behavior may be triggered by seeing an ad on television. Often, people will actually enjoy the behaviors that come after the urge and have no desire to stop, even if there are negative consequences. Again, a gambler may actually enjoy the excitement that comes from high-stakes gambling and may not want to stop, even if they go into debt. In fact, many claim to experience a type of rush during and after the behavior. On the other hand, some feel compelled to carry out the behavior, even though they do not experience a thrill or pleasure either during or after the act. Instead, they admit to carrying out the behavior only because they feel they have to and not because they want to. Some people are fearful of treatment that will help them stop their impulsive behavior for the fear that another compulsive behavior will take its place. While most of the time this does not happen, it can. An example is addictions to nicotine or food (except alcohol) that have a different impact on the brain. In some instances, behavioral addictions can be extremely destructive. Some people with behavioral addictions have impulses to steal or carry out an assault. Others have impulses that result in rage. As a result, some with addictions may have to lie to their friends, families, and employers to create elaborate excuses for their behaviors. Others may face financial ruin from their behavior, especially those who gamble. Research to date indicates that behavioral addictions may be similar to substance addictions because they stem from a complicated interplay of biological, genetic, and environmental factors. They seem to be rooted in an area of the brain that processes feelings of pleasure and reward. However, because many sufferers have been told that they simply lack willpower to stop their behaviors, those individuals who suffer from

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behavioral addictions often do not seek out treatment options. Even those who admit their addiction often do not know or understand that they have a treatable, psychiatric disease. About half of those people who are diagnosed with impulse control disorders also have a problem with substance abuse. It is not yet known why this is the case. When a person has both of these disorders, they are often only treated for the substance disorder, and the impulse control disorder is left untreated. Many trained healthcare professionals are unaware or unfamiliar with behavioral addictions and frequently misdiagnose (or do not diagnose) the abuser as having manic-depressive illness (or bipolar disorder), obsessive-compulsive disorder, major depressive disorder, or borderline personality disorder. When this happens, the patients may be given the wrong medications. Some people feel so frustrated with the lack of treatment that they report having suicidal thoughts as a way to escape their pain. Those who research in this field have discovered that behavioral addictions do not typically occur after a specific trauma or critical event. This is the opposite of what has been the prevailing theory for many years, that behavioral addictions were the result of parental deprivation: when a person had a behavioral addiction, they were unconsciously or subconsciously attempting to attract their parents’ attention. Another prevalent theory to explain behavioral addictions was that the disorder, in the long run, produces soothing chemicals in the abuser’s brain. This is because the person engages in risk-taking behavior, which causes the brain to release neurochemicals. Neither of these theories have been scientifically proven or shown to be true. It seems that teenagers may be more susceptible to behavioral addictions than adults. At the same time, they also respond very

well to early interventions. Early assistance is imperative not only to reduce the severity of the disease, but also as a way to reduce the potential shame, guilt, or remorse that may result after the behavior. For some, diagnosing a behavioral disorder may be more difficult than making a diagnosis for an adult, simply because teens are less mature and typically have a need for rebellion, novelty seeking, risk taking, and impulsive behavior. A teacher or parent who is “tuned into” a teenager may be more likely to see early signs of a behavioral addiction. At this time, there are specific treatments that have been identified as effective medications or treatment for impulse control disorders. Some researchers have identified medications that can be helpful in the short term. This includes some serotonin reuptake inhibitors (SSRIs), opioid antagonists, or mood stabilizers, as they tend to rebalance the patient’s neurochemistry and reduce impulsive urges. These drugs have shown promise in relieving many of the symptoms associated with behavioral addictions, and thus reducing or limiting possible destructive behaviors. Some behavioral disorders seem to respond well to cognitive behavioral therapy, especially if it is targeted to the special needs of the individual, or the specific manifestations of that patient’s disorder. Those who suffer from impulse control disorders, especially teens, seem to have success when they learn new ways to deal with the destructive impulses such as relaxation techniques, habit reversal, and stimulus control. It must be remembered that impulse control disorders are not indicative of a person’s character deficiencies. They do not choose to be harmful, destructive, or immoral. Instead, their behavior is a result of, or a manifestation of, neurobiological abnormalities. They should be treated as if they have a serious illness and need to be treated with the most

Belushi, John (1949–1982)  103

appropriate medical, psychological, and behavioral therapy that is appropriate for their particular needs. Kathryn H. Hollen See also: Addiction; Addiction Liability; Addictive Personality; Bush, George H. W.; Drug Czar; Office of National Drug Control Policy; Recovery

Further Reading Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton. Grant, Jon E., and S. W. Kim. 2003. Stop Me Because I Can’t Stop Myself: Taking Control of Impulsive Behavior. New York: McGraw-Hill. Hyman, S. E., and R. C. Malenka. 2001. “Addiction and the Brain: The Neurobiology of Compulsion and Its Persistence.” Nature Reviews Neuroscience 2(10): 695–703. Kalivas, P. W., and N. Volkow. 2005. “The Neural Basis of Addiction: A Pathology of Motivation and Choice.” American Journal of Psychiatry 162(8): 1403–13. Nestler, Eric J., and Robert Malenka. 2007. “The Addicted Brain.” Scientific American. http://www.sciam.com/article.cfm?chanID =sa006&colID=1&articleID=0001E632 –978A-1019-978A83414B7F0101. U.S. Department of Health and Human Ser­ vices. 2007. The Science of Addiction: Drugs, Brains, and Behavior. NIH Publication No. 07-5605. U.S. Department of Health and Human Ser­ vices, National Institute of Mental Health (NIMH). http://www.nimh.nih.gov.

Belushi, John (1949–1982) John Adam Belushi was born in Chicago on January 24, 1949. His father was an im-

migrant from Albania, and his mother was the daughter of Albanian immigrants. John was raised in Wheaton, a suburb of Chicago, alongside his three siblings: younger brothers Billy and Jim, and a sister, Marian. His name was not always Belushi. The family’s name was actually Belliors. Because of his parents’ background, John was raised in the Albanian Orthodox Church. He then attended Wheaton Central High School, where he met his future wife, Judy Jacklin. They were married on December 31, 1976. Judy eventually became a producer for the longrunning television show, Saturday Night Live (SNL). John and Judy remained married until his death in 1982. During his childhood and school days Belushi was the captain of the football team. John was also the drummer of a rock band. Though acting was his favorite among his childhood hobbies, he was a good comedian and singer. John’s first break as a comedian occurred in 1971 when he joined the Second City comedy troupe in Chicago. In 1972, John was cast in National Lampoon’s Lemmings, a parody of Woodstock, which played off-Broadway. Also appearing in this show were future SNL actors Chevy Chase and Christopher Guest. In 1973, National Lampoon magazine sponsored the National Lampoon Radio Hour, a half-hour comedy program that was syndicated across the country on approximately 600 stations. John became a regular actor on the show. Other players included future SNL regulars Gilda Radner, Bill Murray, Brian Doyle-Murray, and Chevy Chase. Many of the comic sketches on SNL were first performed on the Radio Hour. John joined SNL as a cast member in 1975. It wasn’t long before John achieved national fame for his work. Between seasons of the show, John played a role in a movie called Animal House, which turned out to

104   Belushi, John (1949–1982)

John Belushi, a comedian and actor, died at the age of 33 after using a mixture of cocaine and heroin, more commonly called a speedball. Before his death, Belushi was well known for appearing on Saturday Night Live, and in movies such as Animal House and The Blues Brothers. (AP Photo)

be one of his best-known and popular movies. Shortly after, in 1979, John left SNL to pursue a film career. His next movie, entitled Neighbors, was very successful. During the shooting, John recruited the band Fear and brought them to Cherokee Studios to record songs for the movie’s soundtrack. Cherokee Studios had been a regular hang-out for the original Blues Brothers many years before. After a while, John Belushi and Dan Aykroyd became fixtures at the recording studio. The guitar player for the Blues Brothers, Steve Cropper, called Cherokee his producing home, and Cropper noted that Belushi

was an extremely heavy drinker. The Blues Brothers was the basis of arguably John’s most well-known movie, entitled The Blues Brothers, which co-starred fellow SNL alumnus Dan Aykroyd. John’s next movie, released in September 1981, was a romantic comedy called Continental Divide. John played a Chicago hometown hero and writer named Ernie Souchack, who was put on assignment researching a scientist who studied birds of prey in the remote Rocky Mountains. “We had a budget in the movie for cocaine for night shoots,” Dan Aykroyd told Vanity Fair. “Everyone did it, including me. Never to excess, and not ever to where I wanted to buy it or have it. [But] John, he just loved what it did. It sort of brought him alive at night— that superpower feeling where you start to talk and converse and figure you can solve all the world’s problems.” According to his friend and fellow comedian Dan Aykroyd, John had a very hard work ethic. When interviewed for retrospectives after Belushi’s death, Aykroyd often told stories that after finishing a rehearsal for SNL, or after a day of film shooting, John would be so exhausted he would often walk to nearby homes of friends or strangers, and walk into the home, unannounced. He would scrounge for food and often fall asleep in their homes. The next day, no one would know where he was. It seemed as if John knew he would die young. During the opening of the SNL episode that aired on December 17, 1977, John was playing himself in a skit. He joked, “I plan to be dead by the time I’m 30.” In another episode, SNL featured a short film by writer Tom Schiller entitled “Don’t Look Back in Anger.” In the film, John played himself as an old man and the last-surviving SNL cast member. During the skit, he visits the graves of his now-former cast members.

Belushi, John (1949–1982)  105

In the early morning on March 5, 1982, John had two visitors: friends Robin Williams and Robert De Niro. After they left, Belushi was alone with Catherine Evelyn Smith. Later that day, Bill Wallace went to visit John and found him dead in his room, Bungalow 3, at the Chateau Marmont on Sunset Boulevard in Hollywood, California. He had died of a speedball—a combined injection of cocaine and heroin. His death was investigated by forensic pathologist Dr. Ryan Norris. Belushi was only 33 years of age when he died. Two months later, Catherine Evelyn Smith admitted in an interview with the gossip tabloid National Enquirer that she had been with John the night he died. She also admitted to giving him the speedball shot that killed him. After she was featured in the article “I Killed Belushi” in the Enquirer on June 29, 1982, the case was reopened. Smith was extradited from Toronto, Ontario, and arrested. She was charged with first-degree murder in Belushi’s death. A plea bargain reduced the charge to involuntary manslaughter, and she served a 15-month stint in prison. Before he died, John was pursuing several movie projects, including Noble Rot. He was also scheduled to return to SNL for a guest appearance. In 1989, John Belushi was voted one of the 25 top television stars by People magazine. John was nicknamed the “Black Hole” and “Albanian Oak.” John Belushi was buried on Martha’s Vineyard in Massachusetts. His wife later contracted with journalist Bob Woodward to investigate John’s death. After the investigation, Woodward authored the book Wired: The Short Life and Fast Times of John Belushi. A movie entitled John Belushi was made about his life. Nancy E. Marion See also: Cocaine and Crack; Heroin

Further Reading Belushi, Judith, and Tanner Colby. 2005. Belushi: A Biography. New York: Rugged Land Publishers. Dunham, Chris. 2009. “Before They Were Belushis (or Blues Brothers).” http: //www.genealogywise.com/profiles/blogs/ before-they-were-belushis-orGenealogywise.com. “Figure in John Belushi Case Freed from California Prison.” 1988. New York Times, March 17. http://www.nytimes.com/1988/03/17/ us/figure-in-john-belushi-case-freed-from -california-prison.html. “Jim Belushi Biography.” Jimbelushi.ws. “John Belushi.” Biography Channel. http:// www.biography.com/people/john-belushi -9206502?page=1. “John Belushi Biography.” http://belushi.com/ bio/. “John Belushi Biography” (1949–1982). Filmreference.com. “John Belushi Biopic Could Star Emile Hirsch, Adam Devine or Joaquin Phoenix.” 2013. Huffington Post, November 22. http:// www.huffingtonpost.com/2013/10/22/john -belushi-biopic_n_4144375.html. “John Belushi Dies at the Chateau Marmont.” Franksreelreviews.com. John Belushi: The Official Site. http://www .cmgww.com/stars/belushi/about/fastfacts .html. McFadden, Robert D. 1982. “John Belushi, Manic Comic of TV and Films Dies.” New York Times, March 6. http://www .nytimes.com/1982/03/06/obituaries/john -belushi-manic-comic-of-tv-and-films-dies .html. Sacks, Ethan. 2013. “Jim Belushi: My Son Should Be Starring in John Belushi Biopic— Not Emile Hirsch.” New York Daily News, November 18. http://www.nydailynews .com/entertainment/tv-movies/jim-belushi

106   Bennett, William (1943– ) -sounds-emile-hirsch-casting-article-1 .1520774. Saturday Night Live. 1977. Season 3, Episode 8, December 17—Miskel Spillman / Elvis Costello. “SNL Archives | Episode 3.15 (#61).” http: //snl.jt.org. Woodward, Bob. 2012. Wired: The Short Life and Fast Times of John Belushi. New York: Simon and Schuster.

Bennett, William (1943– ) William John Bennett was named the first director of the Office of National Drug Control Policy in 1989 by President George H. W. Bush. That office had been created by the Anti–Drug Abuse Act of 1988. Bennett was born in Brooklyn, New York, on July 31, 1943, but later moved to Washington, D.C. He graduated from Gonzaga High School in Washington and attended Williams College in Williamstown, Massachusetts, from which he earned his BA in philosophy in 1965. He then continued his education at the University of Texas, from which he received his PhD in philosophy in 1970, and at Harvard Law School, which granted him a JD in 1971. He has held teaching posts at Boston University, the University of North Carolina at Chapel Hill, and North Carolina State University, and had a successful career as a professor of religion and philosophy and university administrator. Bennett is probably best known as a conservative writer, speaker, commentator, educator, and political theorist. Bennett’s political career began in 1981 when President Ronald Reagan appointed him to the post of president of the National Endowment for the Humanities. He remained there until 1985, when Reagan ap-

pointed him secretary of the Department of Education (DOE), a post he held for three years. After leaving the DOE, Bennett was appointed the first director of the White House Office of National Drug Control Policy, where he remained until the end of President Bush’s term in 1991. Throughout his public and private careers, Bennett has taken strong stances against substance abuse, abortion, and other activities to which he is opposed. In an appearance on the Larry King Live radio show on June 15, 1989, for example, he said in response to a caller’s suggestion that drug dealers be beheaded that “morally, I don’t have a problem with that at all.” In his confirmation hearings to become the nation’s first drug czar, there were a few who opposed his nomination. In the process, Bennett said he would resolve conflicts among drug-fighting agencies and in carrying out his strategy, he would seek out executive orders from the president. He told members of the Senate that he would balance his zeal to crack down on drug dealers and users with his respect for civil liberties. To measure his success as the drug czar, Bennett would look for fewer drug-related emergency room admissions, fewer drug-related deaths, and a higher price for illegal narcotics on the street due to diminished supply. Finally, Bennett sought to de-glamorize drug use and be less understanding of people who use cocaine. As the nation’s drug czar, Bennett saw education as the key component in the fight against drugs. He promoted an increased emphasis on drug treatment for offenders, in addition to the well-used approaches involving interdiction and enforcement of laws. As the drug czar, Bennett tried to use education to convince youth that drugs were not “cool.” He attempted to use different media sources to help him in this battle by not glamorizing drug use.

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When he resigned as drug czar after 19 months, Bennett said that the United States was “on the road to victory” over drug abuse. He was followed as drug czar by former Florida governor Bob Martinez. Bennett was not without controversy during and after his term as drug czar. While serving in that position, Bennett responded to a caller indicating that if a person sold drugs to children, or made money selling drugs to children, then they deserved to die, even by beheading. Of course, he said, that might be legally difficult. In 2003 he also admitted to losing millions gambling, but said his gambling never put his family in economic danger. In addition to his many speaking appearances before public audiences and on television and radio, Bennett has been a prolific author with more than a dozen books to his credit, including The Book of Virtues: A Treasury of Great Moral Stories, The Children’s Book of Virtues, The Death of Outrage: Bill Clinton and the Assault on American Ideals, The American Patriot’s Almanac: Daily Readings on America (with John Cribb), Why We Fight: Moral Clarity and the War on Terrorism, The Broken Hearth: Reversing the Moral Collapse of the American Family, and Body Count: Moral Poverty . . . and How to Win America’s War Against Crime and Drugs. His most recent book is entitled Is College Worth It? with David Wilezol (2013) in which he analyzes the role of college in today’s society. Bennett has sometimes been criticized for leading a life that is sometimes at odds with the moral principles he espouses in public. In 2003, for example, he was widely criticized when it became public knowledge that he was addicted to gambling and had lost $8 million over the preceding years at the gaming tables in Las Vegas. David E. Newton

See also: Bush, George H. W.; Clinton, Bill; Office of National Drug Control Policy

Further Reading “Bennett: Drug ‘Czar.’” 1990. In CQ Almanac 1989, 45th ed., 287–88. Washington, DC: Congressional Quarterly. http://library.cq press.com/cqalmanac/cqal89-1138792. Califano, Joseph A., Jr. and William J. Bennett. 2011. “Do We Really Want a ‘Needle Park’ on American Soil?” Wall Street Journal. http://online.wsj.com/news/articles/SB100 0142405270230431440457641161093332 7334. Greve, Frank, and Matthew Purdy. 1989. “Drug Czar Angry At Leaders Says They Lack Will for Fight.” The Inquirer, Philly. com. http://articles.philly.com/1989-11 -07/news/26138629_1_drug-czar-william -j-bennett-drug-treatment-and-education. Steigerwald, Lucy. 2012. “Former Drug Czar William J. Bennett says Legalization Wouldn’t Have Saved Whitney Houston or Anyone Else.” Reason.com. http:// reason.com/blog/2012/02/15/former-drug -czar-william-j-bennett-says. U.S. Congress, Senate, Committee on the Judiciary. 1991. Confirmation Hearings of Federal Appointments to the Office of National Drug Control Policy. Washington, DC: Government Printing Office. U.S. Congress, Senate, Committee on the Judiciary. 1989. Dr. William J. Bennett to be Director of National Drug Control Policy. Washington, DC: Government Printing Office.

Betty Ford Center Founded in 1982, the Betty Ford Center is a hospital dedicated to the treatment of chemical dependency located in Rancho Mirage, California, on the campus of the

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Eisenhower Medical Center. The center is named after Betty Ford, the wife of former president Gerald Ford, who was successfully treated for prescription drug and alcohol abuse and sought to create a center that emphasized the special needs of chemically depen­dent women. The Betty Ford Center sees drug dependencies as chronic progressive diseases that, if left untreated, can become fatal. While it encourages patients to take responsibility for their own well-being and recovery, it also features a family-treatment program that utilizes group therapy to treat family members who have been affected by a loved one’s alcoholism or drug dependency. The Betty Ford Center came into exis­ tence through the considerable efforts of the hospital’s namesake, the former first lady. Born Elizabeth Anne Bloomer in Chicago on April 8, 1918, and raised in Grand Rapids, Michigan, she became Betty Ford after marrying Gerald R. Ford on October 15, 1948. After Ford lost his reelection bid to Jimmy Carter in the 1976 election, the couple left the White House and moved to Rancho Mirage, California, the future home of the Betty Ford Center. In 1978, Betty Ford left the couple’s new home and admitted herself, after a family intervention, to the Long Beach Naval Hospital for treatment of her prescription drug and alcohol use. The details of her chemical dependency are recounted in her 1978 autobiography, The Times of My Life, which included an unplanned chapter on her admittance to treatment in Long Beach. A second book, Betty: A Glad Awakening, detailed the successful treatment she received there, and after her release from the hospital, she became a vocal and prominent figure in public health campaigns to raise awareness of alcohol and drug dependency issues and their treatment.

As part of this new role in life, Ford began discussing with friends the need for a treatment center that would emphasize the special needs of women, whose chemical dependencies have typically been more hidden and neglected in comparison to those of men. These conversations came to a tangible fruition when, in 1982, Ford cofounded, along with her good friend, Ambassador Leonard Firestone, the nonprofit Betty Ford Center at the Eisenhower Medical Research Center. As a result of her considerable fundraising efforts on behalf of the institution, the Betty Ford Center has grown into a treatment facility of international renown. Soon, professionals at the facility had treated people from all 50 states and more than 30 foreign countries. Abiding by Ford’s emphasis on the importance of treating chemically dependent women, the Betty Ford Center’s 80 beds are always evenly divided between women and men. Likewise, the treatment programs offered at the Betty Ford Center are gender-specific. Male and female patients also reside in separate halls. Guided by the view that drug dependencies are chronic progressive diseases that can be fatal if left untreated, the Betty Ford Center offers a variety of programs intended to treat both patients and family members affected by their loved ones’ alcoholism or drug use. The goal is “treatment without shame.” An outpatient program permits patients to continue to reside at home and work in the local community while they are in treatment, while the inpatient program mandates that patients live in one of the on-campus residence halls. The inpatient program utilizes a 12-step approach to recovery, and the cost of the program covers the attendance of one family member. The Betty Ford Center also offers a residential day treatment that likewise features a 12-step program, but unlike in

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the inpatient program, patients live in sober, off-campus homes and only attend treatment during the day. A 90-day program—which is geared toward chronic relapsers, patients with a prolonged detoxification period, and those with multiple prior treatments—is also available, as are five-day family programs that offer support and education. There is also a children’s program, which works with children ages seven through 12 who are not themselves addicted but who have chemically dependent family members. Betty Ford and the center have helped to eliminate the stigma that is sometimes associated with drug abuse and alcohol dependency. Since the clinic has opened, it has treated over 90,000 patients, including celebrities such as Lindsay Lohan, Billy Joel, Elizabeth Taylor, and Kelsey Grammer. Leadership of the Betty Ford Center has been passed from the former first lady to her daughter, Susan Ford Bales. Mrs. Ford passed away July 8, 2011, but the Betty Ford Clinic remains open to help those in need. In September 2013, the Hazelden Center merged to form the nation’s largest nonprofit addiction treatment provider. The new organization will be known as the Hazelden Betty Ford Foundation. Howard Padwa and Jacob A. Cunningham See also: Addiction Medications; Alcoholism; Dependence; Ford, Betty; Ford, Gerald; Hazelden Foundation

Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Felci, Erica. 2013. “Betty Ford Center Merges with Hazelden Foundation.” USA Today, September 24. http://www.usatoday.com/ story/news/nation/2013/09/24/betty-ford -center-merges-with-hazelden-foundation/ 2865931/. Ford, Betty. 2003. Healing and Hope: Six Women from the Betty Ford Center Share Their Powerful Journeys of Addiction and Recovery. New York: Putnam. Gerald R. Ford Presidential Library and Museum. “Betty Ford Biography.” http://www .fordlibrarymuseum.gov/grf/bbfbiop.asp. Greene, John Robert. 2004. Betty Ford: Candor and Courage in the White House. Lawrence: University Press of Kansas. Haroutunian, Harry L. 2013. Being Sober: A Step-by-Step Plan for Getting to, Getting Through, and Living in Recovery. Emmaus, PA: Rodale. West, James W. 1997. The Betty Ford Center Book of Answers: Help for Those Struggling with Substance Abuse and for the People who Love Them. New York: Pocket Books. White, William L. 1998. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chestnut Health Systems.

Further Reading Ashley, Jeffrey S. 2003. Betty Ford: A Symbol of Strength. New York: Nova History Publishers. Betty Ford Center. “Alcohol and Drug Rehabilitation.” http://www.bettyfordcenter.org/ programs/index.php. Betty Ford Center. “A Brief History of the Betty Ford Center.” http://www.bettyford center.org/welcome/ourhistory.php.

Bias, Len (1963–1986) A gifted college basketball player, Len Bias died on June 19, 1986, at the age of 22 after using what was believed to be crack cocaine (according to autopsy reports, the cause was powder cocaine), only two days after being chosen as the first-round draft pick of the Boston Celtics. Just before he died, Bias

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also signed a million-dollar endorsement contract with Reebok. The death of basketball star Bias, an apparently healthy athlete, reinforced the general perception that the country was facing an epidemic of drug use, especially crack cocaine. The outrage about his death was especially pertinent in Boston, the home of congressional House Speaker Tip O’Neill. In the month after Bias’s death, media presented a multitude of stories and segments about the dangers of drugs. In the end, it was determined that his death was probably due to a mixture of alcohol and cocaine, a potentially lethal combination. Bias’s death gave more purpose to a nonpartisan congressional coalition to move forward in their crusade against drugs. The coalition had the full support of President Reagan and his wife, Nancy. After just a few months, Congress skipped the usual congressional hearings that normally take place for significant legislative actions, and passed a $1.7 billion Anti–Drug Abuse Act, sending it to the president for signature. The Act included increased funding drug-treatment programs, more drug interdiction efforts at the U.S. borders, and mandatory minimum sentences for certain federal drug offenses. When they passed the new law, the Congress was sending a message to the American public: that drugs, and especially crack cocaine, are a menace to society, and anyone involved with the sale and use of the drug will be put in prison. At the time the Act was passed, crack was a popularly used drug across the nation. NBC News called it “America’s drug of choice,” and drug czar William Bennett predicted the drug would be in every home in the United States before too long. Newsweek compared crack to the bubonic plague and called it “the most addictive drug known to man.” The new law provided mandatory minimum sentences for those who trafficked, manufactured, or possessed crack cocaine.

Under the new law, those possessing five grams of crack would be guilty of a felony and would be given an automatic five-year prison term. Possessing five grams of the same drug in powder form was a misdemeanor for which an offender would probably not receive a jail sentence. Because a large proportion of crack users were black, the Anti–Drug Abuse Act of 1986 was quickly labeled as a racially biased law that was intended to target African Americans who used the drug. Richard E. Isralowitz See also: Anti–Drug Abuse Acts; Cocaine and Crack

Further Reading Cole, Lewis. 1989. Never Too Young to Die: The Death of Len Bias. New York: Pantheon Books. Harriston, Keith, and Sally Jenkins. 1986. “Maryland Basketball Star Len Bias is Dead at 22.” Washington Post, June 20. http:// www.washingtonpost.com/wp-srv/sports/ longterm/memories/bias/launch/bias1.htm. McCallum, Jack. 2011. “Twenty-five Years Later, Bias’ Death Remains a Seminal Sports Moment.” Sports Illustrated. http://sports illustrated.cnn.com/2011/writers/jack_ mccallum/06/17/len.bias/index.html. Smith, C. Fraser. 1992. Lenny, Lefty, and the Chancellor: The Len Bias Tragedy and the Search for Reform of Big Time College Basketball. Baltimore, MD: Bancroft Press. Weinreb, Michael. “The Day Innocence Died.” ESPN. http://sports.espn.go.com/espn/ eticket/story?page=bias.

Binge Drinking Binge drinking typically refers to someone who has five or more drinks at a time—

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bringing their blood alcohol concentration to .08 percent or higher (legally drunk). A binge drinker can then go weeks or even months before having another alcoholic drink. Binge drinking is the most common form of excessive alcohol use in the United States. Binge drinking may be a more serious problem than previously thought. According to national surveys, one in six adults in the United States, or over 38 million people, binge drink about four times a month, consuming about eight drinks per binge. According to the Centers for Disease Control, most people who binge drink are young adults between the ages of 18 and 29. About 90 percent of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinking. In 2006, among young adults aged 18 to 25, the rate of binge drinking was 42.2 percent, and the rate of heavy drinking was 15.6 percent. Rates of binge alcohol use in 2006 were 1.5 percent among 12- or 13-year-olds, 8.9 percent among 14- or 15-year-olds, 20.0 percent among 16- or 17-year-olds, 36.2 percent among persons aged 18 to 20, and 46.1 percent among those aged 21 to 25. The rate peaked at ages 21 to 23 (49.3 percent at age 21, 48.9 percent at age 22, and 47.2 percent at age 23), then decreased beyond young adulthood from 34.2 percent of 26- to 34-year-olds to 18.4 percent of people who were aged 35 or older. Many have accepted this behavior as a “rite of passage” for youth in today’s culture. They do it because it is fun, it may make someone feel more confident in a social setting, or because of peer pressure. Some people binge drink to forget their problems or because they are simply curious about drinking alcohol. At the same time, statistics show that 70 percent of binge drinkers are 26 years old

and older. Moreover, those aged 65 years and older also report binge drinking and doing so more often than in the past. They report binge drinking an average of five to six times a month. More men than women tend to participate in binge drinking. More males than females aged 12 to 20 reported current alcohol use (29.2 vs. 27.4 percent, respectively), binge drinking (21.3 vs. 16.5 percent), and heavy drinking (7.9 vs. 4.3 percent) in 2006. However, women are at greater risk than males after drinking because they have lower levels of body water, meaning that they have higher concentrations of alcohol in their bloodstream after drinking the same amount of alcohol. In the end, women will absorb around 30 percent more alcohol into their bloodstreams than men. It can be especially dangerous to a woman who is pregnant. Among pregnant women aged 15 to 44, binge drinking in the first trimester dropped from 10.6 percent in 2003–2004 to 4.6 percent in 2005–2006. Among persons aged 12 to 20, past-month alcohol use rates were 18.6 percent among blacks, 19.7 percent among Asians, 25.3 percent among Hispanics, 27.5 percent among those reporting 2 or more races, 31.3 percent among American Indians or Alaska Natives, and 32.3 percent among whites. The 2006 rate for American Indians or Alaska Natives is higher than the 2005 rate of 21.7 percent (Centers for Disease Control). Patterns of binge drinking show that it may be related to household income. Statistics show that binge drinking is more common among those with household incomes of $75,000 or more than among those with lower incomes. There are some serious short-term and long-term effects of binge drinking. Such behavior can lead to accidents and injuries, alcohol poisoning, unsafe sexual activity

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(leading to sexually transmitted diseases and unwanted pregnancies), criminal behavior, and short-term health problems such as hangovers and stomach problems. It can also lead to missed work or other activities. If done long-term, binge drinking can lead to more serious health problems such as pancreatitis, alcoholic liver disease, hepatitis, and possibly stomach ulcers and cancer. It could lead to problems in the workplace and with social relationships. While binge drinkers are not necessarily alcoholics or alcohol dependent, binge drinking can lead to alcoholism, especially if it is done regularly. According to the Centers for Disease Control, the rate of past-month alcohol use among those adults 18 or older increase as education level increases. For those adults with less than a high school education, 36.5 percent were current drinkers in 2006, whereas 67.3 percent of college graduates were current drinkers. However, among adults aged 26 or older, binge and heavy alcohol use rates were lower among college graduates (19.1 and 5.4 percent, respectively) than among those who had not graduated from college (22.3 vs. 6.2 percent, respectively). Young adults who were between the ages of 18 and 22 and who were enrolled full-time in college were more likely than those who were not enrolled in college on a full-time basis (i.e., part-time college students and persons not currently enrolled in college) to use alcohol in the past month, binge drink, or drink heavily. Alcohol use in the past month was reported by 66.4 percent of full-time college students compared with 54.1 percent of the same age group who were not enrolled fulltime in college. Binge and heavy use rates for those enrolled were 45.5 and 19 percent, respectively, compared with 38.4 and 13.3 percent for those who were not enrolled fulltime in college.

The rates of current alcohol use also differed depending on the employment status of the user. The alcohol use for adults who were employed full-time was 62 percent for adults aged 18 or older in 2006, which was higher than the rate of alcohol use for adults who were unemployed (52.1 percent). However, the pattern was different for binge and heavy alcohol use based on employment. The rates of binge and heavy use for unemployed people were 34.2 and 12.2 percent, respectively, while these rates were 29.7 and 8.9 percent for those who were employed full-time. Most binge and heavy alcohol users were employed in 2006. Among the 54 million adult binge drinkers, 42.9 million (79.4 percent) were employed either full- or part-time. Among 16.3 million heavy drinkers, 12.9 million (79.2 percent) were employed (Centers for Disease Control). Drinking patterns also are determined by the place where people live. Among those people who were aged 12 or older, the rate of past-month alcohol use for those living in large metropolitan areas was 53.5 percent, which was higher than the 49.6 percent who lived in small metropolitan areas and 45 percent living in nonmetropolitan areas. Binge drinking was equally as common for those who lived in small metropolitan areas (22.6 percent), large metropolitan areas (23.4 percent), or even nonmetropolitan areas (22.2 percent). The rate of heavy alcohol use in large metropolitan areas increased from 6.1 percent in 2005 to 6.7 percent in 2006. The rates in small metropolitan areas and nonmetropolitan areas in 2006 were both 7.1 percent. The rates of binge alcohol use among youths aged 12 to 17 were 11.2 percent in nonmetropolitan areas, 9.8 percent in small metropolitan areas, and 10.3 percent in large metropolitan areas, where the rate increased from 9.3 percent in 2005. In completely rural counties of nonmetropolitan areas, 12.2

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percent of youths reported binge drinking in 2006 (Centers for Disease Control). Patterns of binge drinking differ by state. The highest number of drinks on average within a short time ranged from 6 drinks by those living in the District of Columbia to 9 drinks by those living in Wisconsin. It is estimated that 10.9 percent of those who live in Utah binge drink, whereas 25.6 percent of those in Wisconsin do the same. Binge drinking is most common in the Midwest, New England, the District of Columbia, Alaska, and Hawaii (Centers for Disease Control). In 2006, it was estimated that binge drinking costs the United States $223.5 billion, or $1.90 a drink, related to losses in productivity, health care, crime, and other expenses. According to the National Institute of Alcohol Abuse and Alcoholism, about 2,000 college students die because of a preventable alcohol-related event. Many colleges and universities are implementing programs to educate students about the dangers of binge drinking. They are also doing more to screen students to identify those who may be exhibiting this behavior. Treatment for binge drinking is varied. A person who would like to stop binge drinking but who has difficulty doing so has many options for help. There is medication available to help someone stop using alcohol. Therapy is also available, either for individuals or in a group setting. This may help someone understand the reasons why they binge drink. Therapy in a group setting may be more helpful to some because there is more interaction with others who share some of the same problems. One well-known group therapy program is Alcoholics Anonymous. This allows people to meet others who also have issues concerning alcohol use and find support for quitting. For those needing more intensive help, residential treatment centers exist.

This typically involves a four-week stay with intensive therapy. However, this can be expensive and time consuming. There are other, alternative treatment options as well, such as herbal remedies or other holistic remedies. Suggestions to prevent binge drinking include increased education about the dangers of such behavior. Another way to stop binge drinking behavior is to increase the costs of alcoholic beverages and/or increase the taxes on them. Limiting the number of retail stores that sell alcohol has been suggested. Other suggestions include holding retailers responsible for the harms caused by their underage patrons, maintaining limits on the days and hours in which alcohol can be sold, enforcing laws against underage drinking and alcohol-impaired driving more consistently, and more effective screening and counseling for misuse of alcohol. Nancy E. Marion See also: Addiction; Al-Anon; Alateen; Alcoholism

Further Reading Bouchery E. E., H. J. Harwood, J. J. Sacks, C. J. Simon, and R. D. Brewer. 2011. “Economic Costs of Excessive Alcohol Consumption in the United States.” American Journal of Preventive Medicine 41: 516–24. Centers for Disease Control and Prevention. “Fact Sheets: Binge Drinking.” http://www .cdc.gov/alcohol/fact-sheets/binge-drinking .htm. Centers for Disease Control and Prevention. 2012. “Binge Drinking: Nationwide Problems, Local Solutions.” http://www.cdc .gov/vitalsigns/BingeDrinking/. Centers for Disease Control and Prevention. 2012. “Vital Signs: Binge Drinking Prevalence, Frequency, and Intensity among Adults.” Morbidity and Mortality Weekly Report 61(1): 14–19.

114   Biological and Psychological Reasons for Substance Abuse College Binge Drinking. http://www.college bingedrinking.net/. Morrow, Deborah. “The Alcoholism Guide.” http://www.the-alcoholism-guide.org/rea sons-for-binge-drinking.html. Naimi, T. S., R. D. Brewer, A. Mokdad, D. Clark, M. K. Serdula, and J. S. Marks. 2003. “Binge Drinking among U.S. Adults.” Journal of American Medical Association 289(1): 70–75. Volkmann, Chris, and Toren Volkmann. 2006. From Binge to Blackout: A Mother and Son Struggle with Teen Drinking. New York: New American Library. Watson, Stephanie. 2012. Binge Drinking. Edina, MN: ABDO. Wechsler, Henry, and Bernice Wuethrich. 2002. Dying to Drink: Confronting Binge Drinking on College Campuses. Emmaus, PA: Rodale.

Biological and Psychological Reasons for Substance Abuse Certain individuals are predisposed to drug and alcohol use because of their genetic makeup. It also appears that a person’s genetic makeup, when combined with environmental and personality factors, can be the reason why certain individuals or groups of people seem to have a significantly higher level of drug abuse or alcoholism than others. Moreover, the National Institute of Drug Abuse reports that genetic factors play a major role in the progression from drug use to abuse and dependence. From a psychological perspective, drug use and dependence may be viewed in two ways: (1) drugs have addictive reinforcement properties, independent of personality factors, and (2) personality pathology, defect, or inadequacy points to problems of

an emotional or psychic nature of certain individuals, leading them to drug use. Drugs are sometimes used by those who seek to escape from their reality or as a means to avoid life’s problems and retreat into a state of indifference. Studies have shown that individuals who abuse drugs tend to lack responsibility, independence, and the ability to defer gratification as a way to achieve longrange goals. They often have difficulties in controlling their emotions, especially rage, shame, jealousy, and anxiety. They tend to have lower self-esteem, and have feelings of peer rejection and parental neglect. It has also been found that drug users tend to be less religious and are less attached to their parents and family members, less achievement oriented, less cautious, more likely to be ambivalent to authority, compulsive, have confusion over sex roles, narcissistic, defiant, and resentful. Richard E. Isralowitz See also: Addiction; Addiction Liability; Addictive Personality; Alcohol Use; Drug Abuse

Further Reading Carter, Adrian. 2012. Addiction Neuroethics: The Promises and Perils of Neuroscience Research on Addiction. New York: Cambridge University Press. Carter, Adrian, Wayne Hall, and Judy Illes. 2012. Addiction Neuroethics: The Ethics of Addiction Neuroscience Research and Treatment. London: Academic Press. Edwards, Scott, and George F. Koob. 2013. “Escalation of Drug Self-Administration as a Hallmark of Persistent Addiction Liability.” Behavioral Pharmacology 24(5–6): 356–62. Goldstein, Avram. 2001. Addiction: From Biology to Drug Policy. New York: Oxford University Press.

Black Tar Heroin  Hall, W. D, C. E. Gartner, and A. Carter. 2008. “The Genetics of Nicotine Addiction Liability: Ethical and Social Policy Implications.” Addiction 103 (3): 350–59. Nielsen, D. A., and M. J. Kreek. 2012. “Common and Specific Liability to Addiction: Approaches to Association Studies of Opioid Addiction.” Drug and Alcohol Depen­ dence 123: S33–S41. Sutton, Amy L. 2007. Alcoholism Sourcebook: Basic Consumer Health Information About Alcohol Use, Abuse, and Dependence. Detroit: Omnigraphics. Twerski, Abraham, and Craig Nakken. 1999. Addictive Thinking and the Addictive Personality. New York: MJF Books. Vanyukov, Michael, and Ty A. Ridenour. 2012. “Common Liability to Drug Addictions: Theory, Research, Practice.” Drug and Alcohol Dependence 123. Walker, Ida. 2013. Addiction in America: Society, Psychology and Heredity. Philadelphia: Mason Crest. Weed, Christopher M. 2013. “The Biology of Addiction.” Alcohol Answers. http://www .alcoholanswers.org/alcohol-education/ biology-of-addiction.cfm.

Black Tar Heroin Customer service and satisfaction are their priorities. “We deliver” might as well be their advertising slogan. Were they selling any legal product, the loosely based organization of franchised dealers with connections to the obscure (to most Americans) rural area of Xalisco, Mexico, might receive accolades for their entrepreneurship in respected business-oriented publications such as Forbes magazine or the Wall Street Journal. As it is, they sell black tar heroin, a lower grade of heroin that results from us-

ing cheaper reagents during one of the main processing steps in heroin production (i.e., acetylation). The production of black tar heroin does not require any complex or expensive lab equipment, high-purity acetylating chemicals, or lengthy steps that are typically required to produce pure heroin. Because of this, black tar heroin is easier for clandestine drug producers. The resulting drug varies in consistency from a dark black, moist, gooey substance to a lighter brown, powdery substance, depending on the ingredients used. The drug is most popular in the western and southern United States, close to Mexico, because it is cheaper and much more potent than Colombian heroin. Deaths from overdoses due to black tar heroin in many of these towns have skyrocketed. Despite this, black tar heroin is as potent as more processed heroin but use entails greater health risks such as bacterial infections owing to its relative impurity, sludgy consistency, and the way it is most often injected (i.e., subcutaneously rather than intravenously). Because it must be heated before injecting, some potential viruses are killed before being injected into the body. Black tar heroin can also be ground into a powder that can be snorted, dissolved into water and used as nose drops (called “water looping”), drunk, heated on foil and the smoke inhaled, or used as a suppository. Traffickers from Xalisco, a small town that lies at the base of volcanic mountains where opium poppies grow, specialize in the small to mid-sized suburban markets in the United States—Reno, Nevada; Myrtle Beach, South Carolina; Boise, Idaho; Salt Lake City, Utah; and Indianapolis, Indiana—that have been overlooked by dealers trafficking in heroin produced in Colombia. They have also chosen to decline sales to African Americans or Latinos, instead focusing on the middleand working-class Caucasian market. This is

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because the traffickers believe that this population is a more safe and profitable clientele. By focusing on customer satisfaction and underserved markets, the Xalisco traffickers have been highly successful at what they do. Shunning the violent disputes that marred drug trafficking in, for instance, crack cocaine in the 1980s, they have been able to operate in near anonymity under the radar of law enforcement for some time. This has also contributed to their success and allowed them to add franchises in new markets as they branch out across the country. However, competition among groups has caused a decrease in prices of the product from $25 to $12.50 per dose. The dealers on the street carry the drug in balloons placed in their mouth. A customer will dial a number to a cell phone to a third party, and place their order, which is then sent to the drug deal on the street. The traffickers use cell phones for texting and calling clients and often deliver the drug directly to clients’ homes. They then follow up with quality control calls, and offer rewards (often free heroin) for referred customers. This obviates the need for their white, middle-­ class, suburban clientele to risk driving into a dangerous inner-city neighborhood to buy drugs, further expanding their markets. Xalisco-based traffickers shun African American and even Hispanic customers and focus on the white market. As each driver only carries a small amount of the drug, there is less risk of a large bust, and decentralization makes it more difficult for law enforcement to identify a central trafficking location. Arrested drivers are easily replaced and can offer little information to authorities about the organization’s structure. To build customer loyalty, the traffickers will call after a delivery to check on the client’s satisfaction. As a local market expands, dealers who are part of an existing network branch

off to form a new dealership in the expanded territory. The competition among networks keeps prices low, leading one dealer to compare their business model favorably to that of Walmart’s. Federal narcotics agents have attempted to crack down on the Xalisco connection. However, since the organization has multiple layers of workers, the leadership is very insulated and it is difficult for law enforcement to crack the business. Agents from the U.S. Drug Enforcement Administration have travelled to Xalisco to try to stop the drug at the source. They discovered that most of the residents of the town are poor sugar cane farmers who are willing to take part in the opium trade for the easy money. The Xalisco drug traffickers allegedly pay high amounts of money to the Arellano-Felix cartel for permission to be part of the drug trade. James A. Swartz See also: Drug Abuse; Drug Enforcement Administration; Drug Trafficking; Heroin

Further Reading Fries, Arthur, Robert W. Anthony, Andrew Cseko, Jr., Carl C. Gaither, and Eric Shulman. 2008. The Price and Purity of Illicit Drugs: 1981–2007. Institute for Defense Analysis, Office of National Drug Control Policy. http://www.whitehousedrugpolicy .gov/drugfact/heroin/heroin_ff.html. “Heroin: Topic Overview.” WebMD. http:// www.webmd.com/a-to-z-guides/heroin -topic-overview. The National Institute on Drug Abuse, Community Epidemiological Work Group. http://www.drugabuse.gov/about/organiza tion/cewg/CEWG-Home.html. Quinones, Sam. 2010. “Sugar Cane Farmers from a Tiny Mexican County Use Savvy Marketing and Low Prices to Push Black-tar Heroin in the US.” Los Angeles Times, Feb-

Blanco, Griselda (1943–2012)  117 ruary 14. http://articles.latimes.com/2010/ feb/14/local/la-me-blacktar14–2010feb14. Quinones, Sam. 2010. “The Heroin Road: How Mexican Black Tar Dope Affects U.S.” Los Angeles Times, February 23. www. latimes.com/news/local/la-me-blacktar14 -2010feb14,0,5863703.story. Rizzo, Mary. Embodying Withdrawal: Abjection and the Popularity of Heroin Chic. http:// hdl.handle.net/2027/spo.ark5583.0015 .004. Sherwood, Chris. 2010. “Side Effects of Black Tar.” Livestrong.com. http://www .livestrong.com/article/165891-side-effects -of-black-tar/. “Three Unlikely Drug Partners in Crime, Part II: Mexican Farmers and Xalisco Drug Entrepreneurs.” Sober Living by the Sea. http://soberliving.crchealth.com/ uncategorized/three-unlikely-partners-in -crime-part-ii-mexican-farmers-and -xalisco-drug-entrepreneurs/ United Nations Office on Drugs and Crime. http://www.unodc.org/unodc/en/drugtrafficking/index.html. The site also has information on treatment programs and prevention at: http://www.unodc.org/unodc/en/ drug-prevention-and-treatment/index.html. U.S. DEA. “National Drug Threat Assessment Report for 2011.” http://www.justice.gov/ ndic/topics/ndtas.htm#y2011.

Blanco, Griselda (1943–2012) Griselda Blanco, known as the Black Widow, La Madrina, and the Godmother, was a powerful Colombian drug trafficker and murderer. She was born in the shantytowns surrounding Cartagena, Colombia, on February 15, 1943. The area in which she was raised was populated with corrugated tin-roof shacks and a murder rate so high that the children would entertain themselves

by digging graves for the multiple murder victims that lay in the streets. To make ends meet, the children relied upon petty crime. When she was 11, Blanco and a group of children supposedly ventured from their hillside ghetto to the more affluent flatlands of Medellín and kidnapped a 10-year-old boy from a wealthy family. He was taken back to the ghetto where he was held hostage by Blanco and the others. They attempted to extract a ransom from the boy’s parents but were unsuccessful. Rather than releasing the boy and with the goading of the other children, Blanco shot the boy in the head. Former DEA agent Bob Palombo, who pursued Blanco for decades, said that the violent behavior displayed by Blanco at such a young age was simply “inherent to Griselda Blanco. This goes back to her life, the way she was brought up. She was just a violent person” (Maxim Staff 2008). Before reaching her teens, Blanco had become a pickpocket and a prostitute. When she was 13 she met Carlos Trujillo. Aside from being an occasional client of Blanco’s, Trujillo was a master forger of immigration papers and a coyote. Blanco was captivated by Trujillo. The two married and had three sons. The marriage did not last and in the early 1970s, Blanco had Trujillo killed following a business dispute. Her second husband, Alberto Bravo, was also a smuggler; rather than illegal immigrants, he specialized in cocaine. The duo moved to Queens, New York, in pursuit of their version of the American dream: establishing a cocaine empire. At the time the cocaine trade was run by the Italian Mafia, who relied upon middlemen. The young Colombian couple, however, had direct connections to the source. In the operation’s early days Blanco relied upon a group of female couriers to smuggle the cocaine in luggage. Within a few years, she was able to

118   Blanco, Griselda (1943–2012)

use her own pilots, who were able to transport sizable quantities directly from Colombia. Every week the operation netted Blanco millions of dollars. Soon she was catering to the cocaine needs of celebrities and gaining the attention of Operation Banshee, a joint NYPD/DEA investigation. This resulted in Blanco’s indictment on federal drug conspiracy charges. Over 30 of her co-conspirators joined her in what was then history’s largest cocaine case. But before the indictment could be handed down, Blanco had slipped out of the country, returned to Colombia, and killed Bravo. Blanco did not spend much time in Colombia; she established a new operation in Miami, a city that was the Latin American “gateway” and a hub of criminality (Maxim Staff 2008). When Blanco arrived in Miami the cocaine trade was beginning to burgeon and, along with it, an increasing crime rate. It was this era in Miami’s history that would be depicted in the movie Scarface and television’s Miami Vice. The violence exploded on the afternoon of July 11, 1979, at a liquor store at the Dadeland Mall when three assassins killed a Colombian cocaine dealer named German Jimenez Panesso and an associate with a barrage of automatic gunfire. When investigators arrived at the scene they discovered the van the assassins had left behind. On the outside it appeared to be a nondescript party supply delivery van; the inside held an armory (shotguns, revolvers, and machine guns). The mastermind behind the brazen daytime attack was Blanco. Her desire to establish a monopoly in Miami’s cocaine market knew no bounds. She ordered hits on dealers who failed to pay for goods on her timetable, or when she had no inclination to pay for the drugs she purchased. Blanco even ordered a hit on one of her own hitmen when he got into a disagree-

ment with her son, Osvaldo. When a crew of assassins attempted to carry out the hit, they accidentally killed the target’s young son. This did not faze Blanco, and from that point on anyone—including family and pets—associated with a target was fair game. Between 1979 and 1981, Blanco was responsible for the majority of homicides in South Florida. As the drug war’s death toll rose, so too did her operation. At its peak, Blanco’s empire spanned the entire country and generated $80 million per month (Maxim Staff 2008). The drug war Blanco had started was not confined to South Florida. After a shipment of cocaine destined for Miami was allegedly stolen by another dealer, Paco Mejilla, Blanco sent Jorge “Rivi” Ayala, her top assassin, to New York City to eliminate Mejilla’s 12-man crew. Within a 24-hour period, Ayala killed 11 of his 12 targets—Ayala spared the final target. Blanco’s quest to eliminate Mejilla and anyone close to him became increasingly public. Mejilla’s father, Paco, was gunned down in Miami’s Mall of the Americas and an unsuccessful attempt was made on the life of Mejilla’s brother, Papo. A couple of weeks later, upon arrival at Miami International Airport, Paco was attacked by another of Blanco’s henchmen in the busy airport terminal. Paco survived despite being stabbed several times with a bayonet, and the would-be assassin was captured by police. By this time, Bravo’s nephew Jaime had discovered that his former aunt was behind his uncle’s death. “Jaime and two gunmen he’d imported from Colombia would go to the malls where Griselda spent time shopping and just wait for her,” Palombo remembers. “It got so bad that we had to interrupt our drug case against Griselda to take Jaime off the streets” (Maxim Staff 2008). Aside from being pursued by authorities for her

Blood-Alcohol Content (BAC)  119

criminal activity in both New York and Miami, Blanco was now being hunted by her own family. In 1984, she sneaked out of Miami and relocated to California. After her departure, the homicide rate in Miami was reduced by half. On the West Coast, Blanco needed to establish new connections to the Medellín cartel. To do this she befriended a member of the Ochoa family, Marta. True to her nature, Blanco had decided that rather than paying for the cocaine, she would kill Marta and claim that Marta had stolen both the money and the cocaine. By crossing the cartel, Blanco had placed a target on her and her family’s heads. Blanco’s cocaine empire collapsed on February 20, 1985, when the home she was sharing with her mother and youngest son, Michael Corleone Blanco, was raided by a DEA team led by Palombo. She was found guilty and sentenced to more than 10 years. Meanwhile, in Miami, Blanco’s top assassin, Ayala, had been arrested and decided to cooperate with the Miami-Dade State Attorney’s Office. This resulted in Blanco’s 1995 indictment on three charges of murder. The case collapsed, however, when it was revealed that a secretary in the prosecution’s office had engaged in an inappropriate relationship with Ayala. Blanco was released from a California prison in June 2004 and was quickly deported to her native Colombia. Although many believed she would be killed within days of arriving in Colombia, Blanco managed to survive until September 3, 2012. Reports state that she was shot twice in the head after exiting a Medellín butcher shop. Witnesses said that the assassin was riding a motorcycle—an assassination technique devised by Blanco. She was reportedly accompanied by her pregnant daughter-in-law who claimed that Blanco had abandoned

her life of crime and was, instead, making a living off of real estate investments. Stacy O’Hara Leiter See also: Cocaine and Crack; Cocaine Cowboys; Medellín Cartel

Further Reading Maxim Staff. 2008. “Searching for the Godmother of Crime.” Maxim, June 23. Movies Blog. 2010. “Cocaine Cowboys.” http:// www.whentheshipcomesin.com/cocaine -cowboys-2006. Ovalle, David. 2012. “‘Cocaine Godmother’ Griselda Blanco Gunned Down in Colombia.” Miami Herald, September 3. http://www.miamiherald.com/2012/09/03/ 2983362/cocaine-godmother-griselda -blanco.html.

Blood-Alcohol Content (BAC) Blood-alcohol content, or BAC, (or bloodalcohol concentration or even blood-alcohol level) refers to the percentage of alcohol in the blood. More specifically, it is the proportion of alcohol in a person’s blood as measured in grams per 100 milliliters. In all states, a BAC of .08 is considered to be the legal threshold of intoxication—a person measuring a BAC of .08 or above is considered to be legally intoxicated, or drunk. A measure of .08 means that alcohol makes up .08 grams per 100 milliliters of blood (or 8/100 of 1 percent alcohol). Typically, with a BAC of .01–.05, a person will appear as if they have not ingested any alcohol. In other words, they appear normal. However, the presence of alcohol can still be determined through medical testing. If a person’s BAC raises to .03–.12, they will usually exhibit mild symptoms such as increased talkativeness and decreased inhibitions. They

120   Blood-Alcohol Content (BAC)

Law enforcement officers administer a breathalyzer test to a suspected drunk driver in Pennsylvania. The results of the test indicated that the driver had a blood-alcohol content that was three to four times above the state’s legal limit. (AP Photo/Pocono Record/Keith R. Stevenson)

will be more relaxed and may have some trouble concentrating on complex tasks. At the same time, the user will have a decreased attention span, impaired judgment, and increased reaction time. A person is considered to be legally intoxicated in this range. These symptoms worsen as a person ingests more alcohol. When the BAC increases to .09–.25, a person will demonstrate even more impaired judgment and a higher reaction time. Other symptoms in this range include emotional instability, memory impairment, and a lack of coordination.

With a BAC of .18 to .30, a user will experience confusion, dizziness, and impaired vision. He or she may also have difficulty walking and have slurred speech. There may be memory loss or “blackout.” The symptoms become more severe as the BAC increases. When the BAC is in the range of .27–.40, the user will have severe lack of coordination to the point where they may not be able to stand or walk. They may vomit or experience incontinence. If a person ingests enough alcohol to have a BAC of .35–.50, they may lose conscious-

Blood-Alcohol Content (BAC)  121 Drink and weight table showing blood-alcohol content (BAC) per drinker’s weight and number of drinks Weight

Number of drinks

(lbs.)

1

2

3

4

5

6

7

8

9

100 120 140 160 180 200 220 240

0.032 0.027 0.023 0.020 0.018 0.016 0.015 0.014

0.065 0.054 0.046 0.040 0.036 0.032 0.029 0.027

0.097 0.081 0.069 0.060 0.054 0.048 0.044 0.040

.0129 0.108 0.092 0.080 0.072 0.064 0.058 0.053

.0162 0.135 0.115 0.101 0.090 0.080 0.073 0.067

0.194 0.161 0.138 0.121 0.108 0.097 0.088 0.081

0.226 0.188 0.161 0.141 0.126 0.113 0.102 0.095

0.258 0.215 0.184 0.161 0.144 0.129 0.117 0.108

0.291 0.242 0.207 0.181 0.162 0.145 0.131 0.121

In all U.S. states, those with a BAC at or over 0.08 are not permitted to drive vehicles or heavy machinery. Note that number of drinks does not give an accurate BAC count if a drink has a greater amount of alcohol or less than the standard of amount of alcohol?

ness, lapse into a coma, or even die from respiratory paralysis. A person’s ability to legally perform certain functions is determined by their BAC. In all U.S. states, those with a BAC over .08 are not permitted to drive vehicles or heavy machinery. There are also limits on operating aircraft and boats. Many states have lower BAC standards for young drivers, inexperienced drivers, or professional (commercial) drivers. Those drivers convicted of violating these laws face punishments including fines, jail sentences, or loss of their driving license. Some states may require an offender attend a DUI class or even put an ignition interlock on their vehicle that will prevent a driver from operating the vehicle if their BAC is above a certain level. The device is attached to the car dashboard, and the driver must exhale into it before the car will start. A person’s BAC can be measured accurately. In many cases a person thought to be under the influence may be asked to take a breathalyzer test, which measures the amount of alcohol in a person’s breath. These tests assume that all of the alcohol in

a person’s stomach has been absorbed. If it has not, the breathalyzer results will not be accurate. For the most part, the results of a breathalyzer are considered to be accurate and the results can be used in a courtroom as evidence. In some cases a person’s BAC can be tested through urinalysis. Results from a urinalysis can be influenced by medications that include alcohol. A BAC can also be determined through a blood test. The following table gives a general estimate of a person’s BAC after drinking alcohol, taking into account their weight. A person’s BAC will be affected by many factors such as their sex (women are usually more affected by alcohol use), the amount of food eaten during this time, a person’s metabolism, body fat, and any medications the user may be taking. Nancy E. Marion See also: Alcohol Use; Alcoholism; Urinalysis

Further Reading Albalate, Daniel. 2008. “Lowering Blood Alcohol Content Levels to Save Lives: The

122   Blow European Experience.” Journal of Policy Analysis and Management 27 (1): 20–39. “Alcohol Impaired Driving: Overview of the Law and Police Practices.” 2013. Supreme Court Debates 16 (2): 7–11. Blomberg, Richard D. 1992. “Lower BAC Limits for Youth: Evaluation of the Maryland .02 Law: Technical Summary.” Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration. “Blood Alcohol.” WebMd. http://www.webmd. com/mental-health/alcohol-abuse/blood -alcohol?page=2. Centers for Disease Control and Prevention. “Effects of Blood Alcohol Concentration” http://www.cdc.gov/Motorvehiclesafety/ Impaired_Driving/bac.html. Faupel, Charles E., Greg S. Weaver, and Jay Corzine. 2014. The Sociology of Drug Use. New York: Oxford University Press. Kiesbye, Stefan. 2011. Drunk Driving. Detroit: Greenhaven Press. Parks, Peggy J. 2010. Drunk Driving. San Diego, CA: Reference Point Press. Taylor, Lawrence, and Steven Oberman. 2010. Drunk Driving Defense. New York: Aspen Publishers. Williams, Brian, and Tom Costello. 2013. “NTSB Calls for New Drunk Driving Definition.” NBC Nightly News, May 14. New York: NBC Universal Media, LLC. Wilson, Mike. 2007. Drunk Driving. MI: Greenhaven Press.

Blow George Jacob Jung was nicknamed “Boston George” and became a major trafficker of cocaine in the United States in the 1970s and early 1980s. Jung became a critical member of the Medellín drug cartel, which was re-

sponsible for smuggling up to 89 percent of the cocaine brought into the United States during that period. He excelled at smuggling cocaine from Colombia on a large scale. Because of secret informants who provided details about his operation, Jung is now incarcerated. A motion picture was made about his life called Blow. In the movie, George Jung and his parents, Fred and Ermine, live in Weymouth, Massachusetts. When George is 10 years old, he sees his father working very hard every day but forced to file for bankruptcy and lose everything. Despite this, Fred tries to make his son George realize that money is not important. As an adult, George moves to Southern California with his friend “Tuna,” and they meet Barbara, an airline stewardess, who introduces them to Derek Foreal. Derek was the marijuana/drug dealer in the neighborhood and making great sums of money for very little work. With Derek’s help, George and Tuna make a lot of money in a short period of time. Kevin, a college student back in Boston, visits them and tells them of the enormous market and demand for marijuana back in Boston. In 1967, Barbara begins trafficking the marijuana by carrying it from one place to the next in her suitcases. However, George wants to make even more money. He decides to expand his operation by flying drugs into the United States from Puerto Vallarta, Mexico, using professional pilots who would fly airplanes stolen from private airports on Cape Cod. At the height of this marijuana enterprise, Jung is reportedly making $250,000 a month (equivalent to over $1.6 million today). Everything stops in 1974, when George is arrested in Chicago for smuggling 660 pounds of marijuana. Jung had been staying at the Playboy Club, where he was to meet someone who was buying marijuana

Blow  123

from Jung. The seller was arrested for heroin smuggling and informed law enforcement about George as a way to get a reduced sentence. George tries unsuccessfully to prove that he was innocent. The judge allows him to leave jail on bail. George quickly skips bail to take care of Barbara, who is suffering from cancer. She eventually dies from the disease. While hiding from the authorities, George returns to Boston to visit his parents. While he is having a frank discussion with his father, George’s mother calls law enforcement, who come to the house and arrest him. And after arguing with the judge about the purpose of sending a man to prison “for crossing an imaginary line with a bunch of plants,” George is sent to a federal prison in Danbury, Connecticut, for 26 months. While in prison, Jung’s cellmate is Diego Delgado. It turns out that Delgado has contacts in the Medellín cocaine cartel. He convinces George to go into the drug business upon their release from prison, which is what they do. When George gets out, he violates the conditions of his parole by travelling to Cartagena, Colombia, to meet up with Delgado. The pair then meet with cartel officer Cesar Rosa and negotiate the terms for smuggling 15 kilograms of cocaine into the United States. The operation goes smoothly, and the operation grows. It isn’t long before Delgado is arrested again. George must find a way to sell 50 kilograms of cocaine and get the money in time to the drug front men by himself. George quickly finds Derek in California and talks him into joining him in selling drugs. The pair successfully sell all 50 kilograms of cocaine within three days, collecting $1.35 million in profit. George is taken to Medellín, Colombia, where he meets the group’s leader, Pablo Escobar, and agrees to go into business with them. With the help of

the middleman Derek, the pair becomes Escobar’s top U.S. importer. George makes millions off of acting as the middle man, selling cocaine for Pablo Escobar. As a way to launder his profits, Jung keeps his money in the national bank of Panama City. It isn’t long before Diego begins to resent George for keeping Derek’s identity a secret and pressures George to reveal his connection. George eventually discovers that Diego has betrayed him. Because of that, and because of the birth of his daughter, and after suffering a drug-related heart attack, George severs his relationship with Escobar and vows to leave the drug business forever. George does well as a civilian for about five years until his wife, Mirtha, puts on a party for him to celebrate his 38th birthday. She invites many of his former drug associates, including Derek, who reveals that he was also cut out of the business as well. Agents from the Federal Bureau of Investigation raid the party and arrest George. He is convicted and his bank account is seized. George becomes a fugitive from the law. One night, as he and Mirtha are driving, they get into a fight and are pulled over by the police. Mirtha tells them that George is a fugitive and has a kilogram of cocaine in his trunk. George is sent to jail for three years. During this time, Mirtha divorces him and is given custody of their nine-year-old daughter, Kristina Sunshine Jung. Upon his release, George wants to renew his relationship with his daughter. He promises her that they can take a vacation together in California. But George needs money for the trip, so he seeks one final drug deal. As he is finishing the deal, he learns that he has been set up by his former friends who wanted pardons for their involvement in the drug trade. George is arrested again, this time with 796 pounds of cocaine. He pleads guilty to three

124   Boggs Act (1951)

counts of conspiracy and is sentenced to 60 years at Otisville Correctional Facility in upstate New York. While serving his sentence, George requests a furlough to see his dying father, Fred. His mother denies his request to go home, saying a visit would only upset Fred. Instead, the prison provides George with a tape recorder as a way to send a final message to his father. In the message, George remembers working with his father, his run-ins with the law, and his understanding of what Fred meant when he said that money is not “real.” The film closes with George as an old man in prison, imagining that his daughter comes to visit him. She slowly fades away as a guard calls out for George. The film concludes with notes indicating that George’s sentence will not expire until 2015. The film’s final image is a photograph of the actual George Jung. George later testified in the trial of former accomplice, Carlos Lehder, to receive a reduction in his sentence. According to the Department of Corrections Web site, prisoner #19225-004 is currently serving in Federal Correctional Institution, Fort Dix, New Jersey, with a possible release date of November 2014.

The Main Cast Members in the Movie: • Johnny Depp as “Boston George,” “Jesse James,” and “Young George” • Penélope Cruz as Mirtha Jung • Franka Potente as Barbara “Barbie” Buckley • Rachel Griffiths as Ermine Jung • Paul Reubens as Derek Foreal • Jordi Molla as Diego Delgado • Cliff Curtis as Pablo Emilio “El Patrón” Escobar Gaviria • Max Perlich as Kevin Dulli • Ethan Suplee as “Tuna”

• Alan James Morgan as Young “Tuna” • Ray Liotta as Frederick “Fred” Jung Blow was a minor box office success. With a budget of roughly $53 million, it managed to rake in just under $53 million domestically, but rose just over $30 million internationally for a worldwide total of $83,282,296. Reviews for Blow were decidedly mixed. The film holds an approval rating of 55 percent at Rotten Tomatoes based on 135 (74 positive, 61 negative). Nancy E. Marion See also: Cocaine and Crack; Colombian Cartels; Drug Trafficking; Escobar, Pablo; Heroin; Marijuana; Medellín Cartel

Further Reading Blow. Box Office Mojo. http://www.boxoffice mojo.com/movies/?id=blow.htm. Blow. Rotten Tomatoes. http://www.rottento matoes.com/m/blow/. “High On Tuna.” impfm.com. Smith, Christopher. 2001. “Blow: Movie Review, DVD Review (2001).” Weekinrewind .com. “True Crime Authors.” History Channel.

Boggs Act (1951) The Boggs Act, passed in 1951, was the first piece of federal legislation to impose mandatory minimum sentences for drug offenses, and the first major federal drug legislation passed since the 1937 Marihuana Tax Act. Together with the Narcotic Control Act of 1956, it ushered in a new, harsher era of narcotics control in the United States. In addition to creating minimum sentences for drug dealers and users, the act also had the unintended consequence of spawning

Boggs Act (1951) 

criticism from the legal and medical communities, which began to advocate for the federal government to reconsider the punitive approach to handling the drug problem. Strict enforcement of the Harrison Narcotics Act and Marihuana Tax Act by the Federal Bureau of Narcotics (FBN), coupled with Supreme Court decisions sanctioning tough anti–maintenance treatment approaches and the internment of addicts in Public Health Service Narcotic Hospitals, had seemingly stemmed the tide of addiction by the beginning of the 1940s. With the United States’ entry into World War II in 1941, restrictions on commerce allowed the federal government to tighten controls and crack down on smuggling. Yet the apparent gains in the FBN’s antinarcotics campaign seemed to be easily lost, as rates of addiction reportedly rose in black and Puerto Rican ghettos in northern cities after the war. Even more disconcerting was the revelation that rates of addiction were rising among teenagers in these areas, as use of both heroin and marijuana became more prevalent. Many feared that organized crime, and possibly the new communist government in China, were behind the increase in drug smuggling. To address the problem, officials in the FBN began pushing for mandatory minimum sentences in order to discourage the illicit drug trade and put the traffickers who were responsible for the uptick in illicit drug use behind bars. In 1951, they got their wish when Louisiana Representative Hale Boggs introduced a new law that modified the 1922 Narcotic Drugs Import and Export Act. The law amended the Import and Export Act by stipulating that any individual who knowingly imported or brought any opiates, cocaine, or marijuana into the United States, or anyone who knowingly received, concealed, bought, sold, transported, or conspired to traffic them,

would be fined up to $2,000 and imprisoned for between two and five years. Repeat offenders were given even harsher treatment, with five to 10 years becoming the punishment for second violations of the act, and 10 to 20 years the punishment for subsequent violations. The law also stipulated that repeat offenders could not be given suspended sentences or granted probation. These provisions stripped judges of the leeway to let individuals found guilty of drug trafficking get away with a slap on the wrist, as now they had no choice but to sentence them to prison time. By including the purchase and transportation of illegally trafficked drugs as offenses, the law also allowed for the prosecution of many users, who even though they may not have been involved in smuggling, were probably using drugs that had been illegally brought into the country. Thus even though the law’s main target was smugglers, addicts could also become subject to the automatic sentencing protocols laid out in the act. President Truman backed the mandatory sentences established in the bill, calling it a useful antidrug measure. He appointed an interdepartmental committee on narcotics made up of representatives from the departments of the Treasury, State, Defense, Justice, and Agriculture, and from the Federal Security Agency, to advise him on the effective implementation of the bill’s provisions. The head of the committee became Harry Anslinger, the commissioner of the Bureau of Narcotics. Anslinger was not interested in having representatives from other departments telling him what to do. In the end, the committee made no recommendations nor took any actions regarding the Boggs Act or mandatory sentencing procedures. In spite of the new regulations, it became clear within a few years that tougher enforcement did not have the desired effect of reducing rates of addiction in U.S. cities.

125

126   Boylan Act (1914)

It became apparent that the mandatory sentencing provisions in the Boggs Act did not stop the heroin from flowing into the United States, or the people from using the drug. Hospitals were seeing a dramatic increase in the number of patients needing treatment for addiction or other maladies related to the heroin epidemic. The excessively punitive nature of the act also spurred two professions whose practice were profoundly affected by it—doctors and lawyers—to take action to oppose it. The American Bar Association responded by creating a special Committee on Narcotics in 1954, and in early 1955 it passed a resolution urging Congress to reconsider the Boggs Act and other aspects of federal drug control policy. The American Medical Association also criticized the tough turn that federal drug policy had taken, leading the New York Academy of Medicine to investigate the efficacy of existing policies and study the possibility of developing more medically oriented approaches to the drug problem. In its report, issued in 1955, the New York Academy of Medicine recommended that the government begin treating addiction as a disease, and to allow doctors to give maintenance doses of narcotics to their addict patients. In spite of these pleas from powerful professional associations, the push towards harsher treatment of drug traffickers, dealers, and users continued in 1956 with the passage of the Narcotic Control Act. Howard Padwa and Jacob Cunningham See also: Anslinger, Harry J.; Federal Bureau of Narcotics; Harrison Narcotics Act; Marihuana Tax Act; Narcotic Control Act; Truman, Harry S.

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press.

“History of Marijuana Legislation.” Schaffer Library of Drug Policy. http://www.druglib rary.org/schaffer/Library/studies/nc/nc2_7 .htm. “Marijuana Timeline.” Busted: Marijuana Timeline; PBS Frontline. http://www.pbs .org/wgbh/pages/frontline/shows/dope/etc/ cron.html. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press. Truman, Harry S. 1951. “Executive Order 10302—Interdepartmental Committee on Narcotics,” November 2. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=78436. Truman, Harry S. 1951. “Statement by the President Upon Signing Bill Relating to Narcotics Laws Violations,” 1951. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=13984. Rowe, Thomas C. 2006. Federal Narcotics Laws and the War on Drugs: Money Down a Rat Hole. Binghamton, NY: Hawthorn Press. Ryan, James G., and Leonard Shulp, eds. 2006. Historical Dictionary of the 1940s. Amherst, NY: M.E. Sharpe.

Boylan Act (1914) The Boylan Act, which was enacted by the New York State legislature in April of 1914, was one of the most rigorous and comprehensive attempts by a state to cut down on the open availability and use of opiates for nonmedical reasons before the passage of the Harrison Narcotics Act. The Boylan Act was particularly noteworthy because it had provisions that allowed for the forced cure of addicts in state institutions. Within a few

Boylan Act (1914) 

years, however, authorities found that the Boylan Act had the unintended consequence of increasing the black market for narcotics, and it was overturned. Beginning in 1910, there was increasing concern about the spread of cocaine and opiate use. In New York City in particular, there was growing pressure to do something to limit the availability of these habit-forming drugs. Charles B. Towns, a man who sold cures for drug addiction, became a staunch advocate of tighter narcotics control and joined forces with other social reformers to convince state senator John J. Boylan to introduce a piece of antinarcotic legislation in the legislature in 1913. It was passed in April of 1914, months before the first federal anti-narcotic law, the Harrison Act, made it through Congress. The Boylan Act anticipated many of the provisions of the Harrison Act, as it established that pharmacists and druggists could only dispense opium and its derivatives with a written prescription from a physician. Furthermore, it required that prescriptions for opiates be written only after doctors performed a physical examination to establish the need for patients to use the drugs. Any prescription for more than four grains of morphine, 30 grains of opium, two grains of heroin, or six grains of codeine had to be verified by physicians over the telephone before pharmacists could dispense them. To limit the spread of morphine and heroin addiction, the act also stipulated that only physicians, or pharmacists filling prescriptions written by physicians, could dispense syringes or hypodermic needles. If physicians were caught violating the law, their licenses could be revoked, and infractions of any provisions of the law were misdemeanor offenses. The most groundbreaking provisions of the Boylan Act lay in its Section 249a, which

allowed for the commitment of some addicts who broke the law to state, county, or city hospitals or other institutions for addiction treatment. For addicts who resisted treatment, there were provisions for their forcible transfer to institutions for vagrants. The state, therefore, had the legal power to force addicts to quit. According to Towns and other critics, however, the law was not strong enough, particularly since it did not allow for the commitment of addicts who received drugs from physicians. This meant that if addicts were getting provisions through medical channels, they could continue to indulge in their drug-taking behavior as much as they liked. What is more, there were no provisions limiting how much doctors could prescribe, thus leaving a loophole for physicians to give maintenance treatment to addicts, instead of compelling them to quit. In spite of the conditions that allowed for the maintenance treatment of addicts, the general public viewed the Boylan Act as a ban on the habitual use of opiates and cocaine. Anxious addicts volunteered to be cured or wanted to be committed so that they would not run afoul of the law, and flooded hospitals and institutions. Stricter enforcement of narcotics control laws fed these fears, as the number of arrests for drugrelated crimes in New York nearly quadrupled between 1913 and 1914. When the Harrison Act took effect in March of 1915, enforcement became even tighter, and many physicians stopped prescribing narcotics for fear of violating both state and federal laws. As the medical channels that allowed for addicts to acquire narcotics legally narrowed, a black market for the substances grew in New York, with many addicts frantically turning to street dealers to get the narcotics they needed. Ironically, in their efforts to limit addiction by placing tighter legal restrictions on supplies, the reformers

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who supported the Boylan Act increased the social costs of drug addiction, as more and more addicts either wound up in state institutions or turned to illegal sources for supplies of drugs. In 1916, Towns began advocating for tighter regulations that would close the loophole that allowed for doctors to prescribe maintenance treatments of narcotics. This bill, also put forward by Boylan, would have set a three-week limit on the provision of narcotics to addicts on an outpatient basis, instituted a system in which addicts would have been forced to register with the state, and called for health departments to take over incurable cases of addiction. Though the bill passed the New York State Senate, the State Assembly did not pass it, instead choosing to appoint a joint committee to examine the narcotics problem. The committee began its work in December of 1916, exploring the various treatments for addiction, and surveying medical professionals in hopes of finding a consensus on how best to tackle the drug problem. While many witnesses before the committee supported the proposed law’s antimaintenance stance, some prominent witnesses, such as physician Ernest S. Bishop, testified that maintenance treatment was medically acceptable and necessary, not a mere indulgence of addiction. Moreover, the committee found that the institutions in place to treat addicts were sorely lacking, and that attempts to treat addiction were generally ineffective. The conclusions of the committee led to the 1917 passage of the Whitney Act, which asserted that physicians had the right to treat addicts as they saw fit, even if it meant giving maintenance prescriptions, provided that their ultimate goal was to wean addicts off of drugs. It also allowed for addicts found in violation of the law to be paroled

to a physician for outpatient treatment, instead of being sent to an institution for detoxification. Justice officials were pleased, as the law cut the number of court cases for illegal possession of drugs in half since it allowed for addicts to go to their doctors— instead of street dealers—to get narcotics. In the course of the next two years, however, it became apparent that this approach to the drug problem had deficiencies as well, since some doctors and pharmacists took advantage of their privileged place under the law to dispense excessive amounts of narcotics for financial gain. Thus even when placed under the control of medical authorities, narcotics remained widely available and addiction continued to spread. This state of affairs strengthened the arguments of Towns and other opponents of outpatient maintenance treatments, as provisions meant to control how doctors and pharmacists dispensed narcotics on an outpatient basis were too difficult to enforce effectively. It was not until 1919, when the Supreme Court decisions in United States v. Doremus and Webb et al. v. United States banned maintenance prescriptions nationwide, that the questions surrounding maintenance and outpatient treatment of addicts would be resolved, both in New York State, and throughout the country. Howard Padwa and Jacob A. Cunningham See also: Harrison Narcotic Act; Rockefeller Drug Laws; United States v. Doremus and Webb et al. v. United States

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. King, Rufus. 1972. The Drug Hang-Up: America’s Fifty-Year Folly. Springfield, IL: Bannerstone House.

Brown, Bobby (1969– )  129 Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press.

Brown, Bobby (1969– ) Bobby Brown was one of the most popular and well-known musicians of the 1980s and 1990s. He was able to combine all different genres of music, including jazz, soul, and R&B. His music career began in 1978 when he and a couple of his fellow schoolmates won multiple talent shows, leading them to form the group New Edition. However, by 1986, Brown had decided to leave the group in order to pursue an adult solo career. Although his first album was not as successful as he had hoped, his second album, Don’t Be Cruel, thrust him into mainstream popularity. The album featured songs including “My Prerogative” (which eventually became the number one song in the country), “Good Enough,” “Get Away,” and “That’s What Love Is.” After his remix album Dance!. . . Ya You Know It, Brown’s popularity eventually leveled off, and many other artists began to capitalize by creating music similar to Brown’s. Like many artists, Brown is not just remembered for his music, but also his problems with the law, and especially drugs. Brown has been arrested for driving under the influence three times. In the 1990s it was reported that Brown developed an addiction to multiple types of drugs, including crack and heroin. In 2002, Brown was arrested for marijuana possession, as well as speeding and driving without a license. In 2003 Brown was charged with a DUI, this time being thrown in jail for eight days. Brown’s most recent DUI charge came in 2012. On January 11, 2000, when Bobby Brown and then wife Whitney Houston were

at an airport, it was discovered that the two possessed marijuana in their luggage. The marriage was tumultuous, with reports of heavy drug abuse, and domestic violence claims against Brown. Many fans of Whitney Houston accuse Brown of introducing Whitney to drugs and for damaging her promising career. The couple eventually divorced in 2007. In an interview with Oprah in 2007, Houston opened up about her marriage with Bobby Brown and the couple’s drug abuse. Houston commented that Brown abused her physically and emotionally on numerous occasions when he was drunk. Houston told Oprah that their drug of choice was marijuana laced with cocaine, and that the couple would have ounces of cocaine available at a time. She said that she and Brown would put the cocaine in the marijuana, lace it, and then smoke the drug. Reportedly, the couple would “get off of their heads” while smoking marijuana laced with cocaine. Predominantly Houston’s, but also the couple’s, chauffeur commented after the death of Whitney Houston on the couple’s drug abuse. On one occasion, he recalled, the couple got “wasted” in the back of the limo and had a threesome with another Alist star. On multiple instances Brown and Houston would smoke crack in the back of the limo. During one of the times the couple was smoking crack in the back seats of the limo, the smoking caused the limo to catch on fire, and the driver had to pull over and extinguish the fire. In 2012 Bobby Brown entered a rehabilitation program just eight weeks after his second marriage. Though Brown claims to no longer struggle with drugs such as cocaine and heroin, he admittedly still struggles with alcohol. This continual struggle with alcohol, as well as part of his plea agreement for his 2012 DUI arrest, is what prompted

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Singer Bobby Brown leaves a courthouse in Massachusetts in 2007. He appeared in court after being arrested on warrants for outstanding fines and failure to appear in court. He was arrested as he was watching his daughter’s cheerleading competition. (AP Photo/Josh Reynolds)

Brown to enter treatment this most recent time. Stacy O’Hara Leiter See also: Alcoholism; Cocaine and Crack; Entertainers and Drug Use; Heroin; Marijuana

Further Reading About Bobby Brown. MTV Artists. http://www .mtv.com/artists/bobby-brown/biography/. “Bobby Brown’s Arrest For DUI: His Addiction History Explained.” 2012. Huffington Post Healthy Living. http://www.huffing tonpost.com/2012/03/27/bobby-brown-ar rested-dui_n_1382879.html. Marikar, S. 2009. “Whitney Houston Reveals Dark Days With Bobby Brown: ‘He Spit on Me’.” ABC News, September 14. http://abcnews.go.com/Entertainment/

whitney-houston-discusses-bobby-brown -oprah-winfrey/story?id=8568203. Skeels, V. 2012. “Bobby Brown Back in Rehab. Just Six Months After Whitney Houston’s Death.” MailOnline.

Bureau of Alcohol,Tobacco, Firearms and Explosives (ATF) The Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) is a federal law enforcement organization located within the Department of Justice. It is responsible for enforcing laws related to the illegal diversion of alcohol and tobacco products as well as the illegal use and trafficking of firearms. The ATF is also responsible for administering and enforcing both criminal and regulatory laws

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regarding bombs, explosives, and arson. Previously, the ATF possessed regulatory functions related to the permitting, labeling, and marketing of tobacco and alcohol. However, the Homeland Security Act of 2002 vested those responsibilities in the newly created Alcohol and Tobacco Tax and Trade Bureau (TTB). While the TTB is located within the Department of Treasury, the former home of the ATF, the Homeland Security Act moved the ATF to the Department of Justice. The ATF is headquartered in Washington, D.C., with field divisions located in over two dozen states and additional field offices located in several foreign countries, including Canada, Colombia, Iraq, and Mexico. The director of the ATF reports to the deputy attorney general in the Department of Justice. A chief of staff, chief counsel, and deputy director assist the director. The deputy director serves as the chief operating officer for the bureau and oversees eight separate offices that constitute the ATF: Enforcement Programs and Services, Field Operations, Management, Professional Responsibility and Security Operations, Public and Governmental Affairs, Science and Technology, Strategic Intelligence and Information, and Training and Professional Development. The earliest predecessors of contemporary ATF agents were the individuals charged by Secretary of the Treasury Alexander Hamilton with collecting a federal spirits tax imposed in 1791, a levy that later gave rise to the Whiskey Rebellion of 1794. The first 20th-century precursor to the ATF was the Prohibition Unit, an organization within the Bureau of Internal Revenue of the Treasury Department devoted to the enforcement of the Eighteenth Amendment and the Volstead Prohibition Enforcement Act. Perhaps the most colorful character in the bureau’s history was Eliot Ness, whose story spawned both a television series and movies. Ness and

his agents, nicknamed the Untouchables, became famous during the Prohibition period for pursuing gangster Al Capone and helping to build a successful case against him on tax evasion charges. Tobacco came within the purview of the ATF during the 1950s, when the bureau was given the responsibility to collect a federal tobacco tax. Even before the tobacco- and alcoholrelated regulatory functions of the ATF were moved to the TTB, firearms regulation and enforcement dominated the bureau’s agenda, both in terms of expenditures and regulatory activity. The regulation of firearms possession (including licensing firearm dealers) and criminal investigations (including tracing guns used in criminal activity) are the bureau’s major firearms-related activities. The National Firearms Act of 1934 (aimed at curtailing the easy availability of firearms for criminal activities) and the Federal Firearms Act of 1938 (prohibiting certain classes of people from owning firearms) gave the bureau its original entry into firearms regulation. Its current responsibilities with regard to firearms derive mostly from the Gun Control Act of 1968 and its subsequent amendments, including the Firearms Owners’ Protection Act of 1986 and the Brady Handgun Violence Prevention Act of 1998. As part of its responsibilities with regard to firearms, the ATF is tasked with issuing federal licenses for gun manufacturers and dealers. The ATF’s National Licensing Center is based in Atlanta and handles these licensing responsibilities. Dealers are required to maintain a permanent place of business from which to conduct their firearms business and are barred from selling to prohibited classes of individuals, including felons, juveniles, and those adjudicated to be mentally incompetent. Individuals who collect guns for personal collections and make sales only occasionally as

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part of their hobby are also required to obtain a federal collector’s license. To ensure compliance with licensing requirements, the ATF conducts occasional inspections of existing licensees but has historically been plagued with insufficient personnel for effective monitoring. The Brady Handgun Violence Prevention Act requires dealers to obtain a criminal background check on a prospective buyer prior to making a sale. They do so through the National Instant Criminal Background Check System (NICS), which is operated by the Federal Bureau of Investigation. Though the ATF does not operate NICS, it is responsible for ensuring dealer compliance with this provision of the Brady Bill, including the background check requirement. In addition, the ATF operates the National Tracing Center (NTC) located in Martinsburg, West Virginia. The NTC is responsible for tracing the ownership of guns recovered from criminal investigations. The NTC collects information on firearms sales, stolen guns, and chains of possession (from manufacturer to purchaser) to aid local, state, and national law enforcement agencies. Such information is part of a computerized database used to identify firearms-trafficking corridors and black markets for guns. In fiscal year 2009, the NTC processed more than 340,000 requests from domestic and international law enforcement agencies to trace guns related to crimes. The NTC also serves as the repository for firearms transaction records from federal firearm licensees that discontinue business, maintains records of multiple sales (i.e., the sale of two or more handguns to the same person within five consecutive business days), and provides assistance in identifying firearms with altered or destroyed serial numbers. The ATF’s current responsibilities with regard to arson and explosives derive from

the Gun Control Act of 1968, which gave the ATF federal jurisdiction for destructive devices, and the Organized Crime Control Act of 1970, which established regulations regarding the manufacture, storage, and sale of explosives. As part of its role in the enforcement of laws regarding explosives and arson, the ATF administers the Federal Explosives License program. There are approximately 11,000 licensees working with commercial explosives, including fireworks and those used in the mining industry. The ATF also maintains a cadre of explosives specialists, fire investigators, and criminal profilers who engage in explosives investigations, assist with bomb disposal, and provide technical assistance to the commercial explosives industry. In conjunction with the U.S. Bomb Data Center, the ATF maintains the Bomb Arson Tracking System, which provides arson and explosives information to aid police officers, bomb technicians, and fire investigators at the state and local level. No longer playing a role in the regulation of the alcohol or tobacco industries, the ATF’s focus in this area is now strictly on the reduction of alcohol smuggling and contraband tobacco trafficking. The objective is to reduce or remove sources of revenue for criminal and terrorist organizations. The ATF directs more of its efforts at tobacco trafficking than at alcohol smuggling because tobacco trafficking is more common. Tobacco has become increasingly more attractive to trafficking organizations that previously focused only on weapons and drugs, as some states have dramatically increased their tobacco taxes. Tobacco diversion is estimated to cost federal, state, and local governments upward of $5 billion in unpaid excise taxes each year. The relationship between the firearms industry and the ATF is volatile and exacer-

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bated by the intense opposition of anti–gun control groups, such as the National Rifle Association (NRA). The ATF has been the target of a number of intense attacks and efforts to dismantle it. For example, when the bureau proposed to computerize records to facilitate meeting its regulatory obligations in the 1980s, Congress prohibited the ATF from spending any of its funds to do so and went so far as to cut the funds the ATF had estimated computerization would have cost from the bureau’s budget. During his 1980 presidential campaign, Ronald Rea­ gan included promises to dissolve the bureau, spurred in part by NRA lobbying and analyses conducted by conservative groups suggesting that major budget savings would accrue from folding the ATF into other agencies. Most recently, the ATF has attracted intense scrutiny and the ire of lawmakers and gun rights groups over its Operation Fast and Furious—a sting operation intended to trace weapons moving illegally across the border between the United States and Mexico and to result in the prosecution of illegal drug sellers. Guns sold to suspects in the sting operation were later traced to the scenes of death for two U.S. border agents. When U.S. attorney general Eric Holder was asked about details of the operation, he claimed not to know many of them; almost immediately, the NRA began a petition to have him fired (National Rifle Association 2011). Other fallout included the call for ATF acting director Kenneth Melson’s resignation, as well as calls for the dissolving of the bureau itself (Gerstein 2011; Stolberg 2011)—which has been the aim of many in the gun rights camp for more than two decades. Wendy L. Martinek See also: Anslinger, Harry J.; Hoover, J. Edgar; Prohibition; Volstead Act

Further Reading Bureau of Alcohol, Tobacco and Firearms. 1998. An Introduction to the Bureau of Alcohol, Tobacco, and Firearms and the Regulated Industries. Washington, DC: U.S. Department of the Treasury. Bureau of Alcohol, Tobacco and Firearms. http://www.atf.gov/. Bureau of Alcohol, Tobacco and Firearms. USA .gov. http://www.usa.gov/directory/federal/ alcohol-tobacco-firearms-and-explosives -bureau.shtml. Gerstein, Josh. 2011. “Could Controversy Kill the ATF?” Politico.com, July 8. http://www .politico.com/news/stories/0711/58532 .html. Martinek, Wendy L., Kenneth J. Meier, and Lael R. Keiser. 1998. “Jackboots or Lace Panties? The Bureau of Alcohol, Tobacco, and Firearms.” In The Changing Politics of Gun Control, edited by John M. Bruce and Clyde Wilcox, 17–44. Lanham, MD: Rowman & Littlefield. Moore, James. 1997. Very Special Agents: The Inside Story of America’s Most Controversial Law Enforcement Agency—the Bureau of Alcohol, Tobacco, and Firearms. New York: Pocket Books. National Rifle Association. 2011. “National Campaign to Fire Attorney General Eric Holder.” https://www.nra.org/fireholder/. Spitzer, Robert J. 2012. The Politics of Gun Control. 5th ed. Boulder, CO: Paradigm Publishers. Stolberg, Sheryl Gay. 2011. “Firearms Bureau Finds Itself in a Rough Patch.” New York Times, July 4. http://www.ny times.com/2011/07/05/us/politics/05guns .html. Vizzard, William J. 1997. In the Cross Fire: A Political History of the Bureau of Alcohol, Tobacco and Firearms. Boulder, CO: Lynne Rienner.

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Bureau of Drug Abuse Control The Bureau of Drug Abuse Control (BDAC) was established within the Food and Drug Administration in December of 1965 by President Johnson with the mandate to implement the new enforcement responsibilities imposed by the Drug Abuse Control Amendments Act of 1965. The first director of the agency was John Finlator. Finlator began his career as a postal clerk in North Carolina. He then went on to be an investigator for the Civil Service Commission, and to various positions in the Department of State. Eventually, Finlater became the head of the Bureau of Drug Abuse Commission. While he worked for the bureau, he supported the policy of imprisoning those who smoked marijuana. Personally, however, he did not support that position. The BDAC was responsible for handling depressants, stimulants, and hallucinogens used most frequently by the emerging “counterculture.” To do this, the agency was divided into three departments: Case Assistance, Drug Studies and Statistics, and Investigations. There were nine regional offices in Atlanta, Baltimore, Boston, Chicago, Dallas, Denver, Kansas City, Los Angeles, and New York. Most BDAC agents had experience in criminal investigation. Most were college graduates, many with graduate degrees or some graduate work. They went through a training program at the School of Criminology at the University of Berkeley. During his career, Finlator asked Elvis Presley to the White House to ask for his help in the antidrug campaign. Finlator arranged to have Elvis admitted into the White House under the pseudonym “John Burroughs,” and arranged for him to be presented with a badge with “consultant” credentials.

Finlator retired from service to write a book in 1973 called Drugged Nation: A Narc’s Story. He also worked for the National Organization for Reform of Marijuana Laws (NORML), a group that advocated the decriminalization of marijuana. In 1968, the BDAC merged with the Federal Bureau of Narcotics to create the Bureau of Narcotics and Dangerous Drugs (BNDD). In 1973, the BNDD was reorganized, along with other agencies, to form the Drug Enforcement Administration. Nancy E. Marion See also: Drug Abuse Control Amendments; Federal Bureau of Narcotics

Further Reading Finlator, John. 1973. Drugged Nation: A Narc’s Story. New York: Simon and Schuster. Lohmann, Joseph D., and Robert M. Carter. 1965. “A University Training Program for Agents of the Bureau of Drug Abuse Control.” Journal of Criminal Law, Criminology and Police Science 57 (4): 526–30. “Narcotics Bureau Official John Finlator Dies.” 1990. Washington Post, August 19. http:// www.highbeam.com/doc/1P2-1143269 .html. President’s Commission on Organized Crime. 1986. America’s Habit: Drug Trafficking and Organized Crime. U.S. Bureau of Drug Abuse Control. 1967. “BDAC: A Review.” Washington, DC: US Department of Health, Education and Welfare, Food and Drug Administration. U.S. Department of Justice. 1968. “Statement by Attorney General Ramsey Clark.” March 20. http://www.justice.gov/ag/aghistory/ clark/1968/03-20-1968.pdf. U.S. Food and Drug Administration and the Bureau of Drug Abuse Control. 1967. Outline on Drug Abuse. Washington, DC: FDA.

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Bureau of International Narcotics and Law Enforcement Affairs In 1978, President Jimmy Carter and officials in the U.S. State Department established the Bureau of International Narcotics Matters (INM) as a way to provide support for law enforcement agencies as they fought the international drug trade. In the 1980s, INM provided funding for antidrug operations internationally, with a focus on Latin American countries. The goal was to stop drugs from coming into the United States. Unfortunately, this did not work, largely because Pablo Escobar and the drug cartels continued to supply Americans. By the 1990s, the U.S. government focused on attempts to destroy the Mexican cartels and their drug activities. President Clinton’s administration gave less attention to the international drug war. In 1993, Clinton signed Presidential Decision Directive 14 that expanded the mission of the INM to allow law enforcement to fight against international crimes other than illicit drugs. As a result, the INM began to give attention to crimes such as money laundering, international traffic in stolen vehicles, sales of arms and other contraband, and smuggling of illegal aliens and human trafficking. Alongside a change in mission was a name change for the agency, which became the Bureau of International Narcotics and Law Enforcement Affairs (BINL). The BINL is currently located within the office of the undersecretary for political affairs for the U.S. Department of State. The head of the bureau is the assistant secretary of state for international narcotics and law enforcement affairs, who reports to the undersecretary for civilian security, democracy, and human rights within the Department of State. The agency’s goal is to develop poli-

cies for combating international narcotics and crime worldwide. They often work with other agencies to do this task. The BINL works to reduce illegal drugs from coming into the United States. Officials in the BINL consider Asia and Latin America to be “core targets,” but they have also worked to eliminate drugs from Afghanistan. In addition to working on stopping drugs, the BINL also works to combat other serious cross-border crimes such as human trafficking, money laundering, and organized crime. They put attention on criminal gangs from Central America and Mexico, and detect trade-based money laundering and customs fraud in Colombia, Brazil, and Argentina. The Human Smuggling and Trafficking Center involves federal officials from many different agencies who work to detect and prevent alien smuggling and human smuggling, as well as clandestine terrorist travel. In order to help law enforcement fight drugs and other crimes, the BINL provides funds to the agencies in the United States and elsewhere. They seek to provide assistance as a way to foster global cooperation. In addition to funding, the BINL provides training for other security forces in other nations. They seek to strengthen other countries’ abilities to fight international drugs and crime. They have many programs to do this, one of which is the International Civilian Police Program. Through this agency, the BINL recruits U.S. police officers to participate in international civilian police activities. This includes sending police officers from over 50 countries to support international peacekeeping. For example, the BINL helped to rebuild the national police force of Afghanistan by providing training to more than 60,000 police. It is helping to rebuild the Iraqi police force. To date, the BINL has created five international law enforcement academies in

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Hungary, Thailand, Botswana, New Mexico, and El Salvador that have trained over 28,000 officials from over 75 countries in different methods of combatting terrorism, terrorist financing, organized crime, cyber crimes, and human trafficking. In addition to these responsibilities, the BINL has an advising role. It advises U.S. officials. The BINL participates in the Narcotics Certification Process, whereby the president must submit an annual report to Congress identifying all major illicit-drugproducing countries. In addition to this report, the BINL also produces the annual International Narcotics Control Strategy Report that lists efforts taken by other countries to attack the international drug trade. The agency’s 2008 budget request stated that the bureau’s focus was on three areas: building stability and democracy in South Asia, combating narcotics and terrorism in the Western Hemisphere, and building a democratic Iraq. The current head of the BINL is Assistant Secretary William R. Brownfield. He was appointed in January 2011, and is currently responsible for overseeing the programs within the State Department geared toward combatting illicit drugs and organized crime. Before his appointment, Brownfield was the U.S. ambassador to Colombia (2007– 2010). Before that, he was ambassador to Venezuela and Chile. He has also served as deputy assistant secretary for western hemisphere affairs, deputy assistant secretary for international narcotics and law enforcement, director for policy and coordination in the BINL, and executive assistant to the Bureau of Inter-American Affairs, among other positions. Brownfield holds the personal rank of career ambassador, the highest rank in the U.S. Foreign Service. He has been awarded the Distinguished Service Award and the Presidential Performance Award three times.

The agency’s website is: http://www.state .gov/j/inl/. Nancy E. Marion See also: Drug Trafficking; Escobar, Pablo

Further Reading “Bureau of International Narcotics and Law Enforcement Affairs.” AllGov.com. http:// www.allgov.com/departments/department -of-state/bureau-of-international-narcotics. “Bureau of International Narcotics and Law Enforcement Affairs.” U.S. Department of State. http://www.state.gov/j/inl/. National Institute of Justice, U.S. Department of Justice, Bureau of International Narcotics and Law Enforcement Affairs. 1995. “Policing in Emerging Democracies: Workshop Papers and Highlights.” 1995. Washington, DC: GPO. “William R. Brownfield.” U.S. Department of State. http://www.state.gov/p/.

Bush, George H. W. (1924– ) George Hebert Walker Bush was president of the United States from 1989 to 1993. Despite the sharp criticism of Ronald Reagan’s antidrug policy, Bush publicly renewed his predecessor’s pledge to wage war on drugs and continued the same policy. Public opinion polls showed that the U.S. public wanted their political leaders to get even tougher on illegal drugs and combat the increasing drug-related violence in many U.S. cities. Congress, under Bush’s leadership, responded by adopting measures that further militarized the country’s antidrug effort. The U.S. military was given a much broader role in the War on Drugs, despite continuing opposition from many military leaders, who felt the new policy would divert the armed forces from its primary role of defending

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U.S. president George H. W. Bush waves as he acknowledges the cheers from schoolchildren in California in 2007, in front of an anti-drug panel. (AP Photo/Bob Galbraith)

U.S. interests abroad against such forces as communism and terrorism. Congress approved and Bush appointed a so-called drug czar as a kind of top-level commander in the War on Drugs who would have direct access to the president. The first czar, William Bennett, a registered Democrat and former philosophy professor, revealed his antidrug plan in the summer of 1989. Bennett called for an even tougher stance against the enemy: more federal agents, more prosecutors, more judges to hear more cases, and more federal prisons to hold more drug offenders. Instead of interdicting drugs at the border, Bennett proposed intervening in the countries where narcotic crops were grown and on the streets of America where they were consumed. The Bennett plan called for $7 billion per year. The drug czar projected that with this fund-

ing the United States could reduce illegal drug use by 10 percent over the first 25 months and by 50 percent in the coming de­ cade. How exactly that would happen was not spelled out. In unveiling his National Drug Control Strategy in September 1989, Bush endorsed Bennett’s plan of action and proposed that 70 percent of the $2.2 billion increase in additional money to be allocated to the War on Drugs over the next several years be spent on law enforcement. Bush also urged Congress to give more military and economic assistance to Andean countries to help stem the flow of cocaine to the United States. “In the past, programs have been hampered by the lack of importance given by this country to the drug issue as a foreign policy concern,” Bush declared. “We must develop .  .  . a broad, meaningful public diplomacy program in a manner that would increase the level of international influence for combating illicit drugs” (Klare 1990, 8). The militarization of the War on Drugs, begun by Reagan in 1982, reached a climax in the 1989 invasion of Panama and the capture of that country’s dictator, General Manuel Antonio Noriega, who had been indicted in a U.S. court for alleged involvement in international drug trafficking. With a force of 24,000 troops, the United States launched Operation Just Cause, an invasion of Panama that led to the arrest of the former U.S. ally and his trial in the United States on drug trafficking charges. U.S. officials defended this military incursion, arguing that kidnapping was a legitimate strategy that the United States could use to improve its role in the War on Drugs. “Some foreign governments have unfortunately failed to take steps to protect the United States from drug traffickers,” said William P. Barr, a deputy attorney general in the U.S. Justice Department’s Office of

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Legal Counsel (Anderson 1991, 25). Critics of Operation Just Cause said the United States had actually kidnapped Noriega—a move that was in violation of international law. The United States shouldn’t be breaking its own laws abroad, they admonished. In late 1988 the Bush administration asked the military to “play a major role in helping to interdict drug traffic in the United States, to create an integrated intelligence and communications network, and to train foreign military personnel and both U.S. and foreign police forces” (Bagley 1988, 155–56). The United States had begun to use its elite special forces, including the Green Berets, in strikes against the drug traffickers in countries like Peru and Colombia where farmers grow plants that are used to manufacture drugs. The justification for the operation was an opinion issued by the Justice Department’s Office of Legal Counsel that concluded that U.S. military forces could go overseas and arrest drug dealers and other criminals, even without the consent of the host country. In September 1989 Secretary of Defense Dick Cheney issued a directive to all military commanders to develop policies and to play a major role against international drug trafficking. Under the new policy, the Department of Defense began to assume a new and bigger responsibility in the interdiction of illegal drugs at the United States’ southern borders. But Congress—not just the president— wanted the military to play a more active role in the drug battle. The mood of the legislature was expressed by Representative Larry Hopkins (R-Ky.), who told the Pentagon in early 1989, “We are serious about your active role in this war on drugs, even if it means we have to drag you screaming every step of the way” (Isenberg 1990, 24).

Times had changed, though, and the military was no longer reluctant to assume more active participation in the United States’ latest crusade. The Pentagon had changed its position, not just because of pressure from the president and Congress, but also for economic reasons. With the Soviet Union collapsing and becoming less of a threat to U.S. security, Secretary Cheney announced in November 1989 that the administration would be cutting the Department of Defense budget by $180 million over five years. The announcement sent shock waves through the military, which could not but conclude that the legislative trend was going to be continued reductions of military expenditures, manpower, and commitments worldwide. As David Isenberg explains, “Pentagon leadership began arguing that military manpower should not be reduced because Congress is mandating increased military involvement in drug interdiction efforts” (Isenberg 1990, 25). Bush, like Reagan, called often for the need to reduce the demand for drugs at home, but, in reality, the United States’ antidrug strategy during the 1980s and early 1990s focused heavily on reducing the supply of illegal drugs from abroad through border and off-shore interdiction efforts. By 1991 nearly 70 percent of the U.S. antidrug budget went towards reducing supply, particularly cocaine from South America. Bush’s search for a military solution to the War on Drugs was evident in 1989 when he unveiled the “Andean Strategy,” a program in which the United States would provide some modest military assistance to the source countries of Peru, Colombia, and Bolivia, while encouraging them to involve their own militaries more in the War on Drugs. Annual U.S. assistance to the Andean countries had been about $40 to $50 million, a minuscule amount compared to

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the billions generated by the region’s drug trafficking industry, but, with the Andean Strategy in place, the United States’ antidrug expenditures for South American source countries increased sevenfold from fiscal year 1989 to 1991. To get the support of the Andean countries for his antidrug program and to show he was serious about his Andean initiative, Bush journeyed to Cartagena in February 1990 for a summit meeting with the leaders of Peru, Colombia, and Bolivia—a move that led to the formation of what has been called “the world’s first antidrug cartel.” Participating nations at the summit vowed to attack international drug trafficking from every angle; economic, political, and military. Bush pledged to work hard to decrease the demand for drugs in the United States, while the Andean leaders said they would work equally hard to reduce drug-related corruption, strengthen the judiciary, and step up law enforcement efforts against the drug traffickers operating in their countries. The Andean nations urged Bush to create new trade opportunities that would provide more employment opportunities for workers displaced from the cocaine economy. To meet his commitment at the Cartagena summit, Bush sent his Andean trade preference bill to Congress for ratification in July 1990. Signed into law on December 4, 1990, the Andean Trade Preference Act was designed to expand possible crop alternatives for the countries that had been fighting to eliminate the production, processing, and shipment of illegal drugs. Specifically, the act gave the U.S. president the authority to grant duty-free entry to importing of eligible articles from certain countries. This economic incentive program was to remain in effect for 10 years. By the time of the 1992 U.S. presidential elections, the consensus among drug

analysts was that the Bush administration’s War on Drugs strategy, which focused primarily on supply and looked for a military solution, had not worked. “U.S. drug policy in much of the hemisphere was viewed not nearly as costly and ineffective, but as perversely counterproductive as well,” explained Professor Bruce Bagley (Bagley and Walker 1994, 69). Despite the assurances made by the U.S. government since 1982 that “the scourge was about to end,” the supply of heroin, cocaine, and other illegal drugs were still plentiful. Because the prices remained so low, the Bush administration’s antidrug strategy may have actually led to more drug abuse and drug-related violence. The policies have also done little to alleviate drug-related corruption, terrorism, and violence in many countries that had been identified with America’s War on Drugs. “The Peruvian-American antidrug policy has failed,” acknowledged Peruvian President Alberto Fujimori. “For ten years, there has been a considerable sum invested by the Peruvian government, and this has not led to a reduction in the supply of coca leaf offered for sale. Rather, in the ten years from 1980 to 1990, it grew tenfold” (Podesta and Farah 1993). Senator Patrick Leahy (D-N.H.), the chairman of the powerful Senate Appropriations Subcommittee that oversees foreign operations, concurred with President Fujimori’s assessment, and in an interview appeared to agree with the opinion of many drug policy analysts who believed that the DEA should stop its support of raids on drug-trafficking operations in Peru. “We’ve spent over $1 billion down there so far and we’ve accomplished virtually nothing,” Leahy explained. “We ought to realize it’s not going to work” (Isikoff 1993). Ron Chepesiuk

140   Bush, George W. (1946– ) See also: Bennett, William; Cocaine and Crack; Drug Czar; Heroin; National Narcotics Border Interdiction System; Noriega, Manuel Antonio; Office of National Drug Control Strategy; Reagan, Ronald, and Nancy Reagan

Further Reading Anderson, Charles Edward. 1991. “Fighting the International Drug War.” ABA Journal 77(1): 24–25. Bagley, Bruce. 1989–1990. “Dateline Drug Wars Colombia: The Wrong Strategy.” Foreign Affairs (Winter): 54. Bagley, Bruce M. 1996. The Drug War in Colombia. Wilmington, DE: Scholarly Resources. Bagley, Bruce M., and William O. Walker, III. 1994. Drug Trafficking in the Americas. Coral Gables, FL: University of Miami Press. Campbell, Colin, and Bert A. Rockman. 1991. The Bush Presidency: First Appraisals. Chatham, NJ: Chatham House Publishers. Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. Isenberg, David. 1990. “Military Options in the War on Drugs.” USA Today, July 7. Isikoff, Michael. 1993. “U.S. Considers Shift in Drug War.” Washington Post, September 16. Klare, Michael T. 1990. “Fighting Drugs with the Military.” Nation, January 1. Podesta, Don, and Douglas Farah. 1993. “Drug Policing in the Andes.” Washington Post, March 27. Terry, Reed, and John Cummings. 1994. Compromised: Clinton, Bush and the CIA. New York: SPI Books.

Bush, George W. (1946– ) George Walker Bush was born on July 6, 1946, in New Haven, Connecticut. He was

the first son of the future president of the United States, George H. W. Bush. He attended primary school in Texas and then Phillips Academy. Upon graduation, Bush attended Yale University, graduating in 1968 with a degree in history. He then enlisted in the Air National Guard, being discharged in 1974. He then attended Harvard University, receiving a master’s degree in business administration in 1975. He married Laura Lane Welch, a teacher and librarian in 1977, and they had two daughters in 1981. Bush worked in the oil industry in Texas and founded Arbusto Energy in 1977. He was able to purchase the Texas Rangers baseball team in 1989 and managed the team for the following five years. In 1978, Bush ran for the U.S. House of Representatives from Texas. Although he lost, he chose to run for governor of Texas in 1994, this time winning the election. He won reelection in 1998, the first governor to be elected to two consecutive terms. Bush became a Republican candidate for the presidency in June 1999. He beat Vice President Albert Gore to become the 43rd president in January 2001. In 2004, he then beat Senator John Kerry to be reelected for a second term. Bush was president during the terrorist attacks of September 11, 2001. Afterwards, he declared a War on Terror. He authorized the War in Afghanistan, which began in October 2001, and the War in Iraq, which began in March 2003. In order to support his new focus on terrorism, he created the Department of Homeland Security, among other new agencies. President Bush had a comprehensive approach to illicit drug use in the country. He described his antidrug agenda in a speech in which he introduced John P. Walters to be the next drug czar. In this speech, Bush

Bush, George W. (1946– )  141

U.S. president George W. Bush makes a statement about teen drug use in 2007. (Yuri Gripas/UPI/ Newscom)

noted that illegal drug use costs the country over $100 billion every year, primarily from lost productivity. But it also caused lost lives, unmet educational and job opportunities, health care costs, school dropouts, and more. Drug use destroys children and families. Because of this, drug legalization would be, according to Bush, a catastrophe. In outlining his approach to fighting drugs, Bush said that there must be a thoughtful approach to antidrug efforts. This must include working with other nations to eradicate drugs at the source and stop the flow of drugs into the United States. Throughout his presidency, Bush worked with other countries to limit drug imports into the United States. He had meetings with Vicente Fox of Mexico, the leaders of the Andean Countries (Colombia, Peru, and Ecuador), and the Caribbean.

But he said that the most effective way to reduce drug use in America is to reduce the demand for drugs. He supported the Drug Abuse Resistance Education (DARE) program as a way to educate children, and to reinforce to them the dangers of taking drugs. He declared one day in April of every year in his presidency to be National DARE Day. Bush supported education as a way to reduce drug use in the country. He focused a lot of attention on preventing children from using drugs. In his State of the Union address in January 2004, Bush said, “One of the worst decisions our children can make is to gamble their lives and futures on drugs. Our government is helping parents confront this problem with aggressive education, treatment and law enforcement. Drug use in high school has declined by 11 percent over the past two years.” He also supported

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drug testing of children in schools. In order to do that, he provided $23 million to those schools that used drug testing of its students to send the message, “We love you, and we do not want to lose you.” Alongside of this, Bush believed that families and schools played a key role in keeping children drug free. He stated that families, schools, communities, and faithbased organizations each help to shape the character of young people, and to teach them right from wrong. Further, a child who reaches the age of 21 without using illegal drugs is more than likely not going to do so as an adult. Bush proposed creating a Parent Drug Corps to provide support to educate and train parents in effective drug prevention. He also proposed an increase in federal funding for drug-free communities programs and for the drug-free workplace program. He provided additional funds to border states as a way to fight drug traffickers more effectively. Understanding that many inmates in our prisons and jails had committed their crimes because of drug and alcohol abuse, Bush provided money for drug testing programs for inmates, probationers, and parolees. For those individuals who become addicted to drugs, Bush proposed closing the “treatment gap” in which those who needed treatment were not receiving it. He provided additional funds each year to do that. Moreover, Bush provided additional money to states for treatment for drug addiction and drug use. He sought to support programs that incorporated faith-based elements into these types of programs. Because drug courts also provide needed treatment for some offenders, Bush increased funding for state drug courts. As a way to increase our understanding of drug use, abuse, and treatment, Bush increased the funding for the National Institute

on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. This way, the country would know more about why people used drugs and how to treat those who rely on them each day. Bush made it clear that athletes who used performance-enhancing steroids were not a good role model for children, and called on athletes and team owners to get rid of steroid use in sports. Since leaving the presidency, Bush created the George W. Bush Institute, a policy institute. Nancy E. Marion See also: Bennett, William; Drug Czar; Office of Drug Control Policy; Steroids

Further Reading Bush, George W. 2004. “Address Before a Joint Session of the Congress on the State of the Union.” January 20. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=29646. Bush, George W. 2001a. “Proclamation 7425— National D.A.R.E. Day, 2001.” April 10. Online by Gerhard Peters and John T. Woolley, The American Presidency Proj­ ect. http://www.presidency.ucsb.edu/ws/? pid=61722. Bush, George W. 2001b. “Remarks at the Summit of the Americas Working Session in Quebec City.” April 21. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=45633. Bush, George W. 2001c.“Remarks Announcing the Nomination of John P. Walters to be Director of the Office of National Drug Control Policy.” May 10. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=45600.

Bush, George W. (1946– )  143 Bush, George W. 2001d. “Proclamation 7496—National Alcohol and Drug Addiction Recovery Month.” November 9. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=61793.

“George W. Bush: Early Life and Career.” George W. Bush Presidential Library and Museum. http://www.georgewbushlibrary .smu.edu/en/The-President-and-Family/ George-W-Bush.aspx.

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C  1. Develop comprehensive plans and programs for the implementation of these policies;  2. Assure that all diplomatic, intelligence, and federal law enforcement programs and activities of international scope are properly coordinated;  3. Evaluate all such programs and activities and their implementation;   4. Make recommendations to the director of the Office of Management and Budget concerning proposed funding of such programs; and   5. Report to the president, from time to time, concerning the foregoing.

Cabinet Committee on International Narcotics Control The Cabinet Committee on International Narcotics Control was created by President Richard M. Nixon in September 1971, as a result of his concern about the flow of illicit narcotics and dangerous drugs into the United States. In order to stop these drugs from continuing to enter the country, he sought to use a comprehensive approach that included diplomatic, intelligence, and law enforcement functions. The new committee was responsible for coordinating the actions of these groups. In short, the goal of the committee was to fight the international drug traffic and to eliminate drugs at their source. The cabinet committee was chaired by the Secretary of State. It originally included Secretary of State William Rogers, Attorney General John Mitchell, Secretary of Defense Melvin Laird, Secretary of the Treasury John Connally, Ambassador George Bush, CIA Director Richard Hems, and others as it became necessary. Later members included Secretary of Agriculture Earl Butz. The embassy from any country that had a connection with illicit drugs or the drug market was given a Narcotics Control Coordinator to work toward strengthened drug control efforts. The committee was given the responsibility of formulating and coordinating all federal policies related to curtailing and eliminating the flow of drugs into the country. Specifically, Nixon listed the committee’s responsibilities as:

In 1972, the president and the committee members posed in front of a $2 million shipment of heroin that had been seized on its way from France to demonstrate the effectiveness of their policies. Along with the committee, Nixon also created a working group that was composed of members of each of the concerned agencies. This group was responsible for the day-to-day operations of the committee. It was overseen by Egil Krogh Jr. The committee met only on three occasions before it was phased out after the 1972 election. Nancy E. Marion See also: Nixon, Richard M.

Further Reading Goldberg, Peter. 1978. “The Federal Government’s Response to Illicit Drugs, 1969– 1978.” Schaffer Library of Drug Policy, 145

146  Caffeine http://www.druglibrary.org/schaffer/library /studies/fada/fada1.htm. Nixon Presidential Library and Museum. “Cabinet Committee on International Narcotics Control.” http://nixon.archives .gov/forresearchers/find/textual/central/ subject/FG330.php. Nixon, Richard. 1971. “Memorandum Establishing the Cabinet Committee on International Narcotics Control.” September 7. Online by Gerhard Peters and John T. Woolley. The American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=3139. Nixon, Richard. 1972. “Statement on Establishing the Office for Drug Abuse in Law Enforcement.” January 28. Online by Gerhard Peters and John T. Woolley. The American Presidency Project. www.presidency .ucsb.edu/ws/?pid=3552.

Caffeine Caffeine is a naturally occurring stimulant that is found in over 60 plants that have been grown and harvested worldwide for thousands of years. Caffeine is known for its ability to boost the user’s energy. Today, it is most commonly ingested in coffee, tea, or cocoa, but is also found in cola-based soft drinks or other beverages to which synthetic caffeine has been added. “Energy drinks” containing large amounts of caffeine have also become very popular. In general, most coffee consumed in the United States each day contains about 100 to 135 milligrams of caffeine per cup. However, since coffee is derived from the seed of many types of coffee plants, the exact amount of caffeine varies dramatically in different coffees. Common tea, which is produced from a species of bush or tree called Camellia sinensis, generally contains about half the amount of caffeine that is found in coffee.

Most soft drinks have slightly less caffeine (regulated to a maximum of 65 mg/12-oz. by the Food and Drug Administration [FDA]), but some soft drinks have high amounts of added caffeine. So-called energy drinks can contain between 80 to 300 mg/8-oz. serving, with some brands marketing their products in 16- to 24-ounce containers. Unlike soft drinks, energy drinks are not subject to FDA regulation. Cocoa, which is derived from the cacao bean, contains very little caffeine. Although many users believe that coffee has addictive qualities, it does not meet the criteria for an addictive substance as described in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM). Many caffeine users may look forward to their daily coffee or tea, and some even miss the beverage if they cannot drink it regularly. Some users experience physical discomfort such as headaches and lethargy if it is withdrawn for a long period of time. But these symptoms do not have negative consequences in a user’s life that characterize true addiction. The DSM does recognize that there may be other problems associated with caffeine use, including caffeine intoxication, caffeineinduced sleep disorders, and caffeineinduced anxiety disorder. Caffeine intoxication can happen if a user ingests too much caffeine in a short period of time. The user may experience nervousness, restlessness, gastrointestinal distress, tremors, rapid heartbeat, and, in some rare cases, disorientation, delusions, and possibly coma. If a person takes two grams or more of caffeine at one time, they may suffer from a serious overdose. In addition to the symptoms above, a person suffering from a serious caffeine overdose may suffer a heart attack. The exact effects of caffeine consumption will vary with the amount ingested, the size of

Caffeine  147

the person, and if they have eaten food. Doses in the 85 to 250 milligram range produce effects that are mild and could include alertness, decreased levels of fatigue, and increased levels of concentration. When higher doses are ingested (from 250 to 500 milligrams), the possible effects include restlessness or hyperactivity, nervousness, anxiety, insomnia, and tremors. Occasionally, a symptom may include myocardial instability and seizures. Doses as low as 50 milligrams may result in anxiety and gastrointestinal distress. Significant toxicity (15 to 30 mg/kg) may result in muscle spasms, myocardial irritability and arrhythmias, seizures, and vomiting. Caffeine-induced sleep disorders as well as anxiety disorders are sometimes found in those individuals who have a history of consuming high levels of caffeine over a long period. If a person has this, they may have difficulties in sleeping or episodes of anxiety that can easily be misdiagnosed as panic attacks, bipolar disorders, or even psychoses. Besides contributing to gastric acidity, coffee acts as a diuretic and causes the kidneys to work harder to produce urine. Most adults can consume a moderate amount of coffee, 200 to 300 milligrams per day, without any adverse effects. Those women who are pregnant should avoid caffeine in any form because it can increase the risk of a miscarriage. Although teens are advised to restrict their caffeine intake to about 100 milligrams per day, the popularity of energy drinks has raised many concerns about the effect that caffeine can have on the health of people in this age group. An “energy drink” is a beverage that contains stimulants drugs, primarily caffeine. They are very popular among young people and are regularly consumed by 31 percent of 12- to 17-year-olds and 34 per-

cent of 18- to 24-year-olds. The first energy drink on the market was Red Bull, which came out in 1997. Now there are many different varieties of energy drinks. While some are carbonated, not all are. Most of these drinks contain high levels of caffeine, along with sugar or another type of sweetener. They may also include herbal extracts. They are marketed as giving the user “super alertness.” The new trend toward energy drinks may be cause for some alarm. It has been said that energy drinks contain unsafe amounts of caffeine. Health officials claim that these drinks contain as much caffeine as 14 cans of soda, but the industry says they have no more caffeine than a cup of brewed coffee. The following gives the caffeine amounts in these drinks: • Red Bull: 80 milligrams per 8.3-ounce serving • Tab Energy: 95 mg per 10.5-oz serving • Monster and Rockstar: 160 mg per 16oz serving • No Fear: 174 mg per 16-oz serving • Fixx: 500 per 20-oz serving • Wired X505: 505 mg per 24-oz serving In comparison: • Brewed coffee: 200 milligrams per 12oz serving • Instant coffee: 140 mg per 12-oz serving • Brewed tea: 80 mg per 12-oz serving • Mountain Dew: 54 mg per 12 oz. serving • Dr. Pepper: 41 mg per 12-oz serving • Pepsi Cola: 38 mg per 12-oz serving • Coca-Cola Classic: 34.5 mg per 12-oz serving • Canned or bottled tea: 20 mg per 12-oz serving

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The effects of these drinks can be very alarming, particularly for young users. In 2012, 19-year-old Alex Morris went into cardiac arrest after drinking a popular energy drink called “Monster.” Alex allegedly drank two cans of Monster every day for the three years before he died. His mother is claiming that the high levels of caffeine in the drink are responsible for his heart failure. Another teenager, 14-year-old Anais Fournier, after consuming two 24-oz cans of Monster, went into cardiac arrest and died, although Monster is fighting a lawsuit about it, saying that there were no lab tests to determine what may have caused Anais Fournier’s death. Other lawsuits claim that Monster targets its drinks to children, who may be more susceptible to its effects. A new trend among young people is to mix energy drinks with alcoholic beverages because the caffeine in the energy drinks masks the depressant effects of the alcohol. Research shows that drinkers who consume alcohol mixed with energy drinks are 3 times more likely to binge drink (based on breath alcohol levels) than those who do not mix the two. Moreover, those drinkers who consume alcohol mixed with energy drinks are about twice as likely as those who do not to report being taken advantage of sexually, to take advantage of someone else sexually, or to report riding with a driver who was under the influence of alcohol. Kathryn H. Hollen

Chambers, Kenneth P. 2009. Caffeine and Health Research. New York: Nova Biomedical Books.

See also: Addiction; Anxiety Disorders; Energy Drinks

Cali Drug Cartel

Further Reading

A Colombian drug-trafficking organization that emerged as the world’s leading purveyor of illicit drugs in the late 1980s, when the Medellín cartel engaged the Colombian government in a war of attrition. The Cali

“Caffeine.” WebMD. http://www.webmd.com/ vitamins-supplements/ingredientmono-979 -CAFFEINE.aspx?activeIngredientId=979 &activeIngredientName=CAFFEINE.

Doheny, Kathleen. 2008. “Energy Drinks: Hazardous to Your Health?” WebMD. http://www.webmd.com/food-recipes/news/ 20080924/energy-drinks-hazardous-to -your-health. Klosterman, Lorrie. 2007. The Facts About Caffeine. New York: Marshall Cavendish Benchmark. Kushner, Marina. 2006. The Truth About Caffeine: How Companies That Promote It Deceive Us and What We Can Do About It. Royersford, PA: SCR Books. “Lawsuit Blames Monster Energy Drinks for California Teen’s Death.” 2013. Fox News, June 26. http://www.foxnews.com/ health/2013/06/26/lawsuit-blames-monster -energy-drinks-for-california-teen-death/. National Institute of Health. “Caffeine.” MedLine Plus. http://www.nlm.nih.gov/ medlineplus/caffeine.html. Preedy, Victor R. 2012. Caffeine: Chemistry, Analysis, Function and Effects. Cambridge, UK: Royal Society of Chemistry. Rath, Mandy. 2012. “Energy Drinks: What Is All the Hype? The Dangers of Energy Drink Consumption.” Journal of the American Academy of Nurse Practitioners 24 (2). Williams, Brian, and Tom Costello. 2012. “Caffeine Drinks Pose Hidden Danger, Report Says.” Video News Report, October 25. New York: NBCUniversal Media, LLC.

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Cartel began supplying most of the cocaine consumed in the United States and Europe, a situation that eventually made Colombia the target of U.S. trade sanctions. The cartel took to establishing legitimate business ventures as a means of forging contacts with key people in business, politics, the law, and the press. It invested plenty of “narco-dollars” to establish an intelligence network that rivaled those of many South American governments and to keep them informed of the Colombian government’s every move in the War on Drugs. The low-key, business-like style worked. Even the police began to speak of Los Caballeros (gentlemen) of Cali in contrast to Los Hampones (hoodlums) of Medellín. “The Cali Cartel will kill you if they have to, but they would rather use a lawyer,” observed Robert Bryden, head of the Drug Enforcement Administration’s (DEA) New York City office (Shannon 1991, 30). “They [the Cali Cartel] are much more astute than the leaders of the Medellín Cartel,” explained Fernando Brito Ruiz, Director of DAS, Colombia’s equivalent of the FBI. “They have economic power and they know how to use it” (Chepesiuk 1999, 16). Los Hampones craved respectability; Los Caballeros enjoyed it. Many Colombians looked upon the godfathers from Cali as Horatio Alger–type success stories—who by brains, enterprise, and hard work had risen out of the slums of Cali and the backwater of the Cauca Valley. The chief executive officers of Cali Cartel, Inc., included Jose Santacruz Londono, a one-time hoodlum who had studied engineering and had transformed himself into the caballero Don Chepe, the billionaire construction magnate; his close associate Gilberto Rodriguez Orejuela, who started out as a kidnapper but ended up owning a vast network of business enterprises that included La Rebaja, the big-

gest drug store chain in Colombia, as well as banks, car dealerships, apartment buildings, and Cali’s talented soccer team; Miguel Rodriguez Orejuela, Gilberto’s handsome brother, who oversaw the business side of the criminal empire; Gilberto and Miguel’s cousin Jaime, and his three brothers, prominent impresarios of concerts and sporting events, who travel frequently to New York City and have business offices in Los Angeles; and Helmer Pacho Herrera, believed to be the son of Benjamin Herrera Zuleta, a legendary Afro-Colombian smuggler known as the Black Pope, who played a big role in the Cali Cartel’s early development. Unlike the Medellín Cartel, the Cali godfathers ran their criminal enterprise conservatively, much like other big corporate heads. It was a cerebral approach that depended more on planning, shrewd calculation, and the use of a boardroom, rather than dependence on the gun to do business. If one played by the company rules and did not make mistakes, one could have a good life as a Cali corporate man or woman. It could be difficult, though, for those who screwed up or tried to sever ties. They weren’t fired; they were discreetly executed. As distasteful as violence was to the cartel, it kept a gun in the desk drawer, just in case. But while the organization was authoritarian—one that demands absolute discipline and loyalty—it still allowed for creativity. Under the chief executive officers and serving as the senior vice presidents of acquisitions, transportation, sales, finance, and enforcement were some of Colombia’s best and brightest. They supervised and coordinated the logistics of importing, storing, and delivering the product and oversaw— through daily, and often, hourly phone calls—ambitious underlings in dozens of overseas branch offices, who moved the drugs to wholesalers.

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Employees of Cali Cartel, Inc., whether executive officers or underlings, were expected to be conservative in their lifestyle: no flashy clothing or cars, no drinking or drug problems, and no loud parties and activities that could call attention to themselves. In the mid-1970s, while the more powerful Medellín Cartel was establishing a strong base in Miami, the Cali Cartel moved into the New York City market. In 1975 Gilberto Rodriguez Orejuela sent Hernando Giraldo Soto, a close boyhood friend, to New York City to develop the Cali Cartel’s Colombian contacts in the borough of Queens, and during the next three years, he refined and enlarged their cocaine distribution line to New York City. Meanwhile, in September 1975 the names of Gilberto and Miguel Rodriguez Orejuela had appeared as 58th and 62nd respectively on a list of 113 top drug traffickers compiled by the intelligence section of Colombia’s Customs Service. The Cali Cartel was on its way. Unlike the Medellín Cartel—which had developed a different, confrontational approach to drug trafficking—the Cali Cartel preferred the bribe to get business done, but no group gets to the top of the criminal underworld and becomes what has been described as the most powerful criminal organization in history on sophisticated style alone. The Cali Cartel showed that it could be as ruthless as any other mafia involved in international drug trafficking. “They are smart; the authorities never seem to find the bodies,” one Bogotá-based journalist explained. “And they always seem to be floating in the river, of course, away from [the city of] Cali” (Chepesiuk 1999, 145). Differences aside, the two Colombian cartels revolutionized cocaine trafficking, not just in the way the drug was transported to the United States, but also in how it was distributed there. The cartels established the

drug trade on a business model with efficient, well-oiled smuggling, marketing, and money-laundering networks operating from coast to coast. By 1989 an estimated 300 Colombian trafficking groups and 20,000 Colombians were involved in the cocaine trade in the United States. At least 5,000 of the Colombians who worked for the cartels lived in the Miami area and another 6,000 in the Los Angeles area. “The Colombians have the momentum by benefit of their early involvement in the cocaine trade,” the President’s Commission on Organized Crime concluded in 1986. “They have evolved from small, disassociated groups into compartmentalized organizations that are sophisticated and systematized in their approach to the trafficking of cocaine in the U.S.” (President’s Commission 1986, 78). According to law enforcement reports, Colombian trafficking groups operate as self-centered cells of about five to fifty members with only a handful of the “managers” knowing all the cell’s members. Toplevel managers both in Colombia and in the United States are recruited on the basis of blood and marriage, which helps to minimize the potential for theft or disobedience, because family members in Colombia are held accountable for failed drug deals. Middle managers are placed all over the United States and may include individuals who are not family members, but who may be friends of top-level capos (leaders or godfathers) or at least have roots in the same region the capos come from. The third level consists of thousands of workers, both inside and outside the United States: accountants, couriers, chemists, lawyers, stash-house keepers, enforcers, bodyguards, launderers, pilots, and wholesale distributors. These individuals perform specialized tasks and may work for different

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groups at different times. While the cartels are predominantly Colombian in membership, they will go outside their group to hire specialists, such as pilots or lawyers, and will, when need be, cooperate with other criminal groups, including Mexicans, Italians, Jamaicans, and Nigerians. During the late 1980s and early 1990s, while the Colombian government waged war with the Medellín Cartel, the Cali Cartel expanded its operation and extended its tentacles deeper into Colombia’s tottering democracy in search of greater profits and more power. With the heat on in Colombia, Cali moved most of its cocaine-refining operations to Peru and Bolivia, and its transportation routes through Venezuela and Central America. The cartel also began to muscle into the heroin trade, growing the opium itself in Colombia and then using its efficient cocaine distribution network to move the refined product. The heroin the Cali Cartel peddled was both purer and cheaper than its chief competitor, the Southeast Asian variety. In 1994 a gram of Colombian heroin was selling for $80 to $150 per gram, compared to $300 to $400 for the type from Southeast Asia. One DEA report revealed that the Cali Cartel’s share of the New York City heroin market had jumped from 22 to 60 percent during the early 1990s. “In the past five years, there has been a steady increase in the flow and purity of heroin in the U.S., suggesting that the taste for the drug is growing,” a U.S. State Department report warned in 1994 (Farah 1994). Although the Cali Cartel led the Colombian connection’s move into big-time heroin trafficking, many other Colombian criminal organizations were involved as well, indicating that the nature of the drug trade was changing. By 1991 one cartel, led by the brothers Ivan and Julio Urdinola and based

in the country’s northern Cauca Valley, was making as much money in drug trafficking as the Cali Cartel. “By expanding from cocaine to heroin production, the [Urdinola] organization has the capacity to become the first true narcotics conglomerate, and it is already shipping mixed loads of the two drugs to the United States and Europe,” the Washington Post reported (Farah 1994). Facing increasing competition and knowing that with the demise of the Medellín Cartel it would be the number one target of Colombian and U.S. officials, the Cali Cartel began to negotiate their exodus from international drug trafficking with the Colombian government. After a meeting with Pacho Herrera, Jose Olmedo Ocampo, and Juan Carlos Ramirez, three leaders of the Cali Cartel, Colombian attorney general Gustavo de Grieff began pushing the Colombian government to accept an agreement with the cartel that would have led to lenient terms of surrender for the drug traffickers. News of the meeting and what transpired caused a storm of controversy both inside and outside of Colombia. The United States charged that de Grieff’s office had been infiltrated by the Cali Cartel and warned that any such agreement with the cartel would seriously damage United States–Colombia relations. Those relations deteriorated, largely be­­ cause of accusations that Colombian president Ernesto Samper Pizano’s 1994 presidential campaign had been infiltrated by the Cali Cartel. A stunned Colombia heard a cassette tape in which Cali Cartel leader Miguel Rodriguez Orjuela revealed that he had arranged to give millions to the Sam­ per Pizano campaign. The “narcocassettes” were based on police wiretaps and intercepts and confirmed the DEA’s long time suspicions that Samper Pizano and key members of his Liberal Party were on the Cali payroll.

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The Colombian Congress, which was dominated by the Liberal Party, eventually declared Samper Pizano innocent of any wrongdoing in the scandal, but several associates in his presidential campaign and in his administration went to jail. U.S.-Colombian relations reached rock bottom on March 1, 1996, the date the United States “decertified” Colombia as a helpful partner in the War on Drugs. The move placed Colombia with such pariahs as Iran, Syria, Nigeria, and Afghanistan. Ironically, while these developments were unfolding, the Colombian government was having stunning success against the Cali Cartel. Between June and August 1995 Colombian police, with the help of the CIA and DEA, captured six of the top seven leaders of the Cali Cartel, including the brothers Rodriguez Orejuela and Jose Santacruz Londono. Authorities captured Gilberto Rodriguez Orejuela after searching a house in a middle-class neighborhood of Santa Monica and found him inside a secret vaulted closet with three pistols and between $100,000 and $200,000 in cash. U.S. officials predicted that Rodriguez’s capture would be a “mortal blow” against the Cali Cartel. In October 1996 Gilberto Rodriguez Orejuela agreed to pay a fine of $105 million to the Colombian state and confessed to crimes involving narcotics trafficking and “illegal enrichment.” He faced a maximum penalty of 25 years in jail. The arrest of other Cali Cartel leaders followed, and in 1998 Helmer Pacho Herrera, who had turned himself in to the authorities in 1996, was murdered in a prison yard. Gilberto and Miguel Rodriguez Orejuela are currently in a Colombian jail, serving 15- and 21-year terms respectively. But will the stunning success against the Cali Cartel have any impact on Colombia’s role as the linchpin in the Latin Ameri-

can drug trade? Drug war analysts believe that, just as it was business as usual after Escobar’s death, there is no reason to expect that the situation will change because another powerful Colombian cartel’s tenure of leadership in the drug trade has ended. Indeed, destroying the Colombian connection might be even more difficult in the future, because instead of one monolithic cartel to deal with, law enforcement will have to confront and try to dismantle several “baby cartels,” not just in Colombia, but in Mexico and other Latin American countries as well. Rosso Jose Serrano, general director of Colombia’s National Police, explained, “These smaller cartels won’t have the corrupting capacity of the Cali cartel, nor will they easily have the organizational reach that made Cali such an international power” (Chepesiuk 1999, 151). Ron Chepesiuk See also: Carter, Jimmy; Drug Cartels; Escobar, Pablo; Heroin; Medellín Cartel; Noriega, Manuel Antonio; Tijuana Cartel

Further Reading Castillo, Fabio. 1988. Los Jinetes de la Cocaina. Bogotá, Colombia: Editorial Documentos Periodísticos. Chepesiuk, Ron. 1987. “Kingpin’s Trial: A Small Win in Losing War on Drugs.” Orlando Sentinel, October 4. http://articles .orlandosentinel.com/1987-10-04/news/ 0150170285_1_lehder-colombia-cartel. Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. Farah, Douglas. 1994. “Cali Cocaine Traffickers Fill Void Left by Medellin Cartel.” Sun Sentinel, June 19. Johnson, Tim. 2003. “Cali Cartel Still in ‘Drug Kingpin’ Business, U.S. Says.” Mi-

Califano, Joseph, Jr. (1931– )  153 ami Herald, February 7. http://www .latinamericanstudies.org/drugs/cali.htm. Rempel, William C. 2011. At the Devil’s Table: The Untold Story of the Insider Who Brought Down the Cali Cartel. New York: Random House. Shannon, Elaine. 1991. “The Cali Cartel: New Kings of Coke.” Time, July 1. http:// content.time.com/time/magazine/article/ 0,9171,973285,00.html.

Califano, Joseph, Jr. (1931– ) Secretary of health, education, and welfare for two years (1977–1979) under President Jimmy Carter, Joseph Califano Jr. mounted major health-promotion and disease-prevention programs targeted against cigarette smoking and alcohol use. In 1992, he founded the Center on Addiction and Substance Abuse (CASA) at Columbia University, a think tank addressing substance abuse from a prohibition perspective. Califano has been critical of drug use, claiming it is the principal and direct cause of crime, health problems, declining worker productivity, homelessness, and a range of other problems. Califano reports that “almost every American child—regardless of race, family structure or financial background—will be faced with the decision of whether to use illegal drugs before they graduate from high school” (Gray 2012, 51). Through his books and talks, Califano attempts to inform parents about patterns in drug use among young people, including times when they may be more likely to use illegal substances. He also informs parents about signs that children exhibit when they are using drugs. His goal is to prevent cigarette, alcohol, and drug abuse among adolescents. When it comes to alcohol and advertising, Califano has said:

“Underage and pathological drinkers are the alcohol industry’s most valuable customers. It is reckless for our society to rely on an industry with such an enormous interest in alcohol consumption by children, teens, alcoholics and alcohol abusers to curb such drinking.” During the Carter administration, Califano became a vigorous critic of smoking. Among other actions, he asked cigarette companies to devote 10 percent of their advertising to a campaign to discourage children and teenagers from smoking, an idea rejected by the companies on the grounds that “the mothers and fathers of this nation, whether smokers or nonsmokers, should continue to have freedom of choice in the education and training of their children.” In 1979, Califano was fired as secretary of health, education, and welfare in part because his crusade against tobacco was a considerable political liability to President Carter. Before his dismissal, he pressed Carter to lend clout to the antismoking crusade. Once converted to the cause, Carter planned if reelected in 1980 to support a major increase in federal tobacco taxes to $2 per pack, believing the action would save hundreds of thousands of lives while simultaneously raising billions for health care reform and deficit reduction. In 1997, prior to the massive tobacco settlement with states, Califano expressed his belief again to President Bill Clinton that a $2-per-pack tax increase on cigarettes was needed to reduce teen smoking and protect the public health. Richard E. Isralowitz See also: Carter, Jimmy; Center on Addiction and Substance Abuse; Clinton, Bill; Tobacco

Further Reading Califano, Joseph A. 1981. Governing America: An Insider’s Report from the White House

154   Camarena Salazar, Enrique (1958–1985) and the Cabinet. New York: Simon and Schuster. Califano, Joseph A. 2004. Inside: A Public and Private Life. New York: Public Affairs. Califano, Joseph A. 2008. High Society: How Substance Abuse Ravages America and What to Do About It. New York: Public Affairs. Gray, James P. 2012. Why Our Drug Laws Have Failed and What We Can Do About It. Philadelphia: Temple University Press. Hanson, David J. “Joe Califano and His Center on Addiction and Substance Abuse (CASA).” Alcohol Problems and Solutions. http://www2.potsdam.edu/hansondj/ Controversies/1114476352.html.

Camarena Salazar, Enrique (1958–1985) On February 7, 1985, U.S. Drug Enforcement Administration (DEA) agent Enrique Camarena Salazar was kidnapped in broad daylight within a block of the U.S. consulate in Guadalajara, Mexico. U.S. ambassador John Gavin, concerned because another DEA agent had been kidnapped several months earlier, immediately demanded that Mexican authorities take strong and quick action to find Camarena. The Mexican authorities resisted and the U.S. government launched Operation Camarena along the Mexican border. Each car entering the United States was carefully searched for Camarena Salazar, a move that created bottlenecks on both sides of the U.S.-Mexican border. The DEA suspected that Camarena Salazar’s kidnapping had been orchestrated by powerful drug trafficker Rafael Caro Quintero. The Mexican authorities, under intense U.S. pressure, raided one of Caro Quintero’s ranches and then issued an order for his arrest. The drug trafficker escaped to Costa

Rica, however, and the mutilated body of Camarena Salazar was found in March 1985. Caro Quintero and Ernesto Fonseca Carillo, a drug trafficker and another suspect in Camarena Salazar’s murder, were arrested in April 1985. A third suspect, Juan Jose Esparragoza Morena, was arrested in Mexico City in March 1986. Camarena’s colleagues at the DEA did not believe that Caro Quintero acted alone. They believed that prominent figures of Mexico’s power elite were behind Camarena’s murder. The U.S. government did all it could to bring the accomplices in Camarena’s murder to trial in the United States, including what many Mexicans complained was the kidnapping of its citizens. Eight people were tried on charges that included murder, and seven of them were convicted. Raul Lopez Alvarez, the first to be convicted, was a member of the Guadalajara homicide squad and became the first person ever convicted in the United States under a 1984 racketeering law that added new penalties for violence in connection with criminal acts. Jurors saw a tape of Lopez telling authorities about the torture of Camarena on orders from Mexican drug lord Rafael Caro Quintero. Camarena’s murder highlighted a contentious issue between the United States and Mexico. The U.S. government has long argued that its drug agents need to carry weapons to protect themselves against violent drug traffickers while on missions on Mexican soil. Mexico has repeatedly rejected the request, seeing armed DEA agents operating in Mexico as a threat to their country’s sovereignty. In August 1998 Senator Mike Dewine (R-Oh.) and Representative Bill McCollum (R-Fl.) introduced a bill that would have included an offer of helicopters for Mexico to fight the War on Drugs if the country

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U.S. Marine Corps pallbearers carry the casket holding the body of slain DEA agent Enrique Camarena Salazar after it arrived at North Island Naval Air Station in San Diego on March 8, 1985. He was killed in Mexico after being tortured by drug lords. (AP Photo/Lenny Ignelzi)

allowed U.S. drug agents to carry weapons there. A top Mexican official responded that the government of Mexico had indicated that it would not grant permission for that. The case became even more contentious when Dr. Humberto Alvarez-Machain, a Mexican gynecologist, was identified as being part of a plot to keep Camarena alive for the purpose of torturing and questioning him. U.S. officials attempted to extradite AlvarezMachain to the United States so he could be tried in a courtroom for these charges, but were unsuccessful. They then paid mercenaries $20,000 to kidnap him and bring him to Texas where he could face charges related to the case. The doctor was eventually acquitted of the charges. However, there was great concern over these events. In reviewing the legality of

the U.S. government’s actions (since it is the court’s responsibility to review the possible excesses of executive acts), the U.S. Supreme Court found that the kidnapping did not violate any treaty and allowed Alvarez-Machain to be held for the purpose of a trial. However, three justices, Harry A. Blackmun, John Paul Stevens, and Sandra Day O’Connor, filed a dissenting opinion. In that document, Stevens wrote, “I suspect that most courts throughout the civilized world .  .  . will be deeply disturbed by the ‘monstrous’ decision the Court announces today. For every nation that has an interest in preserving the Rule of Law is affected, directly or indirectly, by a decision of this character. As Thomas Paine warned, an ‘avidity to punish is always dangerous to liberty’ because it leads a nation ‘to stretch, to

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misrepresent and to misapply even the best of laws.’” In the end, Alvarez-Machain was allowed to bring a lawsuit against the U.S. government and the law enforcement officials who were involved in the kidnapping case. He used the doctrine that “pretrial detainees have a clearly established right to be free from punishment.” Ron Chepesiuk See also: Drug Enforcement Administration

Further Reading Cohn, Bob, and Tim Padgett. 1992. “Nabbed in the Name of the Law.” Newsweek, June 29: 68. Drug Wars: The Camarena Story. 1990. Video recording. Artisan Home Entertainment. Gray, James P. 2012. Why Our Drug Laws Have Failed and What We Can Do About It. Philadelphia, PA: Temple University Press. “Los Angeles: Justice for Camarena.” 1998. Time, 3 October. http://content.time.com/ time/magazine/article/0,9171,968548,00 .html. Marcus, Ruth. 1992. “Kidnapping Outside U.S. Is Upheld: Supreme Court Rules Government Can Seize Foreigners for Trial.” Washington Post, June 16: A1. Shannon, Elaine. 1988. Desperadoes: Latin Drug Lords, U.S. Lawmen, and the War America Can’t Win. New York: Viking. “Special Agent Enrique Salazar Camarena.” Officer Down Memorial Page. http://www .odmp.org/officer/reflections/2699-special -agent-enrique-salazar-camarena/25. United States v. Alvarez-Machain, 504 U.S. 655 (1992). Weinstein, Henry. 1996. “Suit over Camarena Case Gains.” Los Angeles Times, September 25, Orange County Edition, A3.

Campaign against Marijuana Planting (CAMP) The Campaign against Marijuana Planting (CAMP) is an antidrug operation that was set up in 1983 by the State of California and involved task forces composed of multiple federal, state, and local law enforcement officials from the Drug Enforcement Administration, the Bureau of Land Management, the U.S. Forest Service, the California National Guard, California State Parks, the California Department of Fish and Wildlife, and local police and sheriffs. The goal is to eradicate large crops of marijuana plants in the state. As a result of CAMP, law enforcement arrested many marijuana growers and destroyed hundreds of thousands of marijuana plants. Critics of CAMP have charged that the program is too costly and ineffective in deterring marijuana cultivation. According to a report of the National Drug Policy Board, “CAMP has displaced some of the problems to Oregon. The remaining commercial growers tend to view CAMP as a cost of doing business and take a variety of measures to minimize associated costs. Production has increased and product availability appears to have remained unchanged” (National Drug Enforcement Policy Board 1996, 118). While some would say the campaign was largely unsuccessful, it has been reported that between 2010 and 2011, the number of pot plants eradicated by CAMP has decreased significantly. In California alone, there has been a 46.5 percent drop in eradicated plants from 7.3 million in 2010 to 3.9 million in 2011. Nationwide, 10.32 million plants were eradicated in 2010 and only 6.7 million in 2011. In a recent Associated Press report, the Drug Enforcement Administration cites the decentralization of large growing operations

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and a shift to indoor cultivation—along with changes in weather patterns and cuts to both state and local enforcement agency budgets—as key factors in the decline in eradicated plants. Ron Chepesiuk See also: Marijuana; National Drug Policy Board

Further Reading Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. Medicinal Colorado.org. “Campaign Against Marijuana Planting.” http://www.medici nalcolorado.org/taxonomy/term/312. National Drug Enforcement Policy Board. 1996. The Cannabis Problem—Historical Overview: An Analysis Of The Domestic Cannabis Problem and the Federal Response. August. State of California Department of Justice, Office of the Attorney General. “Campaign Against Marijuana Planting.” http://oag.ca .gov/bi/camp. State of California Department of Justice, Office of the Attorney General. 2003. “Campaign Against Marijuana Planting Seizes 80,000 Plants During First Week of Program.” August 13. http://oag.ca.gov/ news/press-releases/campaign-against -marijuana-planting-seizes-80000-plants -during-first-week. Valdes, Manuel. 2012. “Number of Pot Plants Eradicated Drops Nationwide.” August 3. www.bigstory.ap.org/article/number-pot -plants-eradicated-drops-nationwide.

Cannabis Cannabis is a flowering plant that is also known as hemp or marijuana. It is used for its strong fibers, but is probably more

well known for its use both medically and recreationally. There are two primary types, or species, of cannabis. One of those is Cannabis sativa. This commonly grows to a height of 12 to 16 feet and has long stalks, sparse foliage, and slender leaves. These plants are usually grown for industrial purposes, particularly for fiber and textile use. The other type of cannabis is the Cannabis indica, which originated in India. This species of the cannabis plant usually only grows to a height of four to five feet and is more densely foliated. While the fibers of this plant are not strong enough to be used as industrial fiber, the plant contains more psychoactive components (cannabinoids) than the other species and is therefore grown for psychoactive properties. Cannabis has existed for thousands of years. It probably originated in China and from there spread to many other civilizations worldwide. In the Chinese culture, cannabis seeds were used for both food and medicine as a renewable food source rich in B vitamins, protein, and amino acids. Because of its value to that culture, it was China’s second or third most important agricultural food source for thousands of years. Cannabis was mentioned in a Chinese medical reference from 2737 bce, appearing in the writings of Chinese emperor Shen Nung. The Chinese used the drug to treat vomiting, parasitic infections, diarrhea, dysentery, and to stimulate the appetite, among other ailments. Other cultures known to have used cannabis include the Hindus and Nihang Sikhs from ancient India and Nepal. More than likely, the ancient Assyrians used it in their religious ceremonies because of the psychoactive properties. The drug moved into Greece where it was used to relieve inflammation, earaches, to get rid of tapeworms, stop nosebleeds, and reduce pain in the ear.

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Ancient Jews and early Christians may have used cannabis as well, as did Muslims, who may have used it recreationally because drinking alcohol was banned in the Koran. In ancient Egypt, evidence from ruins indicates that cannabis was used to treat gout, rheumatism, foot pain, eye problems, and hemorrhoids. Cannabis has been used in Africa since the 15th century. There it was used to treat snake bites, facilitate in childbirth, and as a treatment for malaria, fever, blood poisoning, anthrax, asthma, and dysentery. In Rome, a doctor in the army of Emperor Nero, Discorides, recommended cannabis as a treatment for many ailments. Cannabis was brought to America in 1492 by Christopher Columbus. The ships that Columbus and his crew sailed to America were filled with cannabis. In 1611 in Jamestown, cannabis was a major commercial crop alongside tobacco and was grown as a source of fiber. The settlers relied on hemp fiber as an important export. In 1619, the colony of Virginia declared that all people were required to grow hemp, and actually imposed penalties on those who did not produce it. George Washington grew cannabis as hemp at his plantation home in Mount Vernon in the 1760s and continued to do so for many years. There is some evidence that he also grew cannabis both for medicinal reasons and for intoxicating properties. The second and third presidents of the United States, John Adams and Thomas Jefferson, also grew cannabis for hemp. When cannabis plants are referred to as hemp, people are referring to the fibrous parts of the plant that have been used for centuries in the manufacture of paper, fuel, and industrial materials. The fibers of the cannabis plant are extremely strong and durable, and thus provide excellent raw materials for cords and ropes, or even clothing.

The Chinese used hemp fibers for fabric and ropes starting as far back as 1000 bce. Fishing nets were also made of hemp. The world’s oldest piece of paper dates back to around 500 bce and was made of hemp fibers. When the Chinese invented hemp paper around 200 bce, it revolutionized recordkeeping processes that became essential to an orderly, functioning government. Cannabis is also known as “marijuana,” which is used recreationally by some. The leaves of the plant contain the psychoactive ingredient delta-9-tetrahydrocannabinol, more often referred to as THC. When used, this drug produces feelings of relaxation, pleasure, and a heightened awareness of sensations. Higher doses may lead to an altered perception of space and time and impaired memory. Extremely high doses of the drug can distort one’s sense of identity and trigger hallucinations. The potentially strong effects of the drug make it dangerous, even in small doses, especially if the user is driving or in other situations requiring rapid reflexes and unimpaired motor coordination. Cannabis is often used for its medicinal qualities. It has been recognized as being effective in relieving pain associated with cancer (and cancer treatment) and other ailments. It is also associated with relieved eye pressure resulting from glaucoma. There have been reports that cannabis stimulates a person’s appetite and suppresses nausea. Many AIDS patients use marijuana to treat these and other symptoms. In recent years, synthetic THC has been developed to treat patients suffering from these diseases and can be prescribed by a physician. These drugs include Marinol or Sativex. While some patients find relief with these drugs, others do not find the lab-created THC to work as effectively as using the actual plant itself. Moreover, the pill form of THC can take much longer to achieve any effect.

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Currently, the growth, manufacture, distribution, and use of cannabis is illegal through the Controlled Substances Act. As a Schedule I drug, cannabis has no currently approved or recognized medical use but a high likelihood of addiction and abuse. Despite this, many states have passed laws or referendums allowing for medical use of cannabis. The states have defined the circumstances under which a user can possess and ingest cannabis, and how the drug will be distributed. However, because federal law trumps state law, the users in the states that have passed laws allowing for medical cannabis can still be arrested and charged with federal drug offenses. Some groups are lobbying to legalize cannabis on the federal level for both medical reasons and pleasure (recreational use). Examples of these include the American Alliance for Medical Cannabis, the National Organization for the Reform of Marijuana Laws, Americans for Safe Access, the Coalition for Rescheduling Cannabis, Common Sense for Drug Policy, and the Marijuana Policy Project. To date, while legislation has been introduced into Congress to change the federal laws, these groups have not been successful. Nancy E. Marion See also: Controlled Substances Act; Drug Classes; Hemp; Marijuana; Medical Marijuana

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Cannabis: Evil Weed? 2009. New York: Films Media Group. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale.

Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Jenkins, Richard. 2006. Cannabis and Young People: Reviewing the Evidence. London: Jessica Kingsley. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Marion, Nancy E. 2014. The Medical Marijuana Maze. Durham, NC: Carolina Academic Press. Parloff, Roger. 2013. “Yes, We Cannabis.” Fortune 167, no. 5 (April 8): 4150–59. Sanna, E. J. 2013. Marijuana: Mind-Altering Weed. Broomall, PA: Mason Crest. U.S. Department of Health and Human Services. National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Ser­ vices, National Institute on Drug Abuse. 2005. Research Report Series: Marijuana Abuse. NIH Publication No. 05–3859, July. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA). http:// www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration (DEA). http://www.usdoj .gov/dea.

Carter, Jimmy (1924– ) Jimmy Carter, born James Earl Carter, a Democrat and former governor of Georgia, was president of the United States from 1977 to 1981. Early in the Carter administration, the federal government’s antidrug policy changed. At the March 1977 House

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Georgia governor Jimmy Carter discussed drug-related concerns during testimony in front of the U.S. Senate Government Operations subcommittee on federal drug control in 1971. (AP Photo/John Duricka)

of Representatives hearings on decriminalization, the chief of the Department of Justice testified that the federal government could no longer effectively prosecute marijuana. The Carter administration also softened the government’s position on cocaine. During the Carter administration, cocaine, like heroin and marijuana before it, was beginning to hit the U.S. mainstream in a big way. Many musicians, intellectuals, artists, politicians, and even government bureaucrats saw nothing wrong with snorting the drug. In 1978 the White House was embarrassed by a story in the Washington Post alleging that the president’s drug policy adviser, Peter Bourne, himself used cocaine at a party. The good doctor resigned, but before leaving his post he had set the tone for the Carter administration’s drug policy.

By December 1979, however, the Carter administration was worrying about the Soviet invasion of Afghanistan, and it began shipping arms to the mujahideen guerrillas. Not all Carter officials agreed with the administration’s Afghanistan policy. Dr. David Musto and Joyce Lowinson, members of the White House Strategy Counsel on Drug Abuse, wrote an editorial opinion article for the New York Times expressing their concern about the growing of opium poppies in Pakistan and Afghanistan by rebel tribesmen. “Are we erring in befriending these tribes as we did in Laos where Air America (chartered by the Central Intelligence Agency) helped transport crude opium from certain tribal areas?” (Lowinson and Musto 1980). Alfred McCoy believed the answer was “yes.” He believed that evidence showed that Afghan heroin had begun flooding the U.S. market in 1979, substantially increasing the number of hard-core addicts, as well as overdose deaths: Although the drug epidemic of the 1980s had complex causes, the growth in the global heroin supply could be traced in large part to two key aspects of U.S. policy: the failure of the DEA interdiction efforts and the CIA’s covert operations. . . . [J]ust as the CIA support of nationalist Chinese troops in Shan States had increased Burma’s opium crop in the 1950s, so the agency’s aid to the mujahideen guerrillas in the 1980s expanded opium production in Afghanistan and linked Pakistan’s nearby heroin laboratories to the world market. After a decade as the sites of major CIA covert operations, Burma and Afghanistan ranked respectively as the world’s largest and second largest suppliers for illicit heroin in 1989. By 1980 and the end of the Carter administration, many were questioning whether the United States’ antidrug policy had pro-

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duced any tangible results. During the Nixon administration, the budget for the United States’ antidrug program had increased significantly and drug enforcement infrastructure underwent a major reorganization to provide the leadership in the War on Drugs and to reduce interagency rivalries, but critics charged that one of the federal agencies, the CIA, had helped fuel drug use in the United States by helping allies in Southeast Asia and possibly Afghanistan who were heavily involved in international drug trafficking. The federal government had tried eradication programs in Turkey and Mexico, but sources for heroin and marijuana had sprung up in other countries and drugs continued to flow freely into the United States. During the 1970s the U.S. government put antidrug policies in place in cocaine source countries, such as Peru and Colombia, and the transit countries of the Caribbean and Central America, but they were small and ineffective, since the United States concentrated most of its attention and resources on heroin during the decade. Meanwhile, the ambitious criminal cartels based in the Colombian cities of Cali and Medellín were poised for their big entrance on the international drug trafficking scene when they would make cocaine the drug of the 1980s. This record led the president’s 1984 Commission on Crime to conclude that “the nation’s drug problem at the end of the 1980s was as great, if not greater, than the problem in 1970.” Ron Chepesiuk See also: Cali Drug Cartel; Control Intelligence Agency; Cocaine and Crack; Decriminalization; Heroin; Marijuana; Medellín Cartel; Opium

Further Reading Carter, Jimmy. 1977. “Drug Abuse Message to the Congress.” August 2. Online by Gerhard

Peters and John T. Woolley, The American Presidency Project http://www.presidency .ucsb.edu/ws/?pid=7908. Carter, Jimmy. 1977. “Rethinking the War on Drugs.” New York: Encyclopedia Americana/ CBS News Audio Resource Library #08773. Carter, Jimmy. 2011. “Call off the Global Drug War.” New York Times, June 16. http://www .nytimes.com/2011/06/17/opinion/17carter .html?_r=0. De Grazia, Jessica. 1991. DEA: The War Against Drugs. London: BBC Books. Lowinson, Joyce H., and David F. Musto. “Drug Crisis and Strategy.” 1980. New York Times, May 22. McCoy, Alfred W., and Alan A. Block. 1992. “U.S. Narcotics Policy: An Anatomy of Failure.” In War on Drugs: Studies in the Failure of U.S. Narcotics Policy. Boulder, CO: Westview Press. Morgan, H. Wayne. 1981. Drugs in America: A Social History, 1800–1980. Syracuse, NY: Syracuse University Press. President’s Commission on Organized Crime. 1986. America’s Habit: Drug Trafficking and Organized Crime. Shaffer Library of Drug Policy, http://www.druglibrary.org/ schaffer/GovPubs/amhab/amhabc3.htm.

Center for Substance Abuse Prevention (CSAP) The Center for Substance Abuse Prevention (CSAP) is an agency of the U.S. government and is found within the Department of Health and Human Services and the Substance Abuse and Mental Health Services Administration. CSAP was originally established in 1992 from a reorganization of the previous Office of Substance Abuse Prevention. Its mission was defined as the reduction of the use of illegal substances and the abuse of legal ones.

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CSAP coordinates its activities with those of other federal, state, public, and private organizations in developing comprehensive drug abuse prevention programs. The agencies do this by providing national leadership and guidance in the development of effective policies, programs, and services that are designed to prevent the use of illegal drug use, prescription drug misuse and abuse, and alcohol and tobacco use by underaged individuals. CSAP also works to promote substance abuse prevention programs that will assist states, communities, and other local agencies to use the prevention knowledge effectively. Over time, CSAP’s efforts have established more supportive workplaces, schools, and communities, They also have helped to create more drug-free and crime-free neighborhoods, as well as more positive connections with friends and family members. CSAP has developed and recognizes six prevention strategies. To meet their first strategy, the dissemination of information about the dangers of drug use, CSAP has distributed materials that demonstrate the dangers of drug use, abuse, and addiction, and the effects it has on individuals, families, and communities. The dissemination of this information is typically characterized by one-way communication from the source to the intended audience, with limited personal or face-to-face interaction between the two groups of actors. The information is often presented as resource directories, media campaigns, and public service announcements aired on the radio or through the television. The second strategy, prevention education, refers to two-way communication between the agency and the recipients. This can be differentiated from disseminating information (strategy 1) because there is an actual interaction or conversation between the educator and the participants. Activities

that typically take place under this strategy are geared toward affect or influencing a person’s critical life and social skills, such as decision making, refusal skills, and critical analysis of media messages. The third strategy is called “alternative activities.” This involves the participation of the target populations in activities that do not involve drug use. The goal is to show that constructive and healthy activities can offset the attraction to drugs, or otherwise meet a person’s needs that are usually filled by drugs. In this case, people will not turn to using drugs. The fourth strategy involved communitybased processes that aim to enhance the ability of the community to provide prevention and treatment services for drug abuse disorders more effectively. Activities in this strategy include organizing, planning, enhancing the efficiency and effectiveness of service implementation, building coalitions, and networking. Environmental approaches is the fifth strategy. Through this, the agency seeks to establish or change community standards, codes, and attitudes that influence the incidence and prevalence of drug abuse in the general population. Finally, problem identification and referral is a strategy that aims to identify those who have indulged in the illegal use of drugs in order to assess if their behavior can be reversed through education. It should be noted, however, that this strategy does not include an activity designed to determine if an individual is in need of treatment. Ron Chepesiuk

Further Reading “Biographies: Frances Harding.” Substance Abuse and Mental Health Services Administration. http://beta.samhsa.gov/about-us/

Center on Addiction and Substance Abuse (CASA)  163 who-we-are/leadership/biographies/frances -harding. Commonwealth Prevention Alliance. “CSAP Prevention Strategies.” http://www.common wealthpreventionalliance.org/Documents/ SAMHSA%20CSAP%206%20Prevention%20Strategies.ppt. SAMHSA. “Center for Substance Abuse Prevention.” http://www.beta.samhsa.gov/ about-us/who-we-are/offices-centers/csap.

Center on Addiction and Substance Abuse (CASA) The Center on Addiction and Substance Abuse (CASA) is a nonprofit organization dedicated to the study of all potentially addictive substances, and it works to combat their abuse. It is the only nationwide organization that brings together individuals from all professional disciplines in order to better understand and prevent addiction. CASA was founded in 1992 at Columbia University in New York City by Joseph A. Califano Jr., the former secretary of health, education, and welfare under President Jimmy Carter, and Dr. Herbert D. Kleber, former deputy director of the Office of National Drug Control Policy. In organizing CASA, Califano brought together a board of directors that included leaders from politics, industry, academia, advertising, and the media. In its early years, CASA received funding from the Robert Wood Johnson Foundation, as well as other foundations, private companies, and government bodies. Initially, CASA focused on providing analysis of the social and economic costs of both illegal and legal drug use. The group then moved on to begin creating national projects in the fields of drug and alcohol treatment and prevention.

In 1992, it launched its CASASTART program, a collaboration between schools, law enforcement, and community organi­ zations, that aims to help teenagers who are either at risk of starting to use, or are already using, alcohol and illicit drugs to avoid drug use and improve their level of academic performance. Early studies of CASASTART showed that the program helped decrease drug use, helped participating students advance in school, lowered violence, and decreased participants’ susceptibility to peer pressures to become involved in drugs and crime. By 2001, there were 17 CASASTART programs across the country. Another of its major projects was CASAWORKS for Families, a program designed to help mothers who were addicted to drugs and alcohol and on welfare become self-sufficient. The three-year project combined drug and alcohol treatment, literacy courses, and job training for participating women. The program was successful, helping participants stop using drugs and alcohol while more than doubling their rates of employment. In addition, CASA has published major reports on teenage substance abuse, drug use in prisons, substance abuse on college campuses, the relationship between drug use and sex, and on substance abuse among people with learning disabilities. CASA has also studied the connection between sports and substance abuse. Today, CASA has a Policy and Research Division that assesses the impact of substance abuse on the U.S. population, studies the links between substance abuse and other health and social problems, and makes recommendations to improve public policies on substance abuse. Its Health and Research Division conducts studies to determine what addiction treatment strategies are most effective. In 2009, CASA merged with Join Together, a major provider of information, strategic planning assistance,

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and leadership development for communitybased drug and alcohol programs. Through articles in the popular press and scientific journals, as well as press conferences and testimonies before governmental bodies, CASA continues to work to spread awareness of the social and economic costs of drug abuse; assess what prevention, treatment, and law enforcement strategies are most effective in combating substance abuse; and remove the stigma surrounding substance abuse so addicts can gain the hope they need to recover. Howard Padwa and Jacob A. Cunningham See also: Califano, Joseph, Jr.; Office of National Drug Control Policy; Partnership for a Drug-Free America

Further Reading Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. CASASTART. “About CASASTART.” http:// casastart.org/content/AboutCASASTART .aspx. National Center on Addiction and Substance Abuse at Columbia University. “About CASA.” http://www.casacolumbia.org/ templates/AboutCASA.aspx?articleid=276 &zoneid=1. National Center on Addiction and Substance Abuse at Columbia University. “CASAWORKS for FAMILIES: A Promising Approach to Welfare Reform and Substance-Abusing Women.” http://www .casacolumbia.org/Absolutenm/articlefiles/ CASAWORKS_for_Families_6_4_01.pdf. National Center on Addiction and Substance Abuse at Columbia University. “Mission Statement.” http://www.casacolumbia.org/ absolutenm/templates/AboutCASA.aspx?a rticleid=2&zoneid=1.

Centers for Disease Control and Prevention (CDC) Founded in 1946, the Centers for Disease Control and Prevention (CDC) serves as the “nation’s health protection agency” (Centers for Disease Control 2012). Headquartered in Atlanta, Georgia, the CDC is a federal agency within the Department of Health and Human Services and is one of the best known National Public Health Institutes. The CDC currently has more than 15,000 employees with field staff located in all 50 states and more than 50 countries. The agency’s main goal is to protect public health and safety by controlling and preventing disease, injury, and disability. This is achieved by preparing the country’s response to emergency health threats, investigating and stopping deadly disease outbreaks around the world, protecting the United States’ food supply, and providing vaccines. In fiscal year 2012, the CDC’s director, Dr. Thomas Frieden, oversaw an operating budget of approximately $6.9 billion. The CDC has many duties when it comes to drugs and drug use/abuse. One of those is the Office on Smoking and Health. This is the lead federal agency for tobacco prevention and control. It was originally established in 1965 as a way to reduce the death and disease associated with tobacco use. Their vision is to have a world that is free from tobacco-related deaths. The CDC also has an alcohol program that seeks to strengthen the scientific underpinnings for preventing excessive consumption of alcohol. The Alcohol Program is located in the CDC’s Division of Population Health, in the National Center for Chronic Disease Prevention and Health Promotion. Their goal is to improve the public’s health when it comes to binge and underage drinking, and its related health outcomes.

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One of the foci of the CDC is on illicit drug use. Center employees work to educate the public about the dangers and medical consequences of illegal drugs, such as HIV, hepatitis, sexually transmitted diseases, and tuberculosis. They continue to research the link between drug use, the brain, and behavior so we can have a better understanding as to why people use drugs, or cannot stop using them. They track trends in drug use, and patterns of drug use over time. For those people who are addicted to drugs, the CDC helps with treatment options. One of the target audiences when it comes to drugs and drug use is young people. The CDC makes it clear that alcohol and drug use among youth is a serious public health problem. To that end, the agency monitors behaviors that lead to drug use by teenagers and assesses school health policies geared toward preventing or stopping this behavior. One such publication is the Health Education Curriculum Analysis Tool that can help school districts develop a health curriculum geared toward their own community needs that emphasizes the prevention of drug and alcohol use. As part of their Youth Risk Behavior Surveillance System, the CDC monitors six behaviors that can contribute to the leading causes of death among young adults. Some of these behaviors are alcohol and other drug use, and tobacco use. The 2011 report showed that, when it came to tobacco use: • 44.7 percent of students had ever tried cigarette smoking (even one or two puffs) (i.e., ever smoked cigarettes). • 10.3 percent of students had smoked a whole cigarette for the first time before age 13 years. • 18.1 percent of students had smoked cigarettes on at least one day during the 30 days before the survey (i.e., current cigarette use).

• 7.7 percent of students had used smokeless tobacco (e.g., chewing tobacco, snuff, or dip) on at least one day during the 30 days before the survey. When asked about alcohol and other drug use, the report indicated: • 70.8 percent of students had had at least one drink of alcohol on at least one day during their life (i.e., ever drank alcohol). • 38.7 percent of students had had at least one drink of alcohol on at least one day during the 30 days before the survey (i.e., current alcohol use). • 21.9 percent of students had had five or more drinks of alcohol in a row (i.e., within a couple of hours) on at least one day during the 30 days before the survey (i.e., binge drinking). Students also reported that: • 39.9 percent of students had used marijuana one or more times during their life (i.e., ever used marijuana). • 23.1 percent of students had used marijuana one or more times during the 30 days before the survey (i.e., current marijuana use). • 6.8 percent of students had used any form of cocaine (e.g., powder, crack, or freebase) one or more times during their life (i.e., ever used cocaine). • 11.4 percent of students had sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high one or more times during their life (i.e., ever used inhalants). • 2.9 percent of students had used heroin (also called “smack,” “junk,” or “China White”) one or more times during their life (i.e., ever used heroin).

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• 3.8 percent of students had used methamphetamines (also called “speed,” “crystal,” “crank,” or “ice”) one or more times during their life (i.e., ever used methamphetamines). • 3.6 percent of students had taken steroid pills or shots without a doctor’s prescription one or more times during their life (i.e., ever took steroids without a doctor’s prescription). • 20.7 percent of students had taken prescription drugs (e.g., OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor’s prescription one or more times during their life (i.e., ever took prescription drugs without a doctor’s prescription). • 2.3 percent of students had used a needle to inject any illegal drug into their body one or more times during their life (i.e., ever injected any illegal drug). • 25.6 percent of students had been offered, sold, or given an illegal drug by someone on school property during the 12 months before the survey. Nancy E. Marion See also: Alcohol Use; Drug Abuse

Further Reading Centers for Disease Control and Prevention. 2012. “CDC Overview.” http://www.cdc.gov/ 24–7/local/documents/2315501–1_Con gressionalFactsheet_Final508.pdf. Centers for Disease Control and Prevention. “Office of Smoking and Health.” http:// www.cdc.gov/tobacco/osh/index.htm. Centers for Disease Control and Prevention. “Persons Who Use Drugs: About Drugs and Addiction.” http://www.cdc.gov/pwud/ad diction.html. Friede, Andrew, Patrick W. O’Carroll, Ray M. Nicola, Mark W. Oberle, and Steven M. Teutsch. 1997. CDC Prevention Guide-

lines: A Guide for Action. Baltimore: Williams and Wilkins. U.S. General Accounting Office. 2004. “Cen­ ters for Disease Control and Prevention: Agency Leadership taking Steps to Improve Management and Planning, but Challenges Remain.” Washington, DC: U.S. General Accounting Office. U.S. Government Accountability Office. 2008. “Centers for Disease Control and Prevention: Changes in Obligations and Activities Before and After FY 2005 Budget Reorga­ nization.” Washington, DC: GPO.

Central Intelligence Agency (CIA), United States Established by the National Security Act of 1947 as a subdivision of the National Security Council, the CIA advises the National Security Council in matters concerning such intelligence activities of government agencies that relate to national security. The director of the CIA is the president’s principal adviser on intelligence matters. To fulfill its mandate, the CIA collects, produces, and disseminates intelligence on foreign aspects of narcotic production and trafficking. The alleged CIA connection to the international drug trade has been one of the most controversial aspects of the nation’s War on Drugs. Critics have charged—and the CIA has denied—that the agency has been involved with drug smuggling since at least the period of U.S. involvement in the Vietnam War from the early 1960s to 1975 and that it has never fully and honestly shared that record with the U.S. people. Some have charged that the Office of Strategic Services, the CIA’s predecessor, was involved during the 1940s in smuggling heroin grown in Myanmar to the United States. With regard

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to the Vietnam War, critics say that the CIA flew shipments of heroin around Asia on CIA proprietary planes owned under the cover of a company named Air America. By the early 1970s, U.S. GIs were spending an estimated $88 million annually on heroin and bringing their habit home with them once they finished their tours of duty. The official U.S. response during the Cold War was to blame the communist enemy in Southeast Asia, and today the CIA continues to deny any responsibility. CIA critics, however, note that given the covert nature of the CIA and the fact that there has been little government oversight of the agency, it has been difficult to prove the CIA connection with international drug trafficking. The CIA, say the critics, has continued to be involved in drug trafficking even with the end of the Vietnam War. In the late 1970s during the Jimmy Carter administration, for example, the CIA was accused of supplying weapons to the Afghanistan rebels, the mujahideen, who were fighting the country’s proSoviet government. Afghanistan is one of the world’s leading opium producers, and much of the territory where the crop is grown was under mujahideen control. At the time, government reports indicated that there was an alarming rise in the amount of heroin entering the United States and that the number of drugrelated deaths soared in many U.S. cities. The U.S. government and the CIA have also been accused of complicity in the socalled cocaine coup in Bolivia in 1980, toleration of Gen. Manuel Noriega’s drugrelated activities for more than 20 years because he was a good ally in the war against communism, and in 1990 and 1991, support of special Venezuelan antidrug units, which have been suspected of smuggling more than 2,000 pounds of cocaine into the United States with the CIA’s knowledge.

The most controversial questioning of the suspected CIA–drug trafficking connection occurred in 1996 when a series of articles in the San Jose Mercury News written by journalist Gary Webb claimed that a drug pipeline from Colombia to the San Francisco area had financed the Nicaragua Contras by selling tons of cocaine to Los Angeles street gangs. In effect, the series contended that the U.S. government, through one of its agencies, may have fueled the crack cocaine boom that began in the mid-1980s and sparked the violence and the crime wave that came to permeate U.S. society. The series caused a public uproar. The mainstream press devoted large amounts of space to debunking the series’ thesis and the Mercury News issued a major clarification, saying that parts of the story did not meet its journalistic standards. Later, reporter Webb was transferred to another beat. Public pressure, however, forced the CIA and the U.S. Justice Department to launch internal inquiries, release thousands of pages of classified documents, and issue three major reports. CIA supporters, as well as many newspapers, said these reports convincingly rebutted the Mercury News article series. Critics, on the other hand, insisted that the reports advanced the series’ main thesis: that the CIA and the Reagan administration tolerated drug trafficking so that they could promote the covert war against Nicaragua. In July 1998, a CIA internal study found that CIA personnel continued to work with almost two dozen members of the Nicaraguan Contras who may have been involved in drug trafficking during the 1980s. The study noted that none of the suspected drug traffickers were in the top leadership of the Contra rebels and that no one in the agency aided the drug trade. Then, in October 1998,

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a newly declassified study by the CIA’s inspector general reported that the CIA had failed to fully inform Congress and law enforcement agencies that Nicaraguan contras were involved in drug trafficking. Today, the role of the CIA in the War on Drugs remained as controversial as ever. Ron Chepesiuk See also: Bush, George Herbert Walker; Bush, George W.; Carter, Jimmy; Noriega, Manuel Antonio; Reagan, Ronald, and Nancy Reagan

Further Reading Arnold, James R., and Roberta Wiener. 2012. The Cold War: The Essential Reference Guide. Santa Barbara, CA: ABC-CLIO. Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. “Contra Drug Links Broader than CIA Said, Study States.” 1998. Rock Hill Herald, October 10. Cothran, Helen. 2003. The Central Intelligence Agency. San Diego: Greenhaven Press. January, Brendan. 2002. The CIA. New York: Franklin Watts. Lamour, Catherine, and Michael J. Lamberti. 1974. The International Connection: Opium from Growers to Pushers. New York: Pantheon Books. McCoy, Alfred J. 1991. The Politics of Heroin: CIA Complicity in the Global Drug Trade. Chicago: Lawrence Hill Books. Risen, James. 1998. “CIA Ignored Contra Drug Allegations.” Miami Herald, July 17. “Secret CIA Report Notes Contra Drug Suspicions.” 1998. Charlotte Observer, July 18. Webb, Gary. 1998. Dark Alliance: The CIA, The Contras and the Crack Cocaine Explosion. New York: Seven Stories Press. Weir, William. 1995. In the Shadow of the Dope Fiend. North Haven, CT: Archon Books.

Child Sexual Abuse and Substance Abuse The relationship between substance abuse and child sexual abuse (CSA) is a complex one. First, substance abuse on the part of parents or caregivers increases the risk of CSA for children living with them. Second, substances may be given to a child by a would-be perpetrator of sexual abuse, in what is called the “grooming process,” to lower a child’s defenses or to establish a “special secret.” Third, experiencing sexual abuse as a child increases the risk of adverse consequences, particularly posttraumatic stress disorder (PTSD) and mood disorders, as well as later substance abuse in adolescence or adulthood (Berliner 2011). In this entry, the term “substance abuse” includes both abuse of and dependence on (also called addiction to) alcohol and other drugs. Substance abuse and dependence symptoms include: recurrent use causing failure to fulfill major role obligations (such as parenting); continued use despite persistent social or interpersonal problems; spending much time obtaining the substance, using it, or recovering from the effects of use; increased tolerance for the substance; and withdrawal (distressing and sometimes dangerous psychological and physiological reactions to stopping use of the substance). A large telephone interview study of more than 4,000 adolescents indicated that parental substance abuse was strongly linked to CSA (Hanson et al. 2006). Other factors also increase the probability of a child experiencing CSA, including the child’s gender, family structure, and family functioning. For example, girls are more likely to be sexually abused than boys; those who had not always lived with a biological parent are also more likely to have experienced CSA than those who did not have these experiences (Hanson

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et al. 2006). One family may have multiple risk factors, such as family conflict, a stepfather, and substance abuse, making it impossible to say with certainty what role each factor may play or that parental substance abuse is a clear cause of CSA. Parents who are drunk or high are less likely to be able to ensure their child’s safety, or to be emotionally available. A parent may fail to monitor the child’s whereabouts and be certain that he or she is with trustworthy others, for example, by allowing drug dealers into a home. Parents may leave their child with unsafe adults while using or seeking substances. Without adequate supervision and seeing the parent’s high-risk behavior, teenage (or even younger) children may themselves engage in high-risk behaviors, such as substance use. These high-risk behaviors in turn further expose these youth to possible sexual abuse. In extreme cases of parental drug-seeking behavior, a child may be exposed to parental prostitution or offered up by an addicted parent or caregiver for sexual abuse in return for substances. Lack of emotional availability (known as emotional neglect) may result in a child who is missing love and closeness becoming more vulnerable to a would-be perpetrator. This person then builds a relationship with the child as part of grooming them to make them more compliant with the intended sexual abuse. A perpetrator may also exploit the child’s fear that his or her substance abuse (and perhaps other illegal acts) will be discovered to persuade the child to keep the abuse secret. Parents and caregivers who are heavy substance users may minimize or be unaware of the increased risks for their children. Once in active recovery, however, caregivers may become acutely aware of how their substance abuse has negatively affected their children. Taking responsibility and coming to terms

with this knowledge may be extremely painful for recovering parents and their children and poses a great challenge for the family to overcome. Parental shame and guilt after this realization can precipitate a return to substance use, while children are asked to trust parents who have not kept them safe in the past. Exactly how many children are sexually abused is unknown, since not all cases are reported. It is therefore impossible to know the number of cases of CSA in which parental substance abuse is a factor. However, the National Survey on Drug Use and Health (SAMHSA 2009) indicates that between 2002 and 2007, at least 1 in 10 children (over 8.3 million) in the United States were living in households where parents abused substances, and these children can therefore be presumed to be at higher risk for CSA. As well as substance abuse increasing the risk of CSA, a clear link has been established between having experienced CSA and later developing substance abuse problems, as well as other mental health problems (Putnam 2003; Simpson & Miller 2002). Simpson and Miller (2002), reviewing over a hundred research studies, reported that both men and women with a history of CSA were significantly more likely to have a subsequent substance use problem, the risk for women being almost doubled. Research has consistently shown that exposure to multiple types of maltreatment over time (also called polyvictimization) is associated with worse outcomes than exposure to one type of maltreatment or other adversity (Ford, Wasser, and Connor 2011). Parental substance abuse and CSA both increase the risk of children experiencing additional kinds of maltreatment and adversity, such as emotional and physical neglect or entering foster care, and thereby falling into this polyvictimized category. These children

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may have severe mental health problems, particularly PTSD, together with extensive involvement in different child and family services systems, such as mental health and substance abuse treatment, the child welfare system, and the juvenile justice system. It is important for those working in these systems to ensure that both children and parents or other caregivers receive comprehensive assessments and services that are responsive to their particular needs. Elizabeth A. Winter See also: Alcohol-Facilitated Sexual Assault; Domestic Abuse and Alcohol

Further Reading American Professional Society on the Abuse of Children. http://www.apsac.org. Berliner, L. 2011. “Child Sexual Abuse: Definitions, Prevalence, and Consequences.” In The APSAC Handbook on Child Maltreatment, 3rd ed., edited by J. E. B. Myers, 215–32. Thousand Oaks, CA: Sage. Child Welfare Information Gateway. http:// www.childwelfare.gov. Crimes against Children Research Center. http://www.unh.edu/ccrc/index.html. Ford, J. D., T. Wasser, and D. F. Connor. 2011. “Identifying and Determining the Symptom Severity Associated with Polyvictimization among Psychiatrically Impaired Children in the Outpatient Setting.” Child Maltreatment 16(3): 216–26. Hanson, R. F., S. Self-Brown, A. E. FriskerElhai, D. G. Kilpatrick, B. E. Saunders, and H. S. Resnick. 2006. “The Relations between Family Environment and Violence Exposure among Youth: Findings from the National Survey of Adolescents.” Child Maltreatment 11(1): 3–15. National Alliance for Drug-Endangered Children. http://www.nationaldec.org/.

National Center on Substance Abuse and Child Welfare. http://www.ncsacw.samhsa.gov/. National Institute on Drug Abuse. http://www .drugabuse.gov/. Putnam, F. W. 2003. “Ten-Year Research Update Review: Child Sexual Abuse.” Journal of the American Academy of Child and Adolescent Psychiatry 42(3): 269–78. Simpson, T. L., and W. R. Miller. 2002. “Concomitance between Child Sexual and Physical Abuse and Substance Use Problems: A Review.” Clinical Psychology Review 22(1): 27–77. Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2009. The NSDUH Report: Children Living with Substance-Dependent or SubstanceAbusing Parents: 2002–2007. Rockville, MD: SAMHSA. Widom, Cathy Spatz, and Susanne HillerSturmhofelk. 2001. “Alcohol Abuse as a Risk Factor for and Consequences of Child Abuse.” Alcohol Research and Health 25(1): 52–57.

Children of Alcoholics Growing up, children look to their parents for nurturing, security, and reassurance. Parents who suffer from alcoholism are often unable to provide their children with appropriate love, care, and security to instill those feelings in their children. This is especially true if the children are removed from the home and placed with other family members or even strangers. Often these children feel neglected and lonely, and face multiple social and emotional difficulties throughout their lives. They may not receive medical attention when needed. Alcoholic parents can place a heavy toll on the children who

Children of Alcoholics 

instead of depending on their parents, are instead only damaged by them. It is estimated that about 7 million children under the age of 18 live in households in the United States with at least one alcoholic parent. There is a genetic factor associated with vulnerability to alcohol dependence; however, there are other issues of concern, including social and psychological dysfunction that may result from growing up in an alcoholic home. Among the symptoms that may be exhibited as a result of living in such an environment, as well as other types of dysfunctional families, are depression, anxiety, crying, bed-wetting, social isolation, fear of school, or nightmares. Statistics show that about one in five adult Americans were forced to live with an alcoholic parent as a child. Psychiatrists who specialize in child and adolescent disorders are quick to explain that these children have more emotional problems than those children whose parents are not abusing alcohol. To make matters worse, alcoholism tends to be more prevalent in certain families, so children not only have a genetic predisposition to alcoholism, but also tend to abuse alcohol as a result of modeling their parent’s behavior. In the long run, children of alcoholics are four times more likely to become alcoholics than are children of nonalcoholics. Many children who live with alcoholics are also more likely to suffer from some form of neglect or abuse, either physical or emotional. A child who lives in a family with parents who abuse alcohol may have a variety of problems, one of which is strong feelings of guilt. Often, children of alcoholics believe that they are the main cause of their mother’s or father’s drinking patterns. They may believe that if they were better children, their parents would not drink alcohol. Children of alcoholic parents may also have strong feelings of anxiety. These young people may

worry constantly about their home situation. They may fear the alcoholic parent will become violent at the smallest disagreement, or may become sick or injured as a result of their drinking. It is very common for children with alcoholic parents to feel embarrassed about what is going on at home. Their parents may tell the child that what happens at home needs to remain a secret and not to tell anyone what is going on. The child may feel ashamed and will not invite friends to the home. They are often afraid to ask anyone for help, especially because they risk violence at home. Children of alcoholic parents report that they have an inability to form close relationships with others their age. These feelings stem from the disappointment the child feels as a result of unfulfilled promises made by the parents. They are then unable to trust others, even though the other people do not drink and have the same relationship with the child. Children raised in a home with alcoholic parents sometimes feel confused, especially when the alcoholic parent changes suddenly from being a loving parent into one that is angry and full of hate, regardless of the child’s behavior. There is often no regular daily schedule in homes where there is an alcoholic parent. There is no constant pattern of mealtimes and bedtimes, which is very important for a young child. According to psychologists, children of alcohol parents often have feelings of anger towards their parents for their behavior. They may also be angry because the parent has not provided support, protection, and other opportunities that children of nonalcoholic parents are given. Finally, parents who drink alcohol excessively sometimes have children who exhibit feelings of depression. Their child may feel lonely and even helpless because they are unable to change the situation.

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Although most children of alcoholic parents attempt to keep the alcoholism a secret, sometimes teachers, relatives, other adults, or even friends (if the child is old enough) may sense that something is wrong in the home. Child and adolescent psychiatrists explain that there are some indications that a drinking problem exists in the home. Some of these include failing grades in school; truancy (because the parent does not ensure that the child is awake and prepared for the school day); lack of close and consistent friends; withdrawal from classmates who have become friends; delinquent behavior, such as stealing or violence toward other students; physical complaints, such as headaches or stomachaches; abuse of drugs or alcohol by the youth or by siblings; risktaking behaviors; and depression or suicidal thoughts or behavior. In some cases, children of alcoholics may begin to act like responsible “parents” within the family and among friends. Because an alcoholic parent is unable to take care of the home or the children, the child may be forced to take charge of the household. They will be forced to care for themselves, younger siblings, or even the parent. They may be forced to fix meals, wash laundry, make sure the other children complete their homework, or carry out other household responsibilities the parent is unable to do. Some children cope with the alcoholism by becoming controlled, successful “over­ achievers” throughout school, and at the same time be emotionally isolated from other children and teachers. Their emotional problems may show only when they become adults. In severe cases, children of alcoholic parents, if the home situation is identified, will be sent to live with relatives in a more stable environment. This causes adjustment problems not only for the children but also the accepting family. The new family will need to adjust

to the addition of a new young, and maybe traumatized, person (or in some cases, multiple people) into their family unit. This can put strains on space, time, and other resources and lead to resentment and arguments. More than likely, there will be additional costs to the accepting family that probably will not be covered by the alcoholic parent. In an ideal situation, the children of alcoholic parents should receive counseling, regardless if the parents are involved in that counseling. They may also benefit from educational programs and mutual-help groups such as Al-Anon and Alateen. Many schools provide counseling options for these children. It is critical that these children receive professional help as early as possible in order to prevent more serious problems in the future. Children and adolescents must also deal with the related feelings of guilt and abandonment that they may be feeling. Psychiatrists can provide assistance to these children, and help them understand they are not responsible for the drinking problems exhibited by their parents. Treatment programs for these children may include group therapy with other young people who are in the same situation. This may reduce the feelings of isolation that children of alcoholics often experience. When possible, a psychiatrist will work with the entire family, particularly if the alcoholic parent has stopped their drinking behaviors, as a way to help both the parent and the children develop healthier ways of relating to their problems and to one another. Nancy E. Marion See also: Alateen; Alcohol Use; Alcoholism

Further Reading Barnard, Marina. 2007. Drug Addiction and Families. London: Jessica Kingsley Pub­­­­­­­lications.

China and the Chinese and Drugs  173 Fitzgerald, Hiram E., Barry M. Lester, and Barry S. Zuckerman. 2000. Children of Addiction: Research, Health, and Public Policy Issues. New York: RoutledgeFalmer. National Institute on Alcohol Abuse and Alcoholism. 1990. Children of Alcoholics: Are They Different? Rockville, MD: National Institute on Alcohol Abuse and Alcoholism. National Institutes of Health, National Institute on Alcohol and Alcoholism. 2005. Family History of Alcoholism: Are You at Risk? Bethesda, MD: U.S. Department of Health and Human Services. O’Connor, Dianne S. 2009. I Can Be Me: A Helping Book for Children of Alcoholic Parents. Bloomington, IN: AuthorHouse. O’Gorman, Patricia A., and Philip Diaz. 2004. The Lowdown on Families Who Get High: Successful Parenting for Families Affected by Addiction. Washington, DC: Child and Family Press. Straussner, Shulamith Lala Ashenberg, and Christine Huff Fewell. 2011. Children of Substance-Abusing Parents: Dynamics and Treatment. New York: Springer Publishers. Yeh, Emerald. 2004. Lost Childhood: Growing Up in an Alcoholic Family. San Francisco, CA: Young Broadcasting.

China and the Chinese and Drugs Both Chinese immigrants and the country of China itself played key roles in the development of U.S. drug policy in the early 20th century. Racism against Chinese immigrants gave political traction to the move towards domestic controls over narcotics, while a desire to help the Chinese government stamp out drug abuse on the Chinese mainland helped spur the push towards international drug control.

Within the United States, the opium habit came to be seen as a foreign and menacing tradition associated with Chinese immigrants in the late 19th century. Chinese immigrants began coming to the United States in large numbers for the California gold rush of 1848, while many others came to work as laborers on the construction of the transcontinental railroad. Even though many of these immigrants had not used opium before they moved to the United States, a good number of them became accustomed to smoking opium during their rare days off once they immigrated. Purchasing the drug at local Chinese stores, in small mining towns, or from shopkeepers in San Francisco’s Chinatown, many of these immigrants gradually developed opium habits as a way to escape from the hard lives they led as immigrant laborers in the Western United States. According to studies conducted by doctors in the late 19th century, about 15 percent of the Chinese immigrants living in the United States smoked opium daily. In the 1870s, two factors made the Chinese opium habit problematic in the minds of commentators in the United States. First, the opium habit began spreading beyond the narrow confines of the immigrant Chinese community at that time. Public smoking shops and opium dens open to both whites and Chinese immigrants began popping up in Nevada, California, and major cities in the Midwest (Chicago, St. Louis), the South (New Orleans), and on the East Coast (New York). At first, most of the non-Chinese who attended opium dens were young people from the lower classes, many of them individuals who made livings in the seedy underworlds of gambling and prostitution. Soon, however, many began to fear that the habit was spreading to the middle and upper classes. They argued that if allowed to spread, opium could lead to both the physical and moral

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decline of youths from all classes and races. Fear of the opium habit’s spread dovetailed with another development that stirred anti-Chinese sentiment—economic depression. When the economy was hit by a severe downturn in the 1870s, many came to see Chinese immigrants as threatening, because it was believed that they took jobs from native-born workers. As economic troubles mixed with traditional racism and fear of foreigners, many began to suspect that Chinese immigrants used opium as part of a wider conspiracy to harm the United States and its citizens; some speculated that they gave the drug to white women in exchange for sexual favors, while others argued that the drug was intimately tied to other deviant practices like prostitution and gambling, both of which were believed to be common in the Chinatowns of U.S. cities. Some even speculated that the Chinese tried to poison whites with the drug, spreading rumors that they mixed it with candy that they sold to children in hopes of getting them hooked. As early as 1875, some local governments in the Western United States were moved to pass legislation based on this anti-Chinese sentiment, and 11 states introduced legislation to crack down on the opium habit between 1877 and 1890. Anti-Chinese sentiment remained prevalent in the writings of anti-opium activists in the late 19th and early 20th centuries, and it helped garner support for some of the first pieces of federal narcotics control legislation in the United States—the Smoking Opium Exclusion Act of 1909 and the Harrison Narcotics Act of 1914. The association of the opium habit with the Chinese continued well into the 20th century. In the early years of narcotics control, both the general public and the authorities believed that the opium habit, and opium dens in particular, were problems associated with the Chinese,

and as late as the 1950s drug control officials blamed China for the illicit importation of other opiates (like heroin) into the United States. Though there is still some connection between China and the opium problem in the United States today, much of the focus has shifted to organizations based in other parts of the world—other Asian countries and Latin America in particular—that orchestrate the traffic of controlled substances into the United States. While fears of Chinese immigrants helped push the move towards domestic narcotics control in the United States, concern over China and opium played an even bigger role when it came to the creation of an international drug control regime. The Chinese had been trying to limit the spread of the opium habit in their country since the 1700s, but with little success. The main reason was that other countries—European powers who had colonial holdings in Asia in particular—got rich off of the Chinese opium problem. The colonial governments of Britain, France, and Holland all had systems in which the authorities were in charge of growing and selling opium, much of which made its way to Chinese customers. The opium habit in China, therefore, was a major source of profit for the European colonial powers. Thus there was a tension between China’s efforts to promote the health of its own citizens by limiting their opium use, and European financial interests. At times in the 19th century, the clash between Chinese public health goals and European economic motives led to armed conflict. The Chinese tried to stand up to the European powers when they refused to restrict the importation of opium into Chinese ports, leading to skirmishes that came to be known as the Opium Wars—the first lasting from 1839 to 1843, the second from 1856 to 1860. In both conflicts, the Chinese suffered bitter defeats, and they were forced

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to allow foreign opium into their country. By the late 19th century, however, many European countries began to soften their stance and consider making changes to their opium policies, and the United States became a leading advocate for reforming the opium trade. Eventually, the desire to help the Chinese address their opium problem led to the convening of the first two international drug control conferences—at Shanghai in 1909 and The Hague in 1911. The agreement struck at The Hague eventually laid the groundwork for the international drug control regime that emerged after World War I. Howard Padwa and Jacob A. Cunningham See also: Hague Convention; Harrison Nar­ cotics Act; Opium

Further Reading Bewley-Taylor, David R. 1999. The United States and International Drug Control, 1909–1997. London: Pinter. Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Dikotter, Frank, Lars Laamann, and Zhou Xun. 2004. Narcotics Culture: A History of Drugs in China. Chicago: University of Chicago Press. Dolin, Eric Jay. 2012. When America First Met China: An Exotic History of Tea, Drugs and Money in the Age of Sail. New York: Liveright. Lovell, Julia. 2011. The Opium War: Drugs, Dreams and the Making of China. London: Picador. McAllister, William B. 2000. Drug Diplomacy in the Twentieth Century. London: Routledge.

Morgan, H. Wayne. 1974. Yesterday’s Addicts: American Society and Drug Abuse, 1865– 1920. Norman: University of Oklahoma Press. Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press.

Cigarettes Approximately 22 percent of Americans were cigarette smokers in 2011. Despite the significant decrease, 3.9 percentage points, since 2002, cigarette addiction continues to be tenacious. In the face of its devastating effects on health, significant out-of-pocket costs, and decreasing numbers of public venues where it is permitted, cigarette smoking is a habit that millions of people adopt every day and then find, to their dismay, very difficult to quit. In an effort to prevent children and adolescents from getting hooked on nicotine— the psychoactive drug in cigarettes—and ingesting the hundreds of dangerous chemicals that cigarettes contain, all 50 states in the United States have passed laws restricting cigarette sales to those who are at least 18 years of age. Other countries enforce similar laws. “Cigarette” usually refers to a slim, paperwrapped cylinder containing an addictive mixture of tobacco and other ingredients, but it may also refer to other products such as marijuana that have been rolled into cigarette paper for smoking. Although they are significantly different from cigars, early European cigarettes may have been modeled on the crude product that the poor created out of discarded cigar butts that the wealthy tossed into the streets. Well before that, probably as early as the ninth century, indigenous

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A 1950 print ad for Camel cigarettes presented the “true” story of secretary Rita Tennant, who “passed the 30-day test of Camel mildness under the observation of a noted throat specialist.” The ad features the slogan,“Not one single case of throat irritation due to smoking Camels.” (Blank Archives/Getty Images)

cultures in the Americas were smoking a harsh form of tobacco in reeds or other crude forms of smoking tubes. Records show that in the 1600s, colonial settlers smoked a type of cigar as well as pipes, first consuming the harsh tobacco to which the Indians had introduced them before learning to cultivate a milder form that proved to be very addicting. Cigarette smoking quickly caught on during the 1800s after the British, who were exposed to the practice during the Crimean War during the mid-1800s, introduced it to the United States. As a newly developed machine able to produce 200 cigarettes a minute made

them more affordable, cigarettes quickly began to outstrip the use of chewing tobacco, pipes and cigars, and snuff. Although most people purchased tobacco and papers to roll their own cigarettes well into the 1940s and 1950s, mass production made manufactured cigarettes accessible everywhere. Cigarette companies spent lavishly to sell their product through print and radio ads and the newly developed medium known as television. By the late 1950s, when nearly every household had at least one smoker living in it, disquieting news about the ill effects of smoking had become more widespread. In 1964, the U.S. surgeon general issued a report detailing the harmful effects smoking could have on health. Almost immediately, cigarette consumption dropped by 20 percent, then rebounded quickly. Despite subsequent legislation restricting advertising and U.S. government-funded reports that verified and strengthened earlier concerns about the dangers of cigarettes and other tobacco products, high consumption has continued. The tobacco industry is now a powerful lobby that has successfully obscured the obvious dangers of their product with aggressive marketing campaigns. Nevertheless, the message has gotten through to many, and so, with fewer consumers choosing to smoke cigarettes and aware that the sooner people start smoking in life the more likely they are to be addicted for life, cigarette companies are marketing mini-cigars and smokeless tobacco products more aggressively to appeal to adolescents. According to the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration, the following are true about cigarette smoking:

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• Among young adults 18 to 22 years old, full-time college students were less likely to be current cigarette smokers than their peers who were not enrolled full-time in college. Cigarette use in the past month in 2011 was reported by 23.8 percent of full-time college students, less than the rate of 39.2 percent for those not enrolled full-time. • In 2011, current cigarette smoking among youths aged 12 to 17 and young adults aged 18 to 25 was more prevalent among whites than blacks (9.3 vs. 4.9 percent for youths and 37.8 vs. 25.7 percent for young adults). The rates for Hispanics were 6.1 percent among youths, 28.4 percent among young adults, and 18.4 percent among those aged 26 or older. • Among youths aged 12 to 17, the rate of current cigarette smoking in 2011 did not differ significantly for females (7.3 percent) and males (8.2 percent). The rate for both males and females declined between 2002 and 2011 (12.3 percent for males in 2002; 13.6 percent for females in 2002). • Among youths aged 12 to 17 in 2011, 2.5 million (10.0 percent) used a tobacco product in the past month, and 1.9 million (7.8 percent) used cigarettes. The rate of past-month cigarette use among 12- to 17-year-olds declined from 13 percent in 2002 to 7.8 percent in 2011. Past-month use of smokeless tobacco, however, was higher in 2011 (2.1 percent) than in 2002 (2 percent). • In 2011, 1.4 percent of 12- to 13-yearolds, 6.0 percent of 14- to 15-year-olds, and 15.4 percent of 16- to 17-year-olds were current cigarette smokers. The percentage of past-month cigarette smokers among 12- to 13-year-olds was slightly lower in 2011 than in 2010 (1.4 vs. 1.8

•

•

•

•

percent). Across age groups, current cigarette use peaked at 34.7 percent among young adults aged 21 to 25. About onefifth (19.7 percent) of persons in the 35 or older age group in 2011 smoked cigarettes in the past month. In 2002 and 2011, the numbers of cigarette initiates who were under age 18 when they first used were the same (1.3 million). However, the number of cigarette initiates who began smoking at age 18 or older increased from 623,000 in 2002 to 1.1 million in 2011. In 2011, among recent initiates aged 12 to 49, the average age of first cigarette use was 17.2 years, similar to the average in 2010 (17.3 years). Of those aged 12 or older who had not smoked cigarettes prior to the past year, the past-year initiation rate for cigarettes was 2.4 percent in 2011, similar to the rate in 2010 (2.6 percent). Among youths aged 12 to 17 who had not smoked cigarettes prior to the past year, the incidence rate in 2011 was 5.5 percent, which was similar to the 2010 rate (5.9 percent). Among males aged 12 to 17 who had never smoked prior to the past year, past-year initiation rates in 2002 to 2010 were not significantly different from the rate in 2011. However, the past year initiation rate among females aged 12 to 17 who were at risk for initiation was lower in 2011 (5.5 percent) than in 2002 to 2006 or in 2008. In 2011, the number of persons aged 12 or older who had started smoking cigarettes daily within the past 12 months was 878,000. This estimate was similar to the 2010 estimate (962,000), but was lower than the estimates in 2003, 2004, 2006, and 2009 (ranging from 1.0 million to 1.1 million). Of the new

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daily smokers in 2011, 38.0 percent, or 334,000 persons, were younger than age 18 when they started smoking daily. This figure averages to approximately 916 initiates of daily smoking under the age of 18 every day.

U.S. Department of Health and Human Services. 2004. The Health Consequences of Smoking: A Report of the Surgeon General. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.

Other statistics from the Centers for Disease Control show that:

U.S. Department of Health and Human Services. 2007. Results from the 2006 National Survey on Drug Use and Health: National Findings. Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. DHHS Publication No. SMA 07–4293.

• Cigarette smoking causes 87 percent of lung cancer deaths and is responsible for most cancers of the larynx, oral cavity and pharynx, esophagus, and bladder. • Tobacco smoke contains thousands of chemical agents, including over 60 substances that are known to cause cancer. • Smoking cessation has major and immediate health benefits, including decreasing the risk of lung and other cancers, heart attack, stroke, and chronic lung disease. Kathryn H. Hollen See also: Cigars; Nicotine; Tobacco

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Federal Trade Commission. 2007. “FTC Releases Reports on Cigarettes and Smokeless Tobacco.” http://www.ftc.gov/opa/2007/04/ cigaretterpt.shtm. U.S. Department of Health and Human Ser­ vices. 1988. Nicotine Addiction: A Report of the Surgeon General. Centers for Disease Control and Prevention, Public Health Service, Center for Health Promotion and Education, Office on Smoking and Health. U.S. Department of Health and Human Services. 2003. Targeting Tobacco Use: The Nation’s Leading Cause of Death. Centers for Disease Control and Prevention.

U.S. Department of Health and Human Services. 2012. Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings. Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. HHS Publication No. SMA 12–4713. http://www.samhsa.gov/data/ nsduh/2k11results/nsduhresults2011.htm. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://apps.nccd.cdc.gov/osh_faq. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco. U.S. Department of Health and Human Services, National Cancer Institute. http:// www.cancer.gov/cancertopics/tobacco. U.S. Department of Health and Human Services, National Institute on Drug Abuse.2006. Research Report Series: Tobacco Addiction. NIH Publication No. 06–4342.

Cigars Cigars are manufactured by wrapping smaller tobacco leaves in larger tobacco leaves. The leaves used on the outside of the cigar usually come from the widest part of the tobacco

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plant. Because of their size, these leaves help to define the character and quality of the cigar. While cigarettes are made of shredded tobacco leaves, cigars are produced from the entire tobacco leaf. The tobacco plant was grown in North America as early as 1610. Cigar factories expanded in size and number during the 1800s because cigar smoking was common by men who were in the upper class. Into the 20th century, cigar smoking continued to be popular with many notable people including Winston Churchill. The popularity of cigars dropped after World War II when cigarettes became more popular. Consequently, cigar manufacturing fell significantly. Things changed again in the 1990s, when cigars again became popular—this time among women. Since about 1993, cigar sales in the United States have increased by about 50 percent, which marks a reversal in the 20-year decline that occurred from 1973 to 1993. Small cigar consumption has increased modestly, about 13 percent, whereas consumption of large cigars has increased nearly 70 percent. Most of the increase appears to be from teenagers and young adult males who smoke occasionally (less than daily). Smoking surveys show that the current level of cigar smoking among adolescents exceeds the use of smokeless tobacco. For example, one Massachusetts survey of students in grades 6 to 12 showed that cigar use (smoked a cigar in the last 30 days) ranged from 3.2 percent in sixth grade to as high as 30 percent in high school. These rates are double the use of smokeless tobacco. The same survey showed that 6 percent to 7 percent of girls in grades 9 to 11 reported they had used cigars in the past month. In general, twice as many teenage boys as girls are likely to smoke cigars. The greatest increase in adult cigar smoking is among young and middle-aged (ages

18 to 44) white males with higher than average incomes and education. According to a 2005 article in the American Journal of Public Health, industry marketing of cigars and mini-cigars directed at women and adolescents has largely been successful, and the cinnamon, grape, and other new flavorings have increased their popularity. The authors estimate that cigar consumption rose about 28 percent in the United States between 2000 and 2004, even as cigarette smoking declined. Cigars come in various shapes and sizes— perfecto, panatela, and cheroot refer to the shape; corona (half corona, petit corona, and double corona) refer to the size. In addition, the color of the tobacco leaf may vary from light (claro) to very dark (colorado maduro), which is likely to be the strongest. Inside the wrapper are fillers, tobacco leaves that in top-quality cigars are hand rolled into the wrappers to keep the tobacco moist. Most of the world’s finest cigars are made in Cuba, where they probably originated, but good cigars are being machine-made around the world to satisfy a growing market. In 1962, when President John F. Kennedy instituted a trade embargo against Cuba, it became no longer possible to import Cuban cigars. Highly prized as the very best cigars made, they are frequently smuggled into the United States from Canada and other countries that can legally purchase them from Cuba. Cigar tobacco is cured (dried) and fermented to develop taste and aroma. This process produces a high concentration of nitrates and other dangerous chemicals, making cigars significantly more toxic than cigarettes and one of the most potent delivery vehicles for nicotine. “Little cigars” look very much like cigarettes in brown paper, and many state tax authorities are lobbying to call them cigarettes in order to generate the increased tax revenue that cigarette sales provide, but cigar manufacturers continue

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to resist that effort. Nevertheless, state and federal authorities as well as the American Cancer Society and other health advocacy groups are currently debating the issue.

Cigars’ Harmful Ingredients Compared to a cigarette, a large cigar emits up to 20 times more ammonia, 5 to 10 times more of the carcinogens cadmium and methylethyl nitrosamine, and up to 80 to 90 times as much of the highly carcinogenic tobaccospecific nitrosamines. The smoke released from cigars and cigarettes contains many of the same toxic agents (carbon monoxide, nicotine, hydrogen cyanide, ammonia, and volatile aldehydes) and human carcinogens (benzene, vinyl chloride, ethylene oxide, arsenic, cadmium, nitrosamines, and polynuclear aromatic hydrocarbons). However, cigars emit significantly more of these substances for a number of reasons: the long aging and fermentation process for cigar tobacco leaves results in higher concentrations of nitrate in cigar tobaccos; the nonporous cigar wrappers make combustion of cigar tobacco less complete than that of cigarette tobacco; and the larger size of most cigars produces more smoke. Not only can cigar smoking cause many cancers (oral cancers, including throat cancer, and cancer of the larynx, esophagus, and lung) but also chronic obstructive lung disease and coronary heart disease. There is also evidence that strongly suggests that cigar smoking is associated with cancer of the pancreas. Many of these cancers—lung, esophageal, and pancreatic—are associated with extremely low survival rates. How Patterns of Use Affect Risk Most cigarette smokers smoke every day and inhale. In contrast, as many as three-quarters of cigar smokers smoke only occasionally

and the majority do not inhale; some may smoke only a few cigars per year. In spite of these differences, daily cigar smokers and cigarette smokers have similar levels of risk for oral (including throat), larynx, and esophageal cancers. Even among daily cigar smokers (smoking 1 or more cigars per day) who do not inhale, the risk of oral cancers is 7 times greater than for nonsmokers and the risk for larynx cancer is more than 10 times greater than for nonsmokers. Inhaling greatly magnifies this risk. Compared to nonsmokers, daily cigar smokers have 27 times the risk of oral cancer, 15 times the risk for esophageal cancer, and 53 times the risk of cancer of the larynx. Cigar smokers are also at increased risk for heart and lung disease compared to nonsmokers. Regular cigar smokers who reported inhaling slightly have double the risk of chronic obstructive pulmonary (lung) disease and increase their risk of coronary heart disease by 23 percent. Compared to cigarette smokers, cigar smokers have lower risks for cancer of the larynx and lung as well as heart and lung disease. Not inhaling probably plays a strong role in lowering these risks. However, with regular use and inhalation, the heart and lung disease risks of cigar smoking increase substantially, and, for some, disease risk may approach that seen in cigarette smokers. In fact, the lung cancer risk from inhaling moderately when smoking five cigars per day is comparable to that from smoking one pack of cigarettes per day. The health consequences of regular cigar use, along with the increased use in teenagers, raise several concerns among public health officials. Addiction studies with cigarettes and spit tobacco clearly show that addiction to nicotine occurs almost exclusively during adolescence and young adulthood when children and teens begin using tobacco

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products. The high rates of adolescent cigar use may result in higher rates of nicotine dependence in this age group. According to the U.S. Department of Health and Human Services’ Centers for Disease Control and Prevention and Substance Abuse and Mental Health Services Administration: • Between 2002 and 2011, past month cigar use declined from 5.4 percent to 5.0 percent. • In 2011, there were 2.8 million persons aged 12 or older who had used cigars for the first time in the past 12 months, which was similar to the 2010 estimate (3.0 million). However, the 2011 estimate was lower than the 2005 estimate (3.3 million). Among past-year cigar initiates aged 12 to 49, the average age at first use was 19.6 years in 2011, which was similar to the estimate in 2010 (20.5 years). • In 2011, an estimated 5.0 percent (12.7 million) of Americans 12 years of age or older were current cigar users. • Regular cigar smoking is associated with an increased risk for cancers of the lung, oral cavity, larynx, and esophagus. • Heavy cigar smokers and those who inhale deeply may be at increased risk for developing coronary heart disease and chronic obstructive pulmonary disease. • Marketing efforts have promoted cigars as symbols of a luxuriant and successful lifestyle. Endorsements by celebrities, development of cigar-friendly magazines, features of highly visible women smoking cigars, and product placement in movies have contributed to the increased visibility of cigar smoking in society.

• Since 2001, cigar packaging and advertisements have been required to display one of the following five health warning labels on a rotating basis. SURGEON GENERAL WARNING: Cigar Smoking Can Cause Cancers of the Mouth and Throat, Even If You Do Not Inhale. SURGEON GENERAL WARNING: Cigar Smoking Can Cause Lung Cancer and Heart Disease. SURGEON GENERAL WARNING: Tobacco Use Increases the Risk of Infertility, Stillbirth and Low Birth Weight. SURGEON GENERAL WARNING: Cigars Are Not a Safe Alternative to Cigarettes. SURGEON GENERAL WARNING: Tobacco Smoke Increases the Risk of Lung Cancer and Heart Disease, Even in Nonsmokers. Kathryn H. Hollen See also: Cigarettes; Nicotine; Tobacco

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do About It. New York: Perseus Books. Delnevo, C. D., Jonathan Foulds, and Mary Hrywna. 2005. “Trading Tobacco: Are Youths Choosing Cigars Over Cigarettes?” American Journal of Public Health 95: 2123. Federal Trade Commission. 2007. http://www .ftc.gov/opa/2007/04/cigaretterpt.shtm Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press. U.S. Department of Health and Human Services. 1988. Nicotine Addiction: A Report of the Surgeon General. Centers for Disease Control and Prevention, Public Health

182   Cipollone v. Liggett Group, Inc. et al. Service, Center for Health Promotion and Education, Office on Smoking and Health. U.S. Department of Health and Human Services. 2003. Targeting Tobacco Use: The Nation’s Leading Cause of Death. Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. 2004. The Health Consequences of Smoking: A Report of the Surgeon General. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. U.S. Department of Health and Human Services. 2007. Results from the 2006 National Survey on Drug Use and Health: National Findings. Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. DHHS Publication No. SMA 07-4293. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2008. http://apps.nccd.cdc.gov/osh_faq. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco. U.S. Department of Health and Human Services, National Cancer Institute. http:// www.cancer.gov/cancertopics/tobacco. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006. Research Report Series: Tobacco Addiction. NIH Publication No. 06–4342.

Cipollone v. Liggett Group, Inc. et al. Cipollone v. Liggett Group, Inc. et al. was a landmark 1980s lawsuit that signaled a turning point in the history of litigation against the tobacco industry. Although the plaintiff ultimately failed to win any compensation after an appeals court set aside the verdict on a technicality, the case exposed a cache of

industry documents that proved big tobacco was aware of the link between smoking and cancer. The case thus paved the way for successful class-action lawsuits and the Master Settlement Agreement. Cipollone v. Liggett Group, Inc. et al. was filed by attorney Marc Edell on August 1, 1983. Edell had become familiar with pulmonary pathology as a result of previously defending an asbestos company in health litigation cases wherein the defendants claimed that workplace health risks resulted from smoking, rather than exposure to asbestos. Familiar with the risks of smoking and sensing that the tobacco industry was ripe for litigation, Edell came across Rose Cipollone, a 58-year-old woman from Little Ferry, New Jersey, undergoing treatment for lung cancer. Shortly thereafter, Edell filed suit against three major tobacco companies—Liggett, Philip Morris, and Lorillard—on her behalf. Rose Cipollone (née DeFrancesco) began smoking Chesterfields at the age of 16, and despite her heavy-smoking father’s fatal stroke (which her mother attributed to cigarettes) just two years earlier, she was smoking an estimated pack and a half of them per day within a couple of years of her first cigarette. Married and pregnant a few years later, Rose was urged by her husband, Antonio Cipollone, to quit smoking for the sake of the baby’s health. During the trial, Rose stated that although she cut down on her smoking during the pregnancy, she found herself addicted and unable to quit. She also testified that in 1955 she switched from Chesterfields to L&Ms, a new Liggett and Myers filtered cigarette with a “Miracle Tip” that was billed as “Just What the Doctor Ordered.” Cipollone’s shift to the ostensibly safer and healthier L&Ms was typical of the times, as by 1958, around half of all smokers switched from unfiltered to filtered cigarettes, which debuted in the wake of a series of scientific

Cipollone v. Liggett Group, Inc. et al.  183

reports in the 1950s that linked smoking to cancer. In 1968, Cipollone began smoking Virginia Slims, a new line manufactured by Philip Morris and advertised as the cigarette for modern, but still feminine, women. She then switched to Philip Morris’s Parliament brand in 1972, in large part, she testified, because they claimed to diminish the level of tar a smoker ingested. Cipollone finally moved on to Lorillard’s True cigarettes in 1974, reportedly at the behest of her doctor. True, which billed itself as being low in tar and nicotine, was suggested by the doctor, who reasoned that if Cipollone intended to continue smoking, it would be the healthiest brand for her. These brand changes, some of them undertaken with the intent of improving her health, did not prevent her from developing lung cancer in 1981, and she died from it at the age of 58 on October 21, 1984. The suit that Edell filed on Cipollone’s behalf in 1981 consisted of five allegations. Edell claimed that the tobacco industry had designed safer cigarettes but opted not to sell them, thus intentionally putting out a product they knew to be dangerous. The suit also alleged that, prior to federally mandated warning labels, tobacco companies had failed to adequately warn consumers about the risks of smoking that they themselves were aware of. Additionally, Edell argued that cigarette advertising made untrue health claims that intended to contradict what was known about the dangers involved in smoking. Furthermore, Edell made the claim that the tobacco industry fraudulently misrepresented cigarettes’ health effects. Lastly, the suit alleged that the tobacco industry had committed fraud by suppressing scientific findings that linked smoking to a variety of illnesses and diseases. Despite the significant popular and scientific awareness of smoking’s perils, Edell’s chances of successful litigation were decid-

edly low. In fact, the tobacco industry had avoided paying even a single cent in damages in any of the approximately 300 lawsuits previously brought against it. Big tobacco’s remarkable record of success was in large part the result of its decision that it would not deliberate over which cases it should take to trial and which cases it should settle out of court; instead it would aggressively defend every claim in order to thwart the overwhelming majority of suits before they even reached trial. With a formidable legal team behind it, the tobacco industry utilized an approach that featured frequent delays, denials, and the filing of numerous (and often unjustified) preliminary legal motions. These actions ratcheted up the cost of litigation for the plaintiffs, so that few could ultimately afford the monetary cost of bringing suits to trial. In those rare instances, as was the case in Cipollone, in which a lawsuit reached the trial stage, the tobacco industry’s two-fold defense was to roundly deny that smoking definitively caused cancer, and, just as importantly, to assert that since it had no knowledge of a link between their product and a serious disease, it had no responsibility to warn consumers about smoking’s dangers. What distinguished Cipollone from other similar cases that were stymied by big tobacco’s effective legal defense strategy was Edell’s acquisition of approximately 300,000 internal tobacco industry documents. Drawing upon his experience as a lawyer for asbestos companies, Edell gained access to a trove of documents that exposed exactly what the tobacco industry really knew about the dangers of smoking. One of the most significant revelations contained within these documents, which formed the basis of many future cases against big tobacco, was that industry scientists were aware of a significant link between smoking and cancer at

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least as far back as the mid-1940s. Additionally damaging to big tobacco were internal memos demonstrating industry executives’ personal knowledge of the dangers of smoking. Equally revealing were memoranda and letters that illuminated how the Council for Tobacco Research (originally called the Tobacco Industry Research Committee), a tobacco industry–funded research center, worked towards discrediting research that linked smoking to cancer, suppressed unfavorable scientific findings, and prepared scientific witnesses for trials and congressional testimony dealing with the medical repercussions of smoking. The tobacco industry’s traditional argument that any illnesses Cipollone suffered were the result of her personal decision to smoke—and that therefore the defendants bore no responsibility for her death from lung cancer—was not nearly as persuasive when considered alongside these revealing industry documents. In fact, Edell used documents exposing the addictive nature of nicotine to argue that the tobacco industry actively worked to engineer and market cigarettes so that smokers who were concerned enough about the safety of smoking to consider quitting would continue smoking despite the serious health hazards. In the end, the jury granted $400,000 in damages to Cipollone’s widower, thus marking the first monetary award won against the tobacco industry. The trial was not a complete victory for Edell, however, as the jury ruled that Cipollone was principally responsible for her fatal lung cancer and that the tobacco industry was not guilty of conspiracy and fraud. The $400,000 was awarded solely on the jury’s decision that Liggett contributed to Cipollone’s death by not warning consumers, as it should have, of smoking’s dangers prior to 1966—the year when the tobacco industry was required to place warning labels on

cigarette packaging. And after both sides appealed the case, the verdict was thrown out in 1990 as a result of a technicality. Antonio Cipollone died shortly thereafter, and the family eventually decided not to continue the case. While the tobacco industry ultimately avoided paying any damages in Cipollone, it hardly emerged from the suit unscathed. For one, its time-tested defense strategy was seriously imperiled by the jury’s finding. More significantly, though, were the internal documents Edell acquired. These letters, memos, and research findings made it impossible for the industry to subsequently claim an ignorance of the link between smoking and cancer, and it opened up big tobacco to a wave of future litigation along the lines of the Cipollone case. And while the Cipollone family eventually chose to drop the case after years of litigation without winning so much as a single dollar for their efforts, other lawyers following the case saw the opportunity for class-action lawsuits that would pool the resources of smokers with similar claims and make it more difficult for the tobacco industry to wait out plaintiffs. Cipollone similarly laid the groundwork for state governments to begin suing tobacco companies in the 1990s for health insurance costs, and it likewise paved the way for the Master Settlement Agreement of 1998. Howard Padwa and Jacob A. Cunningham See also: Master Settlement Agreement

Further Reading Brandt, Allan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America. New York: Basic Books. Cordry, Harold V. 2001. Tobacco: A Reference Handbook. Santa Barbara, CA: ABC-CLIO.

Clinton, Bill (1946– )  185 Goodman, Jordan, ed. 2005. Tobacco in History and Culture: An Encyclopedia. Detroit: Thomson Gale.

Clinton, Bill (1946– ) William Jefferson Clinton was the U.S. president from 1993 to 2001. During the 1992 presidential election, Bill Clinton sensed that the U.S. public was disillusioned with the War on Drugs and pledged to change U.S. policy, promising the U.S. people that he would combine tough law enforcement with more antidrug treatment and prevention programs. Clinton also announced that he would shift the emphasis away from the interdiction of drugs toward a policy that would help countries fight drug trafficking both economically and militarily. In February 1993, the month after Clinton’s inauguration as president, Lee Brown, the former police chief of New York City who was Clinton’s choice for the new drug czar, said at his confirmation hearings that, if Congress approved his nomination, he would develop a “comprehensive and balanced” antidrug strategy, although he did not provide substantive details. In February 1993 Clinton also announced his plan to cut the support staff in the drug czar’s office from 146 to 25, a number fewer than half the size of the White House’s communications staff. Supporters of the move took this as a sign that the Clinton administration was serious about placing the emphasis of the drug policy on reducing demand. Critics, on the other hand, said that Clinton’s announcement reflected the typical lack of commitment that has been exhibited by the president all throughout the drug war. The following month, March 1993, the group called the U.S. Policy on International Counter

Narcotics in the Western Hemisphere presented a strategy for combating cocaine production and trafficking that, among other things, called for a “gradual” shift in focus away from the transit countries of Mexico, the Caribbean, and Central America and to the cocaine source countries of Peru, Colombia, and Bolivia. At her confirmation hearings in May 1993, attorney general nominee Janet Reno said that the U.S. antidrug policy should focus on prevention and treatment and not on combating drug trafficking abroad. In October 1993 the U.S. Defense Department announced that the military would cut spending on drug interdiction, which accounted for 71 percent of the $1.17 billion drug budget, by 11 percentage points, while increasing the amount spent on training and equipment for source countries to 16 percent, an increase of five percentage points. The following month, the

U.S. president Bill Clinton discusses drug trafficking at the Convention of the Mexican Association of Insurance Institutions. (AP Photo/Agencia el Universal)

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executive branch announced that, within 120 days, it would develop a separate strategy to combat the heroin trade, because heroin use was reportedly increasing. The Clinton administration finally released its “new” drug control strategy on February 8, 1994, at a briefing for foreign ambassadors in Washington, D.C. The following day, Robert S. Gelbard, assistant secretary for international narcotics matters, listed the key elements of the Clinton administration’s drug control strategy: “We will help to build democratic institutions . . . strong enough to resist the reach of the drug trade . . . help drug-producing countries create economic alternatives to narcotics and advance applications for sustainable development .  .  . , [and] fight the multinational cartel . . . with a multinational effort” (Wren 1994, 89). As the Clinton administration made public the objectives of its antidrug policy, critics began questioning Clinton’s commitment to the War on Drugs and his seriousness about changing U.S. drug policy. In a candid interview with the New York Times, outgoing DEA head Robert C. Bonner said that he had reservations about whether Clinton really wanted to “develop .  .  . a drug strategy” and whether he “has the will to move Congress and the American people” (Teaster 1993). Some observers looked at the Clinton administration’s fiscal year 1994 budget, which it had submitted to Congress in March 1993, and noticed only a slight shift of priorities toward demand reduction programs. Both Democratic and Republican legislators, as well as independent experts, criticized the Clinton administration for not giving any indication on how specifically the budget would be reapportioned. The disenchantment grew during the year after Clinton’s inauguration, and by early

1994 the Republican-controlled Congress was ready to abolish the office of the drug czar. “If at the end of this trial year (1994), we have not seen a . . . substantial improvement, we will vote to eliminate the office,” warned Representative Jan Keyll (York 1994). Meanwhile, Congress rejected Clinton’s proposal to cut the drug czar’s office staff and budget and actually doubled the office’s allocation from $5.8 million to $11.1 million, while increasing its office staff to 40 from the 25 proposed by Clinton. Statistics showed that funding for drug interdiction did decline during Clinton’s first term of office—from about $1 billion to $569 million—resulting in fewer ships, flight hours, and ground-based radar stations devoted to drug interdiction. Cocaine seizures in the transit zone dropped from 70,336 kilograms in 1992 to 37,181 in 1995. The proposed increased funding for source countries never did materialize. Studies showed that heroin use was on the rise again in the early 1990s, and in November 1993 the Clinton administration announced that within 120 days it would have a plan in place to combat the growing heroin trade. However, as of June 1995—19 months later—the administration still had not developed a heroin control strategy. “Delays involving the strategy were due in large part to the difficulties in balancing U.S. objectives in Burma—the primary source of heroin,” noted one government report (U.S. General Accounting Office 1996, 2). As has happened often in the War on Drugs, the administration subordinated its antidrug strategy to other foreign policy objectives. While heroin was making a strong comeback among U.S. upper classes, a government study called the National Household Survey on Drug Use, released by the U.S. Department of Health and Human Services in August 1996, reported that between 1992

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and 1995 teenage use of marijuana, cocaine, and LSD rose an average of 105 percent. The report became political fodder for both the Republicans and Democrats during the 1996 election. The Republicans accused the Clinton administration of creating a “lost generation” of U.S. youth by cutting the drug budget and failing to exercise strong leadership on the issue. The Democrats countered that the apparent surge in teenage drug use had begun well before Clinton came into office, and they tried to link the rise to the Republican leadership on the War on Drugs under Ronald Reagan and George Bush, who, they charged, had made things worse by cutting the antidrug budget. Robert Dole, the Republican candidate for president in 1996, unveiled his antidrug message, “Just Don’t Do It,” an obvious copy of Nancy Reagan’s famous slogan of the 1980s, “Just Say No,” and kept telling the U.S. public how tough he would be on the War on Drugs. Not to be outflanked, Clinton promised that by September 30, 1996, he would give $75 million worth of helicopters, planes, arms, and other military equipment to the governments of Colombia, Peru, Bolivia, Venezuela, and the Caribbean region, a strong indication that it was going to be the drug war as usual if Clinton were reelected. Dole called drug abuse “the most important news story of out [our] time,” but voters remained unimpressed (Bayona Vargas 1996). According to opinion polls, drugs ranked fifth among the issues that most concerned the voters. In the climate of heated rhetoric over the poll results regarding teenage drug use, both presidential candidates weren’t listening to the experts who said that the reasons for teenage drug use were complex and advised the candidates not to make the drug issue so politically partisan. “Kids are not getting the strong messages they got in the 1980s,”

explained Diane Barry, communications director for Join Together, a Boston-based national resource center for communities fighting substance abuse. “When you look at those messages, it’s no wonder that these kids are willing to start with marijuana. There’s got to be leadership for the entire industry and there’s got to be leadership for parents” (Toner 1996). Many drug policy analysts believed there had to be leadership in the White House and Congress as well. Dr. Rensselaer Lee called the Dole-Clinton debate on national drug policy “artificial” and said that “[n]o good ideas have come out of this campaign, either from [the Clinton] administration or Dole” (Cavalier Castro 1996). Clinton defeated Dole easily, and, as he began his second term of office, it became obvious that there would be no new direction in the War on Drugs. The United States would continue to seek a military solution to the drug problem in a stubborn effort to stop the supply, while paying lip service to decreasing the demand for drugs. As a result, international drug trafficking would expand to more and more countries and the drug abuse, violence, and corruption, fueled by the enormous profits generated by the trade, would continue. Some sources in the media began speaking out for new, more creative approaches to the drug problem. In a November 1996 editorial, the conservative National Review concluded that the War on Drugs was lost and called for the legalization of drugs. Another editorial in the San Francisco Chronicle declared, “We are not saying that all drugs be summarily legalized, but every option—including decriminalization—should be considered in dealing with this complex problem that combines crime, public health, and social disintegration” (“Clinton Pushing Anti-Drug Plan” 1996).

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It was also becoming obvious to America’s allies that war as usual was not working, and they started calling for a global effort to combat international drug trafficking, pointing out that the dynamics of the illegal trade cut across national boundaries and involved criminal organizations that were now operating like multinational corporations in the cut-throat world of international trade. In December 1996 members of the Organization of American States reached an agreement in Montevideo, Uruguay, which ratified a hemispheric antidrug plan. “This is a strategy that can lead to the reduction of drug consumption and supply through international multilateral strategies,” said Diego Cardona, foreign affairs adviser to President Ernesto Samper Pizano (“New Drug Strategy Needed” 1996). Ron Chepesiuk See also: Cocaine and Crack; Decriminalization; Drug Czar; Heroin; Marijuana; Office of National Drug Control Policy

Further Reading Bayona Vargas, Mauricio. 1996. “Bayona: Clinton Reparte Los Dolores.” El Espectador, September 25. Cavalier Castro, Andre. 1996. “Droga: Debate Artificiel In E.U.” El Tiempo, September 14. “Clinton Pushing Anti-Drug Plan.” 1992. Miami Herald, December 2, International Satellite Edition. Hamilton, Nigel. 2003. Bill Clinton: An American Journey. New York: Random House. Hamilton, Nigel. 2007. Bill Clinton: Mastering the Presidency. New York: Public Affairs. “New Drug Strategy Needed.” 1996. Colombia Post, November 18–24. Teaster, Joseph A. 1993. “Exiting Drug War Chief Warns of Cartels.” New York Times, October 31.

Toner, Robin. 1996. “Parties Seek to Cast Blame for Rise in Teenage Drug Use.” New York Times, August 22. U.S. General Accounting Office. 1996. Drug Control: U.S. Interdiction Efforts In Caribbean Decline. Wren, Christopher. 1994. New International Drug Strategy Needed to Combat Drugs. United States Department of State Dispatch, February 21. York, Byron. 1994. “Clinton’s Phony War.” American Spectator, February.

Cobain, Kurt (1967–1994) Kurt Donald Cobain was born on February 20, 1967, at Grays Harbor Hospital in Aberdeen, Washington. Cobain had a younger sister who was born three years after Kurt. Her name was Kimberly. Kurt came from a musical family. His mother’s uncle, Chuck Fradenburg, was a member of the band The Beachcombers. Cobain’s aunt, Mari Earle, played the guitar and performed in many bands throughout Grays Harbor County. His great-uncle, Delbert, was a talented Irish tenor. He even appeared in the 1930 film King of Jazz. This background served to be a major inspiration for Cobain’s interest in music. According to his Aunt Mari, Cobain began singing at the age of two, and at the age four, started playing the piano. When he turned 14, Cobain’s uncle let him choose between a bike and a guitar. Cobain chose the guitar. It was not long after that when Cobain learned to play “Stairway to Heaven” by the band Led Zeppelin. Cobain also began writing his own songs. During high school, Cobain had a hard time finding other people with whom he could play music. He tried to convince his

Cobain, Kurt (1967–1994)  189

Kurt Cobain, lead singer and guitarist for the grunge band Nirvana died after committing suicide in April, 1994. Cobain was addicted to heroin but also used other drugs in his lifetime. (AP Photo)

friend, Krist Novoselic, to form a band with him. After a few months, Novoselic finally agreed to join the band. This was the beginnings of the band named Nirvana. In 1991, Nirvana’s second album, called Nevermind, entered the mainstream music scene. This album had the lead single, “Smells Like Teen Spirit.” The band was creating a new style of music that was labeled “grunge.” It wasn’t long before Nirvana, with Cobain as their songwriter, sold over 25 million albums in the United States, and over 75 million albums worldwide. Cobain began to experiment with drugs at the age of 13. His first drug was marijuana, which he continued to use throughout his adulthood and even until his death. Cobain

also was known to ingest “notable” amounts of LSD and was also prone to alcoholism and solvent abuse. Cobain’s first experience with heroin occurred sometime in 1986. He used heroin sporadically for several years, but by the end of 1990, his sporadic use developed into a full-fledged addiction problem. He first sought treatment in 1992, after learning that he was going to be a parent with Courtney Love, who was also known to abuse drugs. Upon leaving rehab, Nirvana went on tour to Australia. Cobain appeared to be gaunt and pale. Not long after the end of the tour, Cobain began using drugs again. Just before a performance at the New Music Seminar in New York City in July of 1993, Cobain suffered a heroin overdose. Love did not call an ambulance, but immediately injected Cobain with Narcan, a medicine to bring him out of his unconscious state. Afterwards, Cobain performed with his band. The audience had no idea that he had just suffered from a serious overdose. Over the next few years, Cobain went through detox programs numerous times. However, many of his unsuccessful attempts were supervised by questionable physicians in posh hotels. Every time he left rehab, he returned to using the drug. On March 30, 1994, Cobain entered the Exodus Recovery Center in Los Angeles, California. The staff at the center was not made aware of the extent of Cobain’s history with depression. Unknown to them, Cobain had made many prior suicide attempts but failed each time. Cobain did not appear to the staff to be suicidal in any way. He was talking to counselors about his drug abuse problems and his personal problems. The following night, Cobain went outside presumably to have a cigarette. He climbed over a six-foot-high fence and walked away from the program. He took a cab to the airport, and then caught a plane to Seattle.

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A few days later, on April 8, 1994, an electrician named Gary Smith found Cobain’s body in a room above his garage. It was in his home in Lake Washington. Smith had been to the house to install a new security system. Except for a small amount of blood coming out of Cobain’s ear, Smith said there were no visible signs of trauma. In fact, Smith initially believed that Cobain was sleeping. But when he saw a shotgun pointing at Cobain’s chin (some report in his mouth), he knew there was more to it. It appeared to the coroner that Cobain had died on April 5 and that his body had been lying there for a few days. There was a box containing drug paraphernalia next to his body. Cobain had left a note behind, addressed to his childhood imaginary friend “Boddah.” In the note, Cobain wrote that he no longer “felt the excitement of listening to music, creating music or writing music.” An autopsy on Cobain’s body showed that there were large amounts of heroin and traces of diazepam in his body. When the announcement was made that Kurt Cobain had died, about 5,000 people gathered to hold a candlelight vigil in his honor. At the vigil, some of Cobain’s fans clashed with police. An online petition has been set up urging officials in King County to open an investigation into Cobain’s death. Many believe that his death was not a suicide, but that he had been murdered. They point to the lack of blood that is normally associated with a gunshot wound to the head. Nancy E. Marion

Cross, Charles R. 2002. Heavier than Heaven: A Biography of Kurt Cobain. New York: Hyperion. Cross, Charles. 2008. Cobain Unseen. New York: Little Brown and Company. Gaar, Gillian G. 1997. “Verse Chorus Verse: The Recording History of Nirvana.” Goldmine, February 14. http://obitbday.tripod .com/articles/goldmine14.html. Halperin, Ian, and Max Wallace. 1998. Who Killed Kurt Cobain? New York: Birch Lane. “Kurt Cobain Biography.” http://www.biogra phy.com/people/kurt-cobain-9542179. “Kurt Cobain Biography.” http://www.cobain .com/bio_aboutkurt.html. Liu, Marian. 2009. “Kurt Cobain’s Death, 15 Years Later, Being Marked with Friday Tribute.” Seattle Times, April 6. http://sea tletimes.com/html/entertainment/. “The Murder of Kurt Cobain.” http://www .anomalies-unlimited.com/Death/Cobain .html. Ronson, Mick. 1996. “Kurt Cobain Biography.” http://www.burntout.com/kurt/biog raphy/. Sieczkowski, Cavan. 2013. “Kurt Cobain Said He Thought He Was Gay as a Child in Unearthed Jon Savage Interview.” Huf­ fington Post, October. http://www.huffing tonpost.com/2013/10/23/kurt-cobian-gay _n_4150810.html. Whitely, Peyton. 1994. “Kurt Cobain’s Troubled Last Days—Drugs, Guns and Threats; and Then He Disappeared.” Seattle Times, April 19. http://community.seattletimes.nw source.com/archive/?date=19940409&slug =1904636.

See also: Alcohol; Heroin; LSD (Lysergic Acid Diethylamide); Marijuana

Coca Further Reading The Cobain Memorial. http://www.cobain.com /cobain.html?v8.

The coca plant is a flowering shrub or bush with straight branches and thin, oval-shaped

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leaves that is cultivated in the lower altitudes of the Andes, specifically in the valleys and upper jungle regions of the Andean region. Known for its psychoactive alkaloid, cocaine, coca is a cash crop in Argentina, Bolivia, and Peru. The plant has been used in traditional medicine in the region for thousands of years for both social and religious purposes. In the Andean countries, bags of coca leaves are sold in markets. Chewing coca and drinking coca tea is common. Chewing coca leaves is the most natural method of using the drug and results in a very mild euphoric feeling along with numbness in the mouth, an increased heart rate, increased arterial pressure, and faster breathing. Because the effects of ingesting the leaves in this manner are so mild, most addicts prefer other, more intense, methods to ingest the drug. Chewing coca became popular after the Spanish conquistadors forced South Americans to work long hours in the heat. The conquistadors found that the native slaves worked harder and needed less food and sleep if they chewed coca leaves. The term “chewing coca” is a misnomer, however. Users do not actually chew the leaves; they are instead formed into a paste and held between a user’s cheek and gum. It is used in teas, granola bars, cookies, and even candy. Residents claim that it has positive benefits for physical, mental, and social health. It has been used to alleviate fatigue, hunger, and thirst, and to relieve the pain of headache, rheumatism, and wounds. There has been a movement in these countries to expand the legal markets of the crop, recommending its use in salads and other foods. In the 1960s, Chilean groups traveled to Peru and Bolivia to purchase coca leaves and paste, and transported it back to labs in Chile where it was refined. Then it was sent to Cu-

bans in Florida. As the product became more popular, the Chileans employed Colombians as couriers. In 1973 when President Salvador Allende was removed from office and Augusto Pinochet installed, things changed. Pinochet was opposed to trafficking and either jailed traffickers or deported them. Some Chileans moved to Colombia and continued their trade there. However, by the mid-1970s, the Colombians had a monopoly over the cocaine trade. They bought the coca leaves from farmers in the remote mountains of Peru and Bolivia, and refined them in labs in the jungle. Some Colombians came to New York to run distribution networks. Throughout the late 1980s and 1990s, the coca crop expanded worldwide. Today, the majority of all coca cultivation (over half) takes place in Colombia. Farmers there work hard not only to increase the yield but also to hide their crops from law enforcement. While the coca leaf is not cocaine, the leaf is the raw material for the manufacture of cocaine, a powerful stimulant and anesthetic that is extracted from the coca leaves. Outside South America, most countries’ laws make no distinction between the coca leaf and any other substance containing cocaine, thereby making the possession of coca leaves illegal. In South America, however, the cultivation, sale, and possession of unprocessed cocoa leaves is generally legal; restrictions on the cultivation of coca leaves prevents the production of cocaine. Since the 1980s, these countries have come under political and economic pressure from the United States to restrict the cultivation of the crop to reduce the supply of cocaine on the international market. After Sigmund Freud read about how the Peruvian slaves chewed on coca leaves for more energy, Freud tried it to remedy feelings of exhaustion. Freud found that it gave

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him a remarkable sense of well-being, so he recommended it to his family and patients, and wrote several articles espousing the benefits of cocaine. Others who used the drug were Robert Louis Stevenson and Arthur Conan Doyle. The prohibition of the use of the coca leaf except in cases of medical or scientific purposes was established by the United Nations in the 1961 Single Convention on Narcotic Drugs. This document categorized the coca leaf as a Schedule 1 drug, along with cocaine and heroin. Article 26 of the convention requires nations that allow the cultivation of coca to designate an agency that would be responsible for regulating the cultivation and take physical possession of the crops as soon as they are harvested. They were also to destroy all coca that grew in the wild or was illegally cultivated. The effort to enforce these provisions, referred to as coca eradication, has involved many strategies, ranging from aerial spraying of herbicides on coca crops to assistance and incentives to encourage farmers to grow alternate crops. In 1988, officials from Peru and Bolivia were able to add an amendment to the 1988 UN Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. The amendment, which included measures to eradicate illicit cultivation and to eliminate illicit demand, reads in part: “The measures adopted shall respect fundamental human rights and shall take due account of traditional licit use, where there is historic evidence of such use.” One official from Bolivia argued that “the coca leaf is not, in and of itself, a narcotic drug or psychotropic substance” (United Nations 1988). The International Narcotics Control Board denied the validity of the amendment, stating that the use of a coca leaf is an illegal activity under the provisions of both

the 1961 and 1988 conventions. Bolivian officials tried again in 2009, when it requested that the UN reschedule the coca leaf from List 1 of the 1961 Single Convention. At that time, 18 countries out of a total of 184 objected to the change. One single objection would have been sufficient to block the modification. Nancy E. Marion See also: Andean Trade Preference Act; Freud, Sigmund

Further Reading “Alternative Coca Reduction Strategies in the Andean Region.” 1993. Washington, DC: Office of Technology Assessment. Bolivia: Coca Leaf, Food of Poor. 2006. New York: Films Media Group. Coca and the Congressman: Drugs, Farming and Socialism in Bolivia. 2006. New York: WNET Television Station, Films Media Group. Colombia: Cocaine’s Battleground. 2004. New York: Films Media Group. Cortes, Ricardo. 2012. A Secret History of Coffee, Coca & Cola. New York: Akashia Books. Cortes, Ricardo. 2013. “The Condemned Coca Leaf.” New York Daily News, January 13. http://www.nydailynews.com/opinion/ condemned-coca-leaf-article-1.1238569?. Gossop, Michael. 2013. Living with Drugs. Farnham, UK: Ashgate. An Honest Citizen: Cocaine and Corruption in Colombia. 2006. New York: Films Media Group. Jonnes, Jill. 1996. Hep-Cats, Narcs and Pipe Dreams. Baltimore: Johns Hopkins University Press. United Nations. United Nations Convention against Traffic in Narcotic Drugs and Psychotropic Substances, 1988. New York: United Nations, 1988.

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Coca-Cola In the 1880s, as the temperance movement was gaining in popularity, some were recommending coca as an alternative to alcohol. Many people, including educated elite such as Sigmund Freud, pointed to coca as an acceptable alternative to alcohol that could also cure many ailments. Many products of the time included small amounts of cocaine, including drinks such as Coca-Cola, which was marketed as a “temperance drink.” The drink was named “Coca-Cola” because it contained cocaine along with extracts of the African kola nut (caffeine). It promised to “pep up” the drinker. The original formula for the popular soft drink we know today was developed in 1887 by John Styth Pemberton, a patent medicine manufacturer from Georgia. Pemberton had noted the success of Vin Mariani, a drink that mixed wine and coca, and developed a product that he registered as “French Wine Coca—Ideal Nerve and Tonic Stimulant.” He sold the drink for a nickel for an 8-ounce bottle. Its ingredients included coca, a plant that grows exclusively in the Andean mountains of South America, primarily in the countries of Peru, Bolivia, and Colombia. The plant itself can be used to produce a high or stimulation, but once harvested the leaves are dried and put through a chemical process to extract the cocaine. Coca-Cola was marketed with this catchy pitch: This ‘Intellectual Beverage’ and Temperance Drink . . . makes not only a delicious, exhilarating, refreshing and invigorating Beverage . . . but a valuable Brain Tonic, and a cure for all nervous affections— Sick Head-ache, Neuralgia, hysteria, Melancholy, &c. The peculiar flavor of

COCA-COLA delights every palate; it is dispensed from the soda fountain in same manner as any of the fruit syrups. Asa Griggs, a U.S. manufacturer and philanthropist, bought the formula from Pemberton and, after improving its quality, he devoted himself full-time to its production and sale. Cocaine was removed from the drink in 1906. In 1909, the U.S. Bureau of Food and Drugs brought a suit against the company because the drink contained no coca and very little cola. But from 1909 to 1919, Griggs’s company was the defendant in a federal court case under the Pure Food and Drug Act, regarding the contents of the beverage. The case was settled after the Coca-Cola Company assured the U.S.

Coca-Cola ad from the 1890s. At this time, it was sold as a remedy for many diseases such as morphine addiction and headache. (Courtesy of The Advertising Archives)

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government that the formula had been changed to exclude coca. Ron Chepesiuk See also: Coca; Cocaine and Crack; Pure Food and Drug Act

Further Reading Chastain, Zachary. 2013. Cocaine: The Rush to Destruction. Broomall, PA: Mason Crest. Hoy, Anne H. 1986. Coca-Cola: The First Hundred Years. Atlanta: Coca Cola Company. Kahn, E.J. 1960. The Big Drink: The Story of Coca-Cola. New York: Random House. Martin, Jeff. 2001. Coca-Cola: The History of an American Icon. Orland Park, IL: MPI Media Group. Pendergrast, Mark. 1999. For God, Country and Coca-Cola. New York: Basic Books. Thomas, Mark. 2008. Belching Out the Devil: Global Adventures with Coca-Cola. London: Ebury.

Cocaine and Crack Coca, the active ingredient in cocaine, is derived from the leaves of a plant in the Erythroxylaceae family native to South America, where it has been used for centuries by indigenous peoples as a mild stimulant. Coca is concentrated into a stronger substance to become cocaine, a powerful stimulant on the central nervous system that can be highly addictive. Its synthesis usually takes place in the country of origin, where it is neutralized by an acid to produce cocaine hydrochloride and smuggled in powder form into the United States for distribution and sale. Often diluted by having been cut with inactive ingredients to stretch the supply, when snorted it reaches the brain in a few minutes. It can also be dissolved in water and injected,

and the user feels the effects in 15 to 30 seconds. Another form of cocaine is free-base cocaine. This is an extremely addictive form of the drug and also very dangerous to make because it involves the use of ether, an extremely flammable substance. Free-base cocaine is insoluble in water, is in a form that allows for injection, and cannot be swallowed. But it does vaporize at a very low temperature. The user can inhale the heated vapor and get an immediate, very intense feeling of being high. The “rush” is immediate and more intense, lasting about five minutes. Crack cocaine is very similar, but does not require the use of ether. It is distributed as a “rock,” a crystal-like chunk that, when heated, releases vapors that the user inhales. It is called “crack” for the crackling noise it makes when heated and smoked. Crack is usually smoked after being heated in a pipe or on a piece of foil. Some users mix crack with other drugs such as tobacco or marijuana. When used, the drug hits the brain in seconds, flooding the brain with dopamine. The high is short but extremely intense, followed by feelings of depression when the drug wears off. The psychoactive effects produced by the use of cocaine include euphoria, excitation, alertness, and a sense of heightened energy. The physical effects of cocaine use include elevated heart rate and blood pressure, loss of appetite, insomnia, and, in high doses, hallucinations and convulsions. For those users who snort cocaine, they can suffer from localized damage. It is common for users to lose their sense of smell, to suffer from nosebleeds, or develop hoarseness or swallowing difficulties. Reverse tolerance to cocaine may develop with some uses. This means that they become more sensitive to the drug after using it for an extended time.

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Refined cocaine powder ready to be ingested. The razor blade is used by the seller or user to separate the drug into lines, or doses. The drug is often mixed with other substances such as baking soda. (Debora Cartagena/Centers for Disease Control and Prevention)

They may also suffer from physical damage that is normally callused by much smaller doses of the drug. Most of the time, users will develop a tolerance to cocaine so they must increase the amount of the drug used to achieve the desired effect. In some cases, this can be a toxic amount, which can result in seizures, cardiac arrest, or respiratory failure. Prolonged cocaine use is often associated with paranoia, irritability, restlessness, and even psychosis. Cocaine acts by triggering a powerful release of the neurotransmitter dopamine. The effect usually subsides in less than an hour. The brain will soon demand more of the drug in order to maintain the same level of stimulation. Users will stay awake for days in their desire to chase the intense rush they get from

using cocaine, and at the same time avoiding the inevitable crash that follows when the drug is not used. Those addicts may avoid all other activities (school, work) and chase one hit of the drug after another without sleeping, eating, or interacting in any meaningful way within their environment. Crack cocaine, in particular, elicits this behavior. Some users mix cocaine with alcohol as a way to mediate the two and balance the effects of each other. However, this practice is especially dangerous. Scientists at the National Institute on Drug Abuse have discovered that a person’s liver reacts to the combination of cocaine and alcohol by producing a third substance called cocaethylene, a potent chemical that increases the risk of sudden death.

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Cocaine is categorized as a Schedule II drug under the federal Controlled Substances Act. The drug used to be used as an anesthetic medication for dental procedures and ear, nose, and throat surgeries. Sigmund Freud believed the drug had value in treating alcoholism and he was supposed to have used the drug himself. Common street names for cocaine include Blanca, Coca, Coke, Flake, Nieve, Perico, and Snow. Cocaine use peaked in the 1980s because it was seen as a “safe” drug. It was thought to be nonaddictive, and since it could be snorted rather than injected, the fear of transmitted diseases by sharing needles was diminished. Use then diminished to a low point in the 1990s, but in recent years has been on the increase again. People of all ages and races use cocaine. Through the 1970s and 1980s, cocaine was used primarily by upper classes, but this changed when crack cocaine arrived on the scene. Crack is typically much cheaper, so it was available to all. Most of the cocaine today comes from Colombia. Major drug cartels produce, traffic, and supply the cocaine to the United States. They also supply smaller amounts to other countries, including Europe, Australia, and Canada. There is a great deal of violence surrounding the drug trade between Colombia and the United States. The cocaine business has devastated the natural environment of Colombia. Over the last 30 years, drug production has destroyed 10 million acres of the Amazon rainforest. About 15,000 tons of chemical waste resulting from the production of cocaine is dumped into the Amazon River Basin each year. Drug trafficking in Peru generates an estimated $22 billion each year, which is nearly 17 percent of the country’s gross domestic product. In an effort to halt drug production in the Andean countries, the United States has implemented drug eradication programs

and alternative crop programs in Bolivia, Peru, and Colombia. The United States also hired pilots to spray poison on coca plants as part of the “War on Drugs.” Some analysts have argued that the punishments for cocaine are racially biased. Mandatory sentencing laws require that those convicted of offenses with crack cocaine are higher than those related to powder cocaine. Since crack cocaine is cheaper, it is used more by African Americans, who tend to be poorer. Laws passed in 1986 established a 100-to-1 ratio between the amount of crack cocaine and powder cocaine needed for mandatory sentences. That means that an offender who possesses 500 grams of powder cocaine would receive a five-year sentence, but so would an offender with only 5 grams of crack. In 2009, Congress amended that policy when it passed the Fair Sentencing Act. Now the ratio is 18 to1 between the amounts of cocaine and crack that are punishable by mandatory sentences. This difference takes into account the higher dangerousness that crack has over powdered cocaine. Kathryn H. Hollen See also: Andean Trade Preference Act; Cocaine Anonymous; Controlled Substances Act; Neurotransmitters; Stimulants

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do About It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary.

Cocaine Anonymous (CA)  Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Kuhn, Cynthia, et al. 2008. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. New York: Norton. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2004. Research Report Series: Cocaine Abuse and Addiction. NIH Publication No. 99–4342. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Cocaine Anonymous (CA) A 12-step organization modeled on Alcoholics Anonymous (AA), Cocaine Anonymous (CA) is a free, self-supporting group whose only requirement for membership is a desire to quit using cocaine and other mind-altering substances. People with addictions to other drugs are free to join to share experiences and hope in a common effort to rid themselves of drug addiction. Formed in 1983, CA has spread to Canada and Europe and estimated its membership during the 1990s as 30,000. On occasion, a local CA will hold a convention in which speakers are invited to present motivational seminars that will help members remain free of drug use.

Like similar 12-step groups, CA does not engage in research, medical treatment, or drug education. Although the organization credits the origin of its 12 steps and traditions to Alcoholics Anonymous (AA), CA is not affiliated with AA. Other 12-step groups dedicated to helping people who have a problem with drug addiction include All Addictions Anonymous, Crystal Meth Anonymous, Marijuana Anonymous, and Narcotics Anonymous. Nicotine Anonymous is a 12-step group for people addicted to tobacco products.

CA’s 12 Steps   1. We admitted we were powerless over drugs—that our lives had become unmanageable.   2. Came to believe that a Power greater than ourselves could restore us to sanity.   3. Made a decision to turn our will and our lives over to the care of God as we understand Him.   4. Made a searching and fearless moral inventory of ourselves.  5. Admitted to God, and to ourselves, and to another human being the exact nature of our wrongs.   6. We’re entirely ready to have God remove all these defects of character.  7. Humbly asked Him to remove our shortcomings.  8. Made a list of all persons we had harmed, and became willing to make amends to them all.  9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 10. Continued to take personal inventory and when we were wrong promptly admitted it. 11. Sought through prayer and meditation to improve our conscious con-

197

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tact with God as we understand Him, praying only for knowledge of His will for us and the power to carry that out. 12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to drug addicts and to practice these principles in all our affairs. Kathryn H. Hollen See also: Alcoholics Anonymous; Cocaine and Crack; Narcotics Anonymous

Further Reading CA Arizona Area. http://caarizona.org/#. Cocaine Anonymous. “What Is Cocaine Anonymous?” http://www.ca.org. Cocaine Anonymous: New York. http://canew york.org/. Cocaine Anonymous: Serving DC, Maryland, and Northern Virginia. http://www.tradi tion5.org/wmdvaca/. Cocaine Anonymous: UK. http://www.cauk .org.uk/index.asp. Cocaine Anonymous: Washington State Area . http://www.caofwa.org/. Connecticut CA. http://caofct.org/. Fisher, Gary L., and Nancy A. Roget. 2009. Encyclopedia of Substance Abuse Prevention, Treatment and Recovery. Los Angeles: Sage. South Central Texas Area Cocaine Anonymous. http://www.ca-scta.org/.

Cocaine Cowboys (2006) The documentary film Cocaine Cowboys was directed by Billy Corben and produced by Corben and Alfred Spellman through their Miami, Florida, studio Rakontur. The film chronicles the rise and fall of

the illegal cocaine trade in the 1970s and 1980s. The Cocaine Cowboys were a group of smugglers, dealers, and enforcers who transported cocaine from Colombia to Miami for the Medellín Cartel. In Miami the Cowboys worked directly for Griselda Blanco, the Cocaine Godmother, who is also credited with igniting the bloody drug war that was the inspiration for Miami Vice and Scarface. The documentary relies on interviews of key players on both sides of the law, and news footage from the era. In the late 1970s, Miami was a sleepy community populated by mostly senior citizens, and marijuana was the preferred illicit drug. Due to market saturation, dealers were unable to make money selling marijuana and turned to cocaine. Two of the early traffickers were Jon Roberts and Michael “Mickey” Munday. Roberts had left New York City after one of his partners in the nightclub business was murdered by the mafia. Over the course of his career, Roberts distributed over $2 billion of cocaine. Meanwhile, Munday became one of the top transporters of cocaine (approximately 38 tons). Roberts and Munday devised an elaborate system of smuggling the cocaine into Florida and transporting their product to the dealers. Since south Florida was a known hub of marijuana smuggling, the two men adopted some of the tactics used by smugglers, such as flying the cocaine into the Gulf Coast of Florida because the authorities paid little attention to airplane and boat traffic on that side of the state. At this time most interdiction efforts were focused on traffic from the Bahamas. Once on land, the cocaine would be transferred from the airplanes to cars that would then be towed—rather than driven—to their respective destinations. Roberts and Munday used this tactic because it gave the tow truck

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drivers plausible deniability. Eventually, the two men began airdrops off the coast of the Bahamas where the drugs would be loaded into speed boats. Once, in a brazen move, Munday actually towed a disabled Coast Guard boat back to Miami with his own drug-laden boat. At one point, the Colombia–Miami cocaine trade accounted for 80 percent of U.S. cocaine activities. This translated to $7 billion a year in just Miami at a rate of $12,000 per household per year. This led to the rise of the cocaine economy that buffered Miami from the effects of a nationwide recession. Luxury items such as cars, jewelry, houses, and boats were often in short supply. There was a construction boom as skyscrapers, condominiums, and banks were built partly funded by drug money. The traffickers had so much cash they resorted to burying it in their yards or depositing it into Panamanian banks. Roberts even contributed thousands of dollars to the Republican Party. On July 11, 1979, the cocaine drug war began as four suspected drug traffickers were gunned down in a liquor store at the Dadeland Mall in the middle of the afternoon. The suspects, four Latino males, used 14 different types of guns to kill their targets and left behind a van that was essentially a mobile armory. Following the Dadeland shooting, mass murder became a common, nearly daily occurrence. The tactics used by the Cocaine Cowboys were especially brutal. Rather than limiting their killing to the intended targets, the Cowboys would also kill innocent bystanders. No one, not even pets, were spared. At the center of the Cocaine Cowboys was Griselda Blanco, considered the meanest and nastiest of the Colombian drug lords. Blanco is suspected of being responsible for more than 200 murders between 1979 and 1982.

The murder rate in Miami soared. In 1976 only 104 murders were committed. At the height of the drug war, 1981, 621 people were murdered. The ranks of the Cowboys was bolstered in 1980 following the Mariel Boatlift as large numbers of Cubans joined the Colombians’ ranks, quickly adopting their brutal methods. To counter both the rising tide of cocaine and violence, the Miami Police Department began a large recruitment drive. In an effort to build the force, the department began relaxing the requirements. The prevalence of cocaine meant that there were few candidates who had not used drugs. As a result, the requirement that recruits could not have used drugs within the past 10 years was lowered to recruits could not be high at the time of signing the contract. The lax hiring standards led to a major corruption scandal. All the recruits from this period were either jailed or killed. The end of the Cowboys began shortly after President Ronald Reagan took office. To combat the street violence a special police task force, the South Florida Task Force, was created and was aided by the Drug Enforcement Administration’s Central Tactical Program, flooding the streets with federal agents. Soon a cartel middleman named Max Mermelstein was taken into custody by federal agents. His collaboration with the authorities led to the dismantling of the Cocaine Cowboys. Roberts was arrested in 1986 and was released from prison in 2000. Munday was a fugitive for six years and served seven years before his release in 1999. Meanwhile, Blanco accepted a plea deal and was released from prison in 2004, and was subsequently deported to Colombia where she was gunned down in September 2012. Stacy O’Hara Leiter

200  Codeine See also: Blanco, Griselda; Drug Cartels; Medellín Cartel

Further Reading Cocaine Cowboys. 2006. Directed by Billy Corben. Magnolia Pictures. “Cocaine Cowboys.” http://www.whentheship comesin.com/cocaine-cowboys-2006. Ovalle, David. 2012.“‘Cocaine Godmother’ Gri­selda Blanco Gunned Down in Colombia.” Miami Herald, September 3. http://www .miamiherald.com/2012/09/03/2983362/ cocaine-godmother-griselda-blanco.html.

Codeine Codeine is a milder version of morphinelike drugs and the basis of hydrocodone synthesis. Like other opiates, it not only relieves pain and alleviates diarrhea but is an effective cough suppressant also found in many prescription cough medications. As an analgesic, it is often combined with acet­ aminophen and can be made into an injectable formulation. Codeine is more popular as a pain killer because it is less powerful but also produces less sedation. Side effects of the drug include constipation, drowsiness, itching, nausea, vomiting, and dry mouth. In tablet form, codeine is on Schedule II of the Controlled Substances Act; when combined with aspirin or other unregulated drugs, it is on Schedule III; as a cough medicine, it is on Schedule V. Codeine is a natural component of opium, but the codeine used in medications is usually produced from morphine. The drug is addictive, but when used as an oral preparation it does not produce the same level of pain relief or respiratory depression as does morphine. At lower doses, codeine can produce a sense of well-being and warmth in the user, but at higher, more dangerous doses it

can lead to dizziness, confusion, cold and clammy skin, seizures, and unconsciousness. For many years codeine was the most popular cough medicine, but this changed when dextromethorphan, or DXM, was introduced in 1958. However, many people also began abusing DXM by drinking mass amounts of cough syrup as a way to get a feeling of being high. Codeine is available mixed with an anti­ nausea medication (promethazine) in a syrup called Phenergan with Codeine. In this form it is called “syrup” or “purple drank.” This mixture is becoming more commonly abused. Common street names for codeine include Captain Cody, Cody, schoolboy, doors and fours, and pancakes and syrup. Kathryn H. Hollen See also: Controlled Substances Act; Morphine; Opiates

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov.

Codependency  201 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http:// www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Codependency Codependency is sometimes called relationship addiction because of the codependent’s supposed psychological need to preserve the status quo of family relationships, however dysfunctional they may be. It is often diagnosed in families in which one or more members is an alcoholic or is addicted to other drugs or destructive behaviors. It refers to the behaviors and responses that people develop while living with an alcoholic or other substance abuser. While most mental health professionals characterize this kind of relationship as a symptom of a disorder that requires treatment intervention and support through groups like 12-step programs, other experts deny it even exists and claim it is a clinically meaningless term coined during the 1970s and 1980s in response to cultural trends that tended to label any dysfunction as a disease or an addiction. Codependency refers to a pattern of behavior in which one or more family members puts aside their own needs to meet the needs of others. They adopt behavioral patterns to keep the peace in the home, lessen family tensions, and smooth over difficulties by suppressing his own necessities and putting the care and comfort of the addicted person first. Codependent people are thought to have low self-esteem and seek approval and validation by adopting selfless, uncomplaining roles. On a perhaps unconscious level, they are likely to fear that if the sick person becomes well again, they will no longer be

needed. Rather than ask or even insist that an addict or mentally ill person seek treatment, codependent people often serve as enablers by overlooking destructive behavior and making excuses for it. Although they may report how much they dislike the codependent behavior, those involved may be achieving a sense of importance, relieving loneliness, or may be avoiding dealing with some of their own issues or needs. The example frequently cited is of a codependent wife calling her husband’s office to lie about why he must miss work when the truth is that he is too hungover to go. Instead of confronting him, she may also make allowances for his drinking by blaming outside pressures—work issues, family problems, financial difficulties—that “force” him to drink. Although the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) does not recognize codependency, numerous 12-step support programs have formed to help families deal with this pattern of behavior, one that many believe can be passed to other family members. Other professionals reject this assessment, claiming that a certain amount of selflessness and sacrifice are part of any caregiving role, and to label such a person codependent—someone who is only trying to balance the care of an ill family member and running a household with meeting the needs of the rest of the family—is assigning pathology where it does not exist. On the other hand, it has been documented that children growing up in such households are often shown, later in life, to develop relationships with emotionally unstable or addicted individuals, thus perpetuating the so-called codependent cycle. Some of the symptoms of codependency include controlling behavior, distrust, passivity, perfectionism, avoidance of feelings,

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intimacy problems, caretaking behavior, low self-worth, hypervigilance (a heightened awareness for potential threat/danger) and physical illness related to stress. Those with a dependent personality may have an excessive need to be taken care of, resulting in a submissive or “clinging” behavior. They may have a fear of separation, or a fear of making decisions without a lot of advice and reassurance from others. A dependent person may have difficulty expressing disagreement with others because they are fearful of a loss of approval. They may go to great lengths to obtain support from others, even volunteering to complete unpleasant tasks or take part in unpleasant activities. Children of codependent parents may develop patterns of servitude or may be unable to put their needs or wishes before those of others. Kathryn H. Hollen See also: Addiction; Treatment; Twelve-Step Programs

Further Reading AllAboutCounseling.com. “Codependency.” http://www.allaboutcounseling.com/cod ependency.htm. Beattie, Melody. 1986. Codependent No More: How to Stop Controlling Others and Start Caring for Yourself. Center City, MN: Hazelden Foundation. Becker, Robert A. 1989. Addicted to Misery: The Other Side of Co-dependency. Deerfield Beach, FL: Health Communications. Fisher, Gary L. 2013. Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. Boston: Pearson. Fisher, Gary L., and Nancy A. Roget. 2009. Encyclopedia of Substance Abuse Prevention, Treatment, and Recovery. Los Angeles: Sage.

Lancer, Darlene. 2012. Codependency for Dummies. Hoboken, NJ: John Wiley and Sons. Zilney, Lisa Anne. 2011. Drugs: Policy, Social Costs, Crime and Justice. Upper Saddle River, NJ: Prentice Hall/Pearson.

Colombian Cartels By the mid-1970s, the Colombians had a monopoly over the cocaine trade. They would purchase coca leaves from poor farmers in the remote mountains of Peru and Bolivia, and then refine the leaves into cocaine in labs in the remote jungles of Colombia. This was the beginning of a drug trafficking scheme that brought hundreds of thousands of pounds of cocaine into the United States over the next 30 years. One of the major figures to develop the cocaine trade was Carlos Rivas Lehder, the co-founder of the Medellín Cartel. While serving a term for marijuana trafficking, Lehder met another drug trafficker, a young man named George Jung, a New Englander who had moved to California and was making a living trafficking in marijuana. Lehder and Jung decided to use the same methods they were using to smuggle marijuana to instead smuggle cocaine. At the time, cocaine cost $2,000 a kilo in Colombia, but sold in the United States for up to $55,000 a kilo, giving them a huge profit margin. The cocaine business was more than successful in the United States. The drug supplier in Colombia, Pablo Escobar, was impressed with how the two men could be so successful and sell so much cocaine. By 1976, Lehder and Jung had settled in Miami while they continued to grow their cocaine smuggling business. Jung often traveled to the West Coast to sell the drugs. By 1977, Lehder’s dream of selling mass amounts

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of cocaine was becoming reality. The two would have a pilot fly down to Colombia to pick up 250 kilos of cocaine, and fly back to a remote air strip in the Carolinas. Each time, Lehder and Jung made a half-million dollars. While Jung had become fully addicted to the drugs, Lehder considered the drug to be a poison and stayed far away from it. With the profits he made from smuggling drugs, Lehder purchased some land in the Bahamas that could be used as a landing strip. He paid off government officials to “look the other way” so he could continue to succeed in his drug trade. He soon had six to eight pilots who regularly flew loads of cocaine from Colombia to Florida, the Carolinas, Georgia, and Tennessee. He worked closely with Pablo Escobar to continue to expand the drug trade between Colombia and the United States. Soon, the bribes to the Bahamian government became widely known, and officials froze all of Lehder’s assets. He went into hiding, but while he was on the run he became very sick. He called Escobar, who came to get him. Escobar took Lehder home and made sure he received medical treatment. When Lehder was feeling better, he became a bodyguard for Escobar. It wasn’t long after, that the U.S. government captured Lehder. He was put on trial, found guilty, and sentenced to life in prison with an additional 135 years. This left Escobar as the head of the Medellín Cartel. Led by infamous drug lord and kingpin Pablo Escobar, the Medellín Cartel, despite its initial intentions mostly involving marijuana, was the greatest supplier of cocaine to the U.S. population for roughly two decades beginning in the 1970s, using highly technical means of transportation including a submarine to quietly bring thousands, if not millions, of pounds of cocaine into the

United States. As the power and control of the cartel grew at great rates, Escobar became increasingly hungry for the power that he was constantly being fed, and is now credited with responsibility for the deaths of hundreds of persons involved in the government, news, and police, as well as innocent bystanders. His path, constructed by his own temper and lust for power led him to a violent confrontation, with the cartel fighting the Colombian government. The corruption within the cartel as well as many outside factors such as rival cocaine manufacturers and the Colombian law gradually crippled the cartel. Many cartel officials were killed or captured by Colombian police, while some willingly accepted their punishment with hopes of lesser consequences. Pablo Escobar evaded capture and fought his hunters as well as his inevitable fate, never swallowing his misplaced pride until being killed by the Colombian police in 1993. One of the only businesses rivalling the Medellín Cartel—and one of the most prevalent factors leading to its degradation—was the cocaine business based in Cali, Colombia. Desiring less fame and power, these men wisely and quietly laundered money made from their signature trade through the multiple companies they owned. As the police hunted for Escobar and the Medellín Cartel, the Cali Cartel was simultaneously passing information regarding Escobar to the police while continuing to sell cocaine largely under the police’s radar. This was made possible through the use of sophisticated technology created by leading engineers hired specifically for this task (e.g., communicators that could not be bugged) and strategies such as dividing various sections of the business. Despite these efforts, cracks in the Cali Cartel formed, and were found, resulting in the capture of the cartel’s top men. These men are thought to be

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continuing to run the business from prison, but the cartel has lost much of its size and power. Colombia is now home to hundreds of cocaine manufacturers and businesses though none have, or will likely ever have, the power or size held by the Medellín or Cali cartels. These large Colombian cartels became the victims of their size and power. Political leaders in Colombia fought against the hold the cartels had on their society, especially after the cartels assassinated the leading presidential candidate Luis Carlos Galan in 1989. Law enforcement destroyed the Medellín Cartel, soon followed by the Cali Cartel. Nancy E. Marion See also: Cali Cartel; Medellín Cartel; Escobar; Pablo

Further Reading Hagan, Frank E. 2011. Crime Types and Criminals. Thousand Oaks, CA: Sage. Jonnes, Jill. 1996. Hep-Cats, Narcs, and Pipe Dreams. Baltimore: Johns Hopkins University Press. Kleiman, Mark A. R., and James E. Hawdon. 2011. Encyclopedia of Drug Policy. Thousand Oaks: Sage. Langton, Jerry. 2012. Gangland: The Rise of the Mexican Drug Cartels from El Paso to Vancouver. Mississauga, ON: John Wiley and Sons. Nicaso, Antonio, 2005. Angels, Mobsters and Narco-terrorists: The Rising Menace of Global Criminal Empires. Mississauga, ON: John Wiley and Sons. Public Broadcasting System. “The Colombian Cartels.” Frontline. http://www.pbs .org/wgbh/pages/frontline/shows/drugs/ business/insice/colombian.html. Smith, Peter H. 1992. Drug Policy in the Americas. Boulder, CO: Westview Press.

Combat Methamphetamine Act (2005) Methamphetamine surged in popularity in the United States in the late 1960s as part of the counterculture’s broad acceptance of drug use and because it could be easily obtained by prescription or manufactured in home-based laboratories. Its popularity receded with the passage of the Controlled Substances Act of 1970, which made methamphetamine a Schedule II drug with limited access. It became popular again in the 1990s when Mexican drug cartels began manufacturing the drug in quantity in superlabs and distributing it in California and the Southwest. Small, home-based labs in rural states also began springing up at this time and used readily available over-the-counter decongestants as the raw material for making methamphetamine for personal use and limited distribution. In 2005, the federal government included provisions in the Patriot Act that restricted access to the over-the-counter medications in an attempt to shut down the home-based labs. Together with the passage of a law in Mexico that restricted the importation of precursor drugs into that country, the law has had some, albeit limited, success in reducing methamphetamine use. The Combat Methamphetamine Act of 2005 was not the first time federal legislators attempted to restrict access to precursor drugs. In each case, up to and including the 2005 legislation, there was a temporary disruption in the production and use of methamphetamine followed by a rebound as producers found ways to circumvent the laws: • In 1988, the “Chemical Diversion and Trafficking Act” restricted access to and required record keeping for ephedrine and pseudoephedrine obtained in

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bulk. However, intense lobbying by the pharmaceutical industry, which makes billions on the sale of over-the-counter cold and decongestant remedies that contain ephedrine and pseudoephedrine, resulted in a loophole that exempted over-the-counter sales from the new restrictions. The decline in methamphetamine production and use was short-lived as home cooks began getting the precursor drugs by shopping at the local pharmacy. • In 1993, the “Domestic Chemical and Diversion Act” eliminated the loophole for over-the-counter products that contained ephedrine but not pseudoephedrine. Meth producers switched to using pseudoephedrine. Pseudoephedrine in pill form requires an extra processing step that involves the use of flammable chemicals. As a result, meth labs go from being toxic to being toxic and combustible. • In 1996, the “Comprehensive Methamphetamine Control Act” closed the loophole for pseudoephedrine but exempted over-the-counter medications that contained pseudoephedrine as long as they were sold in blister packs. It was thought this form of packaging would make processing the pills more difficult and discourage meth producers. It didn’t. The superlabs continued to get their precursor drugs through Mexico, where bulk purchases of ephedrine and pseudoephedrine were legal. U.S.-based producers could also get the precursor drugs from Canada, where regulations were also lax. And the effects of the 2005 legislation? Forty states followed suit and enacted laws that, to varying degrees, required medications containing pseudoephedrine be kept

behind the counter at pharmacies to further restrict access and established a centralized computer database of all such purchases to discourage “smurfing,” the act of driving from store to store to purchase as much of the drugs as legally allowable at each store. Two states, Oregon and Mississippi, passed laws that made products containing pseudoephedrine available only by prescription. These states have seen the sharpest declines in methamphetamine use, but the pharmaceutical industry continues to lobby heavily against making these drugs prescriptiononly and favors the idea of a centralized database. Mexico, declaring war on drugs in 2006, finally banned importation of pseudoephedrine in 2009. Home lab producers adjusted by adopting a new, simpler method of producing methamphetamine called “shake-and-bake” or “one pot” whereby a much smaller amount of pseudoephedrine is needed. The process is simpler and accomplished in a single step but still involves the use of toxic and combustible chemicals that can result in fiery explosions. Superlab producers have adjusted by finding new sources of bulk ephedrine and pseudoephedrine and smuggling the drugs by rerouting them through other countries before importation into the United States and Mexico. Interestingly, they have also begun using the precursor drug originally used by biker gangs in the 1970s, phenyl-2-propanone. After declines in methamphetamine use, lab seizures, and treatment admissions between 2006 and 2008 shortly after the Combat Methamphetamine Act went into effect, all increased again in 2009. Moreover, based on the DEA’s National Drug Threat Assessment for 2011, production continues apace: High levels of production in Mexico along with an increase in the number of

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domestic manufacturing operations have combined to make methamphetamine readily available throughout the United States. Methamphetamine production in Mexico is robust and stable, as evidenced by recent law enforcement reporting, laboratory seizure data, an increasing flow from Mexico, and a sustained upward trend in Mexican methamphetamine availability in U.S. markets. Rates of domestic methamphetamine production, particularly in small-scale laboratories, will remain high in 2011, even as availability of Mexico-produced methamphetamine increases. As for biker gangs, it appears they did not completely abandon the methamphetamine trade either. In September 2011, an arrest warrant was issued for a Cal State San Bernardino Associate Professor in Kinesiology, Dr. Stephen J. Kinzey, who is also a member of the Devils Diciples [sic] Outlaws biker gang. A police raid on Dr. Kinzey’s home after a months-long investigation yielded more than a pound of methamphetamine. Prior to turning himself in, “Skinz,” as he referred to himself in biker circles, thoughtfully phoned the police to inquire about his bond amount. James A. Swartz See also: Comprehensive Methamphetamine Control Act; Controlled Substances Act

Further Reading Centers for Disease Control and Prevention. 2005. “Acute Public Health Consequences of methamphetamine laboratories—16 states, January 2000–June 2004.” Morbidity and Mortality Weekly, April 15, 356–59. Cimino, K. 2005. The Politics of Crystal meth: Gay Men Share Stories of Addiction and Recovery. Boca Raton, FL: Universal Publishers.

Congressional Subcommittee on Criminal Justice, Drug Policy, and Human Resources. 2005. Fighting Meth in America’s Heartland: Assessing Federal, State, and Local Efforts. Washington, DC: U.S. Government Printing Office. Cunningham, J. K., I. Borjoquez, O. Campollo, L. M. Liu, and J. C. Maxwell. 2010. “Mexico’s Methamphetamine Precursor Chemical Interventions: Impacts on Drug Treatment Admissions.” Addiction 105: 1973–83. Cunningham, J. K., and L. Lon-Miu. 2009. “Impact of US and Canadian Precursor Regulation on Methamphetamine Purity in the United States.” Addiction 104: 441–53. Egan, T. 2002. “Meth Building in Hell’s Kitchen in Rural America.” New York Times, February 6, A14. Gonzales, R., L. Mooney, and R. A. Rawson. 2010. “The Meth-amphetamine Problem in the United States.” Annual Review of Public Health 31: 385–98.

Commission on Marihuana and Drug Abuse The Commission on Marihuana and Drug Abuse (or the Shafer Commission) was created in 1970 when President Nixon signed the Comprehensive Drug Abuse Prevention and Control Act of 1970, more commonly known as the Controlled Substances Act. The intent of the commission was to answer questions regarding the addictive properties of marijuana and the appropriate placement of marijuana into the schedules, or categories, of drugs created in the new law. Marijuana had been temporarily placed into Schedule I, therefore identified as having no approved medical purpose. Some argued that marijuana should be labeled as a Schedule II drug because it is not addictive.

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Prior to this legislation, marijuana use was relatively rare in the United States, generally limited to drug-using subcultures in the inner cities and rural areas. This began to change in the 1960s, as the practice of smoking marijuana became increasingly popular with the emergence of the counterculture. As the number of arrests for marijuana-related offenses grew, so did calls for the government to reconsider the actual effects of marijuana and the wisdom of having such tight controls over it. The commission was tasked with studying the increase in marijuana abuse and the addictive properties of the drug, and its relationship with aggressive or violent behavior and crime. The commission was composed of 13 members, nine of which were appointed by President Nixon, including the chairman, former Republican Pennsylvania governor Raymond Shafer. The commission was given the task to study the current federal policy regarding marijuana and make recommendations for change. They were supposed to report back to Congress within one year, about their findings on marijuana, and within two years, about their findings on the causes of drug abuse. The commission carried out one of the most comprehensive reviews on marijuana and federal drug policy ever completed. On March 22, 1972, the commission issued its first report Marihuana: A Signal of Misunderstanding. In the report, the committee members acknowledged that marijuana had not been tested thoroughly and that there was not a good understanding of its effects. The commission estimated that even though use of the drug was widespread among the adult population, about half of the individuals who tried marijuana only experimented with it out of curiosity, and did not use it regularly. The commission found that most of the individuals who used the drug more

than once did so only occasionally—generally less than once a week—and only for recreational purposes, not because they were addicted. Only 2 percent of the population that used marijuana used it daily. The commission members challenged the government’s policy toward marijuana. They noted that while previous studies indicated that marijuana users were physically aggressive, lacked self-control, and were irresponsible, mentally ill, and even dangerous, they found that “there is no evidence that experimental or intermittent use of marijuana causes physical or psychological harm. The risk lies instead in the heavy, long-term use of the drug, particularly the most potent preparations. Marijuana does not lead to physical dependency. No brain damage has been documented from marijuana use, in contrast to the well-established damage of chronic alcoholism.” The report noted that marijuana users are typically passive and that marijuana use causes users to be drowsy, lethargic, and timid. They claimed that there had been a lot of misinformation about the drug, particularly by an aggressive media campaign of the dangers of marijuana use. The report said that “from what is now known about the effects of marijuana, its use at the present level does not constitute a major threat to public health.” They concluded their report by saying that “marijuana’s relative potential for harm to the vast majority of individual users and its actual impact on society does not justify a social policy designed to seek out and firmly punish those who use it.” The commission also noted little relationship between marijuana use and crime. They reported approximately 16.5 million Americans had been arrested for marijuana violations since 1972, and that more than 8 percent of these people were charged with only minor charges.

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While the committee members recommended a policy of discouraging marijuana use, they also recommended the federal government decriminalize simple possession of marijuana. Also among the commission’s recommendations was the removal of criminal penalties for the nonprofit distribution of marijuana. The report read, “Neither the marihuana user nor the drug itself can be said to constitute a danger to the public safety. Therefore, the Commission recommends . . . [the] possession of marihuana for personal use no longer be an offense, [and that the] casual distribution of small amounts for no remuneration, or insignificant remuneration no longer be an offense.” The commission also concluded that marijuana did not meet the criteria to be classified as a Schedule I controlled substance. The Nixon administration did not support the recommendations made in the committee report. Both the administration and the president ignored the conclusions. Nixon even denounced the commission before the final report was issued. The report likely cost Governor Shafer an appointment to the federal court. The Shafer report continues to be cited by those who seek to remove marijuana from the Schedule 1 of the 1970 CSA law. The commission was disbanded shortly after issuing its third report in 1973. In a televised news conference on May 1, 1971, Nixon said: As you know, there is a Commission that is supposed to make recommendations to me about this subject; in this instance, however, I have such strong views that I will express them. I am against legalizing marijuana. Even if the Commission does recommend that it be legalized, I will not follow that recommendation. . . . I can see no social or moral justification whatever for legalizing marijuana. I think it would

be exactly the wrong step. It would simply encourage more and more of our young people to start down the long, dismal road that leads to hard drugs and eventually self-destruction. A few days later, at a press conference on June 17, 1971, President Nixon declared a War on Drugs. He said, American’s public enemy number one in the United States is drug abuse. In order to fight and defeat this enemy, it is necessary to wage a new, all-out offensive. I have asked the Congress to provide the legislative authority and the fund to fuel this kind of an offensive. This will be a worldwide offensive dealing with the problems of sources of supply, as well as Americans who may be stationed abroad, wherever they are in the world. . . . I have brought Dr. [Jerome H.] Jaffe into the White House, directly reporting to me [as Special Consultant to the President for Narcotics and Dangerous Drugs], so that we have not only the responsibility but the authority to see that we wage this offensive effectively and in a coordinated way. Even though it did not have the support of the president, several prominent organizations, including the American Bar Association, the National Education Association, the National Council of Churches, the Consumer’s Union, the American Public Health Association, and the governing board of the American Medical Association endorsed the decriminalization of marijuana in subsequent years. The report also helped garner support for the National Organization for the Reform of Marijuana Laws, an advocacy group that pushes for a reconsideration of the nation’s marijuana control regime. In 1973, Oregon decriminalized possession of small amounts

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of marijuana, and 10 other states stopped incarcerating individuals caught possessing the drug. Political support for decriminalization began to decrease in the mid-1970s, however, especially after national statistics began to show that marijuana use was on the rise among high school students. As a result of ignoring the commission’s recommendations, approximately 22 million Americans were arrested for marijuanarelated offenses between 1972 and 2002. The Federal Bureau of Investigation estimates that more than 80 percent of those arrests were for possession only. In July 2011, the Obama administration upheld marijuana’s Schedule I classification. Nancy E. Marion See also: Cannabis; Comprehensive Drug Abuse Prevention and Control Act; The Counterculture and Drugs; Decriminalization; Harm Reduction Programs; Legalization; Marijuana; Marihuana Tax Act; National Organization for the Reform of Marijuana Laws

Further Reading Anderson, Patrick. 1981. High in America: The True Story Behind NORML and the Politics of Marijuana. New York: Viking Press. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. “Comprehensive Drug Control Bill Cleared by Congress.” 1971. In CQ Almanac 1970, 26th ed., 03-531-03-539. Washington, DC: Congressional Quarterly. http://library .cqpress.com/cqalmanac/cqal70-1293935. Himmelstein, Jerome L. 1983. The Strange Career of Marijuana: Politics and Ideology of Drug Control in America. Westport, CT: Greenwood Press. National Commission on Marihuana and Drug Use. 1972. Marihuana: A Signal of Misunderstanding. Washington, DC: U.S.

Government Printing Office. http://www .druglibrary.org/schaffer/library/studies/nc/ ncmenu.htm. Nixon, Richard. 1971a. “The President’s News Conference.” May 1. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=2995. Nixon, Richard. 1971b. “Remarks About an Intensified Program for Drug Abuse Prevention and Control.” June 17. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=3047. Nixon Presidential Library and Museum. “FG 308 (Commission on Marihuana and Drug Abuse).” http://www.nixonlibrary.org /forresearchers/find/textual/central/subject/ FG308.php. NORML. 2002. “Nixon Commission Report Advising Decriminalization of Marijuana Celebrates 30th Anniversary.” March 21. http://www.norml.org/news/2002/03/21/ nixon-commission-report-advisingdecriminalization-of-marijuana-celebrates30th-anniversary. NORML. 2007. “National Commission on Marijuana Celebrates 35th Anniversary.” March 22. http://norml.org/news/2007/03 /22/national-commission-on-marihuana -celebrates-35th-anniversary. NORML. 2012. “Forty Years Ago This Week: National Commission on Marihuana Recommends Decriminalizing Cannabis.” March 21. http://www.norml.org/news/2012/03/21/forty -years-ago-this-week-nationalcommission -on-marihuana-recommends-decriminalizing -cannabis. Sterling, Eric A. 2013. “Shafer Commission Report on Marijuana and Drugs, Issued 40 Years Ago Today, Was Ahead of Its Time” Huff Post Politics, March 21. http://www .huffingtonpost.com/eric-e-sterling/shafer -commission-report-b-2925777.html?.

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Committee on Drug Addiction (1928–1938) The Committee on Drug Addiction was an organization within the National Research Council devoted to the study of drug addiction. In its 10 years of work, from 1928 through 1938, it strove to encourage pharmacological research into opiate addiction and sought to create an effective medical substitute for opiates that would not be addictive. Ultimately, however, the committee’s research failed to yield any discoveries on how to effectively substitute other chemicals for opiates in medical practice. The Committee on Drug Addiction was the brainchild of Reid Hunt, a professor of pharmacology at Harvard University, and former member of the Treasury Department’s Special Narcotic Committee. Hunt believed that pharmacological research in the United States was lacking, and that it was important for the country to become more involved in drug research. In particular, Hunt urged for research to discover non-habit-forming opiates and anesthetics that could take the place of potentially addictive drugs such as opium and cocaine. In 1928, Hunt’s vision was realized when the Bureau of Social Hygiene offered to transfer the scientific work of its Committee on Drug Addictions to a new body under the auspices of the National Research Council. That December, the National Research Council appointed a committee—the Committee on Drug Addiction—to oversee research on opiate addiction and the search for nonaddictive opiate substitutes. In 1932, the Bureau of Social Hygiene withdrew its funding for the committee, and the Rockefeller Foundation stepped in to fund its research. The Committee on Drug Addiction focused not so much on the social aspects of drug ad-

diction as it did on the pharmacology behind it, and finding pharmacological solutions for the problem. One of the Committee on Drug Addiction’s major activities involved research carried out by organic chemist Lyndon F. Small at the University of Virginia. The focus of Small’s work was the effort to break down the morphine molecule and then reconstruct it in hopes of developing a new morphine derivative that, while painkilling, would not be habit forming. Others in Small’s laboratory tried to synthetically create molecules similar to morphine. The committee’s pharmacological research was carried out at the University of Michigan, where compounds were tested for their addictiveness and therapeutic effectiveness. Compounds that seemed to hold promise in experiments at the Michigan laboratory were then tested on addicted inmates at the federal prison at Fort Leavenworth, Kansas, and at the Public Health Service Narcotic Hospital located in Kentucky. In 1930, the Committee on Drug Addiction seemingly had a breakthrough with the discovery of a compound later named desomorphine. Small oversaw the synthesis of desomorphine, and initial animal tests at the Michigan laboratory showed that it had significant pain-killing powers, though tests in the mid-1930s revealed that it was indeed addictive. In the late 1930s, Small developed Metopon, a drug that was a mild success—it was less addictive than morphine, and its therapeutic use was limited to the treatment of chronic pain in cancer patients. Though it was less habit forming than morphine, Metopon’s painkilling powers were not as strong, meaning that the search for an effective morphine substitute would have to continue. Over the course of its 11year existence, the committee experimented with several hundred morphine-related com-

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pounds, yet Metopon was the only one that was ever marketed. The Committee on Drug Addiction formally came to an end in 1939, when the programs at the University of Virginia and University of Michigan were transferred to the Division of Chemotherapy at the National Institutes of Mental Health. The members of the National Research Council who had been running the research on drug addiction continued to serve within the National Institutes of Mental Health, though they did so as the Advisory Committee on Drug Addiction. The Advisory Committee was relatively inactive during World War II, but was reconstituted as the Committee on Drug Addiction and Narcotics in 1947. Howard Padwa and Jacob A. Cunningham See also: Committee on Drug Addictions

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press. National Academies. 1969. “Committees on Drug Addiction, Drug Addiction (Advisory) and Drug Addiction & Narcotics, 1928– 1965.” http://www7.nationalacademies.org/ archives/Committees_on_Drug_Addiction .html. National Research Council (U.S.), Committee on Drug Addiction. 1941. “Report of the Committee on Drug Addiction, 1929– 41.” Washington, DC: National Research Council.

Committee on Drug Addictions (1921–1928) The Committee on Drug Addictions was an umbrella organization that supported re-

search in the field of narcotics addiction in the 1920s. Originally, it focused on medical approaches towards understanding and treating addiction, though by the end of the decade, it shifted towards advocating for a more law-and-order approach to the drug problem, pushing more for tighter controls on supplies of drugs and less for the treatment of addicts. This view ultimately shaped the direction of addiction policy in the United States until the 1960s. The Committee on Drug Addictions was the brainchild of New York attorney Arthur D. Greenfield, who was interested in the problem of opiate addiction, and a vocal opponent of maintenance treatment. Leading addiction experts, such as Surgeon General Rupert Blue, Dr. Ernest S. Bishop, and Charles E. Terry all supported the creation of a body that could scientifically study the problems of addiction and addiction treatment. In 1921, John D. Rockefeller Jr. allocated $12,000 for the creation of this group—the Committee on Drug Addictions. Soon, the Bureau of Social Hygiene started providing the majority of funding for the committee. The committee had an impressive membership list, with representatives from the Bureau of Social Hygiene and the American Social Hygiene Association, the former chair of the New York City Parole Commission, and Terry, among others. The intention of the committee was to lay down a definitive scientific groundwork that could guide future drug policy. By 1924, the committee developed a three-pronged approach to dealing with the addiction problem. First, it wanted to focus on education, particularly that of physicians, in order to teach them that overprescription of opiates could be a major cause of addiction. Second, it advocated for sociological research that focused on the troubles caused by drug trafficking and the impact that the

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black market for narcotics had on addicts. Third, it called for what was termed “pure research,” which included the study of how to limit supplies of opium to the world’s scientific needs, studies on the causes of addiction, and psychological research on the effects that class, personality, and the autoimmune system had on opiate addiction. In addition, the committee researched the development of nonaddicting substances that could be substituted for morphine and help wean addicts off of the drug. In all of these arenas, the committee did not lead the research, but rather served as a central coordinating body that gave financial support to, and summarized the work carried out by, other groups, such as the National Health Council, the American Social Hygiene Association, and the National Research Council. In the 1920s, organizations working with the support of the Committee of Drug Addictions began studying various aspects of the drug problem in the United States. Terry led a series of surveys of physicians and pharmacists to try to determine how much opiates were medically necessary in the United States, in large part to provide data that could go to the League of Nations, which was trying to create a worldwide international opium control regime. The committee also funded psychiatric, psychological, metabolic, and pharmacological studies on the effects opiates had on the body. In the late 1920s, the committee funded a three-year study of physiological and psychological effects of addiction at Philadelphia General Hospital’s narcotics ward, leading to the creation of the Philadelphia Committee for the Clinical Study of Opium Addiction. Among the Philadelphia committee’s most important findings was that withdrawal from morphine and heroin, while an extremely unpleasant experience, was not life threatening. It also concluded that there were no major physi-

ological differences that made addicts different from nonaddicts. Another major accomplishment of the Committee on Drug Addictions was the 1928 publication of an exhaustive review of the scientific literature on addiction from the United States and Europe—The Opium Problem. Charles Terry and Mildred Pellens, who was also a member of the Committee on Drug Addictions, authored the encyclopedic work, which drew from over 4,000 different sources. The main theses of The Opium Problem were that addiction was a disease, that the implementation of the Harrison Narcotics Act and the ban on maintenance treatment worsened the plight of addicts, and that bans on the sale of opiates created a widespread, and well-organized, black market for narcotics. When it first came out, George McCoy, the director of the Public Health Service’s Hygienic Laboratory, wanted to keep the work from being published, thinking it would do more harm than good to educate physicians about addiction since most addicts were, he claimed, of the criminal class. Ultimately, however, Terry and Pellens won the debate with McCoy, leading him to resign from the committee. In addition to its research, the Committee on Drug Addictions also became prominent in the policy realm. Committee member Lawrence B. Dunham, who had been a law enforcement official in New York, worked with the League of Nations Opium Advisory Committee, and he also advised Levi G. Nutt on federal drug legislation and helped him set quotas for raw opium imports. In the late 1920s, the committee became more focused on the enforcement side of drug control, as both Dunham and committee chair Katharine Bemet Davis believed that the best way to control the addiction problem would be to limit the world’s supply of opium.

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Anticipating programs that would come to fruition later in the century, the Bureau of Social Hygiene funded a commission that explored the possibility of using crop-substitution programs in Persia—a major grower of opium poppies—to reduce the worldwide supply of narcotics. When Dunham became chair of the committee in 1928, it became even more devoted to a supply-side view of addiction, with a focus on limiting drug production. Dunham maintained that drug addicts suffered from inherent personality defects, so the only way to keep them from becoming addicted was to keep drugs out of their hands. These beliefs ultimately became the most widely held views concerning addiction and addiction policy in the United States until the 1960s. They also alienated original members of the committee, such as Terry, who remained an outspoken critic of the government’s antimaintenance stance and advocate for maintenance clinics. As the Bureau of Social Hygiene realized the limitations of the Committee on Drug Addictions, it invited the Division of Medical Sciences of the National Research Council to assume responsibility over research into drug addiction. In December of 1928, the National Research Council appointed a new, separate entity—the Committee on Drug Addiction—that took on the role of conducting the scientific research that had been done by the Committee on Drug Addictions. Howard Padwa and Jacob A. Cunningham See also: Committee on Drug Addiction; Harrison Narcotics Act; Nutt, Levi G.

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press.

The National Academies. 1969. “Committees on Drug Addiction, Drug Addiction (Advisory) and Drug Addiction & Narcotics, 1928– 1965.” http://www7.nationalacademies.org/ archives/Committees_on_Drug_Addiction .html. Terry, Charles E., and Mildred Pellens. 1928. The Opium Problem. New York: Bureau of Social Hygiene.

Common Sense for Drug Policy Founded in 1995 and based in Falls Church, Virginia, Common Sense for Drug Policy (CSDP) is a nonprofit organization that seeks to reform national drug policies, particularly in the areas of asset forfeiture, marijuana policy, mandatory sentencing for drug-related offenses, and needle exchange programs. To realize its objectives, the CSDP provides local drug reform organizations with speakers and technical assistance as a way to disseminate information about current laws, policies, and practices regarding marijuana. The CSPD also supports policies that promote harm reduction. That includes syringe exchanges and expanding the availability of methadone and buprenorphine as a way to reduce harm to users and restrict the spread of HIV/AIDS and hepatitis C. Moreover, the organization advocates regulating marijuana as alcohol and subject to local rules. They also support decriminalizing the use of hard drugs and providing them only through prescription. Ron Chepesiuk See also: Asset Forfeiture; Marijuana; Needle Exchange Programs

Further Reading Common Sense for Drug Policy. http://www .csdp.org.

214   Compassionate Use Act (1996)

Compassionate Use Act (1996) Marijuana has been an illegal drug since the Marihuana Tax Act of 1937, which classified it as a narcotic on par with heroin and cocaine. During the 1950s, marijuana was included in a series of increasingly punitive laws. Marijuana, along with LSD, became a symbol of the rebellion in the counterculture movement of the 1960s. In the face of the drug’s continuing popularity, the punitive laws passed less than a decade earlier were only laxly enforced and had done little to deter its growing acceptance. The Controlled Substances Act of 1970 designated marijuana (plus heroin and LSD) a Schedule I substance as a drug having a high potential for abuse, no known medical benefits, and lacking accepted safety under medical supervision. This designation meant the federal government believed marijuana was more dangerous than cocaine or morphine, both Schedule II drugs. The Controlled Substances Act of 1970 also spawned the creation of the National Commission on Marihuana and Drug Abuse (the Shafer Commission) which issued a report in 1972 calling for the decriminalization of marijuana. Nixon summarily rejected the commission’s recommendations and instead pushed for greater law enforcement efforts to crack down on all drug use. In spite of these efforts, the use of marijuana continued to grow in popularity, reaching it apotheosis at the end of 1979, when 60 percent of high school students reported trying marijuana and 10 percent reported daily use. In the 1980s, as the use of marijuana declined, increasing numbers of Americans no longer viewed drugs as benign or beneficial. Nancy Reagan’s “Just Say No” campaign and the beginnings of what would become the parents’ movement refocused government efforts to reduce marijuana use. Focus

on the casual user (i.e., including and especially those who used marijuana or other drugs occasionally but not compulsively) only intensified in the late 1980s with the creation of the Office of National Drug Control Policy (ONDCP) under President George H. W. Bush and the first ONDCP director, Bill Bennett. Thousands would be arrested and millions spent on the prosecution and confinement of marijuana users, growers, and distributors. Throughout, marijuana remained the most commonly used illegal drug, albeit at levels below the peak in 1979–80 as indicated by prevalence data. Calls to legalize marijuana, or to allow the use of marijuana for medical purposes, were fairly muted in the 1980s but grew in volume in the 1990s as more people began openly questioning the wisdom of arresting and incarcerating millions of citizens while, at the same time, grossly underfunding treatment and prevention. Marijuana use began rising in popularity among the general public and high school youth, but prevalence remained below the rates of the late 1970s. Additionally, people with medical conditions such as HIV/AIDS, cancer, multiple sclerosis, and glaucoma who used marijuana were reporting it was highly effective in relieving symptoms related to these conditions; more effective than existing legal treatments including Marinol, which is the trade name for synthesized tetrahydrocannabinol (THC), the main active ingredient in smoked marijuana. Until the 1990s, calls to reduce criminal penalties for marijuana use and distribution (depenalization) or to remove criminal penalties outright in lieu of civil penalties such as fines (decriminalization) did not gain much traction outside of dedicated groups of reformists. However, persistent anecdotal reports and some research evidence that smoked marijuana provides relief from the symptoms of a variety of medical conditions

Compassionate Use Act (1996)  215

led to growing public support to pass laws legalizing marijuana use for medical purposes. In 1996, California was the first state to pass such a law, known as Proposition 215; Arizona would shortly follow suit. Since then 16 other states and Washington, D.C., have enacted medical marijuana laws. Ambiguities in the state laws and varying provisions have allowed for abuses. The result has been a backlash in some states to strengthen provisions in the laws to reduce the excesses and the “gaming” that has occurred by limiting distribution. The status of medical marijuana at present has been described as being in legal limbo because the state laws permitting medical marijuana are at odds with the Controlled Substances Act, which prohibits the dispensation and use of marijuana under any circumstances. In 2005, the Supreme Court ruled in Gonzalez v. Raich that federal law supersedes state law—via federal authority over interstate commerce—leaving open the possibility of federal arrests and prosecutions in states that have medical marijuana laws. In 2009, Eric Holder, the current attorney general, indicated that federal resources would not be used to enforce the law, but he seems to have reversed himself on this position. The DEA has continued to conduct raids on medical marijuana dispensaries since that time. On June 21, 2011, the DEA denied a petition filed by the Coalition for Rescheduling Cannabis to initiate proceedings to reclassify marijuana as a Schedule II drug. Medical marijuana advocates were happy to receive this decision from the DEA. Their petition to reschedule marijuana had languished since 2002. The decision can now be appealed in the federal courts. Opponents of medical marijuana present the circular argument that smoked marijuana has no known medical uses and has the high potential for abuse, citing verbatim the lan-

guage pertaining to Schedule I drugs. However, the fact that marijuana is a Schedule I drug means that it is difficult to conduct the kind of large-scale clinical trials necessary to determine if marijuana is medically useful (although limited, smaller-scale trials have shown that it is effective for a variety of conditions). Researchers must first get a license from the DEA qualifying them to conduct such research, and they then must acquire marijuana through the National Institute on Drug Abuse, the only legal source for conducting marijuana research. The FDA must also approve the study protocol. Resistance to permitting research into the possible medical benefits of marijuana has been met at all three levels of the approval process. In other words, to opponents, there is no evidence that marijuana is medically effective and, therefore, it is a Schedule I drug. And because it is a Schedule I drug, such research cannot be done without considerable difficulty. With a limited possibility of largescale research clinical trials, laws regarding marijuana use will continue as is. While marijuana may not be as medically effective as its adherents proclaim, this cannot be determined until large, randomized clinical trials are permitted and funded. That does not seem likely in the near term. James A. Swartz See also: Controlled Substances Act; Medical Marijuana

Further Reading Cohen, P. J. 2011. “Medical Marijuana 2010: It’s Time to Fix the Regulatory Vacuum.” Journal of Law, Medicine, & Ethics 38: 654–66. Conant, E. 2010. “Pot and the GOP; Is the Party of ‘Just Say No’ Morphing into the Party of ‘Just Say Grow’?” Newsweek Magazine, October 25, 30.

216   Comprehensive Drug Abuse Prevention and Control Act (1970) Earlywine, M. 2005. Understanding Marijuana: A New Look at the Scientific Evidence. New York: Oxford University Press. Fergusson, D. M., J. M. Boden, and J. Horwood. 2006. “Cannabis Use and Other Illicit Drug Use: Testing the Cannabis Gateway Hypothesis.” Addiction 101: 556–59. Goodnough, A., and K. Zezima. 2011. “An Alarming New Stimulant, Legal in Many States.” New York Times. http://www .nytimes.com/2011/07/17/us/17salts.html. Hall, W., and M. Lynskey. 2009. “The Challenges in Developing a Rational Cannabis Policy.” Current Opinion in Psychiatry 22: 258–62. Hoffmann, D. E., and E. Weber. 2010. “Medical Marijuana and the Law.” New England Journal of Medicine 362: 1453–57. Johnston, L. D., P. M. O’Malley, J. G. Bachman, and J. E. Schulenberg. 2011. Monitoring the Future: National Survey Results on Drug Use, 1975–2010, Volume 1. Ann Arbor, MI: Institute for Social Research, University of Michigan. http://www.monitoringthefuture .org/pubs.html#reports. Kandel, D. B. 2002. Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis. Cambridge, MA: Cambridge University Press.

Comprehensive Drug Abuse Prevention and Control Act (1970) The Comprehensive Drug Abuse Prevention and Control Act was a sweeping piece of federal legislation that brought all of the major pieces of federal drug legislation—from the 1914 Harrison Narcotics Act through the Drug Abuse Amendment Acts of 1965—under one law. Since it took effect in 1971, the act has remained the basis of federal drug laws in

the United States. Though its focus was, like the legislation that preceded it, on cracking down on drug law violators, the act was also significant in that it followed up on the 1966 Narcotic Addict Rehabilitation Act by calling for the furthering of education to prevent drug abuse, research into narcotic addiction, and rehabilitation for addicted offenders. Before 1970, there were several legal bases for federal drug control. The 1914 Harrison Act governed commerce and possession of opiates and cocaine, while the 1937 Marihuana Tax Act placed controls on marijuana. The penalties for trafficking and using these drugs were expanded dramatically in the 1950s, with the passage of the Boggs Act and the 1956 Narcotic Control Act. All of these laws were enforced by the Federal Bureau of Narcotics, which in 1968 was renamed the Bureau of Narcotics and Dangerous Drugs. The 1965 Drug Abuse Amendment Acts established that amphetamines, barbiturates, and hallucinogens could be controlled by the federal government, and the Food and Drug Administration was charged with enforcing regulations governing these substances. In spite of this slew of laws, however, recreational drug use seemed to proliferate throughout the 1960s, as drug use became a common pastime in the counterculture, and also prevalent among soldiers returning from the Vietnam War. In 1969, President Richard Nixon took notice of the problem, which he aimed to suppress through a 10-point program that included measures to cut down on the drug traffic and provide more education, research, and rehabilitation for addicts. In addition, Nixon recommended a comprehensive new law that would unite all of the existing principles of drug control in the United States under one legislative umbrella. In its stages as a draft piece of legislation, the act focused heavily on enforcement, as the attorney general told Congress its main

Comprehensive Drug Abuse Prevention and Control Act (1970)  217

accomplishment would be to keep drugs off of U.S. streets and launch a tougher enforcement program that would put major drug traffickers behind bars. Some lawmakers, however, wanted assurances that there would be provisions for drug education and rehabilitation in the law as well. The resulting law—the Comprehensive Drug Abuse Prevention and Control Act—reflected the interests that went into its drafting, as it focused heavily on the repression of illicit trafficking and dealing, while also including provisions for drug education to prevent youths from trying drugs, a section authorizing research on narcotic addiction, and a provision for the medical treatment of addicts. Title I of the act, covering Rehabilitation Programs Relating to Drug Abuse, focused on treatment and education. Section 1 of the Rehabilitation section authorized the government to make grants to state and local governments, and also for contracts with private organizations, to collect, prepare, and disseminate educational materials dealing with drug abuse. It also allocated funds to evaluate these programs. Section 3 of Title I authorized research into narcotic addiction, and protected the privacy of individuals involved in this research. In Section 4 of Title I, the secretary of health, education, and welfare was entitled to research what treatment methods could be used to help drug users overcome their addictions. The National Institute of Mental Health was subsequently directed to coordinate health and educational initiatives relating to drug addiction. In 1972, the Drug Abuse Office and Treatment Act further expanded prevention and treatment programs. Title II of the act, which would later become known as the Controlled Substances Act, divided drugs into five schedules, depending on their potential for abuse and their use in mainstream medical practice.

Schedule I drugs were substances that the government believed had high potential for abuse, were not used in medical treatment in the United States, and were not believed to be safe, even when used under medical supervision. Among the drugs placed on this schedule were heroin, marijuana, and LSD. Schedule II drugs were drugs that while having a high potential for abuse, also had accepted medical uses in the United States. Among the substances included on this schedule were cocaine and its derivatives, morphine, methadone, and amphetamines. Schedule III drugs such as barbiturates were substances that were believed to have less potential for abuse, and were considered acceptable for use in medical practice, while drugs on Schedule IV and V were considered to have even lower potential for abuse and were accepted in mainstream medical practice. Drugs on Schedules I and II were the most tightly regulated, as it became a violation to distribute these substances without a written order on a form distributed by the attorney general. Copies of this form needed to be kept for two years, so that government officials could inspect them and closely monitor the transfer of these drugs. The penalties also were steepest for violations involving Schedule I and II drugs, as manufacture, distribution, and possession with an intent to sell these substances was punishable by up to 15 years in prison and a fine of up to $25,000. For repeat offenders, these sentences could be doubled. The penalty for violations involving Schedule III drugs was up to five years in prison and a $15,000 fine, while for Schedule IV drugs the punishments could be up to three years in prison and a $10,000 fine, and for Schedule V drugs the maximum sentences were one year in prison and a fine of up to $5,000. The act also allowed punishments of up to a year in prison and a fine of up to $5,000 for the

218   Comprehensive Methamphetamine Control Act (1996)

possession of controlled substances, and the penalties for repeat possession offenses were doubled. The law did, however, give judges the option of putting individuals brought up on charges of possession on probation. The Controlled Substances Act targeted large-scale drug traffickers in particular. While the act did not impose mandatory minimum sentences on most offenders, it did call for a minimum of 10 years in prison, and possibly a life sentence, for individuals found to be involved in large-scale drug trafficking, and it also allowed for a maximum fine of $100,000. For repeat offenders, these sentences were doubled. Individuals caught trying to import Schedule I and II drugs were also punished severely, with sentences of up to five years in prison and fines of up to $15,000. The act also gave sweeping powers to law enforcement officials, allowing them to carry firearms, execute and serve search warrants, make arrests without warrants, seize property, and even break and enter premises in order to carry out investigations if they had a warrant from a judge. Overall, the Comprehensive Drug Abuse Prevention and Control Act both unified and solidified prior trends in the federal approach to the drug problem. It kept and enhanced many of the repressive characteristics of earlier drug control measures such as the Boggs Act and the 1956 Narcotic Control Act with hefty sentences and fines for drug law violators, though it did rescind the use of the death penalty for heroin dealing that was a key provision of the Narcotic Control Act. At the same time, it also had some provisions in Title I that provided for treatment and allowed for education, and not just repression, to be used in the campaign against drug addiction. In this respect, it reflected some of the trends that began to take shape with the Narcotic Addict Rehabilitation Act of 1966. Howard Padwa and Jacob A. Cunningham

See also: Anti–Drug Abuse Acts; Boggs Act; Drug Abuse Control Amendments (1965); Harrison Narcotics Act; Narcotic Addict Rehabilitation Act

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. King, Rufus. 1972. The Drug Hang-Up: America’s Fifty-Year Folly. Springfield, IL: Bannerstone House. Musto, David F., ed. 2002. Drugs in America: A Documentary History. New York: New York University Press.

Comprehensive Methamphetamine Control Act (1996) The abuse of methamphetamine, a highly addictive drug associated with permanent brain damage in long-term users, increased dramatically throughout the early 1990s. This increase had devastating effects on both the abusers and the communities in which they lived, with a rise in mortality rates among users, increasing rates of violent crime, and rising levels of criminal activity associated with the drug’s importation and the chemical compounds used in its manufacture. There were also reports of an alarming rise in teen use of methamphetamines. Citing these public health threats posed by the drug, Congress enacted the

Compulsions and Impulses  219

Comprehensive Methamphetamine Control Act of 1996 (MCA). The House version of the bill, sponsored by Fred Heineman (R-N.C.), included new mandatory minimum prison sentences for trafficking or possession of meth, but they were later dropped. The House version also wanted to increase penalties for possession and trafficking of speed so that they would be the same as those for crack cocaine. Under this provision, possession of five grams of meth would automatically trigger a five-year mandatory prison term. A defendant convicted of possession of 50 grams would trigger a 10-year mandatory prison term. In the Senate, the bill included penalties for possession or trafficking in methamphetamines, but it did not include any mandatory sentencing provisions. Instead, the bill directed the U.S. Sentencing Commission to determine appropriate penalties. The sponsor of the bill in the Senate, Orrin G. Hatch (R-Utah), argued that he would prefer mandatory sentences, but agreed to forgo them in the interest of getting the bill passed. The final law restricted the access to the chemical compounds and equipment used in the manufacture of methamphetamine by increasing the penalties for their possession. Under the law, law enforcement could now confiscate and regulate any over-the-counter products (such as cold and allergy medications) if they were being used to manufacture methamphetamines. The new law also increased the penalties for the possession, manufacture, or sale of methamphetamine. These were to be set by the U.S. Sentencing Commission. To prevent the interruption of the legitimate distribution of combination ephedrine products (DEA List I chemicals), the MCA amended the Controlled Substances Act to provide temporary exemptions from registration for persons who distribute

these List I chemicals. Registration fees, originally $595, were reduced to $116. The MCA also called for the establishment of a Methamphetamine Interagency Task Force to be chaired by the U.S. attorney general. The task force’s responsibilities included the design, implementation, and evaluation of the education, prevention, and treatment practices and strategies of the federal government with respect to methamphetamine and other synthetic stimulants. This way, the federal government’s efforts against meth could be tracked and coordinated. Nancy E. Marion See also: Controlled Substances Act; Methamphetamines

Further Reading “Crime Prevention Legislation Takes Aim at Multiple Targets, Including Drugs, Fraud, and Crimes Against Children and the Elderly.” 1997. In CQ Almanac 1996, 52nd ed., 5-38-5-42. Washington, DC: Congressional Quarterly. http://library.cqpress.com/ cqalmanac/cqal96-1092382. Federal Register. “Comprehensive Methamphetamine Control Act of 1996; Possession of List I Chemicals, Definitions, Record Retention, and Temporary Exemption from Chemical Registration for Distributors of Combination Ephedrine Products.” http:// www.gpo.gov/fdsys/pkg/FR-1997-02-10/ pdf/97-3086.pdf. Library of Congress. “Bill Text Versions 104th Congress (1995–1996) S. 1965.” http://www .gpo.gov/fdsys/pkg/BILLS-104s1965es/ pdf/BILLS-104s1965es.pdf.

Compulsions and Impulses A compulsion, in terms of obsessive-compulsive disorders, is a compelling, uncontrollable

220   Conant v. Walters (2003)

urge to perform a certain act to quiet obsessive thoughts. There is no inherent pleasure in the act and it is not likely to produce seriously negative consequences—although it is symptomatic of what can be a serious disorder. An impulse, in the context of impulse control disorders, is an irresistible urge to perform a certain act or behavior that gives immediate gratification or pleasure but ultimately produces negative consequences. Although impulse control disorders are frequently referred to as compulsive disorders—for example, compulsive shopping disorder—they are not true compulsions. Much confusion has resulted from the fact that compulsions and impulses have overlapping characteristics; compulsive behaviors can be symptomatic of impulse control disorders just as there may be impulsive components to certain compulsions. Proper diagnosis rests on identifying the critical distinction between the two behaviors: impulsive behaviors, such as pathological gambling and stealing (kleptomania), are consistent with the individual’s wishes; compulsions, such as the need to touch a doorknob exactly seven times before leaving the house every day, are not. Both obsessive-compulsive and impulse control disorders arise from a complex of neurochemical and genetic factors as well as environmental influences, and they respond to treatment with medications and behavioral therapy. Kathryn H. Hollen See also: Addiction; Treatment

Further Reading American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision. Washington, DC: American Psychiatric Association. Grant, Jon E., and S. W. Kim. 2003. Stop Me Because I Can’t Stop Myself: Taking Con-

trol of Impulsive Behavior. New York: McGraw-Hill.

Conant v. Walters (2003) Dr. Marcus Conant was a physician in California who, as part of his practice, had many patients who were HIV positive or who had AIDS. As a physician for 33 years, Conant had prescribed synthetic cannabis (under the brand name Marinol) for his patients. Many of those patients reported to him that the synthetic form of the drug was not effective, and that inhaled (or smoked) medical marijuana was more effective and thus the only viable treatment option for them. But because federal law outlawed prescribing medical marijuana, Dr. Conant was legally unable to do that for his patients. After Proposition 215 was passed in California, Dr. Conant sought clarification about his right to recommend the use of medical marijuana to his patients. Under federal law, any physician found to be recommending the drug, or writing prescriptions for medical marijuana, could be in violation of federal drug laws and could face harsh mandatory sentences (up to life in prison) if convicted. Further, if a patient became a member of a medicinal marijuana dispensary or distribution club on the advice of a physician, that physician could be liable for all of the marijuana that the patient and the distribution center ever bought or sold. Dr. Conant believed that the federal government, by limiting his ability to recommend a drug to a patient, was violating his First Amendment right to free speech. Specifically, Conant argued that the First Amendment to the U.S. Constitution protected him from federal attempts to prevent his discussion or recommending marijuana as a form of treatment for those patients suffering from HIV or AIDS.

Conant v. Walters (2003)  221

The nation’s drug czar at the time, John P. Walters, argued that when Conant discussed medical marijuana with his patients, he was violating the federal law because he was threatening the health and safety of the U.S. public. In response, Conant argued that as a physician, he should be permitted to discuss treatment options fully and honestly with his patients. Conant brought a suit against the federal government, in particular the new drug czar (who had replaced Walters) Attorney General Janet Reno, and Secretary of Health and Human Services Donna Shalala. Conant argued that the federal government’s policy concerning medical marijuana was inconsistent and threatened his constitutional rights. Additionally, the government and the Bush administration officials (in particular, the Drug Enforcement Administration) were acting outside of their authority when they threatened to withdraw the right of doctors to write prescriptions for those doctors who recommended medical marijuana to their patients. Conant did not have to fight this battle alone. The CEO of the California Medical Association, Dr. Jack Lewin, filed an amicus (friend of the court) brief on Conant’s behalf, presenting the argument that the Bush administration and the DEA were putting patients in jeopardy by preventing physicians from discussing all possible medical options available for treating their conditions. At the same time, he argued that they were censoring the physicians’ free speech. Also helping Conant was the American Civil Liberties Union, various medicinal marijuana advocacy groups, other activist doctors, and some patients using medical marijuana. In July 2000, a U.S. district judge issued a permanent injunction against the federal government and their efforts to prosecute any physicians who recommend marijuana to their patients (N.D. Cal. Sept. 7, 2000).

The injunction forced federal law enforcement agencies to allow physicians to discuss treatment options, including medicinal marijuana, with their patients. The federal government appealed the decision to the Ninth Circuit Court of Appeals (Conant v. Walters, 309 F. 3d 629, 2002). The circuit court judges ruled that the federal government could not revoke the licenses of those doctors who recommended marijuana to their patients, noting that doctors must be able to speak “frankly and openly” to their patients. The federal government then appealed the case to the U.S. Supreme Court. In October 2003, the Supreme Court refused to grant certiorari, meaning that they did not choose to hear the government’s appeal. This meant that the decision of the lower court stands. This was a victory for the medical marijuana movement. Dr. Conant’s free speech argument won, and the decision protected physicians’ right to discuss medical marijuana with their patients. Nancy E. Marion See also: Medical Marijuana

Further Reading Gerber, Rudy. 2004. Legalizing Marijuana: Drug Policy Reform and Prohibition Politics. Westport, CT: Praeger. Kreit, Alex. 2003. “The Future of Medical Marijuana: Should the States Grow Their Own?” University of Pennsylvania Law Review 151(5): 1787–826. London, Jeffrey Matthew. 2009. How the Use of Marijuana Was Criminalized and Medicalized. Lewiston, NY: Edwin Mellen Press. Newbern, Alistair E. 2000. “Good Cop, Bad Cop: Federal Prosecution of State-Legalized Medical Marijuana Use after United States v. Lopez.” California Law Review 88(5): 1575–634.

222   Controlled Substances Act (CSA) (1970)

Controlled Substances Act (CSA) (1970) The Controlled Substances Act (CSA) of the Comprehensive Drug Abuse Prevention and Control Act of 1970 represents the U.S. government’s effort to control the manufacture and distribution of controlled substances. Because drugs of abuse can be synthesized in homegrown laboratories, CSA laws continue to be amended and updated to include the chemicals and equipment that are used in the drugs’ manufacture. The act outlines the regulations and penalties imposed for illicit drug trafficking and use, including personal use, as well as provisions for controlling drug-manufacturing processes. It places all regulated substances into one of five categories, or schedules, based upon the substance’s medical use, potential for abuse, safety, and addiction liability. In October 1970, President Richard Nixon signed the Comprehensive Drug Abuse and Prevention and Control Act of 1970, more commonly known as the Controlled Substances Act (CSA). The law was passed as a way to regulate the legal drug industry while at the same time address the importation and distribution of illegal drugs throughout the United States. In the CSA, drugs were classified based on their potential medical use as well as the likelihood for abuse. Congress established five schedules (or categories) of drugs, and placed drugs in each category depending upon how dangerous they were, their potential for abuse and addiction, and whether they had any recognized medical value. This means that a drug placed in Schedule I has no medical value but a high potential for abuse. Schedule II drugs have some limited medical value, but still a high potential for abuse. Examples of these include barbiturates and amphetamines (morphine and

cocaine). Those drugs in Schedule II could be prescribed by a physician, as they had some medical benefits. A doctor would be permitted to write a prescription, but a pharmacist could offer no refills and no orders could be filled by phone. Pharmacies would be required to provide records on dispensation of Schedule II drugs if requested by the government. Schedule III drugs have a high medical use and a high potential for abuse, and include drugs such as morphine and codeine. Those drugs placed in Schedule IV and V have a low potential for abuse and an accepted medical use. Mandatory minimum sentences for drug offenses were also established for possession, possession with intent to sell, sale, and sale to a minor for each drug category. There have been many attempts to reclassify drugs placed in this classification scheme. One drug that is consistently under review is marijuana. After the Shafer Commission recommended in 1972 that marijuana be reclassified out of the Schedule I grouping, other groups have asked the federal government to reconsider this categorization. In 1972, the National Organization for the Reform of Marijuana Laws (NORML) filed documents with the federal government asking that marijuana be reclassified as a Schedule II drug. This would enable physicians to legally prescribe the drug to patients. Officials in the government refused to act on the petition at that time. For many years after that, there was no action taken regarding reclassification. However, in July 1994, the U.S. district court rejected a petition to review a request pertaining to the rescheduling of marijuana. A ruling by the U.S. Court of Appeals (D.C. Circuit Court) upheld the Drug Enforcement Agency’s (DEA) decision to keep marijuana in Schedule I. In response, in July 1995, Jon Gettman, the former national director of NORML,

Controlled Substances Act (CSA) (1970)  223 Criteria for scheduled substances Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V Low potential for abuse relative to drugs in Schedule IV

Potential for abuse

High potential High potential for abuse for abuse

Potential for abuse is less than substances in Schedules I and II

Low potential for abuse relative to drugs in Schedule III

Medical uses

No currently accepted medical use in treatment

Has currently accepted medical use in treatment

Has a currently Has a currently accepted medical accepted use in treatment medical use in treatment

Consequences for abuse

Abuse of drug Lack of accepted safety may lead to for use severe psychological or physical dependence

Abuse of drug may lead to moderate or low physical dependence or high psychological dependence

Abuse of drug many lead to limited physical or psychological dependence

Has currently accepted medical use in treatment or currently accepted medical use with severe restrictions

filed another legal challenge to the drug’s Schedule I status. In 1999, the DEA categorized synthetic THC (Marinol) to Schedule III. This made the drug subject to fewer regulatory controls and decreased the criminal sanctions that could be imposed for those who used it illegally. The drug would also be more readily available to patients. The rescheduling was approved after the DEA and the Department of Health and Human Services found that there were few instances of illicit abuse of the drug. In March 2011, the DEA placed five synthetic cannabinoids into Schedule I of the CSA, citing as the reason “imminent hazard” of the drugs to the public’s safety. These were synthetic drugs given the names “Spice” or “K2,” otherwise known as bath salts, that were popular among young people. The DEA again denied a request to reclassify marijuana that was made in July

Abuse of drug may lead to limited physical or psychological dependence

2011. In doing so, the agency officials declared that marijuana, at that time, had “no accepted medical use” and should remain as scheduled. Today, despite evidence to the contrary, marijuana remains as a Schedule I drug that has no medical use and a high potential for abuse. Nancy E. Marion See also: Barbiturates; Comprehensive Drug Abuse Prevention and Control Act (1970); Drug Classes; Marijuana; Methamphetamine; Nixon, Richard M.

Further Reading Kreit, Alex. 2013. Controlled Substances: Crime, Regulation, and Policy. Durham, NC: Carolina Academic Press. London, Jeffrey Matthew. 2009. How the Use of Marijuana Was Criminalized and Medicalized. Lewiston, NY: Edwin Mellen Press.

224   Council for Tobacco Research Rofman, Roger A. 1982. Marijuana as Medicine. Seattle: Madrona Publishers. Shulgin, Alexander T. 1992. Controlled Substances: A Chemical and Legal Guide to the Federal Drug Laws. Berkeley, CA: Ronin Publishers. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea. U.S. Department of Justice, Drug Enforcement Administration. “Marijuana.” http://www .justice.gov/dea/pr/multimedia-library /image-gallery/images_marijuana.shtml. U.S. Department of Justice, Drug Enforcement Administration. “A Tradition of Excellence: The History of the DEA from 1973–2003.” http://www.deamuseum.org/dea_history_ book/index.html.

Council for Tobacco Research The Tobacco Industry Research Committee (TIRC) was a tobacco lobbying and research group formed in 1953 by Paul M. Hahn, president of the American Tobacco Company. The stated purpose of the group was to “aid and assist research into tobacco use and health, particularly into the alleged relationship between the use of tobacco and lung cancer, and to make available to the public factual information on this subject” (Council for Tobacco Research 1982). While the group attempted to recruit legitimate scientists, and did, it has been widely derided as a part of the tobacco industry’s efforts to sow doubt among consumers about tobacco’s addictive properties and the hazards it presents to human health. The TIRC’s first official meeting was on January 18, 1954, though prior to that the nascent organization was already operating with unofficial officers appointed in late 1953. These consisted entirely of tobacco industry executives from some of the largest tobacco companies in the United States,

including R.J. Reynolds Tobacco Company, Phillip Morris & Co., and the United States Tobacco Company. The organization’s original starting budget was $1.2 million, with $500,000 dedicated to research on the effects of tobacco on health, and the TIRC’s offices were housed in the Empire State Building until 1956. The TIRC’s headquarters later moved to other buildings in New York because of lease issues (Council for Tobacco Research 1982). Even before its first official meeting, the TIRC was engaged in promoting the tobacco industry’s perspective with their first official public communication, “A Frank Statement to Cigarette Smokers.” This document outlined the TIRC’s public position on the medical impacts of tobacco, particularly on cancer— namely, that the science was uncertain and that the link was tenuous. The communication was published widely, and was signed by 14 sponsoring organizations, nine of which were tobacco companies and 4 of which were organizations for growers of tobacco (Council for Tobacco Research 1982; Tobacco Industry Research Committee 1954). In addition to the original board of tobacco industry executives, the TIRC appointed a scientific advisory board to oversee their inquiries into the health effects of tobacco. It consisted of seven scientists from a variety of medical fields, though nine were originally asked to be on the board. The Scientific Advisory Board appointed Dr. Clarence Cook Little, former president of the University of Michigan and of the predecessor to the American Cancer Society, as its chair. Mistrust was high enough among academic institutions that the Scientific Advisory Board originally found it difficult to apportion a significant amount of the $500,000 that had been designated for research. The Tobacco Institute was started in 1958 and led to the gradual diminishment of the

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TIRC’s activity in regard to its public relations. The organization continued to exist until 1964, when its name was changed to the Council for Tobacco Research, USA, and its mission became entirely scientific, as described by the council itself (Council for Tobacco Research 1982). Under this new name, the organization continued to produce research that called into question the link between cigarette smoking and, in particular, cancer. In 1998, under the terms of the Master Settlement Agreement with the tobacco industry in the United States, the Council for Tobacco Research (as well as the Tobacco Institute) were formally required to dissolve (Master Settlement Agreement 1998). The TIRC was formed as a direct response to an increasing number of studies that were linking cigarette smoking to various health issues, especially cancer. It was a direct response, guided by the public relations firm Hill and Knowlton, that sought “a public relations campaign which is positive in nature and is entirely ‘pro-cigarettes’” (House Subcommittee on Health and the Environment 1994). Given that the TIRC was formed after this, the development has been consistently criticized as a clear violation of the organization’s supposed goal of scientific accuracy. This concern was supported in later memos from Hill and Knowlton indicating that they really directed the efforts of the TIRC, from selecting the members of the Scientific Advisory Board (and Dr. Little as chair) to organizational planning, to the operating procedures for the research program. The TIRC, under the influence of Hill and Knowlton, undertook a massive campaign in the early 1950s to influence public opinion on the science behind linking smoking to health issues. According to the House Subcommittee on Health and the Environment (1994), the TIRC was able to promote

obscure scientific reports favorable to the tobacco industry into major headlines, influence the content in major new outlets like the New York Times (among others), and influence medical opinion by sending a pro-tobacco booklet to doctors throughout the United States (House Subcommittee on Health and the Environment 1994). More problematic than the general thrust of the TIRC was the fact that much of the information it disseminated over the course of the organization’s life, and its subsequent iteration as the Council for Tobacco Research, was either misleading or false (Watkins 2004). In particular, there have been significant concerns regarding the mission of the organization to paint mainstream science as inaccurate or uncertain, thus placing many in danger. For nearly 50 years, the TIRC influenced public opinion in the United States regarding the scientific link between cigarette usage and health problems. At first through massive public relation campaigns, and later through more subtle forms of influence, the TIRC and its subsequent iteration as the Council for Tobacco Research was one of the most significant players in the tobacco industry’s public relations apparatus. The organizations have been highly criticized, however, as nothing more than public relations ploys, rather than the scientific organizations they were supposed to be, and with the tobacco industry’s massive settlement in 1998, they were dissolved. Joshua B. Hill See also: Master Settlement Agreement; Nicotine; Tobacco

Further Reading Council for Tobacco Research. 1982. “A Brief History of the Council for Tobacco Research—U.S.A., Inc. (CTR) Originally

226   The Counterculture and Drugs Tobacco Industry Research Committee (TIRC).” http://legacy.library.ucsf.edu/tid/ udt30a00/pdf. House Subcommittee on Health and the Environment. 1994. “The Hill and Knowlton Documents: How the Tobacco Industry Launched Its Disinformation Campaign.” http://legacy.library.ucsf.edu/tid/zqq54a00/ pdf;jsessionid=19807024874CF2B424639 9E1012E70CB.tobacco03. Master Settlement Agreement. 1998. http:// www.naag.org/backpages/naag/tobacco/ msa/msa-pdf/MSA%20with%20Sig%20 Pages%20and%20Exhibits.pdf/file_view. Tobacco Industry Research Committee. 1954. “A Frank Statement to Cigarette Smokers.” http://www.tobacco.neu.edu/litigation/ cases/supportdocs/frank_ad.htm. Watkins, T. 2004. “Government Lays Out Fraud Case against Big Tobacco.” CNN. http://www.cnn.com/2004/LAW/09/21 /tobacco.lawsuit.

The Counterculture and Drugs From the late 1950s through the early 1970s, the United States saw the emergence of a counterculture, a movement among youth that opposed the values of mainstream society. A key part of the counterculture’s rebellion included the use of controlled psychoactive substances. Though it had no official organization, the counterculture was a loosely connected but large community of people who, in the period roughly spanning from 1957 to 1973, opposed the mainstream culture and politics of the U.S. establishment. The counterculture originated as a reaction against the conservative government and norms of the 1950s and in opposition to the segregation and discrimination against African Americans, and it was later galvanized by opposition to the United

States’ war in Vietnam, the call for women’s rights, and a more general rejection of authority. The counterculture had its roots in the socalled Beat generation of the 1950s. Writers such as Jack Kerouac, Allen Ginsberg, and William S. Burroughs helped define the Beats as a group that rejected popular U.S. concepts that equated success with manhood and capitalism, instead focusing on experience as the key to fulfillment. Psychoactive drugs were among the key tools that the Beats believed could be used in achieving novel and individualistic experiences, as they allowed for users to delve deeper into the unconscious and parts of the spirit that were not elements of mainstream culture. Kerouac, for example, used amphetamines while writing The Subterraneans and his iconic classic On the Road. Kerouac believed that amphetamines were valuable tools in the creative process, as they allowed for the creation of spontaneous prose, accelerating writing until it came as smoothly and naturally as thoughts, so it could be done on an unconscious level. Though Ginsberg did not use drugs regularly himself, his 1957 Howl, one of the most influential works of the counterculture, glorified the rebellious character of the drug user, as well as the visions of compassion and peace that could be achieved through the use of peyote. In Junkie, Burroughs recounted his time as an opiate addict in the 1940s and 1950s, describing how he traveled freely and lived a lifestyle that could be a model for his fellow Beats. Burroughs’s Naked Lunch also contained passages that framed drug use as a way to experience funny, frightening, and unreasonable excess, making it seem a chemical embodiment of rebellion against the constricting norms of mainstream society. Also experimenting with marijuana and cocaine, the Beats influenced the counterculture that emerged as a more general rejection of the mainstream.

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A family of hippies living in a bus smokes pot as their child watches. The family were part of the Hog Farm hippie commune associated with the Woodstock Music Festival held in 1969. (Bonnie Freer/Getty Images)

In the 1960s, the counterculture evolved and grew in numbers, as social issues and opposition to the Vietnam War mobilized increasing numbers of youths. Among the main markers of the counterculture were opposition to materialism, the practice of free love, living in communes, going to rock festivals, and practicing Eastern mysticism. Psychoactive drugs were key in many of these activities. Among the most famous countercultural figures who promoted the use of psychoactive drugs was Timothy Leary, a former Harvard professor who advocated for individuals to “tune in, turn on, and drop out” by taking LSD, and started a church called the League of Spiritual Discovery, which used LSD as a sacrament. In 1964, Ken Kesey and a group called the Merry Pranksters went on a famous cross-country trip aboard a psychedelically

painted school bus, and took LSD throughout the journey. The exploits of Leary and Kesey became legendary within the counterculture, and inspired youths to experiment with psychoactive drugs—psychedelics in particular. The use of drugs in the counterculture both hardened and softened the government’s approach to handling addiction. On the one hand, it led to tighter controls, as drugs like LSD were made illegal, and a new, tougher control regime was instituted in 1970 largely in response to the rise of drug use among U.S. youths in the counterculture. On the other hand, the spread of psychoactive drug use beyond the socioeconomic margins—to the children of the wealthy and veterans who joined the counterculture as part of their protest against the Vietnam War—made many Americans realize that drug problems could

228   Crack Epidemic

strike anyone, and spurred a move to provide more treatment options for addicts. Howard Padwa and Jacob A. Cunningham See also: Comprehensive Drug Abuse Prevention and Control Act; Drug Abuse Control Amendments; Leary, Timothy; Narcotic Addict Rehabilitation Act

Further Reading Boon, Marcus. 2002. The Road of Excess: A History of Writers on Drugs. Cambridge, MA: Harvard University Press. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson.

Crack Epidemic The most typical form of cocaine use in the 1970s and early 1980s was the snorting of cocaine powder, but the mid-1980s saw the emergence of a new form of cocaine use— crack smoking. Far cheaper than cocaine in its powder form, crack found a sizeable market in impoverished, inner-city neighborhoods in the 1980s. Some scholars, however, believe that the so-called crack epidemic of the period was more media exaggeration than social reality, resulting from misinformation about crack’s addictiveness combined with crack’s greater visibility amongst the lowest classes in urban ghettos. Though controlled by federal drug laws since the early 20th century, cocaine reemerged as a popular drug in the 1970s, when its use by celebrities and musicians transformed it into a glamorous substance in many circles. The rise of Latin American

drug trafficking organizations also played a significant role in the reemergence of cocaine in U.S. life, as they smuggled it into the United States and distributed it on U.S. streets on a large scale. Nonetheless, cocaine remained relatively expensive, costing between $80 and $100 per gram in the 1970s. Crack emerged in the mid-1980s as a more potent, low-cost alternative to powder cocaine. Underground chemists in Los Angeles first devised crack in the early 1980s by mixing cocaine with baking soda and boiling down the mixture into a smokeable rock form. The new form of cocaine was on the black market by late 1984, and it spread throughout lower-class neighborhoods of Los Angeles, Miami, and New York City by the middle of the 1980s. Originally dubbed “cocaine-rock,” the substance soon came to be known as “crack,” getting its name from the cracking or crackling sound that is made when the substance is heated and smoked in glass pipes. Crack was more powerful than powdered cocaine, faster acting (it got users high within seconds), and also significantly cheaper, costing just $5 to $10 per rock. Crack’s potency and relative cheapness, authorities feared, could make the drug spread like wildfire. Street dealers stood to benefit from crack since its effects wore off quicker than cocaine, meaning that users would need to come back to buy more of the drug more regularly. Users, drug policymakers feared, would turn to crack instead of cocaine since it was relatively inexpensive and created a high that was more powerful. The emergence of crack generated calls of alarm, as many claimed that the country was in the midst of a crack epidemic from the mid-1980s through the early 1990s. Members of the media, politicians, and public health officials alike contributed to a seeming consensus that crack represented the

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most dangerous drug ever created or known. Characterized as extremely destructive and almost instantaneously addictive, crack came to be seen as a kind of narcotic juggernaut that jeopardized the well-being of Americans of all stripes. Newspaper, magazine, and television reports spoke of crack’s rapid spread beyond the ghettos of the big cities in which it originally appeared, and alarmed suburban and rural readers and viewers, who feared a crack epidemic that could cut across social, racial, and geographic lines. In particular, the media seized on the problem of “crack babies”—children who were born to crack-addicted mothers with serious health problems. Fear that crack use had reached epidemic proportions and had tremendous social costs became a driving force behind national drug policies in the 1980s, and Congress passed tough antidrug legislation—the Anti–Drug Abuse Acts—largely in response to the dangers the drug seemingly posed to the U.S. public. Despite (or perhaps because of) this intense focus on the crack epidemic, the true place of crack in U.S. life was obscured in the 1980s. Lost amidst the hubbub over crack was the fact that the drug was never widely used by Americans, and in further contradiction of media reports about the instantaneous addictiveness of the drug, few people who tried crack continued using it. One reason that only a small percentage of people who smoked crack a first time opted to do it again is that the drug has a strong, almost overwhelming, impact. The repeated use of a drug of this strength and impact is generally limited to the small segment of the population that uses heroin heavily. As such, even amongst cocaine users, only a small percentage of them smoked crack heavily. National Institute on Drug Abuse (NIDA) surveys from the 1980s and 1990s confirm the relative rarity of crack use during the so-called

crack epidemic. The NIDA-led National Household Survey on Drug Abuse of 1990 revealed that in the first years after crack’s emergence, overall drug use, including that of cocaine and its derivatives, declined. The survey from the following year showed that the percentage of Americans between the ages of 12 and 25 who had ever tried cocaine and related drugs peaked in 1982—well before the appearance of crack—and continued to decline thereafter. NIDA’s 1986 study measuring crack use among high school seniors found that 4.1 percent had tried crack at least once in the previous year, but as the crack scare continued, yearly surveys showed this figure dropped each subsequent year. Through the early 1990s, this number hovered around just 1.5 percent, clearly indicating that Americans were not using crack in epidemic proportions. An explanation for the disconnect between Americans’ sense in the late 1980s and early 1990s that they were living in the midst of a crack epidemic and the reality that crack never truly threatened wide swaths of the population may lie in the fact that those most affected by crack were the impoverished, blacks, and Latinos. Because they had little financial means of combating their addiction and a greater visibility in the nation’s ghettos and barrios than middle-class cocaine users, crack users and addicts attracted media scrutiny and political attention disproportionate to the true level of crack use in the country. Racial prejudices, too, likely contributed to suburban and rural Americans’ fears of a crack epidemic. By 1990, a number of media reports emerged that called into question the phenomenon of a crack epidemic. These stories revealed that crack was not nearly as addictive as it had been built up to be, nor had it made significant inroads beyond inner-city neighborhoods. By the election year of 1992, fears of a crack epidemic had essentially

230   Crime Control Act (1990)

come to an end. George H. W. Bush said little about illicit drugs during his reelection campaign, and the Clinton administration did not continue to address the drug problem in the same way as its Republican predecessors had done, so the concerns about crack began to fade by the mid-1990s. Howard Padwa and Jacob A. Cunningham See also: Anti–Drug Abuse Acts; Drug Addiction and Public Policy; Drug Smuggling; National Institute on Drug Abuse; Reagan, Ronald, and Nancy Reagan

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Erickson, Patricia G., Edward M. Adlaf, Reginald G. Smart, and Glenn F. Murray, eds. 1994. The Steel Drug: Cocaine and Crack in Perspective. New York: Lexington Books. Fryer, Roland G., Jr. 2005. Measuring the Impact of Crack Cocaine. Cambridge, MA: National Bureau of Economic Research. Raphael, Steven, and Michael A. Stoll. 2013. Why Are So Many Americans in Prison? New York: Russell Sage Foundation. Reinarman, Craig, and Harry G. Levine, eds. 1997. Crack in America: Demon Drugs and Social Justice. Berkeley: University of California Press.

Crime Control Act (1990) The Crime Control Act of 1990 is an omnibus crime bill signed by President George H. W. Bush that addressed many facets of crime prevention, including money laundering, enhancing protections for victims of child

abuse, the building of effective prison systems, enhanced penalties for child pornography, and drug enforcement and prevention measures. After much debate in the House and Senate, the bill was finally passed and sent to the president’s desk for his approval. While the bill has many provisions regarding a variety of anticrime policies, many of them deal directly with drug use and abuse. One of those was Title VIII, provisions related to rural drug enforcement. This section of the 1990 law amended the Omnibus Crime Control and Safe Streets Act passed in 1968 by setting aside specified sums of money for rural drug enforcement assistance. It also set forth additional grant monies that would be made available to local police departments to fight rural drug use. Within each application, it was required that there be a statement specifying how the grants will be coordinated with any other grants received under the 1968 Safe Streets Act for the same fiscal year. Another section of the 1990 bill, Title XV, was entitled the Drug-Free School Zones. This provision directs the attorney general to develop a model program of strategies and tactics for establishing and maintaining drug-free school zones. Moreover, the attorney general was asked to design programs that would provide state and local law enforcement agencies with materials for training and other assistance to establish, enforce, and evaluate the effectiveness of drug-free school zone enforcement efforts. This section of the new law amended the Controlled Substances Act (CSA), passed in 1970, to include within the scope of penalties available for those found guilty for distributing or manufacturing illegal drugs within 1,000 feet of a playground (the law at the time only specified 100 feet). The provisions under Title XV also amended the Drug-Free Schools and Com-

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munities Act of 1986 to authorize an additional $15 million in federal funds that would be made available through grants and contracts for those programs and activities supporting drug-free schools and communities. Examples of these included the determination of geographical boundaries of schools within the state and the posting of signs that identify all school properties as drugfree school zones. They also included drugabuse education and prevention programs for children, and any enforcement policies that are designed to eliminate the illicit use of alcohol and drugs in the drug-free zones. Money was also included for programs that assist school personnel who work with law enforcement officials to punish legal violations relating to illegal drugs; informing the community of the law and the perimeters of such zones; employing the services of the local or substate regional advisory council on drug abuse education and prevention as a resource for advice and support; and communication to students and school personnel that activities that are illicit and harmful to students will not be tolerated. Title XIX of the 1990 act was the Anabolic Steroids Control Act of 1990. This provision amended the CSA to add anabolic steroids to Schedule III of the act. This change would make it illegal for anyone other than a registrant under the act to prescribe, dispense, or distribute such substances, and requiring that prescription, dispensing, distribution, and possession be for a recognized therapeutic purpose. It also amended the federal Food, Drug and Cosmetic Act to increase the possible criminal fines, imprisonment terms, and other penalties for knowingly distributing or possession of steroids with the intent to distribute human growth hormone for any use in humans other than treatment of a recognized disease or other medical condition, with the assistance of a physician. The law

increased the potential penalties if the offense involved an individual under the age of 18 years old. Another provision was Title XXIII, the Chemical Diversion and Trafficking Act. This law made amendments to the CSA to add specified substances to the list of precursor chemicals subject to controls imposed by that act. The Drug Paraphernalia Title XXIV, made changes to the CSA to make it unlawful to sell or offer for sale, use the mails or any other facility of interstate commerce to transport, or import or export, drug paraphernalia. Title XXVI, the Licit Opium Imports Act, required that the president conduct a review of the U.S. narcotics raw material policy to determine if it would be advisable to continue the reliance on the rule by which at least 80 percent of U.S. imports of narcotics raw material must come from India and Turkey; and to report the results of such review to Congress by April 1, 1991. The law specified the agencies that should be involved and the nature and contents of such review, including a report on the extent of diversion from the licit to illicit market in India from the farm gate through the stockpile. Title XXVII, Sentencing for Methamphetamine Offenses, instructed the U.S. Sentencing Commission to amend the existing guidelines for offenses involving smoking crystal methamphetamine under the CSA so that convictions for such offenses will be assigned an offense level that is two levels above that which would have been assigned to the same offense involving other forms of methamphetamine. Title XXVIII, Drug Enforcement Grants, amended the Omnibus Act to authorize appropriations for fiscal years 1991 and 1992 for grants under the drug control and system improvement grant program (Edward Byrne Memorial Programs). Nancy E. Marion

232   Crime Victims and Drugs

Further Reading Bill Summary and Status: S. 3266, Library of Congress, Thomas; http://thomasl.loc.gov/ cgi-bin/bdquery/z?d101:SN03266:@@@L &summ2=m&. Biskupic, Joan. 1990. “Election-Year Crime Measure Starts Moving Right on Cue.” CQ Weekly (May 19): 1555–58. http://library.cq press.com/cqweekly/WR101409301. “Bush Signs Stripped-Down Crime Bill.” 1991. In CQ Almanac 1990, 46th ed., 486– 99. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqalmanac/ cqal90-1113148. Seghetti, Lisa M., 2007. “Federal Crime Control: Background, Legislation, and Issues.” Washington, DC: Congressional Research Service.

Crime Victims and Drugs According to the Bureau of Justice, in 2004, 17 percent of state prisoners and 18 percent of federal inmates reported that they committed their offense as a way to obtain money so they could buy drugs. These percentages show a slight increase for inmates in the federal system (16 percent in 1997) and a slight decrease for those in the state prisons (19 percent in 1997). In 2002, about a quarter of those convicted of property and drug offenses in local jails reported that they committed their crimes as a way to get money so they could purchase new drugs, compared to 5 percent of violent and public order offenders. Among state prisoners in 2004 the pattern was similar, with property (30 percent) and drug offenders (26 percent) more likely to commit their crimes for drug money than violent (10 percent) and public-order offenders (7 percent). In federal prisons property offenders (11 percent) were less than half as likely as

drug offenders (25 percent) to report drug money as a motive in their offenses. According to the National Crime Victimization Survey, in 2007, there were 5.2 million violent victimizations of residents age 12 or older. Victims of violence were asked to describe whether they perceived the offender to have been drinking or using drugs. • About 26 percent of the victims of violence reported that the offender was using drugs or alcohol. • Overall 41 percent of violent crimes committed against college students and 38 percent of nonstudents were committed by an offender perceived to be using drugs, 1995–2000. About 2 in 5 of all rape/sexual assaults and about a quarter of all robberies against a college student were committed by an offender perceived to be using drugs. Of workplace victims of violence, • 35 percent believed the offender was drinking or using drugs at the time of the incident; • 36 percent did not know if the offender had been drinking or using drugs; • 27 percent of all workplace offenders had not been drinking or using drugs. Victims of workplace violence varied in their perception of whether the offender used alcohol or drugs by occupation: • 47 percent in law enforcement perceived the offender to be using alcohol or drugs; • 35 percent in the medical field; • 31 percent in retail sales. Among victims of violence who were able to describe alcohol or drug use by offenders,

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American Indians (71 percent) were more likely than any other racial group to report an offender under the influence of alcohol and/or drugs. Overall, American Indian victims reported alcohol use by 62 percent of the offenders, compared to 42 percent for all races. In violent crimes experienced by American Indians where use was known, 48 percent of the offenders were under the influence of alcohol, 9 percent were under the influence of drugs, and 14 percent were under the influence of both. In the 2004 Survey of Inmates in State and Federal Correctional Facilities, 32 percent of state prisoners and 26 percent of federal prisoners said they had committed their current offense while under the influence of drugs. Among state prisoners, drug offenders (44 percent) and property offenders (39 percent) reported the highest incidence of drug use at the time of the offense. Among federal prisoners, drug offenders (32 percent) and violent offenders (24 percent) were the most likely to report drug use at the time of their crimes. About 74 percent of state prisoners who had a mental health problem and 56 percent of those without were dependent on or abused alcohol or drugs. By specific type of substance, inmates who had a mental health problem had higher rates of dependence or abuse of drugs than alcohol. Among state prisoners who had a mental health problem, 62 percent were dependent on or abused drugs and 51 percent alcohol. Over a third (37 percent) of state prisoners who had a mental health problem said they had used drugs at the time of the offense, compared to over a quarter (26 percent) of state prisoners without a mental problem. A third of the parents in state prison reported committing their current offense while under the influence of drugs. Parents

were most likely to report the influence of cocaine-based drugs (16 percent) and marijuana (15 percent) while committing their crime. About equal percentages of parents in state prison reported the use of opiates (6 percent) and stimulants (5 percent) at the time of their offense, while 2 percent used depressants or hallucinogens. Thirty-two percent of mothers in state prison reported committing their crime to get drugs or money for drugs, compared to 19 percent of fathers. Adam Stilgenbauer See also: Drug Abuse

Further Reading Duhart, Detis T. 2001. “Violence in the Workplace, 1993–99.” U.S. Bureau of Justice Statistics, Office of Justice Programs. NCJ 190076. http://www.bjs.gov/index.cfm?ty =pbdetail&iid=693, Glaze, Lauren E., and Doris J. James. 2006. “Mental Health Problems of Prison and Jail Inmates.” U.S. Bureau of Justice Statistics, Office of Justice Programs. NCJ 213600. http://www.bjs.gov/index.cfm?ty =pbdetail&iid=789. James, Doris J., and Jennifer C. Karberg. 2005. “Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002.” U.S. Bureau of Justice Statistics, Office of Justice Programs. NCJ 209588. http://www.bjs.gov/ index.cfm?ty=pbdetail&iid=1128. Karberg, Jennifer C., and Christopher J. Mumola. 2006. “Drug Use and Dependence, State and Federal Prisoners, 2004.” U.S. Bureau of Justice Statistics, Office of Justice Programs. NCJ 213530. http://www.bjs .gov/index.cfm?ty=pbdetail&iid=1095. Karberg, Jennifer C., and Christopher J. Mumola. 2006. “Drug Use and Dependence, State and Federal Prisoners, 2004.” U.S. Bureau of Justice Statistics, Office of Justice Programs. http://www.bjs.gov/index .cfm?ty=pbdetail&iid=778.

234   Crop Eradication Mumola, Christopher J. 1999. “Substance Abuse and Treatment of State and Federal Prisoners, 1997.” U.S. Bureau of Justice Statistics, Office of Justice Programs. NCJ 172871. http://www.bjs.gov/index.cfm?ty =pbdetail&iid=1095. Mumola, Christopher J. 2000. “Incarcerated Parents and Their Children.” U.S. Bureau of Justice Statistics, Office of Justice Programs. NCJ 182335. http://www.bjs.gov/ index.cfm?ty=pbdetail&iid=981. U.S. Bureau of Justice Statistics, Office of Justice Programs. 2001. “Violence in the Workplace, 1993–99.” NCJ 190076. U.S. Bureau of Justice Statistics, Office of Justice Programs. “Criminal Victimization in the United States, 2007, Table 32.” http://www .bjs.gov/index.cfm?ty=pbdetail&iid=1095. U.S. Bureau of Justice Statistics, Office of Justice Programs. “Drugs and Crime Facts.” http://www.bjs.gov/content/dcf/duc.cfm.

Crop Eradication Crop eradication is a process by which a government attempts to eliminate the cultivation of certain plants or leaves and thus control drug use by reducing the availability of it. It is a way to reduce the supply of the drug; thus it is a type of “supply side” attack on drug use. Crop eradication is used with cannabis, opium poppy, and coca leaves or bushes by many countries. According to Article 14, paragraph 2 of the 1988 United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, crop eradication is a viable strategy in the fight against drugs. This document states, “Each Party shall take appropriate measures to prevent illicit cultivation of and to eradicate plants containing narcotic or psychotropic substances, such as opium poppy, coca bush and cannabis plants, cultivated illicitly in its territory.” Article 14, paragraph 2 also states: “The measures adopted shall re-

spect fundamental human rights and shall take due account of traditional licit uses . . . as well as the protection of the environment.” There are three types of crop eradication methods. One is the aerial spraying of an herbicide mixture on the plants. This technique is used primarily in Colombia to damage the coca bushes. However, it is not without controversy. It is noted that the consequences of spraying includes damage to individual health, including respiratory problems, skin rashes, diarrhea, eye problems, and miscarriages. It is also linked to damaged food crops and harm to the environment. This was the method used to eradicate drug crops when Jimmy Carter became president. When he entered the Oval Office, it was America’s policy to spray marijuana crops with paraquat, an herbicide that was dangerous if consumed by humans. Because of that, Carter stopped all funding for purchasing and use of paraquat. However, Reagan reversed that policy and allowed agents from the Drug Enforcement Administration to spray national forest areas in the United States with paraquat as a way to eradicate mass numbers of marijuana plants, despite the potential for harm. A significant issue with aerial spraying is “spray drift,” where the herbicide does not land directly on the intended plants. This has been blamed for ruined crops, and the United States has had to compensate farmers for accidental spraying and damages resulting from spray drift. However, spray drift can be minimized by the use of large droplets to deliver the herbicide. Another type of crop eradication is forced manual eradication, which involves teams of people, sometimes accompanied by police or military, who pull coca bushes (or other plants) from the ground. In the case of poppy plants, the stalks of opium plants are chopped up and the fields then ploughed

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with tractors to prevent further growth. This has not proven to be an effective method, as crops are easily replanted. The third type of crop eradication is alternative development. This refers to initiatives for legal, alternative crops or industries that are suggested and supported to replace the illicit crops. Although this sounds easy, it can sometimes take years for the start-up process for a new industry. There can be a lack of infrastructure to support the new industry. Introducing a new crop may necessitate technical support for farmers, marketing assistance, and strengthening the transportation infrastructure in order to get crops to a market. Crop substitution is not always successful because the crops that have been recommended for alternative development programs are not conducive to the soil in the Andes. The soil tends to be more acidic and not conducive to particular crops, such as papayas and pineapples, which have been suggested crop replacements. These have not been profitable for the farmers. President George H. W. Bush supported crop substitution policies. The United States has used different forms of drug crop eradication and alternative development programs in the Andes region (particularly Colombia, Bolivia, and Peru) since the 1980s. This is key to the national drug war in the United States because these countries produce nearly the entire global supply of cocaine. Since the United States has used the drug crop eradication methods (since about 2001), coca cultivation in the Andes region has been reduced by approximately 22 percent. Crop eradication programs supported by the United States have not always been popular nor well accepted in other countries. In Bolivia, for example, there have been public social protests from coca growers over the U.S. eradication efforts in their country. The coca growers have organized themselves

into legally recognized labor unions. These unions and their supporters ran a presidential candidate in 2002 who came in second place. Drug eradication was a vital part of the 1986 Anti–Drug Abuse Act signed by President Reagan. That law included provisions that stipulated that the title of any aircraft that was made available to a foreign country to be used for crop eradication would be retained by the U.S. government. Further, the law provided $2 million of assistance for maintaining any aircraft that is used in drug eradication efforts. The secretary of state was required to research the development and testing of safe and effective herbicides that could be used for aerial eradication of coca. Part of the law credited Bolivia’s cooperation in drug interdiction efforts, and stipulated that funds could be given to that government after it was certified that Bolivia had met its eradication targets. Finally, the bill directed the secretary of state to propose to directors of multilateral development banks that they increase the amount of money available for lending for drug eradication programs in major illicit-drug-producing countries. Nancy E. Marion See also: Andean Trade Preference Act

Further Reading Bush, George. 1990. “Declaration of Cartagena.” February 15. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=18155. “Coca, Drugs and Social Protest in Bolivia and Peru, Latin America.” 2005. Report No. 12, International Crisis Group. March 3. Coffin, Phillip, and Jeremy Bigwood. 2005. “Coca Eradication.” Foreign Policy in Focus, October 6. http://fpif.org/coca_eradication/. “Congress Clears Massive Anti-Drug Measure.” 1987. In CQ Almanac 1986, 42nd

236   Cross-Addiction and Cross-Tolerance ed., 92-106. Washington, DC: Congressional Quarterly. http://library.cqpress.com/ cqalmanac/cqal86-1149752. Contreras, Joseph. 2005. “Failed Plan.” Newsweek International, August 29. “Peru Reaches 2013 Coca Eradication Goal.” 2013. Peruvian Times, November 26. http:// www.peruviantimes.com/26/peru-reaches -2013-coca-eradication-goal/20773/. Steinberg, Michael K., Joseph J. Hobbs, and Kent Mathewson. 2004. Dangerous Harvest: Drug Plants and the Transformation of Indigenous Landscapes. New York: Oxford University Press. U.S. International Trade Commission. 1996. “Andean Trade Preference Act: Impact on U.S. Industries and Consumers and on Drug Crop Substitution.” Washington, DC: U.S. International Trade Commission. Veillette, Connie, and Carolina NavarretteFrias. 2005, “Drug Crop Eradication and Alternative Development in the Andes.” CRS Report for Congress, Congressional Research Service; the Library of Congress. November 18.

Cross-Addiction and Cross-Tolerance Those addicted to a drug will often have a cross-addiction to a second or even a third substance. There are three ways this can happen. One is that the user may replace the original addiction with a second one. In another type of cross addiction, a user could use two drugs concurrently, even though neither drug markedly affects the action of the other. Third, the use could ingest them to enhance or otherwise change the effects of each of the drugs on the body. Cross-tolerance occurs when someone tolerant to one drug becomes addicted to a new and different drug. Generally the second drug is pharmacologically

similar to the first one, or at least can be found in the same pharmacological group. This can occur particularly between drugs in the same class, such as nicotine and caffeine, which are stimulants, or between various hallucinogens. An example is someone who develops a tolerance to alcohol may also have a tolerance to a mild tranquilizer such as Xanax, even though the individual never used Xanax. Or a heroin user may be tolerant to other narcotics, and a cocaine user will be tolerant to amphetamines. A closely related term, reverse tolerance, refers to a situation where smaller quantities of a drug produce the same effects as did previous larger doses. In cross-addiction, a user may substitute alcohol for marijuana, particularly when the illegality of marijuana prevents the user from getting high. In the second example of cross-addiction, alcohol and nicotine may be cross-addictions that exist concurrently without materially affecting the effect that each has on the user. In the third case, the user may abuse cocaine and alcohol at the same time to boost and, in some cases, mediate the effect of the other. Cross-addictions can be exceedingly dangerous. Not only is each substance toxic on its own, but the combination can produce synergistic effects—that is, the combined drugs have an even more powerful effect than the sum of effects one would expect from both drugs added together. Unintended overdoses occur regularly in people who are cross-addicted to various substances, even though the quantity of each substance, used alone, may have been relatively moderate. Frequently, cross-addictions are referred to as multisubstance addictions or polysubstance addictions, but there are distinctions that should be made. In cross-addiction, one drug usually predominates as the addictive drug; in multisubstance or polysubstance addictions, the individual uses three or more

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drugs together in an addictive pattern, and no single drug predominates. Kathryn H. Hollen

Door to Relapse.” Hazelden Publishing and Educational Services: New York: Films Media Group.

See also: Addiction; Alcohol Use and Abuse; Betty Ford Center; Cocaine and Crack

Johnson, Marilys C. 1999. Cross-addiction: The Hidden Risks of Multiple Addictions. New York: Rosen Pub. Group.

Further Reading Hazelden Publishing and Educational Services. 2012. “Cross-Addiction: The Back

West, James W. 2010. “What Is Cross Addiction?” Betty Ford Center. http://www .bettyfordcenter.org/treatment/doctors -office/what-is-cross-addiction.php.

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D journalists Guy Gugliotta and Jeff Leen, the Dadeland Massacre was part of a trend that showed how the Colombians would transform Miami into the cocaine Casablanca of the 1980s. Metropolitan Dade County was branded one of the most violent cities in the United States and would become for a time the murder capital of the nation. During that time, Miami had the highest homicide rate in the country. As a result, South Florida saw an unprecedented federal police effort against drug smuggling. At the time, the DEA’s biggest division was based in Miami. They rounded up the drug kingpins and worked to break up the cocaine trafficking routes between Colombia, the Bahamas, and Florida. The 1979 incident at Dadeland Mall was the first publicly visible evidence of the growing presence of Colombian drug dealers in the United States. This drug network had been conceived by Carlos Enrique LehderRivas, who had met George Jung, a drug trafficker from Boston, while in prison. Before their meeting, Jung had been transporting tons of marijuana in private planes. Seeing how successful Jung had been by using this method of smuggling marijuana, Lehder reasoned that cocaine could also be moved in ton quantities in a similar way. The Dadeland Massacre was a pivotal moment, many crediting it with the initiation of the War on Drugs. At the time Miami had become the most dangerous place to live in the United States, and was becoming known as the “Drug Capital of the World” with 100,000 people in Miami involved in the drug trade in some way. Drug lords killed

Dadeland “Massacre” (Miami, Florida) (1979) On a hot day in July 1979, an incident that occurred in the Dadeland Mall, South Florida’s largest shopping center 10 miles south of Miami, offered a startling glimpse of the emerging drug trade in South Florida. At about 2:30 P.M. in broad daylight, two gunmen exited a white paneled Ford truck that had the phrase “Happy Time Complete Party Supply” on the side. Two more gunmen exited a white Mercedes-Benz that approached from the other direction. The men from the Mercedes entered a Crown Liquors store, ordered a bottle of Chivas Regal. Meanwhile, the two men from the truck entered the store, and with a .380 Beretta automatic handgun and an Ingram MAC-100 machine pistol, gunned down two male customers and wounded the store clerk. The men then ran back to the truck and sped away. The dead men were eventually identified as a Colombia-based cocaine trafficker and his bodyguard. The shootout was quickly established as an attack by one Colombian drug cartel on a rival cartel. It was evidence that those involved in the Colombian drug trade had been established in the United States and that it would be much different from the marijuana traffickers. The Colombians would be much more organized and much more violent and ruthless than anything law enforcement had experienced before. The shootouts made national headlines and introduced the term “cocaine cowboys” into the English language. According to 239

240   Dai, Bingham (1899–1996)

each other as they were fighting to protect their turf, killing their opponents to control their territories. The events surrounding the Dadeland Massacre also led directly into the Cocaine Wars. Griselda Blanco, aka the “godmother of cocaine” and more notoriously “the black widow,” has often been considered to be the person who was in charge of the massacre, and the one who ordered the hits. She was largely responsible for a chain of events that developed into the “Cocaine Wars” fought by the “Kings of Cocaine.” Blanco’s story may be easier understood by looking at the numbers. She turned tricks at 14, and quickly got into the drug trade. She was responsible for moving 300 kilos of cocaine a month by the time she was in her forties. Because of her success, she became known as the “godmother” of the cocaine trade. Blanco had up to 20 aliases (police said it was closer to 40), and it is thought that she ordered some 250 murders. In 1985, Blanco died at the Cardiso butcher shop on 29th Street in a Medellín neighborhood. She was gunned down at the age of 69. Ron Chepesiuk See also: Blanco, Griselda; Colombian Cartels; Jung, George

Further Reading “DEA: 1975–1980.” http://www.justice.gov/ dea/about/history/1975-1980.pdf. Gray, Madison. 2012. “Griselda Blanco, ‘Grandmother’ of Cocaine, Gunned Down in Colombia.” Time Newsfeed, September 4. http://newsfeed.time.com/2012/09/04/ griselda-blanco-godmother-of-cocaine -gunned-down-in-colombia/. Gugliotta, Guy, and Jeff Leen. 1990. Kings of Cocaine. New York: Simon and Schuster. Valdez, Diana Washington. 2011. “Cartel Drug Trafficking Reminiscent of ’80s Miami.” El

Paso Times, July 18. http://www.elpasotimes. com/ci_18497864.

Dai, Bingham (1899–1996) Bingham Dai was, along with Alfred Lindesmith, one of the first sociologists to study opiate addiction as a social behavior, rather than a medical disease. His work helped bring a new social perspective to the way that researchers viewed addiction, ushering the study of opiate use out of the specialized realms of medicine and psychiatry, and initiating inquiries into the connections between opiate users and their social environments. Bingham Dai was born in Futien, China, on August 22, 1899, and he completed his bachelor’s degree at St. John’s University in Shanghai in 1923. After teaching high school, Dai began to work with the Shanghai-based National Anti-Opium Association. The group sought to reduce the prevalence of addiction by educating people on the dangers of the drug, and pushing for prohibitive legislation against its use. The subject became more personal for Dai when he saw his uncle, who had worked with him on anti-opium campaigns, fall victim to opiate addiction and die from complications related to it. This experience led Dai to believe that moral persuasion and legal sanctions alone were not enough to battle the problem of opiate addiction, and he sought to develop a more compassionate, understanding view of addiction that was free of the moral biases that colored the way most individuals—both in China and the United States—viewed the opium habit and opiate addicts. The Provincial Government of Futien sent Dai to the United States to study education and also to solicit prominent Americans to assist China in its battle against drug addiction. But when he came to the United States to study sociology at Yale and the University

Dai, Bingham (1899–1996)  241

of Chicago, Dai sought not only to serve as an advocate for China’s anti-opium organizations, but also to study the phenomenon of opiate addiction from a new perspective. At Yale, he wrote a proposal to study addiction as a sociological problem—one that reflected tensions in the way that individuals related to their social worlds—and not merely as a medical or psychiatric one. Since he believed that merely addressing addiction with lawand-order measures that restricted supplies would not suffice, Dai’s proposal was met with skepticism from Lawrence Dunham at the Bureau of Social Hygiene when he solicited him for help with his work. Others, such as Walter Treadway of the Division of Mental Hygiene in the U.S. Public Health Service, were intrigued by his proposal, and soon Dai received permission from Federal Bureau of Narcotics chief Harry J. Anslinger to undertake a detailed study, based on arrest and conviction reports, of opiate addicts in Chicago. Dai’s study, Opium Addiction in Chicago, was published in 1937. Dai’s focus was not on compiling numbers or studying the way that addiction worked, but rather on the relationship between opiate users and their social environments. Dai found that Chicago addicts generally lived in areas of the city with low rents, high vacancy rates, and a high number of transient and homeless people. Due to their destitution and instability, these neighborhoods did not offer the sense of community or instill the social norms that were common in mainstream society. Consequently, Dai concluded that addiction was more likely to strike individuals who lived in areas where people lived by themselves and social control was minimal. Thus the social environment, Dai found, could be a key risk factor for addiction. To determine which individuals in these downtrodden areas were more likely to become addicted, Dai conducted interviews

with addicts at local psychiatric hospitals and shelters. Using a psychoanalytic model, Dai unearthed childhood traumas, bad parenting, and other problems in addicts’ pasts that predisposed them to addiction. In addition to drawing conclusions based on what addicts told him, Dai also observed addicts’ behavior, and concluded that many of them did not follow social norms. To alleviate the feelings of isolation and emotional pain that they experienced as outcasts, Dai concluded, many addicts sought refuge in opiates. Thus individuals who became addicts were socially maladjusted—a conclusion that gave backing to the theories of other addiction specialists such as Lawrence Kolb, who believed that addiction had fundamentally psychological underpinnings. Dai’s research did have one major shortcoming, as he only interviewed individuals who had either run afoul of the law or were in poverty—meaning that all of the people he surveyed were all socially outcast or deprived—so he did not get a picture of what opiate addiction was like for the well-to-do or those who had not been arrested for their drug use. Nonetheless, Dai’s research was groundbreaking, as it was the first study that attempted to construct the addicts’ social world as they experienced it, instead of simply describing it from an outsider’s perspective. Furthermore, he showed that it was not necessarily due to individual shortcomings that people became addicted, but that the social environment could predispose people to opiate addiction. Addicts, therefore, were not always at fault for their disease—the society that put them in such a poor and precarious environment also shouldered some of the blame. With Opium Addiction in Chicago, Dai pioneered a new way to understand addiction. Unlike law enforcement, which believed that addiction was a willful choice made by drug users, and unlike the medical establishment,

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which maintained that psychological problems facilitated addiction, Dai established that the social environment planted the psychological and antisocial seed out of which addiction could grow. From 1943 to 1969, Dai was on the faculty of Duke University, retiring as professor emeritus. He worked as a consultant and guest lecturer after that, and died in Spruce Pine, North Carolina, in 1996. Howard Padwa and Jacob A. Cunningham See also: Anslinger, Harry J.; Committee on Drug Addictions; Lindesmith, Alfred R.

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press. Chih-hsiang, Hoh, ed. 1933. Who’s Who in China: Biographies of Chinese. Supplement to the Fourth Edition. Shanghai: China Weekly Review. Dai, Bingham. 1929. “The Commission of Inquiry and Opium Monopoly: A Frank Discussion of the Problem of Opium-Smoking in the Far Eastern Colonies of Foreign Powers.” Shanghai, China: National Anti-opium Association of China. Dai, Bingham. 1970. Opium Addiction in Chicago. Montclair, NJ: Patterson Smith.

Date Rape Drugs Date rape drugs are those substances that can be used by an offender to alter another person’s consciousness and then victimize that person, usually for sexual reasons. After the drug is ingested by the victim, the offender is able to touch the victim’s body or even have sexual intercourse with the victim. The victim is usually unconscious or unable to reject the offender’s advances

toward them. These drugs, which have no color, smell, or taste, are typically dissolved into a drink when the victim is not paying attention. The victim is not aware that they are ingesting the substance. Within a few minutes, the victim will usually become weak, confused, and lose consciousness. In some victims, they can cause death. How long the drug lasts depends on the size of the victim, their tolerance for drugs, their metabolism, how much food is in their system, or how much of the drug was ingested. Most victims who have taken a date rape drug are unable to recall anything the next day. These drugs are often associated with dance clubs and raves, so they are often called “club drugs.” The use of date rape drugs is becoming more frequent. About 25 percent of women reported that these drugs were a factor in a rape. However, the number could actually be higher because most crimes committed with date rape drugs are not reported. The victim may not know (or may not remember) that the offense occurred, or they may not report it. The crimes may also be unsolved or unproven. There are three common date rape drugs. One is Rohypnol, which is the trade name for flunitrazepam. Two very similar drugs are clonazepam (which is sometimes sold as Klonopin or Rivotril) and alprazolam (sold as Xanax). Street names for Rohypnol include Lunch Money, Mexican Valium, Mind Erasers, R-2, Rib, Roach, Roopies, Roofies, Rope, Riffies, or Whitey. Usually Rohypnol is sold in a pill form that dissolves very quickly in liquids. The pills are most often small and white, but more recently, Rohypnol has been found as oval and gray pills. Once ingested, the effects of Rohypnol can be seen within 30 minutes, and the effects can last for many hours. Some signs that a person has ingested Rohypnol are slurred

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speech, loss of muscle control, difficulty with motor skills, nausea, confusion, dizziness, sleepiness, and low blood pressure. Those who use it can also feel a loss of inhibitions and impaired judgment. This drug is illegal in the United States, but is smuggled into the country and sold illegally. The drug is prescribed in Europe and Mexico for those suffering from sleep disorders. Another common date rape drug is GHB. This drug is most often found in a liquid form, but can also come as a pill or white powder. While it has no specific odor or color, it can make drinks taste salty. Once ingested, a person who has ingested GHB can feel symptoms as quickly as 15 minutes, and can feel them for up to four hours. The symptoms of GHB include drowsiness, dizziness, nausea, loss of consciousness, seizures, difficulty breathing, tremors, sweating, vomiting, and a slow heart rate. Too much of the drug can result in a coma or death. GHB is legal in the United States when prescribed by a physician to treat a sleeping disorder called narcolepsy. A third date rape drug is ketamine, which is called Black Hole, Bump, Green, Jet, K, K-Hole, Kit Kat, Purple Special K, or Super Acid. This drug is found as a liquid or a white powder. Ketamine is a fast-acting drug that may cause a victim to lose their memory or have distorted perception of sight and sound, a confused sense of time, feelings of being out of control, problems breathing, convulsions, vomiting, loss of coordination, and slurred speech. Ketamine is used in the United States medically as anesthetic, but mostly on animals. It has been stolen from veterinary clinics and then sold on the streets. While the term “date rape” drugs is very common, most drug experts tend to use the term “drug-facilitated sexual assault” drugs. Even though these drugs may be legal if pre-

scribed by a medical doctor for a specified medical condition, they are not safe for the general public to use. They are strong drugs that are even more dangerous when mixed with alcohol or when used in a higher dosage than recommended. It is vital that people are very careful in bars and at parties so they are not drugged with a date-rape drug. Party-goers must never accept drinks from strangers, or leave their drinks unattended. It is also important that drinks are never shared with others, and that people refrain from drinking other people’s beverages. If drinks have an odd flavor, consistency, or color, they should not be consumed. A person who feels symptoms of being drugged should seek medical attention immediately. Those symptoms include feeling drunker than you should based on the amount of alcohol ingested, or waking up feeling disoriented or unable to recall the events of the previous night. Nancy E. Marion See also: Alcohol-Facilitated Sexual Assault; Ketamine

Further Reading Crawford, Emily. 2004. Risk Perception and Drug-Facilitated Sexual Assault. Oxford, OH: Miami University. “Date Rape Drugs.” Medicine.net. http://www .medicinenet.com/date_rape_drugs/article .htm. Falk, Patricia J. 2002. Rape by Drugs: A Statutory Overview and Proposals for Reform. Tucson: James E. Rogers College of Law, University of Arizona. LeBeau, Marc A., and Ashraf Mozayani. 2001. Drug Facilitated Sexual Assault: A Forensic Handbook. San Diego: Academic Press. “Rohypnol: Physiological Effects.” 2009. Controlled Substances, June 20. http://ecstasy

244  Decriminalization .com.ua/rohypnol/rohypnol-physiological -effects. Society of Obstetricians and Gynecologists of Canada. “The Hard Facts: Drug Facilitated Assault.” Sexual Health. http://www.sexualityandu.ca/sexual-health/drug_facilitated_ sexual_assault/the-hard-facts. University of Wisconsin. “What to Do If You’ve Been Drugged.” University Health Services. http://uhs.wisc.edu/assault/drugged.shtml.

Decriminalization There is considerable support among the public for the decriminalization of some, if not all, illicit drugs. Decriminalizing means that penalties for possession or use of the drug will be reduced to the point that fewer people will face legal penalties as a result of their drug possession or use. Those that are charged with drug offenses will then face fewer, or lower, charges. This is opposed to legalization, which would erase all criminal penalties for use or possession of a drug. Opponents of decriminalization argue that decriminalization could be perceived as encouraging drug use and could then result in an increased number of drug addicts. Further, illicit drugs are harmful and cause serious harm and damage to individuals, families, and society. Because of that, drugs should remain illegal. Not only does the public support drug legalization, many law enforcement officials also support drug decriminalization. They argue that removing low-level drug offenders from prisons will reduce the number of people being held in state custody. These “victimless” drug users would no longer cause overcrowding problems in the courts and prison systems. For law enforcement, decriminalizing drugs would allow them to spend resources on other, more serious, crim-

inal behavior. Further, the quality and purity of the drugs, as well as doses of drugs, would be standardized, which would make them safer for users. Finally, society could focus its limited resources on the rehabilitation of users, or could find more effective methods to reduce or eliminate drug abuse. One of the most compelling reasons to decriminalize drugs is simply that prohibiting them does not seem to work. The United States has spent hundreds of billions of dollars on law enforcement efforts to eliminate illicit drug use, but demand for drugs remains high. Since the terrorist attacks of September 11, 2001, some people have pointed out that much of the opium found around the world originates in Afghanistan, and is used to fund the terrorists’ activities. They argue that it makes sense to decriminalize opium as a way to destroy the underworld networks that fund these organizations. On July 1, 2001, Portugal decriminalized all drugs in their country, including cocaine and heroin. Under the new laws, drug possession for personal use and drug use are still technically illegal, but violations are considered to be administrative violations only, as opposed to criminal. Drug trafficking continues to be prosecuted as a criminal offense. The shift was considered to be the most effective government policy to reduce drug addiction. Since Portugal decriminalized drugs, the use of many different types of drugs has decreased. Moreover, the rate of people who have consumed a particular drug over the course of their lifetime has decreased for some age groups. For those who are 13–15 years old, the rate decreased from 14.1 percent in 2001 to 10.6 percent in 2006. The lifetime prevalence rate also decreased for those who are 16–18. For that same age group, prevalence rates for psychoactive drugs have also decreased. The total number of drug-related deaths has also decreased.

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Moreover, any resources that had been spent to prosecute and imprison drug addicts are now being used to provide treatment programs to those in need. There have been calls to legalize many drugs in the United States, the most common drug being marijuana. Fifty-eight percent of Americans now support the legalization of marijuana. That is an increase from 2011, when support was only 50 percent. Much of the support for legalization of the drug can be found among independent voters. About 62 percent of these voters support marijuana legalization, which is an increase from 50 percent in 2012. Most people under the age of 64 support laws to decriminalize marijuana. Two-thirds of those people aged 18 to 29 currently support it. Today, 21 states and the District of Columbia have laws that allow for marijuana use in some way. So far, only the states of Colorado and Washington have legalized recreational marijuana use. Most states allow for the use of marijuana only for medical purposes (e.g., pain, nausea, glaucoma, sleep disorders) with a physician’s recommendation. In Colorado, all stores that sell marijuana must participate in the Marijuana Inventory Tracking Solution as a way to ensure the marijuana inventories can be traced from the cultivation or manufacturing plant through the sale. Kathryn H. Hollen See also: Medical Marijuana

Further Reading Drug Policy Alliance. 2013. “Approaches to Decriminalizing Drug Use & Possession.” http://www.drugpolicy.org/sites/default/ files/DPA_Fact%20Sheet_Approaches%20 to%20Decriminalizing%20Drug%20 Use%20and%20Possession.pdf. Edwards-Levy, A. 2013. “Support for Legalizing Marijuana Grows to Highest

Point Ever in Gallup Poll.” Huffington Post Politics, October 22. http://www .huffingtonpost.com/2013/10/22/legal -marijuana-poll_n_4143995.html. Fisher, Gary L. 2006. Rethinking Our War on Drugs: Candid Talk about Controversial Issues. Westport, CT: Praeger. Greenwald, G. “Drug Decriminalization in Portugal: Lessons for Creating Fair and Successful Drug Policies.” Cato Institute. Husak, Douglas. 2005. The Legalization of Drugs. Cambridge: Cambridge University Press. Marion, Nancy E. 2014. The Medical Marijuana Maze. Durham, NC: Carolina Academic Press. Schonsheck, Jonathan. 1994. On Criminalization: An Essay in the Philosophy of the Criminal Law. Boston: Kluwer Academic Publishers. State Marijuana Laws Map. Governing the State and Localities. http://www.governing. com/gov-data/state-marijuana-laws-map -medical-recreational.html.

Demand Reduction Demand Reduction programs are used to reduce the demand for illicit drugs through education or scare tactics. The education programs include DARE (Drug Abuse Resistance Education). The scare tactics include showing children what the possible effects of using drugs could be. A good example is the commercials that use former smokers who have suffered multiple damages to their bodies to show what smoking has done to them. Most demand reduction curriculums are offered through schools and are geared toward young people. Others are geared toward the general public, through print and media ads.

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Demand reduction programs have been noted to be cost effective to society, because it is cheaper to convince people to refrain from drug use than to pay for the consequences of drug use, including contact with the criminal justice system or health care costs. The demand reduction programs vary significantly. Often, the programs involve the classroom teacher presenting drug education to children. In some places, the line-up can include police officers, doctors, or even recovered addicts who come and speak to students. While most programs are held in the school, some are able to transport the students to various places such as hospitals, drug treatment centers, courtrooms, or jails. While some schools are able to integrate the antidrug educational material with other course curriculum, that is not done in all districts. Because the programs vary so greatly, the effectiveness does as well. However, recent attempts at reducing societal demand for illicit drugs through either school-based or mass education campaigns have generally not been successful. While community expectations of antidrug programs are often unrealistically high, any success has typically been limited and transient. Any benefits seen from these programs have been limited to a change in attitudes toward the use of illicit drugs (i.e., less support of drug use) as opposed to any long-term or significant reduction in consumption. Research has also shown that any impacts from the demand reduction programs may take many years to materialize. Different approaches for improving the effectiveness of programs geared toward reducing demand for drugs have been proposed, but the implementation of drug education programs often lacks substance and is not consistent. It should come as no surprise that the demand reduction programs have limited

success. Since the target population is often young, the descriptions of the potential harmfulness of drugs is not taken seriously or as credible. Research indicates, however, that educational campaigns geared toward reducing tobacco smoking have been more effective. It is not known why public education campaigns to reduce tobacco use tend to see results whereas those geared toward reducing alcohol and illicit drugs are less effective. Nonetheless, the anti-tobacco campaigns were successful and the harmfulness of tobacco use is now accepted. Even though significant resources have been spent on demand reduction programs, the public continues to seek and use drugs. On the federal level, there are many national programs geared toward demand reduction. The Drug Enforcement Administration’s (DEA) Office of Congressional and Public Affairs established a Demand Reduction Section that would be responsible for implementing the demand reduction programs of the DEA. According to the DEA, the goals of the Demand Reduction Section were to: establish an aggressive program of public awareness education for opinion and community leaders; reach millions of school-aged children with appropriate and specific drug education and prevention programs; provide support to reenergize the national “parents movement”; and provide businesses and other employees with the tools necessary for establishing and maintaining drug-free workplaces. These goals were noted in the DEA’s Strategic Plan. Their initiatives were described in the Demand Reduction Section, under the strategic goal “to reduce drug-related crime in U.S. communities by utilizing expertise as required by local situations.” The specific strategic objective is “to educate local audi-

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ences with aggressive drug demand reduction programs.” The Office of Justice Programs, found within the U.S. Justice Department, also uses many different programs to lessen drug demand. There are 11 drug demand reduction programs. They include:   1. Byrne Discretionary Grant Program: provides grant funding to states and local government to support courses for preventing drug use and violent crime.   2. Byrne Formula Grant Program: provides federal funding to states and local governments to implement programs that provide a high probability of improving the different functions of the criminal justice system, particularly those that have a special emphasis on drug and violent crime control strategies.   3. Indian Alcohol and Substance Abuse Demonstration Program: provides grant funding for programs that are designed to reduce violent and nonviolent crimes associated with the use of alcohol and controlled substances in tribal communities.   4. Criminal Records Upgrade Program: provides grant funding to states for improving the automation, accuracy, and completeness of criminal records, including protective orders involving domestic violence and stalking; developing complete and accurate sex offender registries; and facilitating the interstate exchange of such records through national systems.  5. Residential Substance Abuse Treatment Program: provides federal assistance to improve the ability of states and local governments to provide

residential substance abuse treatment for incarcerated inmates.  6. Correctional Grant Programs: provides federal monies for constructing correctional facilities for the incarceration of offenders.  7. Weed and Seed Program: allocates federal money to communities that seek to create comprehensive strategies to “weed out” violent crime, drug use, and gun trafficking, and then “seed” the neighborhood with programs geared toward achieving crime prevention and economic revitalization.  8. Safe Start Program: allocates grant funds to improve the accessibility, delivery, and quality of services for young children (up to age 6) and their families who have been exposed to violence or are at risk of exposure.  9. Juvenile Justice Discretionary Grant Program: provides grant money through the Office of Juvenile Justice and Delinquency Prevention to support research, evaluation, information dissemination, training and technical assistance, statistics, program development and demonstration, and the replication of programs to prevent juvenile crime. 10. Title V–Tribal Youth Programs: allocates grant funding, technical assistance, and training for local delinquency prevention programs. In addition to Tribal Youth Programs, Title V includes grant funding for: (1) School Safety Initiative, (2) Safe Schools Task Forces, (3) programs to combat underage drinking, and (4) community prevention grants. 11. Drug Prevention Demonstration Program: a grant program designed to develop, demonstrate, and test pro-

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grams that increase children’s and youth’s perception that drug use is risky, harmful, and unattractive. Nancy E. Marion

Wodak, Alex. 2011. “Demand Reduction and Harm Reduction.” Global Commission on Drug Policies. http://www.globalcommissionondrugs.org/wpcontent/themes/gcdp_ v1/pdf/Global_ComAlex_Wodak.pdf.

See also: Drug Abuse; Drug Enforcement Administration

Dependence Further Reading Madden, Gregory J. 2008. “Ammunition for Fighting a Demand-Side War on Drugs: A Review of ‘Contingency Management in Substance Abuse Treatment.’” Journal of Applied Behavior Analysis 41(4): 645–51. Passell, Peter. 1988. “Economic Scene: A Demand-Side Cocaine Policy.” New York Times, March 16. http://www.nytimes .com/1988/03/16/business/economicscene-a-demand-side-cocaine-policy.html. “Supply and Demand.” Drug Policy Alliance. http://www.drugpolicy.org/supply-and -demand. United Nations, Declaration on the Guiding Principles of Drug Demand Reduction. http:// www.un.org/ga/20special/demand.htm. United Nations, Economic and Social Commission for Asia and the Pacific. 1999. Strategies for Community-Based Demand Reduction. New York: United Nations. United Nations General Assembly, Special Session on the World Drug Problem. 1998. “Reducing the Demand for Drugs.” http:// www.un.org/ga/20special/featur/demand .htm. United Nations Office on Drugs and Crime. “Southeast Asia and Pacific: Drug Demand Reduction.” http://www.unodc.org/southeastasiaandpacific/en/topics/drug-demand -reduction/index.html. United States Office of Drug Control Policy, Executive Office of the White House. 2011. “Fact Sheet: U.S. Demand Reduction Efforts.” http://permanent.access.gpo.gov/gpo 8552/demand_reduction.pdf.

Drug dependence is a pathological condition in which a patient’s normal brain function is disrupted or altered to the point where that person is not able to control his or her drugseeking and drug-using behavior. It is related to how a user’s body adapts or changes as a result of drug use, making the user crave more of the drug. When the drug is not used, the individual may experience symptoms such as general discomfort. A person who is dependent on a drug has not lost total control over their behavior. In some cases, a person with a dependence on a drug may display a tolerance to a drug and may engage in drug-seeking behavior. In other cases, the desire for a drug will disappear relatively soon after the patients stops using the drug. Dependence on a drug is often identified when a person uses a drug compulsively or repetitively. A user will usually have increased tolerance to that drug over time. A user with a dependence to a drug may have the following symptoms: • Tolerance: Over time, the user will require more of the drug for the same experience. If they have a diminished effect after ingesting the same amount of the drug, and have a need for more of the drug to experience the effect, a patient is considered to be drug dependent. • Withdrawal: A drug-dependent user may experience some symptoms of

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•

•

•

•

•

withdrawal, such as shaking, sweating, nausea, or headaches if they do not ingest the drug. In order to avoid the symptoms, another dose of the drug is needed. Dosage: A drug-dependent user will ingest the drug for longer than originally intended or in larger doses than recommended. Use: A drug-dependent user will typically have a desire to either cut down or completely eliminate using the drug. Drug-Seeking Behavior: A dependent user will spend much of their time attempting to obtain the drug of choice. Social Activities: The drug-dependent user will often stop attending social activities, work, or recreational activities because of their dependence. Continued Drug Use: A dependent user will continue to use a drug, even if they know it will result in poor health, or have a health concern that will be aggravated by their use.

Drug dependence occurs when a user’s body adapts to a drug so that more of the substance is needed for the user to achieve a certain effect. This is called tolerance. As more of the drug is used, a person’s tolerance to that drug increases, and more of the substance is required to elicit a specific physical or mental effect. If the user who is dependent on a drug suddenly stops using it, the user may experience withdrawal symptoms. Sometimes, dependence is confused with addiction, which is the compulsive use of a drug that results in harm to the user. A person who is addicted to a drug is not able to stop using it, despite being unable to meet work, social, or family obligations. They also experience strong withdrawal symptoms that necessitate more use.

Members of the public and professionals who assess and treat those who suffer from drug abuse often become confused by the use of the word “dependence” in referring to drug abuse or addiction. While many people use the terms dependence and addiction interchangeably, others insist there are significant differences between the two terms that should be clarified and maintained. Some of the confusion has been caused by the American Psychiatric Association. In 1987, the organization was preparing the third edition of Diagnostic and Statistical Manual of Mental Disorders. In it, they substituted the term dependence for addiction as a way to lessen the stigma that is sometimes associated with addiction. The change was largely unnoticed until it again appeared in the fourth edition. At that point, the people began to make comments about the terms. Many noted that the traditional definitions of the terms addiction and dependence, while very similar, are technically quite different. Specifically, dependence does not incorporate a loss of control that is an essential aspect of addiction. The debate among medical professionals and other experts over the terms dependence versus addiction continues, and will probably continue long into the future as we learn more about drug use patterns. Kathryn H. Hollen See also: Addictive Personality; Alcoholism; Treatment

Further Reading American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision. Washington, DC: American Psychiatric Association, 2000. Colligan, L. H. 2011. Drug Dependence. New York: Marshall Cavendish Benchmark.

250  Depressants Erickson, Carlton K. The Science of Addiction: From Neurobiology to Treatment. New York: Norton, 2007. Hoffman, John, and Susan Froemke, eds. Addiction: Why Can’t They Just Stop? New York: Rodale, 2007. Isralowitz, Richard E., and Peter L. Myers. 2011. Illicit Drugs. Santa Barbara, CA: Greenwood Press. Jarvis, Tracey J. 2005. Treatment Approaches for Alcohol and Drug Dependence: An Introductory Guide. Hoboken, NJ: John Wiley. Klosterman, Lorrie. 2008. Drug Dependence. New York: Marshall Cavendish Benchmark. National Institute in DrugAbuse. U.S. Department of Health and Human Services. “Is There a Difference between Physical Dependence and Addiction?” Principles of Drug Addiction Treatment: A Research-Based Guide. http://www.drugabuse.gov/publications/ principles-drug-addiction-treatmentresearch-based-guide-third-edition/ frequently-asked-questions/there-difference -between-physical-dependence. World Health Organization, Western Pacific Region. 2009. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Manila: World Health Organization.

Depressants Depressants are substances that slow down the normal function of the central nervous system. By suppressing activity in the central nervous system (CNS), depressants such as alcohol, sedatives, and tranquilizers help alleviate anxiety, induce sleep, and reduce stress. They work by triggering the release of gamma amino butyric acid (GABA), an inhibitory neurotransmitter that, among its other effects, produces a sense of calm and

lowers respiration rate. Of the hundreds of drugs that fall into the category of depressants, alcohol is the most widely used and abused. It is almost universally available and accessible, and although many believe it is a stimulant because of the levity and euphoria it initially produces, chemically it is a depressant that in large doses can dangerously suppress breathing and other vital functions. Two club drugs, gamma hydroxybutyric acid (GHB) and flunitrazepam (Rohypnol), are depressants that are sometimes categorized as hallucinogens. The major depressants that are subject to abuse are alcohol, barbiturates (sedative-hypnotic drugs), benzodiazepines (tranquilizers), chloral hydrate, flunitrazepam, GHB, glutethimide, meprobamate, methaqualone, and paraldehyde. Methaqualone was often used during the 1960s and 1970s by college students who referred to capsules containing the drug as “ludes,” but pharmaceutical companies stopped marketing the drug in 1984. The sudden discontinuation of depressants, such as during detoxification from alcoholism or barbiturate addiction, can lead to seizures as the brain tries to rebound and rebalance neurochemical levels disrupted by use of the depressants. For this reason, anyone withdrawing from abuse of depressants, especially more than one, would be advised to consult with a medical professional first. Depressants may be swallowed, injected, smoked, or snorted. Some depressants are dispensed in vapor form and inhaled. There is some evidence that in the ancient Greek, Judaic, Egyptian, and Babylonian cultures, the aroma of burnt spices and other natural vapors were enjoyed by the citizens and sometimes used in religious rituals. In more recent cultures, more synthetic solvents were manufactured that produce a stronger psychoactive effect when used. They come in many commercially sold

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products, most of which are not intended for medical use. Depressants are commonly used to reduce anxiety, lower inhibitions, or induce sleep. If they are only used for a few days to alleviate a temporary problem or concern, then they are typically quite safe. However, if they are used over a longer time span, depressants can be very addictive. The user will experience a diminished effect due to tolerance. If their use is discontinued, insomnia will often return. Those who use depressants sometimes see side effects such as a slowed pulse and breathing, slurred speech, drowsiness, lowered blood pressure, poor concentration, fatigue, and confusion, as well as impaired coordination, memory, and judgment. Rohypnol (flunitrazepam) may cause visual and gastrointestinal disturbances, urinary retention, and temporary memory loss. Prolonged or heavy abuse of any type of depressant can result in a drug addiction, impaired sexual function, chronic sleep problems, respiratory depression and respiratory arrest, and even death. Those who abuse depressants with high doses of the drugs may experience physical dependence. If the dosage of the drug is either reduced or stopped, serious withdrawal symptoms may result. CNS depressants work by slowing the brain’s activity, so when someone stops taking a CNS depressant very suddenly, activity in the brain can race out of control. In serious cases, users can experience seizures or even death. The term used for the potentially deadly effect of sudden withdrawal is delirium tremens, or DTs. These are often experienced by chronic alcoholics and include tremors, sweating, insomnia, disorientation, and seizures. Chronic alcohol use can also lead to liver dysfunction (alcoholic hepatitis or cirrhosis), cancer, heart disease, and neuro-

logical dysfunction (i.e., brain damage accompanied by psychosis). Someone who is either thinking about discontinuing use of depressants, or who has stopped taking the drugs and is suffering withdrawal symptoms, should seek medical treatment. Counseling through either an inpatient or outpatient setting can be very helpful in showing people how to overcome their addiction to CNS depressants. One type of therapy, called cognitive behavioral therapy, has been used successfully to help people in treatment for abuse of benzodiazepines. This type of therapy focuses on helping to change a patient’s thinking, expectations, and behaviors while simultaneously increasing their skills for coping with various life stressors. Depressant drugs go by many different names on the streets. They include: Barbiturates: Barbs, Reds, Re Birds, Phennies, Tooies, Yellows, Yellow Jackets Benzodiazepines: Candy, Downers, Sleeping Pills, Tranks, Benzos Flunitrazepam: Forget-Me-Pill, Mexican Valium, R2, Roche, Roofies, Roofinol, Rope, Rophies GHB: G, Georgia Home Boy, Grievous Bodily Harm, Liquid Ecstasy Methaqualone: Ludes, Mandrex, Quad, Disco Biscuits Many celebrities have died because of addictions or abuse of depressants. Errol Flynn (actor) died of acute alcoholism; Jeff Hanneman (musician) died of cirrhosis of the liver; Jimi Hendrix (musician) passed away due to respiratory arrest caused by an overdose of alcohol and barbiturates. Virginia Hill (Chicago Mob courier) died of a sleeping pill overdose, and Jack Kerouac (author) died of cirrhosis of the liver after a lifetime of drinking. Kathryn H. Hollen

252   Designer Drugs See also: Alcohol; Drug Classes; Neuro­transmitters

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Faupel, Charles E., Greg S. Weaver and Jay Corzine. 2014. The Sociology of American Drug Use. New York: Oxford University Press. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Partnership for Drug-Free Kids. “Depressants.” Drug Guide. http://www.drugfree .org/drug-guide/depressants. U.S. Department of Health and Human Services, National Institute on Drug Abuse (NIDA), June 2007. http://www.nida.gov U.S. Department of Health and Human Services, National Institute on Drug Abuse. NIDA for Teens. 2013. “Central Nervous System (CNS) Depressants.” http://teens .drugabuse.gov/drug-facts/central-nervous -system-cns-depressants. U.S. Department of Health and Human Ser­ vices, Substance Abuse and Mental Health Services Administration.http://www.samhsa .gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Designer Drugs Designer drugs (also known as club drugs) are drugs that are totally synthetic (created in labs) to be similar to, but not identical to, psychoactive drugs that are illegal to possess or sell for human consumption. They were created to resemble drugs such as cocaine, Ecstasy, and marijuana and produce psychoactive effects on users that range from mild anesthesia, stimulant effects, or even severe hallucinations. Examples of designer drugs include methylene, MDPV, Ecstasy, and synthetic cannabinoids in “Spice” or “K2.” They are often sold inexpensively as bulk powders, and may be labeled as “research chemicals,” “bath salts,” “plant food,” or “incense.” They are labeled as “not for human consumption” as a way to circumvent the law. This way, drug manufacturers can sell their products legally. Designer drugs were created by those who wanted to avoid legal sanctions related to trafficking illegal drugs. They simply changed the molecular structures of the illicit drug and redesigned them into new substances. It was thought the lab-created drug would have the same effect on users as the natural drug. But the effect is sometimes much worse than expected, and sometimes worse than the natural drug. The new designer drugs became very popular during the 1970s and 1980s. During this time, the use of drugs was increasing, and dealers were seeking ways to avoid potential punishments for selling drugs. As the harm done by designer drugs was recognized, the newly developed synthetic drugs were made illegal under amendments to the Controlled Substances Act in 1986. More regulation of these drugs was established on July 9, 2012, when President Obama signed the Synthetic Drug Abuse Prevention Act of 2012–Subtitle D of Title XI of the Food and

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Designer drugs such as Ecstasy are commonly used in raves and dance clubs.The effects can range from mild euphoria to panic attacks and death. (G. K./Dreamstime.com)

Drug Administration Safety and Innovation Act (P.L. 112-144). The act added “cannabimimetic agents” to Schedule I of the CSA. Under this new law, a cannabimimetic agent is one of five structural classes of synthetic cannabinoids (and their analogues). The act also provided 15 specific examples of cannabimimetic substances, such as: 5-(1,1-dimethylheptyl)-2-[(1R, 3S)3-hydroxycyclohexyl]-phenol (CP-47, 497); 5-(1,1-dimethyloctyl)-2-[(1R, 3S)3-hydroxycyclohexyl]-phenol (cannabicyclohexanol or CP-47, 497 C8-homolog); 1-pentyl-3-(1-naphthoyl)indole (JWH018 and AM678); 1-butyl-3-(1-naphthoyl)indole (JWH-073);

1-hexyl-3-(1-naphthoyl)indole (JWH-019); 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200); 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250); 1-pentyl-3-[1-(4-methoxynaphthoyl)]indole (JWH-081); 1-pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122); 1-pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398); 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM2201); 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM694); 1-pentyl-3-[(4-methoxy)-benzoyl]indole (SR-19 and RCS-4); 1-cyclohexylethyl-3-(2-methoxyphenyl­ acetyl)indole (SR-18 and RCS-8); and

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1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203) Despite their potential for harm, the new designer drugs have become a recurring and serious threat to public health. Their use has exploded over the past few years. They are easily purchased in convenience stores and gas stations, and through Internet Web sites that provide detailed information on the sensations a user may experience after using the drug. Law enforcement is often unable to prevent the sale of these drugs because they may be technically legal. The drug is produced in such a way that they are composed of all legal substances. Moreover, being labeled as “not for human consumption” protects the manufacturer. Law enforcement is also prevented from shutting down Web sites that sell the drugs because of sometimes weak international agreements or jurisdictional issues that do not allow for legal action. The designer drug industry has become a new market with high profits. Often, a consumer may believe the drug being sold is legal and therefore safe to use. The drugs are also sold by Internet retail distributors that have begun advertising newly synthesized addictive drugs as research chemicals. Their quality is unknown, and they are therefore potentially deadly. They have been labeled with confusing names that are intended to disguise the true composition. Because the chemicals used to make the drugs are suspect, they are highly dangerous, and their use in the manufacture of designer drugs has had sometimes tragic results. Despite the dangers, the drugs continue to be used. One study of people attending a rave in Chicago showed that 48.9 percent of the participants had used drugs. Of those, 29.8 percent used LSD, and 27.7 percent had ingested Ecstasy. They had also used club drugs in conjunction with other illicit drugs

such as marijuana (87 percent), alcohol (65.2 percent), and cocaine/crack (26.1 percent). According to another survey, 0.7 percent of eighth-grade and 1.1 percent of 12thgrade students reported using GHB in the past year, a decrease from 2000. However, GHB use among 10th-grade students was reported at 1.0 percent, an increase from 2008. One percent of eighth graders reported using ketamine; as compared to 1.3 percent of 10th graders and 1.7 percent of 12th graders reporting ketamine use. Kathryn H. Hollen See also: Bath Salts and Synthetic Cannabis; Ecstasy; Ketamine

Further Reading Cotton, Simon. 2012. Every Molecule Tells a Story. Boca Raton, FL: CRC Press. Designer Drugs. 2006. New York: Films Media Group. Freye, Enno. 2009. Pharmacology and Abuse of Cocaine, Amphetamines, Ecstasy and Related Designer Drugs: A Comprehensive Review on Their Mode of Action, Treatment of Abuse and Intoxication. Dordrecht, New York: Springer. Kuhn, Cynthia, et al. 2008. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. New York: Norton. Olive, M. Foster. 2004. Designer Drugs. Philadelphia: Chelsea House Publishers. Sacco, L. N., and K. Finklea. 2013. “Synthetic Drugs: Overview and Issues for Congress.” Congressional Research Service, September 16. http://www.fas.org/sgp/crs/misc/ R42066.pdf. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2010. “Club Drugs (GHB, Ketamine, and Rohypnol).” http://www.drugabuse

Dimethyltryptamine (DMT)  255 .gov/publications/drugfacts/club-drugs -ghb-ketamine-rohypnol. Yuodelis-Flores, C. 2014. “The New Club Drugs: Designer Drugs & Legal Highs Synthetic Cannabinoids and Cathinones.” Northwest AIDS Education and Training Center. http://depts.washington.edu/nwaetc/ presentations/uploads/84/club_drugs_and_ hiv.pdf.

Dimethyltryptamine (DMT) Dimethyltryptamine, or DMT crystals, are a powerful hallucinogen that is popular among drug users. A member of the tryptamine family, it is a naturally occurring chemical that was first identified by chemist Richard Helmuth Fredrick Manske in Canada. The hallucinogenic effects of the drug were studied by Hungarian chemist Dr. Stephen Szara. He performed experiments in the mid-1950s, using volunteers who took the drug and reported on its effects. The drug is often used by indigenous Amazonian Amerindian cultures in religious ceremonies and for healing. DMT can be found in many plants that are easy to purchase and easy to grow in most areas of the world. Some of these plants have very high levels of DMT. The drug can also by synthetically created in a lab environment. The chemical is found in people at all times and is widespread throughout the plant kingdom. DMT can be inhaled, injected, or swallowed. When it is inhaled, the effects occur quickly, but are shorter lasting, about 15 minutes. Those who smoke the drug will put crystals on marijuana, which is then smoked together. This is called a “green screen.” The user will feel the highest within about one minute after ingesting the drug. They will first experience an intense rush, called a “blast off,” and will then black out. The effects last about 15 minutes.

Those who inject the drug will also have a powerful experience. Users feel that they have left their bodies, or enter into different realms. If the drug is taken orally, it must be combined with a monoamine oxidase inhibitor (MAOI), or it has no effect. When it is taken with an MAOI, the effects are long lasting and produce visual and auditory hallucinations. The drug can also be snorted, with many of the same effects. The effects of the drug range from short term to long term, depending on the amount of the drug taken. It can produce mild psychedelic states in some users, whereas others will experience powerful hallucinations that involve traveling to different realms, encounters with spiritual beings, or different time periods. It does not appear that users will build a tolerance to the drug. In addition to hallucinations, users will also experience an increased heart rate and blood pressure, dilated pupils, dizziness, amnesia, diarrhea, and seizures, among other symptoms. DMT is not readily available on the street, and when it is, the drug is fairly expensive. According to the Substance Abuse and Medical Health Services Administration (2006), the drug is more commonly used among those between the ages of 18 and 25. However, only 0.2 percent of this population reports using it within the past year. DMT is classified as a Schedule I drug under the Controlled Substances Act, meaning that the federal government has defined it as having no legitimate medical uses and a high potential for abuse. The Food and Drug Administration has never approved the drug for human consumption. Common street names for DMT are God Agent, God Drug, the Businessman’s Lunch, Dimitri, and Special LSD. Nancy E. Marion

256   Disease Model of Addiction See also: Hallucinogens; LSD; Marijuana

Further Reading “Dimethyltryptamine.” http://www.southwestprevention.com/page_attachments/0000 /0944/DMT.pdf. Drug Enforcement Administration, Office of Diversion Control, Drug and Chemical Evaluation Section. 2013. “N,N-Dimethyltruptamine (DMT).” http://www.deadiversion.usdoj.gov/drug_chem_info/dmt.pdf. Korsmeyer, Pamela, and Henry R. Kranzler. 2009. Encyclopedia of Drugs, Alcohol and Addictive Behavior. Detroit, MI: Macmillan Reference. Kuhn, Cynthia, Scott Swartzwelder, and Wilkie Wilson. 2008. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. New York: W. W. Norton. Levinthal, Charles F. 2012. Drugs, Behavior and Modern Society. Boston: Allyn and Bacon. Shaffer Library of Drug Policy. “Dimethyltryptamine (DMT).” http://www.druglibrary. org/schaffer/dea/pubs/abuse/chap5/dmt.htm. Substance Abuse and Mental Health Services Administration. 2008. “Use of Specific Hallucinogens: 2006.” National Survey on Drug Use and Health Report. http://www .samhsa.gov/data/2k8/hallucinogens/ hallucinogens.htm.

Disease Model of Addiction The disease model of addiction assumes an addict has a medical illness that stems from a pathological brain disease. The model assumes that addiction is not a person’s choice. Instead, there are biological components and genetic factors that cause addiction, just as they would another type of medical condition. It assumes that an addict is powerless when it comes to battling their disease. In

order for treatment to be successful, it has to be considered a public health issue and must incorporate the help of many others in the community. Treatment must also seek to remove the stigma associated with addiction, to increase the motivation of addicts to confront their disease. There has been significant research and other clinical studies that support the idea that addiction is a disease. They show that a percentage of the population has a biogenetic predisposition to chemical and/or addictive behaviors. For some people, a traumatic experience early in their life may also affect their predisposition to drug and alcohol abuse. This can be an event such as isolation or abuse. Moreover, exposure to any addictive substance can also create vulnerability to addiction in some people. Specifically, the results of some recent studies suggest that even one exposure to an addictive drug such as morphine can make permanent changes in the user’s brain. It can affect a person’s memory and “teach” a brain to crave more of the drug. Other studies have found that certain alcohol-related behaviors including sensitivity to intoxication, development of a tolerance to alcohol, and susceptibility to organ damage may have a genetic origin. Studies completed on families, twins, and adopted family members have each pointed to a genetic aspect to alcoholism. The Human Genome Project is also contributing to a better understanding of the role that genetics plays in determining alcoholism. Critics of the disease model argue that it is simply a way to let addicts escape responsibility for their drug use behavior. They dispute the idea that addictive behavior often takes a predictable course. Instead, critics believe that addicts can learn to control their behaviors through treatment therapies and other programs. They argue that addicts who are provided adequate behavioral therapy

Dole,Vincent (1913–2006) 

can learn to use drugs in moderation, and that 12-step programs are able to substitute one type of dependency for another. Critics argue that a person’s choices and behaviors determine if they will become an addict. Further, the changes seen in the brains of addicts are caused by the use of drugs rather than the brain causing the drug use. Treatment approaches under the disease model are based on a 12-step model similar to that used with Alcoholics Anonymous. These steps mandate the total abstinence of drugs and alcohol. It also seeks a comprehensive treatment program for every addict. The treatment must be multifaceted to be successful. This is needed because an addict has problems with learning, memory, motivation, and decision making. This means that an effective treatment plan must include physical, psychosocial, spiritual, and, in many cases, pharmacological interventions. It includes teaching nonchemical coping skills that help an addict address underlying problems. This treatment approach that includes many different aspects is called a therapeutic community. A therapeutic community consists of a group of peers who has sobriety as their goal. They are often common in settings such as hospitals and residential treatment centers. In these places, behavior modeling is stressed. This refers to the modeling of appropriate behaviors by senior patients. There is an expectation that individuals in the group will abstain from drug use and obey the rules of the program. These expectations are expressed by all of the group members. Another aspect of successful treatment, making connection with others, is also satisfied through small treatment groups. Kathryn H. Hollen See also: Dependence; Jellinek, E. Morton; Minnesota Model; Twelve-Step Programs

Further Reading Angres, D., and K. Bettinardi-Angres. 2008. “The Disease of Addiction: Origins, Treatment, and Recovery.” Dis Mon. http://www .reshealth.org/pdfs/subsites/addiction/the_ disease_of_addiction.pdf. Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton. Halpern, John H. 2002. “Addiction Is a Disease.” Psychiatric Times 19(10): 54–55. Schaler, Jeffrey A. 2002. “Addiction Is a Choice.” Psychiatric Times 19(10): 54, 62. Vaillant, George. 1995. The Natural History of Alcoholism Revisited. Cambridge, MA: Harvard University Press, 1995. White, William. 2000a. “Addiction as a Disease: Birth of a Concept.” Counselor Magazine 1(1): 46–51, 73. White, William. 2000b. “The Rebirth of the Disease Concept of Alcoholism in the 20th Century.” Counselor Magazine 1(2): 62–66. White, William. 2001. “Addiction Disease Concept: Advocates and Critics.” Counselor Magazine 2(1): 42–46. White, William. 2007. “A Disease Concept for the 21st Century.” AddictionInfo: Alternatives to 12-Step Treatment. http:// www.addictioninfo.org/articles/1051/1/A -Disease-Concept-for-the-21st-Century/ Page1.html.

Dole,Vincent (1913–2006) Vincent Dole was a leading researcher into the science of addiction in the mid-20th century. He opposed the Federal Bureau of Narcotics’ punitive approach toward the addiction problem, and he worked to find medical solutions to solve the problems caused by addiction. Most notably, along with his wife Marie Nyswander, he helped pioneer

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the use of methadone maintenance treatments for opiate addicts. Vincent Paul Dole was born on May 18, 1913, in Chicago. He earned his bachelor’s degree in mathematics from Stanford University in 1934, and a medical degree from Harvard in 1939. After serving as an intern at Massachusetts General Hospital in Boston, Dole became an assistant in kidney research at the Rockefeller Institute in New York City in 1941. After a stint as a lieutenant commander with the Naval Medical Research Unit during World War II, Dole was named an associate member of the Rockefeller Institute in 1947, and he was appointed a full member in 1951 before becoming a professor there in 1955. In 1962, Dole was examining metabolic diseases while working on a study of obesity, and he found that some people craved food just as much as addicts craved drugs. Around the same time, Dole became aware of the enormity of the drug problem in New York City. This prompted him to become interested in the study of addiction, and he soon read one of the most recent works on individuals addicted to narcotics, Marie Nyswander’s The Drug Addict as Patient. In 1964, he invited Nyswander to come work with him at the Rockefeller Institute to conduct research on the treatment of opiate addiction. At the time, heroin addiction and its social ramifications were major social and public health problems in New York City. However, there had been very little community-based research into the problem at the time, since most research was focused in the government’s Public Health Service Narcotic Hospitals. Given his background as a physician, Dole believed that addiction was a physiological problem caused by changes that occurred due to continuous administration of opiates. Methadone, he believed, could prevent

withdrawal symptoms and stabilize the physiology of the addict since it was longer acting than heroin. Together, Dole and Nyswander began testing the effectiveness of methadone substitution treatments for opiate addicts, administering it to addicts who had been using heroin for at least 14 years. In their research, they found that 100 milligrams of methadone blocked the effects of 200 milligrams of heroin, but that addicts who took the drug did not experience many of the painful withdrawal symptoms that usually came on when they stopped using heroin. They found that methadone was so effective in attenuating the withdrawal symptoms associated with heroin use that many of their volunteers were able to redevelop interests in going back to school or work. Thus long-term methadone maintenance—legally stabilizing heroin-addicted patients on a daily oral dose of methadone— held the promise of breaking the cycle of using heroin and engaging in criminal activity to support the habit. Consequently, methadone could decrease addicts’ tendency to turn to the black market for drugs so they could avoid withdrawal symptoms, and increase the likelihood that they would reintegrate into society as law-abiding citizens. And since methadone was itself an opiate, it decreased the likelihood of relapse, which until then had been a major stumbling block in attempts to treat heroin addiction. In 1965, Dole and Nyswander published their findings in the Journal of the American Medical Association, and that same year, they also got married. In spite of the promise of his research, Dole faced opposition from the Federal Bureau of Narcotics (FBN), which did not want doctors to have the authority to provide narcotics to addicts. Though the FBN tried to intimidate him into stopping his work, and spread rumors about him in order to dis-

Domestic Abuse and Alcohol 

credit him, Dole was undeterred and continued his research into the potential benefits of methadone. Impressed by Dole and Nyswander’s work, Ray Trussell, the commissioner of New York City hospitals, helped them establish a research and demonstration project on methadone at Manhattan General Hospital. The project proved a success and garnered public attention, leading many in the scientific and drug policy communities to advocate for methadone maintenance as a viable medical option for the treatment of heroin addiction. By the early 1970s, methadone maintenance programs spread across the country, and eventually, overseas as well. Today, there are methadone treatment centers in all 50 states partly in honor of Vincent Dole. These centers offer treatment for people addicted to methadone, or people who need the drug to get off of some other drug addiction. These methadone clinics and centers provide addicts with easy access to the prescription methadone that is necessary to ease the symptoms of withdrawal, or to reduce or eliminate cravings for the drug. These clinics help patients to live a more satisfying and healthy lifestyle. Just as an opiate addiction affects everyone in a negative way, everyone benefits when the addiction is under the treatment of a qualified methadone maintenance program with the medication being administered by a qualified methadone center. Part of New York Presbyterian Hospital is the Vincent P. Dole Treatment and Research Institute for Opiate Dependency. This rehab center accepts patients who are at least 18 years old and who have a history of drug dependence. They help those people seeking assistance in breaking their drug addiction habits by providing methadone maintenance and methadone detoxification services on an outpatient basis. They also provide special services for those with HIV.

Dole passed away in 2006, at the age of 93, in New York City. Howard Padwa and Jacob A. Cunningham See also: Federal Bureau of Narcotics; Methadone; Nyswander, Marie

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press. Drug Policy Alliance Network. “Vincent P. Dole, 1913–2006.” http://www.drugpolicy .org/news/080306dole.cfm. Edwards, Griffith. ed. 2002. Addiction: Evolution of a Specialist Field. Oxford: Blackwell Science. Hevesi, Dennis. 2006. “Vincent P. Dole. Methadone Researcher, Is Dead At 93.” New York Times, August 3: B7. Lowinson, Joyce, Ira Marion, Herman Joseph, John Langrod, Edwin A. Salstiz, J. Thomas Payte, and Vincent P. Dole. 2005. Methadone Maintenance. Philadelphia: Lippincott Williams and Wilkins. Methadone Treatment Centers. http://www .methadonecenters.com/. “Vincent P. Dole Treatment and Research Institute for Opiate Dependency.” http://nyp .org/services/meth_program.html.

Domestic Abuse and Alcohol Various reports have found a connection between alcohol abuse and domestic violence, but it remains unclear the degree to which there is a causal relationship. While it is well known that alcohol use is linked to impaired judgment, reduced inhibition, and increased aggression, some argue that no real research exists to indicate that alcohol abuse causes domestic violence. Some suggest that the

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use of alcohol may actually be adaptive and may facilitate stress relief, increase conjugal relationships, and potentially improve mood states. However, the more prevalent and accepted hypothesis is that alcohol consumption is maladaptive, increases dissatisfaction, and may provoke domestic violence.

Prevalence In a study in the Journal of the American Medical Association, Brookoff and colleagues (1997) described the characteristics of perpetrators of domestic violence and their victims. Most (78 percent) of the assailants were male, while most of victims (72 percent) were female. Of the victims who were male, 45 percent were the children of female victims who had tried to intervene in the assault of their mothers. While 86 percent of the responding assailants acknowledged using alcohol on the day of the assault, their victims and family members reported that 92 percent of assailants used alcohol or drugs the day of the assault. Further, 45 percent of victims and family members reported that assailants used alcohol or drugs to the point of intoxication, on a daily basis, during the prior month; with 19 percent being classified as alcoholics and 14 percent dually diagnosed as drug addicts and alcoholics. Although to a lesser extent (42 percent), victims were reported to have been using drugs or alcohol on the day of the assault. According to the National Institute on Alcohol Abuse and Alcoholism study by Cae­ tano and colleagues (2001), results from a 1995 national study showed that domestic violence rates were higher among black and Hispanic couples than among white couples for both male-female and female-male perpetrations. While the authors state no single factor is able to explain the higher prevalence, alcohol plays an important part, as 30–40 percent of men and 27–34 percent of women

who perpetrated violence against their partners were drinking at the time of the assault.

Cause and Effect Studies have also shown a correlation between increased alcohol consumption and domestic violence, even when the abuser is sober. Alcohol has been shown to impair neural processing, which could impact executive functioning such as inhibition and social interaction. Alcohol impedes a person’s ability to consider the consequences of his or her actions and increased the likelihood that a person will act out in anger and rage. On the other hand, some researchers claim that this correlation is nothing more than a coincidence. It’s the age-old chickenegg argument: Researchers question whether abusers use alcohol-fueled rage as an excuse for abuse, or if alcoholism and domestic violence are two separate social problems with considerable overlap. Both alcoholism and domestic violence share similarities. For example, both focus on power and control; are laden with denial and avoidance of the problem; may involve segregation, isolation, and seclusion; and could be perpetuated throughout generations. Alcohol and Physical Violence For most people, alcohol increases the inhibitory signaling in the brain, making them feel laid-back, relaxed, sedate, or calm. However, some people exhibit a completely different reaction to alcohol, becoming angry, depressed, agitated, and even violent. One study (Fals-Stewart 2003) suggests that men who consume alcohol and are prone to engage in physical violence toward their female partners are more likely to be violent on the days they drink alcohol. Utilizing a combination of structured interviews and drinking and physical aggression logs over a 15-month period, the authors found that for

Domestic Abuse and Alcohol 

men entering a domestic violence treatment program, the odds of any level of male-tofemale physical aggression was eight times higher on days when they drank alcohol than on days no alcohol was consumed. For men entering alcohol treatment programs, maleto-female physical aggression was 11 times more likely on days alcohol was consumed. Further, for both groups, the likelihood of severe male-to-female physical aggression on drinking days was more than 11 times higher. As alcohol severity increased (e.g., heavy drinking days), the likelihood of any violence and severe violence also increased in both groups (17–19 times). Of note, the likelihood of male-to-female violence was still higher on days male partners drank versus days they did not drink, even after controlling for levels of relationship disharmony and alcohol severity. Another study (Umhau et al. 2012) shows that those who experience repeated episodes of rage and violence (called Intermittent Explosive Disorder), may be more apt to inflict harm on a domestic partner after drinking alcohol. This behavior may be learned from their social and cultural background, or it may be the result of biological factors such as nutritional deficiencies, brain tumors, or metabolic disorders. If caused by a medical problem, the offender may respond well to treatment. Research shows that violent behavior can be reduced with substance abuse treatment.

Societal Contributions Several studies have indicated a relationship between the density of alcohol outlets and negative behavioral outcomes, such as higher levels of alcohol consumption among youth and adults; and a greater prevalence of alcohol-related crime, violence, and injury. Research suggests that areas of increased alcohol outlet density may be signals of low-

ered normative constraints regarding general violence within the neighborhood, promote problematic drinking, and suggest more tolerant attitudes, norms, and behaviors regarding domestic violence (Alcohol Abuse Info; Waller et al. 2012). Kimberly Bellon and Stephanie A. Kolakowsky-Hayner See also: Alcohol-Facilitated Sexual Assault; Domestic Abuse and Drugs

Further Reading Alcohol Abuse Info. “Alcohol Abuse and Domestic Violence.” http://www.alcohol -abuse-info.com/Alcohol_Abuse_and_ Domestic_Violence.html. Bowen, Erica. 2011. The Rehabilitation of Partner-Violent Men. Malden, MA: Wiley-Blackwell. Brookoff, Daniel, Kimberly K. O’Brien, Charles S. Cook, Terry D. Thompson, and Charles Williams. 1997. “Characteristics of Participants in Domestic Violence Assessment at the Scene of Domestic Assault.” Journal of the American Medical Association 277(17): 1369–73. Buddy T. 2014. “Domestic Abuse and Alcohol: Some Doubt the Role Alcohol Plays.” http://alcoholism.about.com/cs/abuse/a/ aa990331.htm. Caetano, R., J. Schafer, and Carol B. Cunradi. 2001. “Alcohol-Related Intimate Partner Violence among White, Black, and Hispanic Couples in the United States.” Alcohol Research and Health 25(1). http://pubs. niaaa.nih.gov/publications/arh25-1/58-65 .pdf. Center for Substance Abuse Treatment. 1997. Substance Abuse Treatment and Domestic Violence. Rockville, MD: Substance Abuse and Mental Health Services Administration. Treatment Improvement Protocol (TIP) Series, No. 25. Chapter 1—Effects of Do-

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262   Domestic Abuse and Drugs mestic Violence on Substance Abuse Treatment. http://www.ncbi.nlm.nih.gov/books/ NBK64441/. Fals-Stewart, W. 2003. “The Occurrence of Partner Physical Aggression on Days of Alcohol Consumption: A Longitudinal Diary Study.” Journal of Consulting and Clinical Psychology 71(1): 41–52. Hanson, P. J. 2012. “Alcohol Linked to Partner Violence? Alcohol Problems and Solutions.” http://www2.potsdam.edu/hansondj/ HealthIssues/1055873025.html. Livingston, Michael. 2011. “A Longitudinal Analysis of Alcohol Outlet Density and Domestic Violence.” Addiction 106(5): 919–25. National Coalition Against Domestic Violence. “Domestic Violence and Substance Abuse.” http://www.ncadv.org/files/SubstanceAbuse .pdf. Sullivan, T., R. Ashare, V. Jaquier, and H. Tennen. 2012. “Risk Factors for AlcoholRelated Problems among Victims of Partner Violence.” Substance Use & Misuse 47(6): 673–85. Testa, Maria, Audrey Kubiak, Brian M. Quigley, Rebecca J. Houston, Jaye L. Derrick, Ash Levitt, Gregory Homish, and Kenneth E. Leonard. 2012. “Husband and Wife Alcohol Use as Independent or Interactive Predictors of Intimate Partner Violence.” Journal of Studies on Alcohol and Drugs 73(2): 268–76. Umhau, John C., Karysse Trandem, Mohsin Shah, and David T. George. 2012. “The Physician’s Unique Role in Preventing Violence: A Neglected Opportunity?” BMC Medicine. http://www.biomedcentral.com/ 1741-7015/10/146. Waller, Martha W., et al. 2012. “Relationships among Alcohol Outlet Density, Alcohol Use, and Intimate Partner Violence Victimization among Young Women in the United States.” Journal of Interpersonal Violence 27(10): 2062–86.

Domestic Abuse and Drugs Although advocates are careful to point out that drug or alcohol use or abuse does not cause domestic violence, there is a significant correlation between the two. According to the National Coalition Against Domestic Violence, regular abuse of alcohol is one of the most significant predictors of domestic violence. In 2002, the U.S. Department of Justice found that 61 percent of domestic violence offenders also have substance abuse problems. It is estimated that one fourth to one half of men who commit domestic violence use drugs or alcohol. Further, the battering incidents that occur when an abuser is using drugs or alcohol tend to be more severe, often resulting in greater damage. Domestic abuse is the use of emotional, psychological, or physical force by one family member to control another. Batterers living with women who have alcohol abuse problems often try to justify their violence as a way to control their victims when they are drunk. Such men try to deny responsibility for their violence, blaming it on the effects of alcohol. Often, men who are abusive by nature will become so after ingesting drugs. While most people believe that alcohol and drug use by an offender is the cause of domestic violence, another way to look at the relationship is that the substance abuse gives the offender an excuse for being violent. The substance abuse gives the offender a way to justify, or explain, his or her abusive behavior. In other words, the offender does not become violent because they drank, but they were abusive to begin with and the substance abuse just gave them a reason to let that behavior come to the forefront. The substance does not cause the behavior, but may affect the severity of the abuse.

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The domestic abuse can take the form of emotional abuse such as verbal harassment or emotional insults. Sexual abuse including spousal rape or molestation is also common. Physical force can include assaulting a partner, or any physical attack that causes bodily harm. Not only are substance use and abuse correlated with the perpetration of abuse, but research has also demonstrated a clear link between the two among victims. Studies have shown that alcoholic women are more likely to report having endured physical abuse in the past than women who do not abuse alcohol. In fact, the National Center on Addiction and Substance Abuse found that 69 percent of women who were in treatment for substance abuse reported that they were sexually abused as a child. An abusive past may make a woman more accepting of being part of an abusive relationship. Once in an abusive relationship, women are more likely to abuse substances. Compared to women who use drugs and alcohol sparingly or abstain, women who are being abused are 15 times more likely to abuse alcohol and 9 times more likely to abuse drugs. They may often abuse substances as a way to cope with the abuse. Additionally, the substance abuse may cause a woman to remain in an abusive relationship. When both partners use drugs, the link between drug use and domestic use becomes stronger. Up to 80 percent of child abuse cases are also associated with the use of drugs or alcohol. Children of substance-abusing parents are more likely to experience physical, sexual, or emotional abuse than children in non-substance-abusing households. Children who have experienced family violence are at greater risk for alcohol and other drug problems later in life than children who do not experience family violence. Evidence

suggests that children who run away from violent homes are at risk of substance abuse. Many cases of domestic abuse are not reported to law enforcement by the victim, especially when the offender was using drugs. Because the offender often apologizes when they are sober or no longer under the influence, the victim does not feel as if the offender meant harm, or that they will commit the abuse again. Thus, they do not feel the need to report the offender to officials. One problem is that courts still mandate attendance in substance abuse programs for abusers. While these programs may address the substance abuse problem, they have not been proven to reduce the incidence of domestic violence. Effective treatment programs must include both alcohol or drug treatment mixed in with counseling geared toward halting the abusive behavior. Alcohol treatment on its own will not stop the abusive behavior. Although attention has been paid to the intersection of domestic violence and substance abuse, few domestic violence shelters have substance abuse treatment programs. This is for several reasons: (1) Domestic violence programs typically have limited resources and cannot afford to pay for the equipment, staff, and other resources needed to provide substance abuse programs; (2) Domestic violence programs primarily focus on providing safety and shelter and thus tend not to include other kinds of programming; and (3) There is a fear that focusing on the substance abuse problems of victims will encourage victim blaming. Women may fear seeking help for either issue because they think they will lose their children. The Center for Substance Abuse Treatment recommends the following: • More federal funding so that substance abuse services can be provided in shelters;

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• Furthering efforts to link domestic violence and substance abuse treatment programs in human services systems; • Providing counseling, childcare, and substance abuse and mental health treatment, among other services, in one program; • Creating mechanisms for interagency cooperation at the state and local level; and • Funding demonstration projects to test the feasibility and effectiveness of linking domestic violence and substance abuse treatment programs. It is recommended that substance abuse providers screen participants for domestic violence. Staff should be trained to identify abuse, provide appropriate referral information, and help ensure victims in crisis receive appropriate intervention and safety planning. Laura L. Finley See also: Domestic Abuse and Alcohol

Further Reading “Alcohol and Domestic Violence.” Stop Viol­ ence Against Women. http://www1.umn .edu/humanrts/svaw/domestic/link/alcohol .htm. Bennett, Larry W., and Oliver J. Williams. 2001. Intervention Programs for Men Who Batter. Thousand Oaks, CA: Sage Publications. Bennett, L. W. 1998. Substance Abuse and Woman Abuse by Male Partners. Harrisburg, PA: VAWnet. http://www.vawnet.org. Brookoff, Daniel. 1997. “Drugs, Alcohol and Domestic Violence in Memphis: A Summary of a Presentation.” Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice. Collins, J., and D. Spencer. 2002. “Linkage of Domestic Violence and Substance Abuse

Services, Research in Brief, Executive Summary.” U.S. Department of Justice. Domestic Violence and Substance Abuse. National Coalition against Domestic Violence. http://www.ncadv.org/files/Substance Abuse.pdf. Jamiolkowski, Ramond M. 1996. Drugs and Domestic Violence. New York: Rosen. Lawrence, S., M. Chau, and M. Lennon. 2004. “Depression, Substance Abuse and Domestic Violence.” National Center for Children in Poverty. http://nccp.org/publications/pdf/ text_546.pdf. U.S. Department of Health and Human Services. Substance Abuse Treatment and Domestic Violence: Quick Guide for Clinicians. http://www.kap.samhsa.gov/products /tools/cl-guides/pdfs/QGC_25.pdf.

Drug Abuse Drug abuse refers to using a drug in a way that is not prescribed by a physician or not following proper dosage. It also refers to using a drug for the purpose of achieving a high, or an altered state of mind as opposed to using a drug to treat a medical condition. Drug abuse can affect the way a person’s brain works. Drugs contain particular chemicals that interrupt a brain’s communication system. They can then disrupt the way nerve cells send, receive, and process information. The drugs can cause this disruption by acting as a natural chemical messenger, or by overstimulating the “reward circuit” of the brain. The structure of some drugs, particularly marijuana and heroin, are similar to chemical messengers called neurotransmitters that are produced normally in the brain. This allows the drugs to trick the brain’s receptors, activating nerve cells to send abnormal messages to create the feeling of being “high.”

Drug Abuse 

Drug abuse of any kind has a variety of negative effects, ranging from high blood pressure and insomnia to seizures, paranoia, and death. Drug abuse can also damage one’s relationships with family and friends. Drug abuse can have serious effects on a person’s behavior and habits. Use of a drug can change the brain’s ability to focus and form coherent thoughts and ideas. A person abusing drugs may be aggressive, lethargic, depressed, or see changes in their social network. Any of these symptoms may indicate a problem with drug abuse. Some other drugs, including methamphetamine and cocaine, cause a user’s nerve cells to release unusually large amounts of natural neurotransmitters (dopamine), which is necessary to halt signaling between neurons. When there is such a large amount of dopamine in the brain, it affects how a particular neurotransmitter controls a person’s movement, motivation, emotions, and feelings of pleasure functions. The excessive dopamine produces euphoric effects associated with drug use. This “good” feeling encourages people to abuse drugs over and over, despite the negative consequences that can result from abusing drugs. However, if a person continues to abuse drugs, the brain eventually adapts to the huge surges of dopamine that are caused by the drug, and will actually produce less dopamine when that drug is used. This means that when a user ingests the same amount of a drug multiple times, the brain will create less dopamine. The user will not feel “high” after ingesting the same amount of the drug. This may compel the addicted person to use more of the drug, or to use multiple drugs, to achieve the same feeling. Larger amounts of the drug will be needed for the use to achieve the same high. This is called tolerance, and is a common concern for drug addicts.

Long-term drug abuse can also alter other chemical systems in the brain. One of those is glutamate, a neurotransmitter that affects a person’s ability to learn. When a person’s glutamate concentration is altered as the result of drug abuse, the brain will attempt to compensate, which may affect a person’s cognitive learning. Brain scans of drug addicts indicate changes in areas of the brain that are tied to judgment, decision making, learning and memory, and behavior control. Specific symptoms of drug abuse differ depending on the drug. Signs of alcohol abuse include frequent hangovers, aggressive behavior, or excessive binge drinking. Some signs of marijuana abuse include dilated pupils or bloodshot eyes. In the long term, symptoms of marijuana abuse can include changes in short-term memory and decreases in motivation. Those who abuse methamphetamine typically become paranoid or develop a “twitchy” demeanor. They are also prone to aggressive outbursts or an inability to sit still, and may have sudden weight loss. If drug abuse continues, a person’s performance at school or work may decrease as the user experiences difficulty in being able to focus and think clearly, or may have difficulty performing physical aspects of a job. There may also be a shifting of priorities. The user may choose to skip class or skip work. They may also choose to spend more money on drugs, causing financial problems. In some cases, those people abusing drugs may be forced to sell their personal possessions, or commit criminal behaviors as a way to get money to purchase drugs. While most people can take drugs and not abuse them, others become drug abusers after simply experimenting with drugs. It is impossible to predict if a person will become a drug abuser. The risk of abuse is influenced

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by many factors such as an individual’s biology (genetics), social environment, and age. The more risk factors an individual has, the greater the chance that a person will become addicted after using drugs. An individual’s makeup, or the genes that people are born with can account for a person’s vulnerability to drug abuse. Additionally, a user’s gender, ethnicity, and the presence of other mental disorders may also affect the possibility of abuse. A person’s environment can play a large role in drug abuse. This can involve a person’s family and friends, their socioeconomic status, or even their quality of life. Other factors such as peer pressure, physical and sexual abuse, stress, and quality of parenting can greatly influence the occurrence of drug abuse. These factors interact with a person’s developmental stage to determine how likely they are to abuse drugs. Although people of any age can abuse drugs, research indicates that the earlier that drug use begins, the more likely it is that the user will abuse drugs. This is especially critical for adolescents since their brains are still developing. The parts of their brains that govern decision making, judgment, and self-control are not mature. This means that users in this age group may be especially prone to abusing drugs.

Current Statistics According to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, 23.5 million people aged 12 and over were in need of treatment for abuse of an illicit drug or alcohol problem in 2009. Of these individuals, only 2.6 million—11.2 percent—received the treatment they needed. Moreover, according to the National Institute on Drug Abuse, almost 2.1 million visits to hospital emergency departments

across the nation in 2009 were due to drug abuse. Statistics also show that many people abuse alcohol. There are about 50,000 cases of alcohol overdose reported each year. In 2009, an estimated 30.2 million people 12 or older reported driving under the influence of alcohol at least once in the previous year. Abuse of marijuana use has increased since 2007. In 2011, there were 18.1 million current users, which is about 7.0 percent of adults in the United States. This was an increase from 2007. However, the use of drugs other than marijuana has not changed significantly over the past decade. Abuse of cocaine use decreased from 2006 to 2011, as has abuse of methamphetamine. Research also shows that the majority of people try drugs for the first time when they are teenagers. There were a little over 3 million new users of illicit drugs in 2011. Most of those new users used marijuana as their first drug. Then they abused prescription pain relievers, followed by inhalants. Alcohol abuse by underage people has declined, as has binge drinking and driving under the influence. Fewer Americans are abusing tobacco than before. In 2011, about 56.8 million Americans aged 12 or older, or 22 percent of the population, used tobacco. In 2002, about 26 percent abused this drug. A person with a drug abuse problem may seek treatment as a way to come “clean.” If a person seeks a drug abuse treatment program, they have many options. While many programs to treat drug abuse are quite expensive or require that the user have insurance, other programs are free. It is safe to say that there is no single way or method to treat someone who is abusing drugs. While one drug abuse program will be very successful for one person, it may not be for another abuser. How success-

Drug Abuse and Treatment Act (1972) 

ful the abuser will be after treatment in remaining drug-free depends on many factors. For those individuals who are fighting drug abuse, the toughest step is deciding to seek treatment and change their life. The abuser must first go through detoxification (sometimes called detox). This is when the body gets rid of the drug completely, and becomes less physically dependent on it. This can take a variety of time, depending on the drug, but on average it takes around 30 days. Patients must be carefully watched for withdrawal symptoms. After this, the abuser must go through therapy to help patients understand why they abuse drugs. Many abusers seek drugs as a result of stress and peer pressure. Therapy helps the abuser understand how to deal with stress in a healthy way and keep their addiction under control in the future. Sometimes, the treatment process for drug abuse must continue for a longer period after the initial treatment. In those cases, group counseling sessions and support groups are positive alternatives whereby abusers can continue to learn about staying drug free. In these settings, abusers also have emotional and social support from other abusers. These sessions usually take place every week or every other week. This helps to reduce the chances that an abuser will return to using drugs. When needed, family counseling is used to mend relationships among family members who were harmed due to the drug abuse. Nancy E. Marion See also: Alcohol Use; Marijuana; Substance Abuse and Mental Health Services Administration

Barth, Kelly. 2007. Drug Abuse. Detroit: Greenhaven Press. Coalition on Drug Abuse. Symptoms and Signs of Drug Abuse. http://drugabuse.com/library/ symptoms-and-signs-of-drug-abuse/. Etingoff, Kim. 2013. Abusing Over-the-Counter Drugs. Broomall, PA: Mason Crest. Fisher, Gary L., and Thomas C. Harrison. 2009. Substance Abuse. Boston: Pearson. Friedman, Lauri S. 2012. Drug Abuse. Detroit: Gale. Henderson, Harry. 2005. Drug Abuse. New York: Facts on File. Karr, Justin. 2007. Drug Abuse. Detroit: Greenhaven Press. Kerr, Ethan K., and Owen E. Gibson. 2009. Substance Abuse: New Research. New York: Nova Science Publishers. Langwith, Jackie. 2007. Drug Abuse. Detroit: Greenhaven Press. “Overcoming Drug Addiction.” Help Guide. Org A Trusted Non Profit Resource. http:// www.helpguide.org/mental/drug_abuse_ addiction_rehab_treatment.htm. Reuter, Peter, ed. 2010. Understanding the Demand for Illegal Drugs. Washington, DC: National Academies Press. U.S. Department of Health and Human Services, National Institute on Drug Abuse. “The Science of Drug Abuse and Addiction.” http:// www.drugabuse.gov/publications/drugfacts/ understanding-drug-abuse-addiction. Zilney, Lisa Ann. 2011. Drugs: Policy, Social Costs, Crime and Justice. Upper Saddle River, NJ: Prentice Hall/Pearson.

Further Reading

Drug Abuse and Treatment Act (1972)

Abadinsky, Howard. 2008. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Thomson/Wadsworth.

In the 1960s, the use of illicit drugs became a symbol of youthful rebellion against society,

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social upheaval, and political dissent. About this time, the government chose to stop any further scientific research to evaluate the medical safety of the popular drugs at the time. In June 1971, President Nixon declared a “war on drugs.” As part of his war, Nixon dramatically increased the size and presence of federal drug control agencies, and encouraged Congress to pass new laws to create mandatory sentencing and no-knock warrants. Nixon chose to temporarily place marijuana in Schedule I of the Controlled Substances Act, the most restrictive category of drugs, pending review by a commission he appointed led by Republican Pennsylvania governor Raymond Shafer. In 1972, the commission recommended that the possession and distribution of a small amount of marijuana intended for personal use be decriminalized. In the end, Nixon ignored the report and rejected its recommendations. Nixon sought new laws that would allow for better coordination of the federal response to the problems of illicit drug use in the United States. He supported Congress when it passed the Controlled Dangerous Substances Act to revise existing drug laws and establish a new penalty structure that would give guidance to courts when they were sentencing drug offenders. He also signed the Comprehensive Drug Abuse Prevention and Control Act of 1970 to provide new agents, and gave the attorney general a larger role over new types of drugs. Beyond that, Nixon sought to reorganize drug-related agencies to make the drug war more effective. He established a central office what would be given overall responsibility for all major federal drug-abuse prevention programs, education, treatment, rehabilitation, training, and research. The agency, the Special Action Office of Drug Abuse Prevention, was located within the Executive Office of the President and lead by a director who

would be accountable only to the president. Nixon created the office when he signed the Drug Abuse Office and Treatment Act. The new law had other provisions as well. One provision established a National Drug Abuse Training Center that would develop, conduct, and support a full range of training programs relating to drug abuse prevention functions. Another provision of the bill created the National Institute on Drug Abuse (NIDA) that would be housed within the National Institute of Mental Health. NIDA was given the responsibility to administer any drug abuse programs assigned to the secretary of health, education and welfare. Four new advisory bodies were created in the law signed by Nixon. The president wanted these experts to provide him with counsel and recommendations about drug law. These four new agencies were the Drug Abuse Strategy Council, the National Advisory Council on Drug Abuse, a Federal Drug Council, and the National Advisory Council on Drug Abuse Prevention. One other part of the new bill authorized a new formula grant program of $360 million to assist states in coping with drug abuse. These grants were administered by the Department of Health, Education and Welfare between 1972 and 1975. Nancy E. Marion See also: Controlled Substances Act; Nixon, Richard M.; Special Action Office for Drug Abuse Prevention

Further Reading “Drug Abuse Prevention: New Programs Approved.” 1973. In CQ Almanac 1972, 28th ed., 03-162-03-166. Washington, DC: Congressional Quarterly. http://library.cqpress .com/cqalmanac/cqal72-1250269. Drug Policy Alliance. A Brief History of the War on Drugs. http://www.drug-

Drug Abuse Control Amendments (1965)  policy.org/new-solutions-drug-policy/ brief-history-drug-war. Nixon, Richard. 1972. “Statement About the Drug Abuse Office and Treatment Act of 1972.” March 21. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=3782. “Presidential Statement to Congress: Nixon on Drug Control Programs.” 1972. In CQ Almanac 1971, 27th ed., 11-94-A-11-98-A. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqalmanac/ cqal71-869-26707-1255187. Research Foundation for the State of New York University. “Drug Abuse Office and Treatment Act of 1972.” https://portal.rfsuny.org/ portal/page/portal/The%20Research%20 Foundation%20of%20SUNY/home/What_ we_do/Federal_Laws_and_Regulations/ Antidiscrimination/Drug_Abuse_Office_ and_Treatment_Act_of_1972.

Drug Abuse Control Amendments (1965) The Drug Abuse Control Amendments of 1965 expanded the number of substances that were controlled by the federal government in the United States. Until the passage of the Amendments, many addictive substances such as amphetamines, barbiturates, and psychedelics were not closely regulated, or subject to the same tight controls as opiates, cocaine, and cannabis were. The 1965 Drug Abuse Control Amendments changed this, helping set the stage for the range of controlled substances to be dramatically expanded with the Comprehensive Drug Abuse Prevention and Control Act of 1970. In the 1950s, many in the federal government began to fear that certain substances—amphetamines and barbiturates

in particular—were beginning to pose a public health risk. Amphetamines began to become more prevalent in the decades after World War II, particularly in the form of diet pills and other medicines sold to keep people awake. Use of barbiturates also became more widespread during this time, as they were key ingredients in medicines designed to control anxiety, such as Valium. In 1947, Representative Edith Rogers of Massachusetts proposed a bill to bring barbiturates under federal control, in a law similar to the Harrison Narcotics Act. A few years later, Representative Hale Boggs of Texas—the author of the 1951 Boggs Act—also proposed broadening the gamut of federally controlled substances to include barbiturates, though the Federal Bureau of Narcotics, which did not want the added responsibility of policing the use and distribution of more substances, opposed the idea, and the list of controlled substances was not expanded. Instead, the Food and Drug Administration (FDA) was empowered in 1951 to classify substances as being safe for self-administration or dangerous enough to require control by doctors and pharmacists. In October of 1955, the FDA began a campaign to stamp out the sale of stimulant drugs, including amphetamines, at gas stations and truck stops, and 43 defendants in six states were brought up on charges. In spite of the tightening of FDA rules governing amphetamines and barbiturates, use of these drugs continued to spread in the late 1950s. In 1955 and 1956, when Senator Price Daniel was investigating the nation’s drug control policies, FDA officials warned of the dangers that barbiturates posed, claiming that they were just as dangerous, if not more so, than opiates. The mass media publicized some high-profile accidents and crimes linked to amphetamines and barbiturates, thus increasing the calls for the government to take action to control the substances.

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Like Harry J. Anslinger of the FBN had done in earlier decades to emphasize the need for tighter controls over narcotics, members of Congress, led by Senator Thomas Dodd, told spectacular stories about crimes, violence, and sexual deviance among youths who were under the influence of barbiturates and amphetamines. The push for tighter controls finally got the jumpstart it needed in 1962, when Senator Estes Kefauver began investigating the drug industry and the FDA. In 1962, the Kefauver Commission’s findings led to the strengthening of the FDA’s power to control drugs, and around the same time, the death of actress Marilyn Monroe from a barbiturate overdose increased public concern over the drugs. In 1964, Dodd introduced another piece of legislation, which he titled the Psychotoxic Drug Control Act, which would have empowered FDA inspectors to carry guns, make arrests, and seize contraband drugs. President Lyndon Johnson, however, was reluctant to empower another federal enforcement agency to enforce the nation’s drug laws, though he did support the move to take action against amphetamine and barbiturate abuse. In one of his first messages as president, Johnson urged lawmakers to rush through a piece of legislation to institute tighter controls over the production and distribution of amphetamines, barbiturates, and other psychoactive drugs not covered under the Boggs Act and the Narcotic Control Act of 1956. Soon thereafter, a group of senators, including Senator Dodd, began crafting a new piece of legislation to carry out the president’s wish. The proposal, titled the Drug Abuse Control Amendments of 1965, amended the 1938 Food, Drug, and Cosmetic Act, which had expanded the regulatory powers of the FDA. Instead of just targeting amphetamines and barbiturates, the legislation was more expansive, targeting all drugs that were depressant

(containing barbiturates), stimulant (containing amphetamines), or hallucinogenic. The Amendments stipulated that individuals involved in the transfer of these drugs needed to register with the government and become subject to regular inspections. Possession of the drugs without a license or prescription was made a federal crime under the Amendments, though medical practitioners were exempt if they were using the drugs in the course of their professional practice. Though as rigorous as the laws controlling opiates, cocaine, and cannabis, the Drug Abuse Control Amendments were not as harsh when it came to punishment. The penalty for possession was a maximum of two years imprisonment and a $5,000 fine, and repeat offenders could face up to six years in prison and a fine of up to $15,000. The Amendments also increased the power of FDA officials to police drug trafficking, giving them the right to carry firearms, serve warrants, seize drugs, and in certain circumstances, even to make arrests without warrants. To gain the support of the pharmaceutical industry, which may have opposed the Amendments since they restricted access to some of its most popular drugs, it also included a provision that cracked down on the production of counterfeit drugs. The House Committee passed the proposal 402–0, and the Senate quickly followed suit. In July 1965, President Johnson signed the Amendments into law. Shortly after they were passed, 15 substances, including LSD, mescaline, and peyote (except when being used for religious purposes), were added to the list of drugs controlled under the Amendments. To help enforce the Amendments, the FDA borrowed officials with experience cracking down on drug trafficking from the FBN. The FDA, however, only needed to enforce the Amendments for a few years, as the drugs controlled under them were brought under the umbrella of substances governed by the

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Comprehensive Drug Abuse Prevention and Control Act in 1970. Howard Padwa and Jacob A. Cunningham See also: Anslinger, Harry J.; Comprehensive Drug Abuse Prevention and Control Act; Federal Bureau of Narcotics; Food and Drug Administration; Nixon, Richard M.

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. King, Rufus. 1972 The Drug Hang Up: America’s Fifty-Year Folly. New York: W. W. Norton. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press. Musto, David F., ed. 2002. Drugs in America: A Documentary History. New York: New York University Press.

The DARE program teaches students that they should not abuse illicit drugs or alcohol, nor should they take part in violent activities. Maybe more importantly, the program gives children tips for how to say no to drugs and violence. This means that DARE goes above traditional anti–drug abuse and violenceprevention learning. Rather, it also provides children with skills that are needed for them to recognize the pressures that can lead to drug experimentation or gang violence, and to resist such influences. DARE was first started in 1983 as a cooperative program between the Los Angeles Police Department and the Los Angeles School District. It was meant to provide fifthgraders with information and skills for staying away from drug use and violent behavior. The initial DARE program was meant to last

Drug Abuse Resistance Education (DARE) Drug Abuse Resistance Education (DARE) is a school-based program designed to give youths from kindergarten through high school the skills they need to avoid becoming involved in drugs, gangs, and violence. It is one of the most widespread and wellrecognized substance abuse prevention programs across the nation. Through the DARE program, police and teachers attempt to teach children about the dangers of drug use. They also focus on building self-esteem, through emphasizing that friendship can be found through positive behavior, and that people do not need to abandon their own values. Instead, a person’s self-confidence and self-worth result from asserting ones’ own feelings and at the same time, resisting destructive choices.

First Lady Nancy Reagan, wife of President Ronald Reagan, discusses her policy to reduce drug use among teens, who should “Just Say No” to drugs and alcohol. (National Archives)

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for 17 weeks. It was to be led by a friendly police officer, who would lead the students in taking a pledge to stay away from drug use and violence as part of the graduation ceremony. As the program became more popular, children graduating from the DARE program were also given small rewards such as Tshirts, pins, bumper stickers, and other small gifts. This ensured a higher visibility within the schools and the surrounding community. Those children who took the class were given different ways to resist anyone who offered them drugs by using simulations and role-playing situations in the classroom. By doing this, children were given the chance to practice saying “no” to someone who offered them drugs, and staying free from peer pressure to use drugs. The children were given information about drugs and violence so they had the necessary information to make better decisions about the use of drugs. Additionally, by increasing students’ self-esteem, it demonstrated the tenet that those who are comfortable with themselves, as well as optimistic about their future, and confident in their ability to realize their goals would be less apt to give in to peer pressure to experiment with illicit drugs. Furthermore, the DARE program sought to create more productive relationships between the students and the police officers in their communities. As the success of the DARE program grew, officials in the federal government soon began to recognize the program’s success and sought to expand the program nationwide. Government officials provided local communities (schools and police) federal grant money to begin their own DARE program in their schools. Once the funding was distributed, the DARE program grew dramatically. Before too long, the program could be found in 75 to 80 percent of the nation’s school districts. At this time, DARE can still be found in schools. It is estimated

that DARE has about 30 million students in about 300,000 classrooms in all 50 states. DARE is also taught in other countries. DARE was the result of Nancy Reagan’s “Just Say No” program that was so popular throughout the 1980s. Since then, the program has changed as some studies seemed to indicate that it was not as effective in reducing drug use and violence as originally believed. Some of the earliest negative results were published in 1994 by the Research Triangle Institute. The results of their studies seemed to show that those youth who graduated from a DARE program were in fact no more likely to stay drug-free than children who did not graduate from the program. Moreover, the study results seemed to indicate that a young person may have been even more curious to try drugs after learning about them in a DARE classroom. A report by the General Accountability Office (GAO) published in January 2003 also indicated that the there was no difference between the drug use patterns found in fifth and sixth graders who graduated from a DARE program were no different from students who did not. The 2003 GAO report examined the overall effectiveness of the DARE program. The title of the report was Youth Illicit Drug Use Prevention: DARE Long-Term Evaluations and Federal Efforts to Identify Effective Programs. The researchers at the GAO searched social science, business, and education databases, including the Department of Health and Human Services’ National Institutes of Health’s National Library of Medicine. They sought to find any evaluations of the DARE program that had been previously published in any professional or academic journals. They examined articles published throughout the 1990s that all used illicit drug use as the outcome. They used those studies that utilized a longterm evaluation design and as well as a con-

Drug Abuse Warning Network 

trol groups as a means for comparisons. The GAO researchers were able to identify six long-term evaluations that were completed at different times, which were based on three separate studies in three different states. The GAO researchers summarized the results of the six studies, but did not repeat the analyses. The six studies reviewed by the GAO found no statistically significant differences in the patterns of illicit drug use between those youth who took part in DARE lessons in the fifth or sixth grade (the intervention groups), and other students who did not have DARE training (control groups). This seemed to indicate that DARE had no statistically significant effect on preventing illicit drug use by youth into the future. Five of the studies also examined the students’ attitudes toward illicit drug use. Once again, there were not significant differences between the students who completed the DARE program and those who did not. As a result of these reports, the national DARE program changed its core curriculum for seventh-grade students. The changes centered on some of the beliefs that young people had about using drugs. The new course revolved on showing children the effects that drugs have on how the brain functions, but also sought to educate the children about positive decision-making skills. The new curriculum sought to teach concepts with the use of more active learning, with interactive exercises and role-playing components. While still part of the program, local police officers now play less of an instructor role but instead act more as coaches. Some initial analysis of the revised DARE program seems to show that it is much more effective than the previous program. The DARE curriculum also has after-school programs as a way to reinforce the concepts of the program. In some areas, there are community education projects to support the ideas taught in DARE.

Because of the negative results of these studies, the Department of Education withdrew grant funding for DARE programs in schools in 2001. However, they continue to be popular programs in many schools today. Howard Padwa and Jacob A. Cunningham See also: Office of National Drug Control Policy; Partnership for a Drug-Free America; Reagan, Ronald, and Nancy Reagan

Further Reading Berman, Greg, and Aubrey Fox. 2009. “Lessons from the Battle over DARE: The Complicated Relationship Between Research and Practice.” New York: Center for Court Innovation. DARE. “About DARE.” http://www.dare.com/ home/about_dare.asp. “The DARE Program: A Review of Prevalence, User Satisfaction, and Effectiveness.” 1994. Washington, DC: U.S. Department of Justice, Office of Justice Programs, National Institute of Justice. “GAO Literature Review Reiterates Ineffectiveness of Original DARE.” 2003. Alcoholism & Drug Abuse Weekly 15, no. 4 (January 27). Retsinas, Joan. 2001. “Decision to Cut Off U.S. Aid to DARE Hailed.” Providence Business News. March 12: 5B. Rosenbaum, Dennis. 1998. “Assessing the Effects of School-Based Drug Education: A Six-Year Multilevel Analysis of Project DARE.” Journal of Research in Crime and Delinquency 35(4): 381–412. Tennessee Department of Safety and Homeland Security. “DARE Program.” http:// www.tn.gov/safety/d.a.r.e/daremain.shtml.

Drug Abuse Warning Network The Drug Abuse Warning Network (DAWN) is a national system set up to oversee the

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public’s health and monitor the number and type of drug-related visits to hospital emergency departments (EDs). A case is included in the DAWN system if it involved an ED visit related to recent drug use. DAWN includes visits to an ED if the emergency was directly caused by drug use as well as those in which drugs are a contributing factor (but not the direct cause) of the visit. This can include cases where drugs are accidentally ingested, adverse reactions, overdoses, suicides, or accidents resulting from drug use. Each year, a DAWN report estimates the number of drug-related visits to EDs for the entire nation and for certain metropolitan areas. The statistics found in a DAWN report can be used for many purposes. Sometimes they are used to monitor trends in drug use and abuse, or to identify the emergence of new drugs or new drug combinations being used by people across the country. The statistics can also be used by officials to assess the potential health hazards associated with drug abuse and changes in drug use, or to provide an estimate of the impact of drug misuse and abuse on the nation’s health care system. According to DAWN, a drug can be defined as a substance that is used as a medication or in the preparation of medication, or is an illicit substance that causes addiction, habituation, or a marked change in consciousness. DAWN collects information regarding abuse of illicit substances such as club drugs, cocaine, heroin, marijuana, stimulants, and alcohol when used by a minor. DAWN does not collect information on prescription drugs including antibiotics, antidepressants, anticoagulants, beta blockers, birth control pills, hormone replacement, insulin, muscle relaxants, pain relievers, or sleeping aids. It also does not collect information on drugs that are used in the treatment of medical conditions (respiratory therapy, chemotherapy, radiation therapy), vaccines, dietary supple-

ments, vitamins, and other over-the-counter pharmaceutical products. A case is identified for inclusion in DAWN by a review of medical records in the EDs of participating hospitals. In each department, a sample of between 50 percent to 100 percent of the days of the month are chosen, and a review of the visits is completed. Those cases that involve a drug-related accident or incident are tallied. Incidents included in the DAWN reports include those related to all types of drugs, not just illicit drugs. DAWN records the use of alcohol if it was present in addition to the primary drug. Since alcohol use is considered to be an illicit drug for those under the age of 21, alcohol abuse itself is considered a drug-related visit to an ED if the patient is a minor. DAWN does not include incidents that involve any prescription medications and other pharmaceuticals that have been used on a regular basis by the patient, or if they are deemed by the ED medical staff to be unrelated to the visit. For every visit, information on the patient’s sex, age, and race/ethnicity are also collected. Information is also provided for the disposition of each case (if the patient was treated and released, admitted to the hospital intensive or critical care unit, or died). Additional information on the types of drugs involved is also detailed. Howard Padwa and Jacob A. Cunningham See also: Alcohol Use; Drug Abuse

Further Reading Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. Substance Abuse and Mental Health Data Archive. http://www.icpsr .umich.edu/icpsrweb/SAMHDA/series/97.

Drug Addiction and Public Policy  275 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. 2011. Drug Abuse Warning Network Methodology Report, 2011 Update. http://www.samhsa.gov /data/2k13/DAWN2k11ED/rpts/DAWN 2k11-Methods-Report.htm⩾thods-2.1. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2005a. “Drug Abuse Warning Network: Area Profiles of Drug-Related Mortality.” Rockville, MD: Substance Abuse and Mental Health Services Administration. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2005b. “Drug Abuse Warning Network: National Estimates of Drug-Related Emergency Department Visits.” Rockville, MD: Substance Abuse and Mental Health Services Administration.

Drug Addiction and Public Policy Drug addiction poses difficult questions from a public policy perspective. On one hand, addiction can be treated as a disease to be eradicated, with the focus of public policy being the elimination of addictive behaviors. Yet nearly a century since the United States passed its first piece of federal drug control legislation, addiction remains prevalent, and some of the main effects of prohibitive policies have been to stimulate a black market for illicit drugs and put a tremendous number of individuals involved in drug trafficking and drug use behind bars. The government could take a more hands-off approach to addiction, letting people use psychoactive substances and engage in addictive behaviors as they choose, even if it means that they will harm themselves and society. This approach, however, is also

problematic—a fact that has been borne out by the tremendous public health and social costs that harmful psychoactive substances that are loosely regulated, such as alcohol and tobacco, have inflicted on U.S. society. Given the shortcomings of tight controls over addictive substances, and the problems caused by control regimes that are too loose, addiction is a social problem that has no easy solutions. Consequently, addiction has spawned a good number of debates—both philosophical and practical—concerning how it should be treated by society. There are no clear answers to the social and public policy questions brought up by addiction, and according to some drug policy analysts, addiction is a problem that has no clear-cut “solution”—the best society can do is work to minimize the harm that addiction causes. This approach, however, also brings up as many questions as it answers. Most prominent among them: How exactly is society supposed to minimize the harms caused by drug addiction? While most people agree that psychoactive drugs can cause harm to both individuals and society as a whole, a growing number of critics have begun to argue that the policies in place to restrict their use cause even more harm than the drugs themselves. The fact that the United States spends billions of dollars on drug control every year, but still has the worst drug problem of any industrialized nation, shows that perhaps the U.S. approach to handling the drug problem has been less than ideal. Taking these considerations into account, many intellectuals have begun to argue for the decriminalization and/or legalization of marijuana, cocaine, and heroin, believing that if legal, these substances would do less harm than they currently do on the black market. There are two main lines of argument for a change in the United States’ drug laws—one based on the collateral damage caused by the drug war, the other based

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on the public health crises caused by tight restrictions on narcotics. The arguments for legalization are based not so much on the belief that drugs are good, but rather the understanding that the social harm they cause today comes largely from the fact that they are highly restricted. While tight controls over substances such as heroin or cocaine may keep them out of some people’s hands, they also drive up their prices, leading users to steal to feed their habits. Thus while restrictive controls probably keep many individuals from using drugs, the rules that enforce them have the unintended consequence of instigating crime—theft by users seeking to feed their habits, and violent crime that results from street battles waged by cartels and street dealers. The potentially lucrative profits that the drug trade offers, especially for inner-city youths with few other opportunities for socioeconomic advancement, encourages participation in criminal activity instead of continuing school or seeking out legal work. According to studies, the potential for quick money offered by the illicit drug trade lures many youths into the drug trafficking underworld, and is partially responsible for high school dropout rates and low levels of employment in economically depressed areas. Furthermore, the fact that drug prices are so high has led highly organized and violent criminal syndicates to become involved in the trafficking and distribution of narcotics on America’s streets. Even when the government was able to break up criminal organizations involved in the drug traffic in the 1970s, new homegrown and international syndicates quickly took their place, and the supply of drugs on U.S. streets continued to grow in spite of the government’s efforts to stamp out the traffic. The problems caused by these gangs, who some-

times engage in violent turf battles, are enormous, and these groups are responsible for a good amount of the crime and random violence that takes place in the United States. If the profit motive were taken out of drug dealing, critics argue, these gangs would cease to exist, or at least cut back on their operations. Beyond the criminal activity that occurs because of the limitations on drugs, another argument against the current control regime is that the punishments it metes out to druglaw offenders are too severe. Prisons in the United States are severely overcrowded, and a major reason for this is that so many druglaw offenders are behind bars. The number of drug-law offenders incarcerated in U.S. prisons increased eightfold between 1985 and the late 1990s, and three-quarters of the individuals locked up for drug-law violations are either black or Hispanic. This has tremendous social costs, as it leads many individuals charged with drug-related crimes to have criminal records early in life, meaning that even when they get out of prison, they have limited prospects of future education or employment. What is more, since drug addiction is such an expensive habit, many users spend all the money they can get on drugs and neglect other aspects of their health. Consequently, infectious diseases such as tuberculosis are particularly prevalent among the drug-using population. Despite the fact that so many Americans lose their freedom because of antidrug legislation, illicit drugs remain available and widely used by the people the drug laws hope to keep from using them—adolescents and young adults. In the late 1990s, over half of high school seniors reported having used an illicit drug at least once in their life—a sign that despite the efforts of law enforcement, dangerous drugs are still widely available

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to those who seek them out. What is more, drug enforcement is a costly enterprise, as by the mid-1990s, federal, state, and local governments spent some $35 billion per year on drug control, up from just $10 billion in the mid-1980s. The thrust of this spending is on enforcement, as three-quarters of drug control budgets go toward the apprehension, punishment, and incarceration of drug law offenders, while less than one-fifth of these budgets are devoted to the treatment of addiction. Critics also point out that an increasing proportion of drug-related arrests have been of individuals convicted of illegal possession, not sales. Between 1980 and 2006, the number of arrests for drug possession more than tripled, from 500,000 to over 1.5 million nationwide, and by 2007, 82.5 percent of all drug-related arrests were for possession, not manufacture or sale. Drug use was the most common reason for individuals to be arrested in 2007, with over 1.8 million people being brought up on drug-related charges nationwide. Another argument for the legalization, or at least the loosening, of narcotics controls comes from the angle of health concerns. Since intravenous drugs such as heroin are illegal, users are often in dire need of a dose when they are able to procure them. Consequently, they take little care to practice safe hygiene when using these drugs, and they often use needles that have already been used by others. The sharing of needles by intravenous drug users is among the more prevalent ways that infectious diseases such as hepatitis and HIV-AIDS spread. In the mid-1990s, about 35 percent of new AIDS cases resulted from intravenous drug use, and in areas such as New York City, where the heroin addict population was particularly numerous, nearly half of intravenous drug users tested positive for HIV.

Despite all of these arguments for a reconsideration of the United States’ drug policies, there are also powerful forces that advocate for the maintenance of the status quo. Chief among them is the political establishment. Though intellectuals, reformers, and a handful of lobbyists may put forward persuasive arguments as to why drug laws should be changed, few politicians want to take the risk of being seen as “soft on drugs.” Voters, often concerned that either drugs or drug dealers may affect their lives or the well-being of their children, rarely elect candidates who advocate a reconsideration of the United States’ drug policy. Even if candidates for public office explain that they want to reform drug laws in order to minimize the social harm that drugs cause, there is concern that softening the government’s stance on narcotics would “send the wrong signal,” and tacitly encourage drug use. Furthermore, statistics show that despite the shortcomings of the U.S. approach to drug control, limiting the availability of substances does have public health benefits. Comparisons of illicit drugs with substances such as alcohol and tobacco—which are legal, but still harmful—bear this out. Four times as many individuals in the United States suffered premature death due to alcohol than illegal drugs, and 16 times as many premature deaths are attributable to tobacco. Despite the arguments of drug war critics that the current regime does not effectively limit the availability of illicit drugs, demographic data shows that overall, the use of controlled substances such as cocaine, heroin, and methamphetamine is declining. What is more, the restrictions that force these drugs onto the black market makes them more expensive; cocaine, for example, sold for more than the price of gold in the late 1990s. Thus

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while creating incentive for organized crime to become involved in the drug business, the current control regime has also made illicit drug use less prominent, simply because the drugs are too expensive for most people to procure regularly. Some critics point out that alcohol and tobacco cause greater overall harm to public health than substances that are controlled more tightly, and that therefore the legal controls over narcotics should be loosened. What they do not take into account, however, is that a major reason alcohol and tobacco cause significant damage is because they are so widely available and so many people use them. If other drugs, such as cocaine or opiates, were as openly available as alcohol and tobacco, it is possible that they would cause even greater damage than they already do, since more people would use them. In the last decade, policy options other than simple prohibition or legalization came to the fore in several states. According to some polls, over 60 percent of Americans considered drug abuse a problem that should be addressed primarily with counseling and treatment to help addicts overcome their afflictions, rather than using coercion and the criminal justice system to solve the problem. In 1996, for example, Arizona passed Proposition 200, which allowed for first- and second-time nonviolent drug-law offenders to receive treatment instead of incarceration. According to studies, the program saved the state $6.7 million in 1999, since drug treatment is less costly than imprisonment. In 2000, California passed Proposition 36, which allowed for some nonviolent drug offenders to receive community-based drug treatment instead of going to jail. Maryland also passed a treatment law that diverted many prisoners into drug treatment, and Washington, D.C., passed a similar measure in 2002. Other municipalities have passed “harm reduction” measures,

such as methadone maintenance programs to help get addicts off of heroin, or needle exchange programs to prevent the spread of infectious diseases. In addition, the creation of drug courts, which allow for nonviolent drug-law offenders to participate in courtsupervised community treatment instead of prison, have also proliferated throughout the country and proven successful by helping addicts overcome their afflictions instead of punishing them for them. Though these alternatives have shown promise, they still have not been panaceas, as they have not “fixed” or “solved” the drug problem by any means. They have, however, opened the door for policymakers to consider new options on how to reduce the damages caused by drug addiction. Howard Padwa and Jacob E. Cunningham See also: Drug Courts; Drug Enforcement Administration; Drug Policy Alliance Network; Drug Smuggling

Further Reading Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Behavior. 2nd ed. New York: Macmillan Reference USA. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Coombs, Robert Holman, ed. 2004. Handbook of Addictive Disorders: A Practical Guide to Diagnosis and Treatment. Hoboken, NJ: John Wiley & Sons. Gray, James P. 2012. Why Our Drug Laws Have Failed and What We Can Do about It. Philadelphia: Temple University Press. Huggins, Laura E., ed. 2005. Drug War Deadlock: The Policy Battle Continues. Stanford, CA: Hoover Institution Press. Kleiman, Mark A. R. 1992. Against Excess: Drug Policy for Results. New York: Basic Books.

Drug Cartels  279 Kleiman, Mark A. R., Jonathan P. Caulkins, and Angela Hawken. 2011. Drugs and Drug Policy. New York: Oxford University Press. MacCoun, Robert J., and Peter Reuter. 2001. Drug War Heresies: Learning from Other Vices, Times & Places. Cambridge: Cambridge University Press. U.S. Department of Justice, Bureau of Justice Statistics. 2009. “Drugs and Crime Facts.” http://www.ojp.usdoj.gov/bjs/dcf/enforce .htm#arrests. West Huddleston III, C., Karen Freeman-Wilson, Douglas B. Marlowe, and Aaron Roussell. 2005. Painting the Current Picture: A National Report Card on Drug Courts and Other Problem Solving Court Programs in the United States. Bureau of Justice Assistance. http://www.ndci.org/publications /10697_PaintPict_fnl4.pdf.

Drug Cartels Drug cartels are composed of smaller, independent drug trafficking groups that have come together and pooled their resources to cooperate with each other and advance their drug operations. By outsiders, drug cartels are often thought to be a single organized crime group with thousands of members, wide geographical scope, and vertical control of the drug business. But this is not correct. Drug cartels are simply groups of numerous, smaller organized crime groups that have come together, like a loose confederation of business associates. In these larger cartels, some of the groups are responsible for the production of the raw drug material, whereas others take on the role of transporting the materials from the place where they were grown to the secret labs where they are processed. Other groups may be responsible for the money laundering operations, or even for bribing important political and law en-

forcement officials as a way to ensure their drug operations run smoothly. Smaller drug trafficking groups may decide to enter into a cartel relationship for many reasons. Typically, smaller groups will choose to enter into a relationship with a larger, better-organized, and more stable syndicate for that reason: the larger groups are more efficient and more likely to survive for a longer period of time. Another reason to join a larger drug cartel is to bring together trafficking groups that have different strengths in the many aspects of the drug trade. When this happens, each of the smaller groups knows that they are strong in one area (growth, production, transportation) and therefore weaker in another. At the same time, other groups have a strength that complements their weakness. One group, for example, may not have strong connections to the farmers who grow a particular plant. It makes sense for them to join with another group that can grow massive quantities of the plant. They may also join with another group that has the skills to convert that plant into a high-quality drug. Another organization may be able to smuggle the drug, whereas another may have contacts with buyers in other countries. While separately these groups may not be able to effectively be part of the larger drug scene, if they come together they can be a major actor in trafficking of drugs. In some cases, the smaller, independent drug groups will join together into a cartel because there may be a need for highly specialized services. This happened when opium-growing warlords in the Golden Triangle (Burma, Laos, Thailand) of Southeast Asia joined together with Chinese organized crime groups in Hong Kong and Taiwan as a way to sell their product worldwide and launder their profits. A more recent form of drug cartel revolves around a simple trade-off between

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Police transfer one of seven alleged members of the Sinaloa drug cartel to a police station after their arrest in Mexico City in 2008. (AP Photo)

independent criminal organizations in which a good or service is exchanged for another. For example, the Colombian cocaine syndicates and drug trafficking organizations in Mexico have joined together because each has a different niche. The Colombian dealers contract with the Mexican dealers to smuggle their cocaine into the United States. In return for this service, the Mexican drug organizations can take half of the drugs they transport as their fee and then distribute it to smaller Mexican drug trafficking groups in the United States for sale to drug users on the streets.

Colombian Cocaine Cartels Colombian drug trafficking groups oversee about 75 percent of the world’s cocaine supply. Colombia’s ability to produce large quantities of cocaine is largely due to their

geographical location. Colombia shares a border with Peru and Bolivia, two countries that are major producers of the coca leaf, from which cocaine is derived. More­ over, Colombia has a close proximity to the United States, the major drug market. It only takes two and a half hours to fly from Colombia to Miami. Additionally, Colombia is the only country located in South America that has both a Caribbean and Pacific Ocean coastline, which gives Colombian drug traffickers many different options for smuggling drugs by air and sea. Drug cartels transport raw coca leaves from Peru and Bolivia into Colombia along remote mountain trails. The leaves are taken to hundreds of covert labs where they are converted into coca paste. The coca paste is then transported, usually by use of a light aircraft, to facilities within the Colombian

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interior, where the paste is converted into cocaine hydrochloride, the white powder that is eventually sold to users around the globe. Throughout the 1970s and 1980s, the Colombian cocaine cartels did much of their own smuggling by using air and sea routes. But in the 1990s, they found it was more efficient to subcontract the cocaine distribution to Mexican drug traffickers. In this new arrangement, the cocaine was transported from Colombia into Mexico, where it was given to Mexican drug organizations, which then smuggled it into the United States. Thus, by the 1990s, most cocaine entering the United States from Colombia was transported through Mexico. When law enforcement caught on to the new arrangement, Colombian drug cartels began to add chemical compounds to the cocaine hydrochloride, making black cocaine that was undetectable by standard chemical tests or drug-sniffing dogs. Some Colombian drug cartels continue to operate throughout the United States. These cartels have established cells in specific geographic areas of the country. Many times these cells, or small groups, are structured around families or longtime close friendships. Each cell is compartmentalized and specializes in a different aspect of the cocaine trade in that specific geographic location. For example, some of the cells are responsible for transporting the drugs, whereas others have the task of storing the cocaine for future sale. Other cells specialize in laundering the profits from the drug sales. Often, these groups will have limited or even no contact with the drug at all. The organization of the cells is very decentralized. Often, one cell is not aware of the membership, activities, or location of the others. This way, if law enforcement arrests the members of one cell, the others are safe. Cells are generally composed of

around 10 people and have a structure that is characterized by a typical chain of command found in any business organization. The person acting as the head of the cell will report to a regional director for the drug trafficking network. The regional director, in turn, reports to a designated individual in Colombia. Colombian cartels use the most modern communications technologies available. Particularly important to the drug dealers are state-of-the-art encryption devices that translate communications into indecipherable codes. Encryption technology hides information about drug transactions from anyone outside of the organization but also hides financial information related to money laundering.

The Medellín Cartel The first major Colombian cartel, the Medellín Cartel, began appearing in the mid1970s. The group’s headquarters are in Medellín and its leaders are the Ochoa brothers (Fabio, Jorge, and Juan David), Carlos Lehder, Pablo Escobar, and Jose Rodriguez Gacha. The Medellín cartel was able to dominate the cocaine trade in New York and Miami for many years. The Medellín cartel was never a single drug trafficking organization, but rather comprised many, smaller drug syndicates that joined the cartel. Carlos Lehder first introduced the idea of transporting cocaine by the use of small, private airplanes from a transshipment point. In 1976, Lehder purchased a large portion of the Bahamian island of Norman’s Cay, which was located only 225 miles southeast of Miami. On that land he built an airstrip that was used as a refueling spot for the aircraft that flew the cocaine from Colombia and then on to the United States. The cartel was eventually brought down because of the violence used by many of the

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members to solve disputes or maintain their territory. The Medellín Cartel was responsible for the assassination of Colombia’s minister of justice, Rodrigo Lara Bonilla, in 1984. They also carried out an attack on the Colombian Supreme Court. In response to the violence, the Colombian government agreed to extradite Lehder to the United States in February 1987, where he was convicted of cocaine trafficking and sentenced to 135 years in a federal prison. His sentence was later reduced after he agreed to cooperate in the prosecution of Panamanian dictator Manuel Noriega. Despite the convictions, the violence continued. In 1989, an Avianca commercial airliner was bombed, killing 110 people on board, including two police informants. Additionally, cartel member Pablo Escobar placed bounties of $1,000–$3,000 on police officers in Colombia. He was forced to turn himself in to law enforcement in June 1991, but then escaped the following year. Escobar was eventually shot and killed by Colombian police in December 1993 after a lengthy nationwide manhunt. Escobar’s demise, of course, did not lead to the demise of Medellín drug trafficking networks. Smaller, more decentralized, and more profuse networks have filled any gap created by the removal of Escobar and Lehder from the scene. The Ochoa brothers continue to be active participants in large-scale cocaine trafficking.

The Cali Cartel In the 1980s, cocaine trafficking groups based in Cali, Colombia, a city 200 miles south of Medellín, became noticeable in the cocaine trade. Like the Medellín Cartel, the Cali Cartel was not one single group but rather comprised many smaller syndicates who joined together to share their particular resources and expertise. Cali Cartel members tried to

stay away from publicity, avoided violence, and had the outward appearance of being legitimate businessmen. In doing so, the group members relied on business techniques as a way to manage their drug-running operations and avoid arrest. They relied on thousands of contract employees who had the task of managing the actual cocaine trafficking. Like the cells in the Medellín Cartel, the Cali Cartel insulated every aspect of their drug running from the other aspects. The leaders of the Cali Cartel were the Rodriguez-Orejuela brothers (Gilberto and Miguel), Jose Santacruz-Londono, “Pacho” Herrera-Buitrago, and Victor Julio Patino-Fomeque.

Colombian Heroin Syndicates One reason that the Colombian cartels were comfortable in including the Mexicans in the cocaine trade was because the Colombians were turning their attention more and more to the production and sale of heroin. Beginning in the late 1980s, and then increasing throughout the 1990s, the Colombian drug cartels expanded into growing and smuggling high-grade heroin. It is now estimated that the Colombians supply around 65 percent of the U.S. heroin market. Opium poppies thrive along the eastern slopes of the Central Andean Mountains in Colombia. Opium farmers in that region have a contract to a particular drug cartel. The cartel provides the farmers with seeds and other agricultural supplies needed to grow the poppies, and the farmers agree to sell the opium gum only to that cartel. The farmers are often extremely poor, and rely on these crops to support their families. Once the opium is gathered, the cartel transports the material to clandestine labs, where chemists process the opium gum into a morphine base, which is then turned into heroin. The heroin is then smuggled to markets in the United States and across the world.

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The heroin is smuggled in small quantities. This means that the methods for smuggling are virtually unlimited and the smugglers tend to be very successful. Some techniques used by smugglers include the use of hollowedout shoes, or sewing the drug into the lining of clothing. Some smugglers hide the drug in other shipments of commercial goods, whereas some have found success by wrapping the drug in condoms and swallowing it. Like the other drug cartels, the Colombian heroin trade is dominated by cartels that are made up of smaller drug cartels that operate independently of each other. The Colombian heroin networks sell most of their product to customers in the United States.

Contemporary Colombian Cartels Law enforcement efforts against the Medellín and Cali cartels have led to the downfall of these groups. While they may still exist, they are not nearly the organized groups they once were. However, the drug trade from Colombia has not stopped. The drug trafficking groups have simply become more segmented and decentralizing, making it more difficult for law enforcement to detect and control. Today, drug traffickers in Colombia operate largely independently of each other. They have passed many of the major responsibilities for cocaine smuggling on to drug trafficking syndicates in Mexico. Among the drug organizations in this region are the Henao-Montoya syndicate, the MontoyaSanchez organization, and the UrdinolaGrajles network. These groups are closely allied with right-wing death squads and paramilitary units in the region under the control of Carlos Castano. In the Cali region, Victor Patino-Fomeque, a Cali Cartel leader, directs a drug syndicate from prison. The Cali-based HerreraVasquez organization moves large quantities

of cocaine to the United States via Central America and Mexico. The Herrera-Vasquez organization also launders drug money destined for Colombia through Panama and Mexico. In Bogotá, “Juvenal” Bernal-Madrigal provides transportation services for Mexican Colombian traffickers. He is responsible for multiton shipments of cocaine and the transportation of large amounts of drug money from Colombia to Mexico. Finally, in Medellín, the Ochoa brothers are also back in the cocaine business.

Mexican Drug Cartels Mexican drug syndicates have been trafficking drugs for decades. In the 1990s, Mexican groups became active in trafficking of cocaine, working with the Colombian drug syndicates. The necessary plants from which the drugs are derived grow easily in Mexico. The country has extensive coastal and inland mountain systems that are perfect settings for growing both marijuana and opium poppies. Once the plants are grown and processed, much of the final product is smuggled into the United States. This is primarily because the border between the United States and Mexico is about 2,000 miles long, much of it found in isolated, rural areas with rugged terrain. Moreover, there is an enormous flow of legitimate commerce across the U.S.– Mexican border every day, and the illicit drug trade can mix in easily. There are many opportunities for illegal drug smuggling that can be combined with legal trade. Mexico is also a haven for drug growing and smuggling because there is widespread corruption in both the law enforcement and judicial systems in Mexico. To make matters worse, there is a severe lack of resources available to Mexican police to fight drug producers and traffickers.

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Through the 1980s, Mexican drug groups acted as transshipment agents for the Colombian drug cartels. But this changed, and in the 1990s, Mexican traffickers became more involved in smuggling of cocaine. They were allowed to keep half of each drug shipment. This arrangement allowed them to enter the wholesale cocaine business. By 1995, Mexican cartels dominated the wholesale cocaine market in the Midwestern and Western states in the United States. Like the Colombian cartels, Mexican cartels are compartmentalized and have a vertical chain of command. Unlike the Colombian cartels that have cells with autonomy that insulate their operations in foreign countries, the Mexican leaders provide specific instructions to their operatives on issues regarding storing of the drugs, transportation, and money laundering. Two-thirds of the cocaine sold in the United States is smuggled from Mexico. The drug is brought into Mexico from Colombia either via airplanes or by sea on a boat. It is then transported by truck to repositories in Juárez or Guadalajara. From these repositories, the cocaine is smuggled across the border, usually to dealers in Los Angeles, Chicago, and Phoenix. Cartel members in those cities have contractual arrangements with trucking companies to move the cocaine across the country to smaller warehousing facilities that are closer to the point of sale. Individuals working in these storage facilities guard the drugs and make arrangement for its distribution. The heroin from Mexico makes up about 29 percent of the U.S. heroin supply. Mexican cartels produce six metric tons of heroin a year for sale in the United States. Because of crude refining methods, Mexican heroin is frequently dark in color and sticky or gummy (like tar), resulting in its name of black-tar heroin.

Mexican cartels also play a large role in supplying methamphetamine to the United States. Mexican drug producers have clandestine laboratories in Mexico and California that are capable of producing hundreds of pounds of the drug at a time. Major Mexican cartels include the Arellano-Felix organization that is based in Tijuana. This group is responsible for trafficking in large quantities of cocaine and marijuana as well as heroin and methamphetamine. The Caro-Quintero syndicate, based in Sonora, specializes in trafficking only in cocaine and marijuana. A third Mexican cartel, the Juárez Cartel, relies on trafficking in cocaine, heroin, and marijuana. Based in Guadalajara, the Amezcua-Contreras drug organization focuses on trafficking massive quantities of methamphetamine as well as the precursor chemicals needed to produce methamphetamine.

Dominican Drug Organizations The Dominican Republic is one of the poorest countries in the world. Drug traffickers from this country began by selling cocaine to users in immigrant communities in the United States, the most well-known being the Washington Heights area in New York City. In the mid-1970s, Dominican immigrants worked with the Colombians to supply cocaine to users. They quickly spread to selling cocaine throughout New Jersey, Connecticut, and some suburbs of New York. In the 1990s, Dominican traffickers offered the Colombians a fee of only 25 percent of each load, whereas the Mexicans demanded 50 percent. After that, two major Dominican drug groups became prominent. One operated out of the Dominican Republic and provided places to store the cocaine shipments for the Colombians. Under this agreement, the cocaine was transported into the Dominican Republic via small boats or

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by airdrops. The traffickers in the Dominican Republic then smuggled the drugs into Puerto Rico through boats, where the cocaine was repackaged and shipped into the continental United States in cargo ships or on commercial air flights. Once the drugs were in New York City, the cocaine was distributed by the second Dominican group. The Dominican syndicates rotate their members operating in the United States. Typically, the operatives stay in the United States for a period of two years, and then return to their country.

Southeast Asian Heroin Cartels The areas of Burma and Laos have made Southeast Asia the second-largest region for the production of the world’s supply of heroin. The opium poppy remains the primary revenue source for many of the poor farmers and tribes living in isolated and impoverished areas of Southeast Asia. The heroin is often smuggled on fishing boats down the Gulf of Thailand where it is transferred to the major international maritime shipping centers found in Singapore and Hong Kong. Cambodia is also being used more frequently as a transshipment route for the heroin. Because of widespread corruption of the political and law enforcement groups in Southeast Asia, criminal organizations are virtually immune to interference and are free to operate without much fear of punishment. Nancy E. Marion See also: Black Tar Heroin; Cali Drug Cartel; Central Intelligence Agency; Colombian Cartels; Drug Trafficking; Golden Triangle; Heroin; Medellín Cartel; Mexican Drug Trade

Further Reading Carpenter, Ted Galen. 2012. The Fire Next Door: Mexico’s Drug Violence and the Danger to America. Washington, DC: Cato Institute.

Elkridge, Chris. 1998. “The Mexican Cartels: A Challenge for the 21st Century.” Criminal Organizations 12(1/2): 5–15. Jackall, R. 1997. Wild Cowboys: Urban Marauders and the Forces of Order. Cambridge, MA: Harvard University Press. Kline, H. 1995. Colombia: Democracy under Assault. Boulder, CO: Westview. Langton, Jerry. 2012. Gangland: The Rise of the Mexican Drug Cartels from El Paso to Vancouver. Mississauga, ON: J. Wiley and Sons, Canada. Renard, R. 1996. The Burmese Connection: Illegal Drugs and the Making of the Golden Triangle. Boulder, CO: Lynne Rienner, 1996. Schaffer, E. 1996. “Mexico’s Internal State Conflict over the War on Drugs.” Criminal Organizations 10(3): 14–16. Zabludoff, S. 1998. “Colombian Narcotics Organizations as Business Enterprises.” Transnational Organized Crime 3(2): 20–49.

Drug Classes The 1970 Comprehensive Drug Abuse Prevention and Control Act, also known as the Controlled Substances Act (CSA), was signed by President Richard Nixon in 1970. The new law grouped all drugs into five classes based on their potential for abuse. The drugs are regulated by federal law to control their manufacture, production, and use. The method by which they are placed into each class, or schedule, depends on things like their chemical composition, medical application, safety, and potential for addiction and abuse. The groups of drugs subject to regulation include anabolic steroids, depressants, hallucinogens (including cannabis), opiates (narcotics), and stimulants. Inhalants are not included in the CSA classifications be-

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cause they cannot be held to the same regulatory standards. The intent of the bill was to regulate the legal drug industry and at the same time curtail importation and distribution of illegal drugs throughout the United States. The drugs were placed in groups based on their potential for medical use as well as their potential for patient or user abuse and addiction. There were five basic schedules, or categories, of drugs established. All substances were categorized and placed into one of the schedules. A drug placed in Schedule I meant that it had no recognized medical value and a high potential for abuse. A drug in Schedule II meant that it had some limited or accepted medical purpose, but a high potential for abuse. Examples of these include barbiturates and amphetamines (morphine and cocaine). Schedule III includes those drugs with high medical use and a high potential for abuse, including morphine and codeine. Those drugs placed in Schedule V have a low potential for abuse and an accepted medical use. Schedule IV drugs are those that pose a low potential for abuse and a low risk of dependence. Types of drugs in this category include Xanax, Darvocet, and Valium. Mandatory minimum sentences for drug offenses were also established for each drug category. Because many drugs, both licit and illicit, have more than one effect on a person, there has been great confusion about how drugs are placed in these categories. For example, opiates could be grouped under depressants instead of being placed in a category of their own. Moreover, alcohol or cannabis (marijuana and hashish) are often placed in separate categories instead of being listed under depressants or hallucinogens. Cocaine is treated as an opiate within the categories even though the drug does not bind to opiate receptors in a user and does not pro-

duce morphine-like effects as do opiates. Finally, the date-rape drugs Rohypnol and GHB are categorized as hallucinogens when they are technically depressants. As a way to solve these problems and resolve any confusion, many experts have suggested categorizing all drugs into seven groups: anabolic steroids, cannabis, depressants (including alcohol), hallucinogens, inhalants, opiates (narcotics), and stimulants. Examples of each are below:

Anabolic Steroids These drugs have properties similar to testosterone and are used to stimulate bone growth and treat chronic wasting system associated with AIDS. These include: • • • • • • • • • • • • • • •

Boldenone undecylenate (Equipoise) Fluoxymesterone Methandriol Methandrostenolone (Dianabol) Methenolone Methyltestosterone Nandrolone decanoate (Deca-Durabolin) Nandrolone phenpropionate (Durabolin) Oxandrolone (Oxandrin) Oxymetholone (Anadrol) Stanozolol (Winstrol) Sten Sustanon Testosterone cypionate (Depo-Testosterone) Trenbolone

Cannabis This flowering plant contains THC, which can cause feelings of euphoria in those who ingest it. Forms of cannabis are: • Hashish

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• Hashish Oil • Marijuana

Depressants These drugs inhibit the central nervous system and cause the user to be relaxed and drowsy. Types of depressants are: • • • • • • • • • • •

Alcohol Barbiturates Benzodiazepines Chloral hydrate Flunitrazepam Gamma Hydroxybutyric Acid (GHB) Glutethimide Meprobamate Methaqualone Paraldehyde Rohypnol

Hallucinogens These drugs affect a person’s awareness and state of mind, sometimes resulting in a user “seeing” things that are not real. Many hallucinogens exist, such as: • • • • • • • • • •

Dextromethorphan Ecstasy Flunitrazepam (See Depressants) Gamma Hydroxybutyric Acid (See Depressants) Ibogaine Ketamine Lysergic acid diethylamide (LSD) Mescaline Phencyclidine (PCP) and similar compounds Psilocybin, Psilocin, other tryptamines

Inhalants This type of drug is inhaled by the user. These include:

• Gases such as those found in aerosols and dispensers (whippets), lighters, and propane tanks; refrigerants; and nitrous oxide or chloroform that are used in medical settings. • Volatile solvents, which are regular- or industrial-strength products that contain solvents; these include gasoline, glue, felt-tip markers, paint thinners, degreasers, and dry-cleaning fluids. • Aerosols, which are widely available in most households, including hair spray, vegetable sprays, spray paint, and similar products. • Nitrites fall into two categories: organic, such as butyl or amyl nitrites (“poppers”), and volatile, such as those found in bottles featuring products such as leather cleaner, room odorizer, or liquid aroma.

Opiates These are drugs that contain some form of natural or synthetic opium and have a sedative effect on users. These include: • • • • • • • • • • • • • • • • • •

Buprenorphine Butorphanol Codeine (derived from opium) Dextropropoxyphene Fentanyl Heroin Hydrocodone Hydromorphone LAAM Meperidine Methadone Morphine Opium Oxycodone Oxymorphone Pentazocine Thebaine Tramadol

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Stimulants These are psychoactive drugs that cause improved mental and/or physical functioning in users. Many types of stimulants exist, including: • • • • • • • • • • •

Amphetamines Ephedrine Caffeine Cocaine and Crack Dextroamphetamine Khat Methamphetamine Methcathinone Methylphenidate Nicotine Pseudoephedrine Kathryn H. Hollen

See also: Cannabis; Cocaine and Crack; Comprehensive Drug Abuse Prevention and Control Act; Drug Typologies; Hallucinogens; Hashish; Nicotine; Opiates; Nixon, Richard M.

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Erickson, Carlton K., Martin A. Javors, William W. Morgan (guest editors), Barry Stimmel (editor). 1990. Addiction Potential of Abused Drugs and Drug Classes. New York: Haworth Press. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary.

U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www .samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Drug Courts Drug courts are special judicial proceedings that are used as sentencing alternatives for nonviolent drug-law offenders. With drug courts, a first-time offender charged with a nonviolent drug offense will be placed in a community-based treatment program in lieu of a prison. The offender must successfully complete the treatment program without committing any further crimes. If the offender does not complete the program, they can be sent to a correctional facility for the remainder of their original sentence. Preliminary studies of these courts show that they are very successful in keeping offenders off of drugs for the long term. According to President Obama’s Office of National Drug Control Policy, every four minutes someone in America is sent to treatment instead of a prison through a drug court. Drug courts began in the late 1980s, when several states and local jurisdictions set them up to handle the increasing number of drugrelated cases on court dockets, and address the problem of drug-law violators crowding prisons that resulted from tougher statutes against drug trafficking. At that time, Congress and state legislatures were responding to increased drug use with mandatory minimum sentences for all drug offenders, and police were conducting rigorous campaigns

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that led to a large number of arrests. As a result of the emphasis on tougher laws and tougher enforcement, arrests for drug use skyrocketed. Court dockets became overcrowded, leaving judges little time to deal with more serious felony cases. Furthermore, the large number of drug-related incarcerations overwhelmed the capacity of local jails and state prisons in many jurisdictions. This problem was especially prevalent in Miami, which had become a major hub of the illicit drug traffic during this time. It was estimated that 90 percent of felony de­ fendants in that state tested positive for illicit drug use. Many officials began to recognize that simply arresting offenders and sending them to prison was not solving the drug problem. Offenders continued to use drugs, either while in prison or when they were released. Instead, courts and prisons simply became overcrowded. Judicial and law enforcement officials in Miami then opted to try a new approach: to provide treatment to offenders as an alternative to prosecution and incarceration for those convicted of nonviolent drug offenses. So Miami established the first drug court in the United States in 1989, allowing for felony drug-law defendants to enter an intensive, community-based treatment and rehabilitation program under close judicial supervision. Within just a few years, 471 other jurisdictions across the country adopted the Miami model and created their own drug court programs. The treatment programs associated with the drug courts involves a collaboration of judicial, prosecution, defense, probation, law enforcement, treatment experts, mental health, and social services that provide a comprehensive plan for helping offenders. They must undergo long-term, intensive treatment in the community under close judicial scrutiny. The offenders receive both

substance abuse treatment alongside mental health treatment. They must undergo regular, unannounced drug testing and probation supervision. The judges involved in drug courts receive extra training and develop expertise on drug abuse and treatment options. Drug courts are innovative in two respects. First, the role of the judge is transformed from a traditional role where they simply enforce the law into problem solvers, where they must consider the underlying causes for a defendant’s behavior and the best options for changing that behavior. In the new role, they must address the problems that lead to a defendant’s illegal behaviors regarding their use of controlled substances. Second, drug courts help to establish innovative partnerships that are designed to help addicts become productive members of society. Research has shown that by increasing the direct, judicial supervision of drug offenders, coordinating their access to resources, and expediting the processing of cases through the system, drug courts can effectively break the cycle of crime and substance abuse that often occurs when an offender is released into the community without support, In 2005, the U.S. Government Accountability Office (GAO) conducted a study that showed that drug courts were effective in reducing the re-arrest rates of participants. The GAO study also showed that drug courts not only helped the offenders who participated in the treatment, but that they were also more cost effective than traditional sentencing. By 2009, there were over 2,140 drug courts implemented across the United States. Every state either had an operating drug court or was planning on creating one. Because they have been so successful, many jurisdictions throughout the United States have created similar programs for first-time, nonviolent drug offenders.

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Drug courts for juvenile offenders use a similar model as used in adult drug courts, but they are tailored to the needs of juvenile offenders. In addition to providing treatment for the juvenile offender, these programs provide youth and their families with opportunities for counseling, education, and other services that may be needed. They attempt to address any issues, physical or emotional, that may contribute to the offender’s use of drugs. They also attempt to build skills that increase the juveniles’ ability to lead drugfree lives, as well as strengthen the family’s capacity to offer structure and guidance to that juvenile. Family drug courts are being created in more jurisdictions across the United States and use the drug court model of assisting defendants in need rather than relying on punishment. In these courts, treatment for parents who may be abusing drugs is made available as a way to help a family deal with the abuse and eventually come back together. This is especially critical if there are allegations of child abuse or neglect, especially if substance abuse was identified as a contributing factor to that abuse. Howard Padwa and Jacob A. Cunningham See also: Anti–Drug Abuse Acts; Drug Addiction and Public Policy; Narcotic Addict Rehabilitation Act

Further Reading Calahan, Joan B. 2013. Adult Drug Courts: Brief Overview and Assessments. New York: Nova Publishers. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO.

National Criminal Justice Reference Service, Office of Justice Programs. Drug Courts. https://www.ncjrs.gov/spotlight/drug_ courts/summary.html. Office of National Drug Control Policy. “Drug Courts.” http://www.whitehousedrugpolicy .gov/enforce/drugcourt.html. Terry III, W. Clinton, ed. 1999. The Early Drug Courts: Case Studies in Innovation. Thousand Oaks, CA: SAGE Publications. U.S. Department of Justice, Office of Justice Programs. 2013. Drug Courts. https://ncjrs .gov/pdffiles1/nij/238527.pdf. West Huddleston III, C., Karen Freeman-Wilson, Douglas B. Marlowe, and Aaron Roussell. 2005. Painting the Current Picture: A National Report Card on Drug Courts and Other Problem Solving Court Programs in the United States. Bureau of Justice Assistance. http://www.ndci.org/publications/ 10697_PaintPict_fnl4.pdf.

Drug Czar “Drug czar” is the popular name for the leader of the U.S. War on Drugs, though the official title is director of Office of National Drug Control Policy (ONDCP). The ONDCP is a cabinet-level agency found within the Executive Office of the President. The president nominates the head of the ONDCP, otherwise known as the drug czar, who then must receive the approval from the members of the Senate before being installed into office. The drug czar is responsible for overseeing the nation’s policies geared toward reducing illicit drugs and, as such, oversees both domestic and international antidrug efforts as well as serves as an advisor to the president on matters related to the War on Drugs including budgeting, personnel matters, and policy initiatives. The ONDCP

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White House Office of National Drug Control Policy acting director Michael Botticelli at the Drug Court 25th Anniversary Celebration in the Stephen P. Clark Center in Miami, Florida, in 2014. (AP Photo/Mitchell Zachs)

and the drug czar position were established by the 1988 Anti–Drug Control Act (PL 100-690). Some people would argue that Harry J. Anslinger was the first drug czar, serving as the head of the Federal Bureau of Narcotics under five presidents from 1932 to 1962. In this position, Anslinger oversaw the nation’s antidrug policies and advised the president and Congress, just as today’s drug czar. The drug czar is responsible for implementing the National Drug Control Strategy that is prepared each year by the ONDCP. This document is divided into four policy areas: prevention, treatment, domestic law enforcement, and interdiction and international counterdrug support. The drug czar oversees that the recommendations provided in this document are implemented throughout the nation. The history of drug czars has been filled with controversy, from people saying the

czars have ignored information about ineffective policies, to others saying the czars have lied about statistics. The first drug czar was William Bennett, who was appointed to the position by President George H. W. Bush. Bennett was a conservative Republican who served as the secretary of education prior to being the drug czar. He was vehemently opposed to legalizing drugs, claiming that legalizing drugs would allow more drugs to end up in the hands of children. The next drug czar was Republican Bob Martinez, who served from 1991 to 1993. The former governor of Florida was nominated to the position of drug czar by President George H. W. Bush. While he was drug czar, he supported a program to eradicate poppies in Mexico and Colombia as a way to reduce cultivation of the drug. Martinez sought to create a “most wanted” list for

292   Drug Enforcement Administration (DEA)

drug trafficking organizations, and sought to require states to match any federal funding for drug-education programs. After Martinez resigned, Lee Brown became the drug czar and served from 1993 to 1995. Brown led police departments in Atlanta, Houston, and New York, and also served as the mayor of Houston before becoming the drug czar. Nominated by President Bill Clinton, Martinez was the first Democratic drug czar. Brown supported the High Intensity Drug Trafficking Area teams and increased the investigation of the role of the Colombian Cali drug trafficking cartel. The aggressive investigation under Brown resulted in the indictment of that cartel’s leaders and their lawyers who aided criminal drug activities across the United States. From 1996 to 2001, the drug czar was Barry McCaffrey, who was nominated by President Clinton. He received praise for improving the efficiency of the ONDCP, and often showed his support for demand reduction programs (however, spending for both demand reduction and supply reduction decreased under McCaffrey). McCaffrey tended to focus more on an international approach to drug control policy, in particular international law enforcement and interdiction programs. He supported methadone maintenance programs, but not the push toward legalizing marijuana. John P. Walters served as the drug czar from 2001 to 2009 after being nominated by President George W. Bush. A conservative Republican, Walters called medical marijuana “medical crack” and opposed legalization of marijuana or any drug. He fought against prescription drug addictions and worked to counter narcoterrorism in Colombia, Mexico, and Afghanistan. Since leaving office, Walters has written a book in which he posits that the “moral poverty” of

today’s youth is the cause of increased crime and drug abuse. The current acting director of the Office of National Drug Control Policy is Michael Botticelli. Gil R. Kerlikowske, who was the drug czar from 2009 to March 2014, was nominated by President Barack Obama. Kerlikowske was the police chief of Seattle prior to his taking office. He made it clear that he opposed the legalization of marijuana or other drugs. He has also indicated that the focus of the Obama administration’s drug policy would be on treatment of offenders as the best way to reduce drug use. Nancy E. Marion See also: Anti–Drug Abuse Acts; Bennett, William; Clinton, Bill; National Drug Control strategy; Office of National Drug Control Policy

Further Reading Bennett, William J., John J. DiIulio Jr., and John P. Walters. 1996. Body Count: Moral Poverty—and How to Win America’s War Against Crime and Drugs. New York: Simon and Schuster. Graves, L. 2013. “Drug Czar Defends Funding Punishment Over Prevention.” Huffington Post Politics, April 26. http://www .huffingtonpost.com/2013/04/26/drug-czar -defends-funding_n_3165613.html. United States Office of National Drug Control Policy. http://www.whitehousedrugpolicy .gov.

Drug Enforcement Administration (DEA) The Drug Enforcement Administration (DEA) is the federal agency assigned with enforcing the laws and regulations concerning controlled substances in the United

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States. The agents in the DEA are responsible for investigating and prosecuting major violators of federal drug laws, and managing the national drug intelligence program in cooperation with federal, state, local, and foreign officials. They also have the power to seize assets from criminals who have derived that property from drug activity or if it was related to illicit drug trafficking. Agents also cooperate with foreign governments and international bodies to coordinate trans­ national drug control efforts. The DEA grew out of the reorganization of the nation’s previously existing drug-law enforcement agencies in the late 1960s and early 1970s. The Federal Bureau of Narcotics within the Treasury Department had been in charge of drug-law enforcement from 1930 until 1968, when President Lyndon Johnson merged it with the Bureau of Drug Abuse Control within the Department of Health, Education, and Welfare to form

a new agency, the Bureau of Narcotics and Dangerous Drugs (BNDD). Though the BNDD enjoyed some success in breaking up major drug-smuggling rings, concern over the increase in drug use in the late 1960s led the federal government to take action to further curtail drug use, most notably with the passage of the Comprehensive Drug Abuse Prevention and Control Act in 1970. Some drug enforcement efforts remained hampered, however, by bureaucratic divisions, particularly between the BNDD, the Customs Service, and other organizations within the Justice Department. In 1973, President Richard Nixon declared a “war on the drug menace,” and called for a reorganization of the nation’s drug enforcement apparatus to become better coordinated in order to face what he believed was increasingly organized and complex international drug traffic. In particular, Nixon wanted to respond to the

Drug Enforcement Administration officers remove several pickup truck loads of black bags filled with marijuana from a medical marijuana supplier in Oregon. Medical marijuana is illegal by federal law, despite state laws that permit its use. (AP Photo/Mail Tribune/Bob Pennell)

294   Drug Enforcement Administration (DEA)

development of cocaine processing in Latin America and heroin refining in Southeast Asia, both of which were believed to feed the illicit market in the United States. That year, he presented Reorganization Plan Number 2 to Congress, proposing the creation of a single federal agency to both consolidate and coordinate the government’s drug control efforts. By Executive Order, Nixon created a new organization—the DEA—to coordinate all federal drug control efforts. Nixon’s Executive Order empowered the attorney general to coordinate all drug-law enforcement efforts among federal, state, and local authorities. In the early 1980s, the DEA began working under the FBI. A major DEA responsibility is to develop and maintain a national narcotics intelligence system to collect and produce intelligence concerning drug trafficking, establish and maintain close working relationships with all agencies involved in drug-related intelligence gathering, and increase the efficiency of intelligence reporting and analysis. The DEA divides drug intelligence into three main categories—tactical, operational, and strategic. Tactical intelligence is designed to provide support to investigative efforts by identifying traffickers and their operations; operational intelligence is designed to provide analytical support to investigations; and strategic intelligence focuses on developing a more comprehensive understanding of the entire system by which illicit drugs are produced, smuggled, and distributed worldwide. The DEA’s intelligence program has two major components—an Office of Intelligence at its national headquarters, and Regional Intelligence Units in field offices located throughout the world, which are designed to provide a continuing flow of intelligence and facilitate the exchange of information between the agency and its field offices.

Domestically, DEA agents collaborate with local law enforcement through its State and Local Task Force Program, which allows for the agency to exchange intelligence and expertise with state and local law enforcement. The DEA also has a strong international presence, as it maintains field offices in 63 countries. Overseas, DEA officers assist foreign drug enforcement agents in their undercover work and surveillance, and they provide their foreign counterparts with information concerning the drug trade. The DEA also conducts trainings for police in countries that host its agents at its training facilities in Quantico, Virginia, and on-site in host countries. In addition, the DEA helps coordinate transnational drug control efforts by participating in international forums on drug control that bring together drug law enforcement officials from throughout the world to share intelligence and develop strategies for cracking down on international drug traffic. Today, the DEA is involved in virtually every aspect of the federal government’s campaign against drug traffic. It oversees the Department of Justice’s Asset Forfeiture Program, which confiscates the money and property of major drug traffickers. The agency also has 106 aircraft that it deploys to gather intelligence concerning the growing of narcotics that may go to the illicit market, both domestically and abroad, and it also uses aircraft to track and crack down on smuggling operations. It oversees crop eradication programs domestically, and assists foreign governments with their own efforts to track down and destroy narcotics that are being grown for distribution on the illicit market. To assure that substances produced for medical purposes are not diverted to the black market, the DEA also has a program designed to investigate and crack down on organizations that sell legally

Drug Interdiction and International Cooperation Act (1986)  295

produced drugs in violation of the Comprehensive Drug Abuse Prevention and Control Act. The DEA also has a laboratory, which it uses to test seized samples and build cases against major drug traffickers. Though the majority of its activities focus on limiting the activities of traffickers and drug dealers, the DEA also has agents assigned to serve as Demand Reduction Coordinators, who work with community coalitions, civic leaders, drug prevention organizations, treatment experts, and the general public in order to help educate the public on the dangers of illicit drug use. Today, the DEA has approximately 5,235 special agents and an annual budget of more than $2.3 billion. Yet in spite of all of its efforts and resources, the DEA estimates that it only halts $1 billion worth of the $65 billion illegal drug trade each year. More information on the DEA and its activities is available at its Web site: http:// www.usdoj.gov/dea/. Howard Padwa and Jacob A. Cunningham See also: Comprehensive Drug Abuse Prevention and Control Act; Drug Addiction and Public Policy; Federal Bureau of Narcotics; United States International Drug Control Efforts

Further Reading Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Drug Enforcement Administration. 2008. “DEA History in Depth.” http://www.usdoj .gov/dea/history.htm. U.S. Department of Justice. 2009a. “DEA Mission Statement.” http://www.usdoj.gov/dea/ agency/mission.htm. U.S. Department of Justice. 2009b. “Programs and Operations.” http://www.usdoj.gov/ dea/programs/progs.htm.

Drug Interdiction and International Cooperation Act (1986) The Drug Interdiction and International Cooperation Act of 1986 was Title IV of the Drug Free America Act of 1986, which was signed into law by President Reagan. Through this act, Reagan sought to emphasize international cooperation in the fight against illicit drugs and narcotics. There were multiple provisions of this legislation. Subtitle A of the act was the International Forfeiture Enabling Act of 1986. This act declared any property within the jurisdiction of the United States to be “forfeitable” to the government if it was used in or purchased by unlawful drug activity. Even if the crime was committed within the jurisdiction of a foreign country, the property could still be forfeited. Subtitle B was entitled the Mansfield Amendment Repeal Act of 1986. Under this section of the law, the Mansfield Amendment to the Foreign Assistance Act of 1981 was repealed. This act required that the Congress be provided with reports regarding international narcotics control activities. Subtitle C, the Narcotic Traffickers Deportation Act of 1986, revised the federal law related to deporting those people who were convicted of violating the controlled substances laws on narcotic drugs, marijuana, depressants, or stimulants. Subtitle D, entitled the Customs Enforcement Act of 1986, revised the Tariff Act of 1930. Changes were made to the reporting requirements of vessels arriving into the United States, and the reporting requirements for individuals coming to the United States. Also revised were regulations regarding smuggling via aviation, making of false

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refund claims, the seizure of conveyances, the exchange of information with foreign customs and law enforcement officers, and inspections and preclearance in foreign countries. This provision also increased criminal and civil penalties for violations of the law. Under the new law, fines of up to $5,000 or a prison sentence of up to two years, or both, could be imposed for any aircraft owner who knowingly and willingly violated the law. Another provision in this act amended the Controlled Substances Import and Export Act to make it illegal for any U.S. citizen on board any aircraft, or any person on board an aircraft owned by a U.S. citizen, to manufacture, distribute, possess or distribute a controlled substance. Criminal penalties for operating an aircraft without lights and for illegal fuel installations aboard aircraft were established. The last section of the act, the Maritime Drug Law Enforcement Prosecution Improvements Act of 1986 (Section E) made it illegal for any person on board a U.S. vessel or a vessel subject to U.S. jurisdiction to knowingly or intentionally manufacture, distribute, or possess a controlled substance. Penalties were established for anyone who violated this law. Nancy E. Marion See also: Reagan, Ronald, and Nancy Reagan

Further Reading “Congress Clears Massive Anti-Drug Measure.” 1987. In CQ Almanac 1986, 42nd ed., 92–106. Washington, DC: Congressional Quarterly. http://library.cqpress.com/ cqalmanac/cqal86-1149752. Library of Congress. S2849 Drug Free America Act (1986). https://www.govtrack.us/ congress/bills/99/s2849#summary. Reagan, Ronald. 1986. “Message to the Congress Transmitting Proposed

Legislation to Combat Drug Abuse and Trafficking.” http://www.reagan.utexas.edu /archives/speeches/1986/091586b.htm.

Drug Intervention Programs A drug intervention is a structured process undertaken to persuade someone who is abusing drugs to seek help in overcoming the addiction. Family, friends, and others who are involved in the person’s life participate in the intervention as a way to demonstrate to the individual the full extent of the effects that drinking or drug use had on the individual and others. A successful intervention is not a confrontation, but rather an opportunity for an addicted individual to accept help in taking the first step toward recovery. Drug addiction is a complex illness characterized by intense and, at times, uncontrollable drug cravings. Along with that, the abuser may experience compulsive drugseeking behavior as they experience withdrawal symptoms and need the drug to feel better. Even if there are no withdrawal symptoms, a person may seek to use the drug to experience the euphoria or high that comes with drug use, despite potential devastating consequences. While a person may choose to take the drug at first, over time, they may become addicted and their ability to choose whether to take the drug no longer exists. They must have that drug to survive, and finding the next dose of a drug and consuming it becomes compulsive. The addiction is largely the result of changes in the brain due to prolonged drug exposure. Addiction is a brain disease that affects a user’s motivation, learning and memory, and inhibitory control over behavior. Because long-term drug abuse and addiction can disrupt many aspects of an indi-

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vidual’s life, treatment for that addiction is not simple, and what is an effective treatment for one person may not be for another person. Those treatment programs that are effective usually incorporate many separate components, each directed to a different aspect of the addiction. Effective treatment must help the individual refrain from using drugs and then maintain a drug-free lifestyle. The treatment program must also help the abuser become a productive member of society who can function within a family unit, at work, and in society in general. Because addiction is a chronic disease, most people cannot simply stop using drugs for a few days and be considered to be cured. Instead, there must be long-term or repeated treatment options if the long-term goal of sustained abstinence and recovery is to be achieved. According to the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health, about 23.2 million people (or 9.4 percent of the U.S. population) who are 12 years old or older needed treatment for an illicit drug or alcohol use problem in 2007. Of these individuals, about 2.4 million (10.4 percent of those who needed treatment) received treatment at a specialty facility (at a hospital, or drug or alcohol rehabilitation or mental health center). Thus, 20.8 million persons (8.4 percent of the population aged 12 or older) needed treatment for an illicit drug or alcohol use problem but did not receive it. These estimates are similar to those in previous years. Scientific research shows that drug intervention programs can help patients addicted to drugs stop using the drugs and avoid relapse in the future. Based on this research, it has become clear that treatment needs to be readily available for all addicts. Effective

treatment incorporates all needs of the addict and does not simply focus on their drug addiction, and is long enough to provide the counseling needed to allow the person to be completely healed. The counseling can be in either an individual or group setting. For some addicts, medications may be helpful and can supplement the counseling. The treatment plan must be continually reviewed and modified as needed. The drug intervention can result in treatment through an outpatient program, where the individual visits a clinic at regular intervals, but does not reside there for a period of time. Other programs are residential, where the patient is not permitted to leave. Nancy E. Marion

Further Reading Coalition on Drug Abuse. Drug Intervention Programs. http://drugabuse.com/library/ drug-intervention-programs/. Prendergast, M. L. 2009. “Interventions to Promote Successful Re-Entry Among Drug Abusing Parolees.” Journal of the National Institute on Drug Abuse 5(1): 4–16. U.S. Department of Health and Human Services, National Institute on Health, National Institute on Drug Abuse. 2009. “Treatment Approaches for Drug Addiction Abuse.” http:// www.drugabuse.gov/publications/drugfacts/ treatment-approaches-drug-addiction. U.S. Department of Health and Human Services, National Institute on Health, National Institute on Drug Abuse. 2014. “Principles of Drug Abuse Treatment for Criminal Justice Populations—A Research Based Guide.” http://www.drugabuse.gov/publications/ principles-drug-abuse-treatment-criminal -justice-populations. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/.

298   Drug Kingpin Death Penalty Act (1988, 1994)

Drug Kingpin Death Penalty Act (1988, 1994) The death penalty had been declared unconstitutional in the case Furman v. Georgia in 1972. The Supreme Court decided that existing death penalty statutes failed to give juries adequate guidance in selecting the offenders to be sentenced to death. But in 1976, the Supreme Court upheld revised death penalty statutes in Gregg v. Georgia. The death penalty provisions were roughly modeled on those laws. The Drug Kingpin Death Penalty Act was passed in 1988, but then amended and expanded in 1994 to cover dozens more crimes, many of them drug-related or violent. The 1994 version of the law had provisions to allow the imposition of the death penalty for those considered to be a “drug kingpin,” or someone who plays a significant role in the drug trade or controls the drug network. The law authorized the death penalty for a defendant who was convicted in federal court of a murder that was committed while the offender was engaged in a “continuing criminal enterprise” that involved either large quantities of a controlled substance or $20 million in receipts over a one-year period. The controlled substances defined in the act are large quantities of heroin, cocaine, ecgoine, phencyclidine (PCP), lysergic acid diethylamide (LSD), marijuana or methamphetamine. This means that the defendant did not have to commit the murder him/herself, but either ordered it take place, know about it, or be part of the organization whose members carried out the murder. Moreover, the death penalty could be applied to a person who intended to cause the death or act with reckless disregard for human life, or who engaged in a federal drug felony offense that resulted in the death of another person.

The act requires that government prosecutors prove beyond a reasonable doubt that the defendant intended to commit the murder and that certain aggravating factors (listed in the law) apply to the offense at hand. The law required that the jury be unanimous if it found that there was an aggravating factor present in the case. Under the law, the defendant would be permitted to present evidence of any mitigating factors so the jury could consider those when deliberating the case. However, the jurors did not have to agree unanimously in the decision regarding the mitigating factors. They would be required, however, to consider the aggravating and mitigating factors that had been presented in the case before deciding to impose a death sentence on the defendant. The jurors were not required to recommend a death sentence even if they found that the aggravating factors outweighed the mitigating ones. Under the law, a judge was required to instruct a jury that the race, color, religious beliefs, national origin, or sex of the defendant or any victim should not play a role in considering a sentence of death. The court must impose a death sentence on a defendant if the jury returns a recommendation of such after deliberations. The procedures for review and implementation of the death sentence are outlined in the legislation. Rules for providing counsel for indigent defendants are provided, and standards were set to determine the competence of counsel to help in these cases. One person executed under this statute was Juan Raul Garza, who was convicted in 1993 of murdering three people as part of a marijuana drug-smuggling operation in Texas. After his conviction, he was sentenced to death. He appealed, claiming that the jury in his case was not told that they could recommend a life imprisonment sentence instead of the death penalty. His appeals failed, and on June 19, 2001, Garza was executed at

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the Federal Correctional Complex in Terre Haute, Indiana, by lethal injection. Civil rights advocates have argued that the Drug Kingpin law is used in a racially biased way. They point out that some of the individuals who were prosecuted under the kingpin law were not drug kingpins per se, but simply young black males who were members of inner-city gangs or small-time individuals who had committed crimes for the kingpins. But the U.S. Department of Justice refuted those claims. The attorney general, John Ashcroft, stated that there was no racial bias in the statute nor in the Garza case itself. Nancy E. Marion

Further Reading “Bush Signs Stripped-Down Crime Bill.” 1991. In CQ Almanac 1990, 46th ed., 486– 99. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqalmanac/ cqal90-1113148. Death Penalty Information Center. “Federal Death Penalty.” http://www.deathpenaltyinfo. org/federal-death-penalty. “Election-Year Anti-Drug Bill Enacted.” 1989. In CQ Almanac 1988, 44th ed., 85–111. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqalmanac/cqal 88-1141196. “Expansion of the Federal Death Penalty.” Capital Punishment in Context. http://www.capitalpunishmentincontext.org/issues/expansion. Furman v. Georgia, 408 U.S. 238 (1972). Gregg v. Georgia, 428 U.S. 153 (1976). “H.R. 696–103rd Congress: Drug Kingpin Death Penalty Act.” 1993. http://www .govtrack.us/congress/bills/103/hr696. Serrano, Richard A. 2001a. “Garza Loses Bids to Avoid Execution.” Los Angeles Times, June 19. http://articles.latimes.com/2001/ jun/19/news/mn-12189. Serrano, Richard A. 2001b. “Texas Murderer Becomes 2nd to Be Executed by U.S. in 8 Days.”

Los Angeles Times, June 20. http://articles.latimes.com/2001/jun/20/news/mn-12583.

Drug Nomenclature Whether addictive or used in the treatment of addiction, most drugs have two names, generic and trade. The generic name represents the permanent, simplified name given to its molecular composition. The pharmaceutical company that manufactures or markets the drug gives the trade name, which identifies it as proprietary, or exclusive. When the patent expires, other companies may compound the generic drug into their own trade-named versions. Although the active ingredients may be identical, different formulations of trade-named drugs might have different therapeutic effects based in part on inactive ingredients and the dosage regimen. For example, even though the therapeutic compound in both is the same, one company’s tablet taken twice a day might have slightly different effects from another company’s sustained-release capsule taken once a day.

Drug Nomenclature: Generic and Trade Names The following are generic and trade names of both addictive drugs and therapeutic drugs used to treat addiction. Addictive drugs, alphabetically by generic names Generic names

Trade names

Dextroamphetamine Diazepam Ethchlorvynol Flunitrazepam Oxycodone

Dexedrine Valium Placidyl Rohypnol OxyContin, Percocet, Percodan Salvinorin A Ambien

Sage Zolpidem

300   Drug Paraphernalia Therapeutic drugs, alphabetically by generic names Generic names

Trade names

Bupropion Citalopram Escitalopram oxalate Fluoxetine Naltrexone Nicotine polacrilex Sertraline Varenicline Venlafaxine

Wellbutrin, Zyban Celexa Lexapro Prozac Depade, ReVia, Vivitrol Nicorette Zoloft Chantix Effexor

Kathryn H. Hollen See also: Drug Typologies

Further Reading “Nomenclature.” Drugs.com. http://www .drugs.com/dict/nomenclature.html. “Nomenclature and Classification of Drugand Alcohol-Related Problems: A WHO Memorandum.” 1981. Bulletin of the World Health Organization 59(2): 225–42. U.S. Food and Drug Administration. “Drug Classification.” http://www.fda.gov/Drugs/ DevelopmentApprovalProcess/FormsSubmissionRequirements/ElectronicSubmissions/DataStandardsManualmonographs/ ucm071664.htm.

Drug Paraphernalia Drug paraphernalia is defined as any equipment, product, or material that has been modified for making, using, or concealing illicit drugs such as cocaine, heroin, marijuana, and methamphetamines. There are two categories of drug paraphernalia. One is user-specific products that are marketed to drug users to assist them in taking or hiding illegal drugs. These include pipes

or containers used to conceal drugs. The other type of drug paraphernalia is dealerspecific products that are used by drug traffickers to prepare illegal drugs for distribution at the street level and include such items as scales. According to Title 21 of the Controlled Substances Act, it is illegal to possess, sell, transport, import, or export drug paraphernalia. Many states have laws prohibiting its use or distribution as well. Although its sales in “head shops” or on the street have not been legally permissible for many years, marketers have been able to operate via the Internet and through legitimate tobacco stores where legal smoking accessories such as smoking pipes and rolling papers are sold. The illegal materials are also available in some convenience stores and novelty shops. It can sometimes be challenging for law enforcement to intervene in businesses that sell these products because many of them are marketed as though they were designed for legitimate purposes or reasons. For example, marijuana pipes and bongs frequently carry a disclaimer which states that they are intended for use only with tobacco products. Anyone found in violation of federal law concerning the possession of drug paraphernalia may serve up to three years in jail. Of particular concern to enforcement officials is that much of the paraphernalia is targeted specifically to youth. It is made to seem harmless by covering it with colorful logos, celebrity photos, and smiley faces, or appealing to teens’ sense of rebellion and alienation by decorating it with skulls, devils, dragons, and wizards. Examples of paraphernalia include baggies, bongs, cocaine freebase kits, hollowedout containers, marijuana grow kits, miniature spoons, pipes (metal, wooden, acrylic, glass, stone, plastic, or ceramic), roach clips, scales,

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A police officer displays pipes and other paraphernalia that were seized in a raid of a convenience store and gas station in Florida. The owner was charged with selling synthetic drugs in an area accessible to young children. (AP Photo/The Tampa Bay Times/Douglas R. Clifford)

syringes, and vials. It also includes any equipment, products, and materials that are used, or designed to be used, in planting, cultivating, growing, manufacturing, producing, testing, or packaging illicit drugs. Moreover, the term refers to scales, diluents, and mixing devices intended to be used for compounding illicit substances. Also included are objects used to store or conceal drugs (capsules, balloons, or envelopes) and objects used to inject controlled substances (needles). However, there are ways that a person may be exempt from federal laws concerning drug paraphernalia. First, a person may be authorized by local, state, or federal law to manufacture, possess, or distribute such items. Second, any item that, in the normal lawful course of business, is imported, exported, transported, or sold through the mail or by any other means, and traditionally intended for use with tobacco

products, including any pipe, paper, or accessory, may be excluded. The Supreme Court attempted to rule and define drug paraphernalia in the 1982 case Hoffman Estates v. The Flipside, Hoffman Estates, Inc. In this case, the city of Chicago passed an ordinance requiring stores to acquire a license in order to sell drug paraphernalia. Guidelines defined the items that needed to be licensed to sell, including roach clips that are used to smoke cannabis, according to the definition. The Flipside, Hoffman Estates, sold a variety of merchandise in its store, including roach clips and specially designed pipes used to smoke marijuana. When they were notified that they may be in violation of the law, they brought suit in Federal District Court, claiming that the ordinance is unconstitutionally vague. They requested both relief and damages. The

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District Court upheld the ordinance, and the Court of Appeals reversed on the grounds that the ordinance was indeed unconstitutionally vague. The Supreme Court disagreed with the Court of Appeals, and unanimously voted to uphold the Chicago law. The justices wrote: With respect to the facial vagueness challenge, appellee has not shown that the ordinance is impermissibly vague in all of its applications. The ordinance’s language “designed . . . for use” is not unconstitutionally vague on its face, since it is clear that such standard encompasses at least an item that is principally used with illegal drugs by virtue of its objective features, i.e., features designed by the manufacturer. . . . Under this test, appellee had ample warning that its marketing activities required a license, and by displaying a certain magazine and certain books dealing with illegal drugs physically close to pipes and colored rolling paper, it was in clear violation of the guidelines, as it was in selling “roach clips.” It is important to note that roach clips are a small tweezers-like tool that is used to hold the butt of a marijuana cigarette, in order to prevent one burning his or her fingers. Justice Marshall, who delivered the majority opinion of the court, ended the opinion of the Supreme Court by saying that “the ordinance’s language is sufficiently clear that the speculative danger of arbitrary enforcement does not render it void for vagueness in a pre-enforcement facial challenge.” There was another noteworthy Supreme Court case regarding drug paraphernalia: Posters ’N’ Things v. United States (1994). Upon searching petitioner Acty’s residence and the premises of her business, Posters ’N’

Things, Ltd., officers seized, among other things, pipes, bongs, scales, roach clips, drug diluents, and advertisements describing various drug-related products sold by petitioners. Petitioners were indicted on many charges, including the use of an interstate conveyance as part of a scheme or plot to sell drug paraphernalia to others. They were then convicted in the District Court of the charges. The Court of Appeals affirmed the decision. In this case, the Supreme Court affirmed the opinion of the Court of Appeals. Justice Blackmun wrote the majority opinion. He wrote that the law was not unconstitutionally vague, because it listed the items that constituted drug paraphernalia, including many of the items involved in the case. The law also set forth particular criteria that could be used to assess whether items constituted drug paraphernalia. Because the petitioners in the case operated a full-scale head shop that was devoted to the sale of drug paraphernalia, it was not necessary for the Court to address the law’s possible application to a legitimate merchant who was selling items such as scales, razor blades, and mirrors that may be used for legitimate as well as illegitimate purposes. Further, the Court decided that although the government must establish the fact that a defendant knew the items of concern were likely to be used with illegal drugs, it did not need to prove specific knowledge that the items were “drug paraphernalia” within the meaning of the statute. Nancy E. Marion See also: Drug Abuse

Further Reading Addiction Search. “Drug Paraphernalia: What Every Parent Should Know.” http://www .addictionsearch.com/treatment_articles/

Drug Policy Alliance Network  303 article/drug-paraphernalia-what-every -parent-should-know_113.html. Hollen, Kathryn H. 2008. “Paraphernalia.” Encyclopedia of Addictions. Santa Barbara, CA: Greenwood. 21 USC § 863, Drug Paraphernalia. Cornell Legal Information Institute. http://www.law .cornell.edu/uscode/text/21/863.

Drug Policy Alliance Network The Drug Policy Alliance Network is one of America’s leading organizations promoting changes in U.S. drug policy. The group maintains that policies grounded in science, concerns over health, and a respect for human rights should replace the current U.S. drug control regime, which is rooted in largely punitive pieces of legislation, such as the of 1970 Comprehensive Drug Abuse Prevention and Control Act and the Anti–Drug Abuse Acts. The Drug Policy Alliance Network was formed in 2000 when two organizations calling for drug policy reform—the Drug Policy Foundation, and the Lindesmith Center— merged. Arnold S. Trebach, a lawyer and professor at American University, and Kevin B. Zeese, an attorney who had worked with the National Organization for the Reform of Marijuana Laws in the early 1980s, founded the Drug Policy Foundation in 1987. The group based out of Washington, D.C., used debates and seminars on drug policy issues to promote discussion and reconsideration of the nation’s drug laws. Among the major topics considered at Drug Policy Foundation meetings included the legalization and decriminalization of currently illegal substances such as marijuana and heroin, and finding ways to curb drug abuse while protecting individual rights, which they maintained were unjustly curtailed by the nation’s

law-and-order drug control regime. The foundation was also active in litigation concerning federal drug possession laws, and it had a grant program to support reformminded research centers, needle exchange programs, and harm reduction groups. International financier George Soros was one of the foundation’s biggest backers. Lawyer and professor Ethan Nadelmann in New York City founded the Lindesmith Center, named for early critic of federal drug policy Alfred R. Lindesmith, in 1994. The center, also funded by Soros, quickly emerged as a leading drug policy reform advocacy institute, dedicated to broadening debates on U.S. drug policy and pushing for more harm reduction policies. To fulfill its mission of educating people interested in exploring drug policy, the center had a library and information center, and it organized conferences and seminars that brought the media, government officials, and scholars together to discuss drug policy alternatives. In July of 2000, the Drug Policy Foundation and the Lindesmith Center merged to form the Drug Policy Alliance Network, in order to create a more powerful advocacy presence, both nationally and internationally, in their calls for drug policy reform. Today, the Drug Policy Alliance Network continues to advocate drug policies that decrease the harms of both drug abuse and drug prohibition, and seeks solutions to the drug problem that promote safety while maintaining individual rights and liberties. The main premise of many of the Drug Policy Alliance Network’s activities is that while drug abuse is problematic, attempts to combat the drug problem with zero-tolerance approaches that lead to the incarcerations of hundreds of thousands of Americans have even more disastrous results. The network funds many projects, both nationally and at the state level. Among its more prominent programs

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are Safety First, a project that aims to spread information to parents and teens about psychoactive drugs, and marijuana law reform projects, and it also has an Office of National Affairs in Washington, D.C., that lobbies in order to promote programs that offer treatment instead of incarceration for nonviolent drug-law offenders. It also has state offices in California, New Mexico, New York, and New Jersey. On the state level, the Drug Policy Alliance Network and some of its member organizations have enjoyed significant success. Beginning in 1996 with California’s Proposition 215, which modified state law to allow for the medical use of cannabis, the Drug Policy Alliance Network and its affiliated organizations have seen seven other states pass similar laws. In 2006, the Drug Policy Alliance Network helped push through needle exchange programs for intravenous drug users in New Jersey. Currently, the Drug Policy Alliance Network is organizing broad coalitions to eliminate state mandatory minimum sentencing laws in Alabama, New York, Maryland, and Wisconsin. More information on the Drug Policy Alliance Network and its activities is available at their Web site: http://www.drugpolicy. org. Howard Padwa and Jacob A. Cunningham See also: Anti–Drug Abuse Acts; Comprehensive Drug Abuse Prevention and Control Act; Drug Addiction and Public Policy; Lindesmith, Alfred R.; National Organization for the Reform of Marijuana Laws; Soros, George

Further Reading Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO.

Drug Policy Alliance. “About DPA Network.” http://www.drugpolicy.org/about/history/ and http://www.drugpolicy.org/about/.

Drug Possession The Supreme Court has said that there is no more ambiguous term than possession. It has defined possession as the ownership, control, or occupancy of a thing, most frequently land or personal property, by a person. The legal term possession also has roots in Natural Law and John Locke. There are many different types of possession; however, the two concepts that are most often related to drug possession are “criminal possession” and “possession and intent (to distribute).” Both federal and state statutes make possession of many dangerous or undesirable items a criminal offense punishable by time in prison or a fine. For example, the federal statute 26 U.S.C.A. § 5861 (1996) prohibits possession of certain firearms and other dangerous weapons. Similarly, the law makes it illegal for people to possess other items considered harmful to the public, such as narcotics. Recently, laws have criminalized the possession of “precursor” chemicals, which are the chemicals that are used in drug cultivation and manufacturing. An example of this is ephedrine. Criminal possession, especially of drugs, has been a major source of controversy. Making possession a crime allows for arrests and convictions without proving the use or sale of the prohibited item. In civil cases, the person’s intent is usually not an element to possession. This means that what the person intended to do with the drug is not important, nor does it require that the person know the drug is illegal. However, in most criminal cases, possession

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usually requires a conscious possession. That means that the person facing charges must be conscious and aware of the fact that the drug is illegal to possess and that he or she possesses it. A person in possession of illegal drugs may avoid conviction if he or she truly believed the drugs were legal and were allowed to have them. In order to be found guilty of criminal possession of a drug, a person must either know the item is illegal when they received it, or they must keep the item in their possession even after learning it is illegal to hold that drug. A person who is convicted of drug possession faces a broad range of possible penalties, depending on the state in which they are located. The penalty depends on many factors, including the type of drug involved, the circumstances surrounding the possession, and the criminal background of the person. If found guilty, an offender could be charged with a fine that ranges from $100 to $100,000. Another possibility is incarceration in jail from a few days or weeks to 10 years or more. Probation is a viable sanction in some states, in which case the offender must check in with a probation officer on a regular basis and comply with specific terms, such as not using drugs or not associating with certain people. If the offender does not comply with the provisions of the probation, they could be sent to jail. Another option for punishment of possession is diversion, in which case an offender enters into counseling program instead of going to trial. If the offender completes the treatment program, the criminal charges will be dropped. Most often this is used with firsttime, nonviolent offenders. Nancy E. Marion

Further Reading Cornell University Law School. “Penalties for Simple Possession.” http://www.law .cornell.edu/uscode/text/21/844.

Diroll, David. 2011. Drug Offense Quick Reference Guide. Columbus: Ohio Criminal Sentencing Commission. “Drug Possession Explained in Depth.” Laws.com. http://criminal.laws.com/drug -possession. Hazelden Publishing. 2012. Legal Consequences of Alcohol and Other Drugs. New York: Films Media Group. National Safe Deposit Co. v. Stead, 232 U.S. 58. (1914). United States Department of Justice, Bureau of Justice Statistics. “Drugs and Crime Facts.” http://www.bjs.gov/content/dcf/enforce.cfm. United States v. Nenadich, 689 F.Supp. 285 S.D. N.Y. (1988).

Drug Purity Drug purity refers to the relative concentration of the active ingredient in an illegal drug relative to impurities (or inactive ingredients). The purity of a drug affects is price, is effects, and its usage, and has been connected with a variety of issues of drug use. In particular, the purity of drugs is closely related to elements such as overdose as well as the effectiveness of the disruption of drug markets. There are various methods used to assess the purity of a drug, and often these differ across different types of illicit materials. The overall quality of data on drug purity is questionable, because of the nature of illegal markets and the active attempts to persuade buyers with purer drugs. As purity refers to the relative absence of impurities, adulterants, diluents, or substitutes (for the abused substance), there is necessarily a difference in types of purity across different illegal drugs. Additionally, as drugs are dissimilar to regular markets, in which purity is generally regulated by a state body

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(e.g., alcoholic beverages in many countries are capped at 60 percent alcohol), and given that the markets for drugs in most locations are illegal, the purity is usually gauged by the user experience. This, in turn, changes the level of price that the user pays for the drug, as “purer” drugs are worth more in the illegal market than drugs that have been adulterated in some fashion. Impurities can be added to drugs for a variety of reasons. Often drugs are “cut” by users, through adding a diluent or adulterant for resale, in order to assist them with purchasing more of the drug in a purer form. Adulteration of drugs affecting purity can take place at several points during the manufacturing process. “Impurities of origin” refers to the fact that drugs, even in their original form, can contain multiple pharmacoactive substances. Shesser, Jotte and Olshanker (1991) state that certain varieties of opium have over 25 separate alkaloids, with different pharmacologic properties, in addition to the morphine that is used in the manufacture of heroin. “Impurities of manufacture,” on the other hand, arise from the manufacturing process itself, during the synthesis of a drug. Both types of impurities can lead to significant differences in the effects of the substance being used. Diluents and adulterants refer to types of impurities that are purposefully introduced to a drug to either increase the amount of the drug or to increase or mimic the effect of a drug. For instance, starch is often added to heroin to increase the amount of heroin for sale. The introduction of diluents is primarily to increase the saleable amount of the drug. Adulterants, in contrast, are often used to enhance or augment a drug’s effects and can, like diluents, affect a drug’s per­ formance upon ingestion. Another element affecting the purity of a drug is the location in which it is produced.

In the case of drugs such as heroin, methamphetamine, and cocaine, research has shown that geographic proximity to the point of entry is an important element when examining drug purity. This is likely because there are multiple points of sale after entry (e.g., wholesaler to retailer), and impurities of various types are introduced at several stages of the process. The effects of variation in drug purity, or the introduction of various impurities either through manufacture or origin, can be significant. In particular, the effects of drug purity on issues such as accidental overdose are important concerns for practitioners in criminal justice and medical fields. Various additives can change the toxicity of a drug and make the necessary steps to arrest an overdose more problematic. Further, as additives can vary according to both drug type and purpose, and as users do not necessarily know what kind of additive is in the drug they are using, it increases the overall risk of problems with toxicity and makes treatment difficult if an overdose happens. In addition to physiological effects, drug purity also has strong impacts on issues like price. In fact, purity is the central consideration of price for most illegal drugs. Drugs are “experience goods,” insofar as users can only judge the quality and purity of a drug by its use, and thereby judge its value. In practice, it is difficult to determine drug purity, though many users report attempting to gain purity information, particularly through asking other users. Problematically, however, even use is not a reliable indicator of a drug’s purity, particularly when adulterants are used to enhance the user’s experience. This, in turn, changes the calculation of the user in terms of payment for a more or less “pure” drug. Purity measures have also been strongly correlated without outside meas-

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ures of illegal drugs’ impact. Emergency department admissions, medical examiner mentions, household surveys, and urinalysis results all tend to correlate with the purity of a drug sold in a given area. Information on drug purity is limited because of the illicit nature of drug markets and the corresponding unwillingness of individuals engaging in those markets to allow for analysis of their products. Thus, the primary source of information regarding drug purity are databases set up by law enforcement to detect issues with drug purity (and other, related issues) relevant to public safety. These two databases, the Drug Abuse Warning Network (DAWN) and the System to Retrieve Information from Drug Evidence (STRIDE) are the main sources of data for drug purity for most academic and law enforcement purposes. The DAWN database gathers information from the treatment of patients who are using illegal drugs at the time of treatment. The sample is 760 emergency departments from across the United States. While the information is primarily geared towards identifying trends in drug supplies, the database is hindered by the fact that patients must have information about, and admit, their drug use, and in the case of impurities within illegal drugs, users often do not have sufficient information. The second system, STRIDE, is based on evidence collected and submitted to Drug Enforcement Administration (DEA) laboratories. Samples of drugs are analyzed to understand the composition of drugs, though analysis is limited to the “primary” and “secondary” drugs present in the sample. Further hindering its usefulness as a measure of purity, most of the evidence submitted is from larger-scale wholesalers, who in many cases sell it to smaller dealers that “cut” the drug again.

In addition to these larger databases, there are smaller sources of information, such as newsletters like Microgram, published by the DEA, that includes specimen analysis of local sales to undercover agents and officers from smaller departments. While these sources of information have proven useful, they have been heavily critiqued because of their shortfalls. In particular, the databases have been used in econometric analyses of drug markets, and though much information has been gleaned from these, it is uncertain how accurate that information is. In addition to drug price information for purposes of tracking use issues, the databases have frequently been used to attempt to identify the effects of drug interdictions, with the general process suggesting that increased success in interdiction will lead to more significant adulteration of the drugs to attempt to make up for losses incurred. Several organizations, like the Office of National Drug Control Policy, have used this data to argue for the success of some interdiction programs. Joshua B. Hill See also: Drug Abuse Warning Network; Office of National Drug Control Policy

Further Reading Caulkins, J. P. 2005. “Price and Purity Analysis for Illicit Drug: Data and Conceptual Issues.” Heinz Research, Paper 25. http:// repository.cmu.edu/heinzworks/25. Cunningham, J. K., J. C. Maxwell, O. Campollo, K. I. Cunningham, L. Liu, and H. Lin. 2010. “Proximity to the US–Mexico Border: A Key to Explaining Geographic Variation in US Methamphetamine, Cocaine, and Heroin Purity.” Addiction 105: 1785–98. Fries, A., R. W. Anthony, A. Cseko Jr., C. C. Gaither, and E. Schulman. 2008. “The Price and Purity of Illicit Drugs: 1981–2007.”

308   Drug Reform Act (1986) IDA Paper P-4369. Institute for Defense Analysis. Johnston, J., M. J. Barratt, C. L. Fry, S. Kinner, M. Stoove, L. Degenhardt, J. George, R. Jenkenson, M. Dunn, and R. Bruno. 2006. “A Survey of Regular Ecstasy Users’ Knowledge and Practices Around Determining Pill Content and Purity: Implications for Policy and Practice.” International Journal of Drug Policy 17: 464–72. Reuter, P., and J. P. Caulkins. 2012. “Purity, Price, Production: Are Drug Markets Different?” In Illicit Trade and the Global Economy, ed. C. C. Storti and P. De Grauwe. Cambridge, MA: MIT Press. Shesser, R., R. Jotte, and J. Olshaker. 1991. “The Contribution of Impurities to the Acute Morbidity of Illegal Drug Use.” American Journal of Emergency Medicine 9: 336–40.

Drug Reform Act (1986) In 1986, Congress passed the Drug Reform Act as a way “to strengthen Federal efforts to encourage foreign cooperation in eradicating illicit drug crops and in halting international drug traffic, to improve enforcement of Federal drug laws and enhance interdiction of illicit drug shipments, to provide strong Federal leadership in establishing effective drug abuse prevention and education programs, to expend Federal support for drug abuse treatment and rehabilitation efforts, and for other purposes.” In 1986 Ronald Reagan signed the enormous omnibus drug bill, which appropriated $1.7 billion to fight the drug crisis. An additional $97 million was allocated to build new prisons, $200 million was allocated for drug education, and $241 million was allocated for drug treatment. The Drug Reform Act was one of the U.S. government’s first

major steps in the war on drugs. The most controversial part of the bill was the creation of mandatory minimum penalties for drug offenses. Under the new law, a person convicted of possessing at least one kilogram of heroin or five kilograms of cocaine could be sentenced to at least 10 years in prison. As a response to the crack epidemic hitting the streets of the United States, the sale of 5 grams of crack could result in a mandatory five-year prison sentence. This was controversial because mandatory minimums like this had been under fire for promoting racial disparities in the prison population, mostly because of the differences in sentencing practices for crack vs. powder cocaine. It was not only the mandatory minimums that were criticized. The policy process involved in making this law did not include any experts on sentencing, judges, a representative from the Bureau of Prisons, or from any other government office, who would be able to provide advice to policymakers on the idea of mandatory minimums before it was sent through the committee and passed into law. The committee members received only minimal comments informally. The Anti–Drug Abuse Act of 1986 finally passed both houses of Congress a few weeks before the November elections. When Congress passed the law, proponents of the bill claimed that the new, tough mandatory minimum sentences would have a significant impact on major drug traffickers. But over time, the drug dealers learned that the law did not affect them as they thought, especially if they were dealing in crack cocaine. This is because the law institutionalized a sentencing disparity of 100 to 1 for crack cocaine to powder cocaine by mandating a five-year minimum term for 5 grams of crack—the weight of less than two sugar packets—or for 500 grams of powder cocaine.

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The act was amended in 1988. The new law created the Office of National Drug Control Policy (ONDCP) that was responsible for creating and implementing the nation’s anti–drug use policies. The head of the ONDCP, the nation’s drug czar, advises the president on matters concerning drug control, and coordinates all federal drug-control activities and federal funding across the government. The ONDCP also produces the annual National Drug Control Policy, which outlines administration efforts to reduce illicit drug use, manufacturing and trafficking, drug-related crime and violence, and drugrelated health consequences. The mandatory sentencing guidelines were reformed in 2010 to change the ratios of powder to crack cocaine to 18:1. Nancy E. Marion See also: Drug Interdiction and Internation Cooperation Act (1986); Drug-Free America Act; Mandatory Minimum Sentences

Further Reading Saunders, Debra J. 2009. “Huge Crack in System of Drug Prosecution.” San Francisco Chronicle, May 7, A13. Sterling, E. E. “Drug Laws and Snitching.” PBS Frontline. http://www.pbs.org/wgbh/ pages/frontline/shows/snitch/primer/. White House, Office of National Drug Control Policy. http://www.whitehouse.gov/ondcp/ about.

Drug Screening and Testing Some schools, private-sector employers, and the federal government test students or employees for drug use. Many schools have begun to carry out random drug testing for those who participate in extracurricular activities, and they test other students if there

is reasonable suspicion or cause to believe they are using drugs. Private companies may want to screen employees for drug panels— a range of predetermined drugs—based on their own internal standards. Federally regulated drug testing was instituted decades ago to determine whether federal employees and others performing services for the U.S. government were current or former drug users. Five drug groups were singled out at that time for testing: amphetamines, cannabinoids, cocaine, opiates, and PCP. Because these groups of drugs were defined decades ago, some tests cannot detect synthetic substitutes like oxycodone; however, most drug-testing facilities have introduced updated laboratory procedures that allow them to do so. Nevertheless, some newer steroids can evade detection. There are many methods available to test for drugs. The most common is urinalysis, but drug tests can also be completed on a person’s hair, oral fluids, and sweat. These methods vary as to their cost, reliability, drugs detected, and detection period. Employers must decide on their needs and then choose the best method for them. Usually, a drug test can identify use of marijuana, cocaine, opiates, amphetamines, and PCP. However, there are tests for other drugs as well. Alcohol does not remain in the blood for a sufficient time for most tests to detect. Breathalyzers and oral fluid tests can detect current use only. Thus, while it is easy to detect if someone is under the influence of alcohol at the time, the use of alcohol is difficult to determine after that. While most tests are fairly accurate, sometimes there is a “false positive” where a test indicates drug use when the person has not used drugs at all. If a test is positive, it is important that a second test be conducted. While there are products that promise to “clean” a urine test that may indicate drug

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use, the products are costly and do not work. They are easily identified in the drug test. Some schools, hospitals, or places of employment screen potential employees for drug use as a means of pre-employment screening. Some also use random drug testing, or testing if there is reasonable suspicion or cause for testing an individual for drug use. Many employers use postaccident testing, for example, for bus drivers who may be involved in an accident. Some employees may be tested if they return to work after a long time off. Drug testing usually involves collecting urine samples of the employee to check for the presence of drugs such as marijuana, cocaine, amphetamines, PCP, and opiates. Some schools have begun random drug testing of their students, while others test students where there is reasonable suspicion or cause to believe the student has been abusing illegal substances. Those schools that have implemented random testing will occasionally choose one or more students to undergo the test. Currently, random drug testing may only be conducted on those students who participate in competitive extracurricular activities. Reasonable suspicion/ cause testing requires a student to be tested if there is sufficient evidence that the student may have used an illicit substance. This often occurs after a school official witnesses unusual behavior, or if the student shows the physical symptoms of being under the influence. Those schools that have chosen to randomly test students for drug use are hoping to decrease drug abuse among their students. The tests will decrease drug use in two ways. First, officials hope that random testing will be a deterrent because students will be afraid of being caught using drugs. Second, the drug testing can identify those teens who may have used drugs so that interventions or

treatment can occur early. Because of that, those students who test positive for drug use will not be punished or face disciplinary action. In most schools, testing is only one component of programs to reduce drug use among teens. It is especially important to test teens because drug use at this time, when the brain and body are still developing, can be especially harmful. Using drugs can affect a person’s judgment and decision making, resulting in accidents, poor performance in school or sports, unplanned risky behavior, and the risk of overdosing. These risks are even more serious when drugs are used by young people. Most research shows that teens who stay away from drugs in high school are less likely to develop drug abuse problems as adults. In June 2002, the U.S. Supreme Court upheld the right of public school officials to test students for the possible use of illegal drugs. In a 5 to 4 decision in Pottawatomie County v. Earls, the justices decided that it was legal to perform random drug tests on middle and high school students who participated in competitive extracurricular activities. Prior to that decision, school drug testing was used only for student athletes. Depending on the circumstances, modern drug screens can detect alcohol, amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, opiates, nicotine, LSD, methadone, or PCP. Some dipstick urine tests can be evaluated on the spot, although more accurate results are obtained from laboratory analysis. Advantages of on-site, onthe-spot urine or saliva tests are that they can be used for random drug testing and to detect immediately whether drugs were implicated in accidents or other incidents in which drug use is suspected. Alcohol is rapidly eliminated from the body, so samples should be

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obtained as quickly as possible, but blood, hair, urine, and sweat tests can be used to detect past drug use. Many employers require pre-employment screening, return-toduty screening, or on-site testing that may involve random and unannounced screening. Parents find saliva tests to be an immediate and convenient tool to check for current drug use in their children, and schools may use them when there is cause to believe students are using.

Types of Drug Tests Blood and Hair Testing blood and hair for the presence of drug residue produces very accurate results, although it may take a few days for the test to be processed. Body hair works as well as hair from the head, so drug users’ attempts to foil the test by shaving their heads does not work, especially since hair follicles can be removed for testing, which can be very painful. Saliva Tests Many organizations test for drug use by testing a person’s saliva. A major advantage of saliva tests is that they can be done on-site and the results are immediate. They are also virtually impossible to adulterate. Sweat Patches Sweat patches are applied to the person’s skin and collect sweat samples over a period of days or even weeks. The user cannot remove them without the knowledge of the testing agency. Many people question the reliability of the results of this form of drug testing. Urine Tests Urine tests are very accurate, but the samples can be easily adulterated. Many drug users

take diuretics or drink excess fluids in an attempt to dilute their urine, but most tests can screen for dilution or masking agents. Kathryn H. Hollen See also: Urinalysis

Further Reading Friedman, Lauri. 2012. Student Drug Testing. Detroit: Greenhaven Press. James-Burdumy, Susanne, Brian Goesling, John Deke, Eric Einspruch, and Marsha Silverberg. 2001. The Effectiveness of Mandatory-Random Student Drug Testing. Washington, DC: U.S. Department of Education, National Center for Education Evaluation and Regional Assistance, Institute of Education Sciences. http://permanent .access.gpo.gov/gpo3608/Executive%20 summary/20104026.pdf. Lawler, Jennifer. 2000. Drug Testing in Schools: A Pro/Con Issue. Berkeley Heights, NJ: Enslow. National Institute on Drug Abuse. “Drug Testing.” http://http://www.drugabuse.gov/ related-topics/drug-testing. Sawvel, Patty Jo, ed. 2006. Student Drug Testing. Farmington Hills, MI: Greenhaven. Verstraete, Alain. 2011. Workplace Drug Testing. London: Pharmaceutical Press.

Drug Sentencing The criminal sentencing for offenders found guilty of drug-related offenses has varied over time. Sentences for drug violations became more severe through the 1980s as a result of stricter sentencing policies. At this time, many states and the federal government passed sentencing guidelines that mandated sentences for offenders. There was also an increase in arrests of drug offenders by law enforcement personnel. As a result,

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there were more offenders being placed in prisons for longer sentences. In 1984, Congress created the United States Sentencing Commission to write sentencing guidelines for all federal crimes and to provide proportional sentences and unwarranted sentencing disparity among similar defendants. When Congress passed the Anti–Drug Abuse Act of 1986, it established mandatory minimum sentences for drug offenders. Originally, the sentencing guidelines were mandatory. Judges were given only a limited amount of discretion (or choice) to decrease a recommended sentence. However, in 2005, the Supreme Court decided in Booker v. United States that these mandatory guidelines were “advisory” guidelines. This gave judges the ability to sentence within, above, or below the calculated guideline range. The Supreme Court indicated that judges must choose a sentence that is sufficient but no greater than necessary to achieve the purpose of punishment. The 1986 law also established mandatory minimum sentences for possession of specific amounts of cocaine. When it did that, it created a 100-to-1 disparity between the distribution of powder cocaine and crack cocaine. In other words, a person charged with distributing 5 grams of crack cocaine could be sentenced to a minimum five-year sentence in a federal prison. At the same time, a person found guilty of distributing 500 grams of powder cocaine could get the same sentence. The problem was, because of its relatively low cost, crack cocaine is more accessible to those who are poor, many of whom are African Americans. On the other hand, the much more expensive powder cocaine tends to be used by affluent white Americans. This issue was addressed by presidential candidate Barack Obama, who promised to address the discrepancy be-

tween powder and crack cocaine sentences if elected to office. Obama signed the Fair Sentencing Act on August 3, 2010, which reduces the disparities in sentencing for crack and powder cocaine offenses. The new law lessened the ratio to 18:1. The Anti–Drug Abuse Act of 1986 also provided more money for the sentencing and imprisonment of offenders. The law allocated $6 billion over three years for “interdiction and enforcement measures.” Recently, there have been calls to reform the drug sentencing system, largely because the tough sentencing policies for drug offenders results in overcrowding problems in prisons and jails. Most of these offenders are sentenced to prison terms for nonviolent, firsttime offenses. It is thought that as much as 80 percent of state budgets for prisons, parole, and probation is spent on offenders involved with drugs. Most of that money is spent on building and operating prisons, according to a study by the National Center on Addiction and Substance Abuse at Columbia University. While only 20 percent of inmates in state prisons are serving time for drug crimes, 53 percent of them are considered substance abusers. Many people have begun to point out multiple problems in the sentencing system when it comes to drug offenses. Prison overcrowding is one of the most significant problems in the criminal justice system, and it is directly linked to drug sentences. The tremendous influx of inmates into state prisons and jails during the 1980s is directly linked to the increase in funding and tough sentencing that occurred during President Reagan’s “War on Drugs.” According to the Department of Justice, there were 216,000 people incarcerated in 1974. That number rose to more than 1.3 million in 2001. This is an increase of over 600 percent. The number of prison inmates then rose to 2 million in 2003 and 2.2 million in 2006.

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In 2011, the state of Delaware reformed its drug sentencing policies. For many years, its drug code was complex and revolved around tough sentencing of offenders. Mandatory minimum sentences had been increased many times. Lawmakers in the state decided to revise their drug sentencing laws, with the support of police officials, defense and prosecuting attorneys, and judges. They created a system whereby drug offenses were organized into three main categories—simple possession, possession of large amounts, and drug dealing. Possible aggravating factors, such as resisting arrest or committing the crime in a drug-free school zone, were listed. If these elements were present during an arrest, the penalties for that offense were then increased. In Colorado, lawmakers revised their drug sentencing after realizing that providing substance abuse and mental health treatment for prisoners can, in the long run, reduce recidivism. They instituted more drug treatment options for some drug offenders in prison. They focused on lower-level drug offenders (i.e., those convicted of use and possession offenses). Lawmakers decreased felony and misdemeanor classifications, shortening some sentences and sending fewer offenders to prison. Any cost savings the state received from imprisoning fewer prisoners were reinvested into drug treatment programs. They also increased the opportunities for parole for nonviolent, first-time drug offenders, and removed some possession offenses from habitual offender sentencing laws. Arizona lawmakers also reformed the state’s sentencing laws. Arizona voters passed Proposition 200, or the Drug Medicalization, Prevention and Control Act of 1996. In doing so, the state recognized that drug abuse is a public health problem that should be treated as a disease rather than a crime. Thus, options for drug treatment and

prevention for nonviolent offenders were increased, or given as an option as an alternative to incarceration. At the same time, drug sentences for those convicted of violent drug-related crimes were increased. According to the statute, “any person who is convicted of the personal possession or use of a controlled substance or drug paraphernalia is eligible for probation.” Moreover, “the court shall require participation in an appropriate drug treatment or education program.” Persons not eligible for probation include those who have been convicted three times of personal possession or use of a controlled substance; have refused drug treatment as a term of probation; have rejected probation; were convicted of personal possession or use of a controlled substance where the offense involved methamphetamine; and finally, anyone who was convicted of a trafficking offense, such as possession for sale, production, manufacturing, or transportation for sale. After the law was implemented, there were fewer inmates in prisons in Arizona. There are more offenders on probation. Further, because there are more offenders receiving treatment, recidivism in the states has decreased. Nancy E. Marion See also: Drug Addiction and Public Policy; Treatment

Further Reading Cutler, L. M. 2009. “Arizona’s Drug Sentencing Statute: Is Rehabilitation a Better Approach to the ‘War on Drugs’?” New England Journal On Criminal & Civil Confinement 35(2): 397–420. Nadelmann, Ethan. 2010. “Obama Takes a Crack at Drug Reform.” The Nation, August 26.http://www.thenation.com/article/154164/ obama-takes-crack-drug-reform.

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Drug Smuggling As a way to reduce the amount of illegal drugs in the United States, officials have been passing and implementing laws that attempt to limit the flow of drugs into the country. Despite this, there have been numerous individuals and criminal organizations that have successfully imported, trafficked, and sold illegal drugs. Despite these efforts, the black market for controlled substances has continued to flourish. The first federal law that restricted the flow of drugs into the United States was the Smoking Opium Exclusion Act in 1909. Even then, smugglers found ways to undermine the law. Within just a few months of the law’s passage, smugglers on the West Coast began bringing opium into the country illegally by hiding it in the recesses of ships that were carrying ordinary consumer goods. When the Harrison Narcotics Act was passed in 1914, new restrictions were placed on the transfer of opiates and cocaine in the United States. This law had the unintended consequence of prohibiting doctors from legally prescribing drugs to addicts. Many addicts and users were forced to turn to the black market for their drugs and supplies. This became more of a problem when the U.S. Supreme Court ruled that the law forbade the prescription of maintenance doses of drugs to addicts. Even though the Geneva Opium Convention of 1925 closed many loopholes used by drug traffickers to legally purchase opium overseas and traffic it internationally, the illicit drug traffic continued to grow stronger throughout the 1920s and 1930s as criminal organizations from Europe, Latin America, and Asia imported controlled substances into the United States. Often, traffickers made deals with diplomatic personnel to smuggle drugs into a country since they were less

likely to be inspected at the border. Prior to the 1970s, the biggest drug smuggling operation was the “French Connection,” which began in the 1930s and supplied more than 90 percent of the illicit heroin that made its way on to U.S. streets until it was broken up. The French Connection was collaboration between French criminal Jean Jehan and the Italian Mafia. The groups brought opium poppies from Turkey into southern France, where opium was converted into heroin in clandestine labs. From there, French traffickers brought the heroin into the United States, where they sold the drugs to the Italian Mafia. The organized crime families in the United States were responsible for distributing the drugs to people on the local level. At the end of World War II, the drug smuggling operations of the French Connection expanded. Large amounts of heroin were produced and smuggled across the U.S. border on a regular basis. By the early 1950s, the number of people addicted to heroin was increasing, largely because of the drugs manufactured and smuggled through the French Connection. The French Connection was broken up in the 1970s when the United States convinced officials in Turkey to stop growing opium. The French police and the drug-law enforcement agencies in the United States arrested many people involved in the scheme, which effectively disrupted the drug ring. However, throughout the 1980s, other smugglers began using the same networks and connections originally developed in the French Connection. Now, other criminal groups illegally traffic large amounts of heroin made from poppies grown in Iran, Pakistan, and Afghanistan into the United States. After the French Connection was dismantled, drug trafficking operations sprang up in Latin American countries. By the late 1970s,

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a drug-running syndicate, led by Jaime Herrera-Nevares and based out of Durango, Mexico, was established. This quickly became a $60 million-a-year smuggling operation that targeted many U.S. cities. In the early 1980s, the same group established drug-running connections in South America. This time, they began dealing in cocaine as well as opium. In 1985, after a two-year criminal investigation of the Herrera-Nevares crime ring, about 120 traffickers were arrested. A few years later, in 1988, the leaders of the gang were arrested. A group that trafficked in marijuana around that time was the Black Tuna gang. They brought marijuana into the United States from Colombia through Miami. In the late 1970s, the group smuggled about 500 tons of marijuana into the country. At that same time, traffickers from Medellín, Colombia, began smuggling both marijuana and cocaine into the United States. This cartel was extremely violent and would calmly carry out bombings, kidnappings, and killings as a way to quell any threats to its operations. The organization used the banking and import industries in the United States, and bribed high-ranking government officials to take part in the smuggling. One of the more famous politicians who was involved with the Medellín cartel was Manuel Noriega. The Medellín Cartel was successful for many years, but in 1993, the group’s cocaine trafficking operation ceased when their leader, Pablo Escobar, was killed by police. But this did not mean that the smuggling of drugs into the United States stopped. Instead, other criminal groups filled the void. On group in particular, the Cali Cartel, quickly took over drug smuggling into the United States. When the leaders of the Cali Cartel were arrested, Mexican organizations then took over drug smuggling operations. These

groups are extremely violent and corrupt. Groups such as the Amado Carrillo-Fuentes, Arellano-Felix Brothers, Juan Garcia Abrego, and the Miguel Caro-Quintero organizations smuggle heroin, marijuana, cocaine, and amphetamines into the United States. Moreover, drug smugglers from Asia and Africa also traffic heroin from poppies grown in Southeast Asia, while MDMA is smuggled in from Europe and Israel. Terrorist organizations such as Al-Qaeda and rebel organizations such as Columbia’s FARC are behind much of the drug trafficking, and use the proceeds to fund their activities. Some drugs, such as methamphetamine, marijuana, and hallucinogens manufactured within the United States enter the black market as well. Despite rigorous enforcement efforts, the Drug Enforcement Administration estimates that it is only able to stop $1 billion worth of the $65 billion illicit drug trade each year. According to critics of U.S. drug policy, the continued prevalence and efficiency of drugsmuggling operations serve as proof that the war on drugs is an unwinnable one, and evidence that the government should try different approaches to the drug problem. Nancy E. Marion See also: Drug Addiction and Public Policy; Drug Enforcement Administration; Federal Bureau of Narcotics; French Connection; Medellín Cartel; Opium

Further Reading Campbell, Lindsay. 1909. “Foiling the Opium Smugglers.” San Francisco Call, January 23. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcot-

316   Drug Tolerance ics, 1500–2000. London: Weidenfeld & Nicolson. Drug Enforcement Administration. 2008. “DEA History in Depth.” http://www.usdoj .gov/dea/history.htm. Huggins, Laura E., ed. 2005. Drug War Deadlock: The Policy Battle Continues. Stanford, CA: Hoover Institution Press.

Drug Tolerance Drug tolerance refers to an individual’s desensitization to a drug. In other words, with repeated or extended use of a drug, a user does not respond to the drug in the same way as they used to. A user requires more of the substance, or even a different substance, to achieve the effect he or she had when they first used that drug. Put another way, a person’s reaction to a drug decreases so they need a larger dose to have the same effect. The degree of tolerance that develops varies for different substances depending on their effect on the brain. In heavy opiate users, tolerance can build to such a degree that the addict can withstand up to 10 times the amount of the drug that a nonuser can withstand. Very strong tolerances to methamphetamine tend to occur quickly. Drug tolerance occurs because the user’s body adapts to the presence of the drug. A person’s body may be able to break down, or metabolize, the drug within the body more quickly than when it was first used. There may also be a decrease in the number of cell receptors in the user’s body that the drug attaches to. Moreover, the strength of those bonds may weaken, thereby lessening the effect of the drug for the user. Another cause of tolerance is called learned tolerance. This happens when a person ingests a drug in the same setting multiple times. The user will be less likely to feel

the effect of the drug in that setting. If they use the drug in another social setting or environment, the drug may have the intended effect. Tolerance to a drug can become a significant problem for people taking prescribed drugs because the drugs may be less effective over time. For example, someone taking drugs for pain may need more and more of that medication to handle the pain. Tolerance can also be dangerous to addicts because as their tolerance to a drug develops, they must ingest more of the drug to get the same effect, which could possibly lead to an overdose. Tolerance to a drug can develop after a person becomes physically addicted to the drug, or the addiction can lead to a drug tolerance. Those users who are addicted will need more and more of the substance to ward off cravings. On the other hand, those who have built up a tolerance will need to use more of the drug to achieve the effect, leading a person to become addicted. Drug tolerance is often reversible. If a person does not use the drug for an extended period, the effect of its use will once again result in the original effect. A related occurrence is reverse tolerance, which refers to situations in which a user will experience the reversal of the insensitivity to a drug that was caused by a drug tolerance. When reverse tolerance occurs, a person will be more affected by the same amount of the drug. While this phenomenon is not fully understood, it is known that it occurs less frequently than drug tolerance. It may have to do with an increase in the body’s ability to change the drug into an active chemical. In some cases, reverse tolerance refers to situations in which a user needs a lower dosage of a drug to feel the same effects. They may also feel more intense or longer impacts of the drug.

Drug Trade 

Another related term is cross tolerance, which refers to a situation in which a user has a resistance to that medication as a result of tolerance to a pharmacologically similar drug. In other words, there is a decrease in the effect of one drug due to the use of another drug. Nancy E. Marion See also: Addiction

Further Reading Leith, N. J., and R. Kuczenski. 1981. “Chronic Amphetamine: Tolerance and Reverse Tolerance Reflect Different Behavioral Actions of the Drug.” Pharmacology, Biochemistry and Behavior (September 15): 399–404. National Institute on Drug Abuse. 2007. “The Neurobiology of Drug Addiction, 6: Definition of Tolerance.” http://www.drugabuse .gov/publications/teaching-packets/neurobiology-drug-addiction/section-iii-actionheroin-morphine/6-definition-tolerance.

Drug Trade The international drug trade is a global black market in which illegal drugs are cultivated, manufactured, processed, and sold, despite laws prohibiting them. According to the United Nations Office on Drugs and Crime, the industry is estimated to be worth more than $320 billion a year, or 0.9 percent of the world’s gross domestic product, but the true value remains unknown. This figure constitutes about 14 percent of agricultural exports worldwide. The primary drugs that make up the drug trade include opiates (mostly heroin), cocaine, marijuana, and amphetamines. The market for marijuana and hashish is valued at $142 billion, followed by cocaine at $71 billion, and opiates at $65 billion. The drug trade has no boundaries and no na-

tional identity, but it has become the primary source of income for millions of low-income farmers in many countries. Illegal drugs are grown and produced in countries around the world. According to the researchers connected to UNESCO’s MOST program, the countries of the former Soviet Union now produce 25 times more hashish than the rest of the world and traffics it worldwide. Coca plantations, traditionally found in Bolivia, Peru, and Colombia, today are found in Ecuador, Brazil, Venezuela, Panama, Guyana, and even other regions of the world. Opium poppy plantations, which were typically found in Laos, Myanmar, Thailand, Afghanistan, Iran, and Pakistan are being cultivated in Turkey, Egypt, Eastern Europe, Mexico, Central America, and in Central Asia. Tajikistan, Uzbekistan, Turkmenistan, and Afghanistan produced 2,800 tons of raw opium, which was 58 percent of the world’s illicit supply. Once the drugs are produced, they are transported worldwide. It has been argued that the opening up of the former Soviet Union and China has led to the reopening of the ancient silk roads, which have become major drug roads. Central Asia has an extensive network of roads, air transport, and railways that, along with porous borders, has become a major drug trafficking corridor. The borders dividing the states of Central Asia are a complicated maze that is virtually uncontrollable; it is possible to change countries several times when driving from one city to another in the same republic. This means drug traffickers can move their cargos easily without detection. Organized criminal groups are largely responsible for global drug trafficking simply because the profits are so high. Many of these groups were able to develop and become truly organized during Prohibition in the United States. They developed

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production facilities and distribution methods to supply an illegal product, alcohol, to the public. These groups now control the drug trafficking industry worldwide. The profits can be used to fund other criminal activity or terrorism. The illegal drug trade can be very violent. Violence is common as groups vie for control of the international black market. Murder is common, as are burglaries, robberies, and other crimes. Law enforcement from many countries must often work cooperatively in order to attack the groups who make up the drug trade. This is sometimes difficult, however, because laws vary widely from one country to another. A large portion of the drugs grown and manufactured in other countries end up in the United States, which is one of the most lucrative markets for coca and opiates. In recent years, however, illicit drug consumption is increasing rapidly in Eastern Europe, South East Asia, and throughout Africa. In these countries, Ecstasy, cocaine, crack, and heroin are becoming increasingly popular. Cannabis and its derivatives are also now used around the world. The high consumption means that the drugs must be continually supplied—there is no end to the need for the product. Drug trafficking is a problem when it comes to synthetic drugs as well. Synthetic drugs can be made in underground laboratories, and are stronger and cheaper than any natural drugs. Alongside natural drugs, the demand for synthetic drugs continues to rise among people of all countries. It is difficult to estimate the value of the illicit drug market. In 2000, Americans spent about $36 billion to purchase cocaine, $10 billion on heroin, $5.4 billion on methamphetamine, $11 billion on marijuana, and $2.4 billion on other substances. Nancy E. Marion

See also: Drug Trafficking; Drug Trafficking and Organized Crime; Drug Trafficking Networks; Golden Crescent; Golden Triangle

Further Reading Abt Associates. 2001. “What America’s Users Spend on Illegal Drugs: 1988–2000.” Washington, DC: Office of National Drug Control. Chalk, Peter. 2011. Latin American Drug Trade: Scope, Dimensions, Impact and Response. Santa Monica, CA: RAND Corporation. “Drug Statistics: Spending on Illegal Drugs.” http://www.worldometers.info/drugs/. “Illegal Drug Trade in Africa: Trends and U.S. Policy.” 2009. U.S Congressional Research Service, Library of Congress. “International Drug Trade and U.S. Foreign Policy.” 2006. U.S. Library of Congress, Congressional Research Service. “Trafficking Statistics.” http://www.drugabuse .net/drug-policy/drug-trafficking-statistics/. United Nations Drug Control Program. 1998. “Economic and Social Consequences of Drug Abuse and Illicit Trafficking.” Technical Series No. 6. Williams, S., and C. Milani. 1999. “The Globalization of the Drug Trade.” Sources: 1–9. http://www.unesco.org/most/sourdren.pdf. Zeese, K., et al. 2009. “Estimating The Illicit Drug Market.” Drug War Distortions. http://www.drugwardistortions.org /distortion19.htm.

Drug Trafficking Despite the “war” on drugs, illegal narcotics are cheaper, more potent, and more readily available than ever before. The United Nations reports that in recent years, illicit drug consumption “has become a global phe-

Drug Trafficking 

nomenon.” The growth of the drug problem is not necessarily the sole consequence of failed antinarcotics efforts. In fact, it is also a result of post–Cold War policies that have opened up economic markets, societies, and technologies. Briefly, as societies have democratized and liberalized their economies, they often find themselves facing serious problems with the abuse of illegal narcotics. The rise in drug problems is attributable to many factors, including those that are characteristic of legitimate economic activities that shape market operations in free, democratic societies. For example, criminal markets and black-market entrepreneurs copy entrepreneurial activity that exists comparatively unfettered in democratic societies. Markets, legal or illegal, cater to consumers. Also, the evolution of modern business technology (cell phones, faxes, computers, and the Internet) operating in the legitimate marketplace function most effectively in illegal markets. Despite decades of intensified eradication programs and aggressive drug control and enforcement efforts, more drugs are being produced and distributed. Gauging the quantities of heroin, cocaine, marijuana, and related substances is difficult because of the illegal nature of producing and trafficking in these drugs. Moreover, consumption of drugs takes place in environments that scarcely lend themselves to public scrutiny. Clearly, this complicates any rigorous assessment of the economic, social, and psychological consequences of illicit drug activity. Indeed, the problem’s relentless spread throughout the world has given rise to a greater awareness of the enormous negative effects of drug abuse and trafficking on the economic and social fabric holding societies together. The growth of drug use has occurred within many international statutory structures whose laws and criminal codes have been

Colombian drug kingpin Pablo Escobar in 1984. Escobar, also known as the King of Cocaine, was a notorious drug lord through the 1980s. He was shot in December 1993,  by Colombian law enforcement. (AP Photo)

designed to contain it. In the United States, the federal government has invested nearly $275 billion to control drugs, but the drug business continues to thrive. Aside from being more available and affordable today, drugs represent one of the world’s largest and most lucrative markets. Estimates of value run as high as $500 billion. Marketing narcotics and trafficking has become truly global: drug seizures of cocaine manufactured in South America and heroin originating in Southeast and Central Asia and Latin America have occurred increasingly in areas outside the United States. Virtually every nation reports that drugs are more available now than at any other time.

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The vaunted “War on Drugs” appears to have failed in many respects. This failure may be related to the continual reliance on ineffective anti-trafficking strategies. In the United States, for example, the drug trade thrives in states where controls are weak or nonexistent. Such states are often too corrupt to take action to stop the cultivation of raw drug material within their borders. Furthermore, with international trade rising sharply, it is not difficult to mix illicit narcotics into the huge tide of legitimate goods, services, and people across national borders; and it is most improbable that drug seizures will occur that will have a significant impact on the drug-using population.

Drug-Trafficking Impacts on NationState Stability The expansion of drug trafficking has led to social turmoil in many nations. The profits from trafficking are enormous and provide terrorists, insurgents, and criminals with new resources to buy even more (and advanced) weapons, hire gunmen, and intimidate state agencies and officials. Office holders are corrupted by massive amounts of drug money, as a result of which the legitimacy of political and judicial institutions is undermined. Social cleavages can only be sharpened and deepened by illicit profits circulating throughout the economic underground of nations teetering on the brink of economic collapse. Economic and Social Consequences of Illicit Trafficking The illicit drug industry outside the United States, which is very destructive to the economy and social welfare of the indigenous societies in which drugs are cultivated, constitutes a great threat as well to the welfare and social stability of the United States.

Drug addiction carries a terrible human cost in terms of social, economic, and health concerns, including HIV/AIDS, which especially afflicts users of illicit narcotics (Fuentes and Kelly 1999). The negative effects of addiction on family cohesion pose lifelong negative consequences for the lives of children, the quality of community life, and the workplace in terms of man-hours lost to illness and distress. Results from the National Household Survey on Drug Abuse, conducted in 1995, indicated that 14.8 million Americans, or about 6.7 percent of the population 12 years or older, were current users of illicit drugs. Moreover, in 1999, according to a study sponsored by the Office of National Drug Control Policy, Americans spent $63 billion on illegal drugs. The National Institute for Drug Abuse estimated that the total cost of drug abuse in the United States, including health care and lost productivity, was $110 billion in 1995. In terms of decreased productivity and lost earnings, drug use is estimated to cost $77 billion a year.

Illicit Drug Production The most dangerous drugs abused in the United States are cocaine (and crack), heroin, methylenedioxy methamphetamine (MDMA) (known popularly as Ecstasy), and methamphetamine (speed). According to the Drug Enforcement Administration, the bulk of Ecstasy and speed is manufactured in Mexico and distributed in the United States. The source countries for heroin and cocaine are in Asia and Latin America. Cocaine is produced in the South American Andean countries of Colombia, Peru, Bolivia, and Ecuador. The United States constitutes the largest market for cocaine and its byproducts such as crack. Robert J. Kelly, Jesse L. Maghan, and Joseph D. Serio

Drug Trafficking and Organized Crime  321 See also: Drug Trade; Drug Trafficking and Organized Crime; Drug Trafficking Networks; War on Drugs

Further Reading Bauder, Julia. 2008. Drug Trafficking. Detroit, MI: Greenhaven Press. “Drug Trafficking and North Korea: Issues for U.S. Policy.” 2007. Washington, DC: U.S. Library of Congress, Congressional Research Service. Fortson, Rudi. 2002. Misuse of Drugs and Drug Trafficking Offenses. London: Sween & Maxwell. Fuentes, Joseph R., and Robert J. Kelly. 1999. “Drug Supply and Demand: The Dynamics of the American Drug Market and Some Aspects of Colombian and Mexican Drug Trafficking.” Journal of Contemporary Criminal Justice 15(4): 328–51. Paul, Christopher, Agnes Gereben Schaefer, and Colin P. Clarke. 2011. The Challenge of Violent Drug-Trafficking Organizations: An Assessment of Mexican Security Based on Existing RAND Research on Urban Unrest, Insurgency, and Defense-Sector Reform. Santa Monica, CA: RAND. Sherman, Jill. 2010. Drug Trafficking. Edina, Minn: ABDO Publishing. Steinberg, Paul. 2010. How Might Marijuana Legalization in California Affect Drug Trafficking Revenues and Violence in Mexico? Santa Monica, CA: RAND. U.S. Office of National Drug Control Policy. 2011. Use of High Intensity Drug Trafficking Area Funds to Combat Methamphetamine Trafficking: Report to Congress. Washington, DC: Executive Office of the President, Office of National Drug Control Policy. Williams, Phil, and Vanda Felbab-Brown. 2012. Drug Trafficking, Violence, and Instability. Carlisle, PA: Strategic Studies Institute, U.S. Army War College.

Drug Trafficking and Organized Crime Organized crime may be defined as continuing criminal conspiracy that derives profits from illegal activities and goods that the public demands. The existence and structure of criminal groups are sustained through the use of violence, corruption of police and public officials, intimidation, credible threats, and control of particular illicit markets in drugs, gambling, loan sharking, and extortion. One of the most dangerous developments in organized crime at the end of the 20th century was the trend toward the formation and consolidation of transnational organized crime groups. These groups collaborate and cooperate in ways that facilitate the delivery of illicit goods and services on a vast international scale. The transnational style of many modern crime organizations does not appear to have resulted from a conscious master plan concocted by some arch criminals. Rather, it emanates from the organizational flexibility of some groups to respond to nuances within the complex economic environment. Many crime syndicates are suited for the cyber age: namely, they have informal organizations, and they are sensitive to changes in their surroundings, alert to opportunities and threats from law enforcement or from competing criminal organizations. Law enforcement (first-responder) agencies are also rooted in local conditions and therefore are not able to aggressively attend to local corruption and sophisticated illegal markets. In addition, regional political and economic organizations such as the European Union, which promote the free flow of people and goods, simultaneously weaken national borders, thereby creating a serious dilemma. The very factors that promote economic

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prosperity contribute to the growth of transnational organized crime and illicit trafficking. Free trade, the movement of capital production capacities and skilled labor, and the availability of cheap labor along with wholesale and retail markets for consumer goods also facilitate illicit trade and transnational organized crime. Russian, Polish, Italian, British, Chinese, Mexican, and Corsican syndicates, among numerous others, have responded to the new emergent reality. It is not the Mafia and Triads (secret societies of a criminal character that flourish among overseas Chinese) that have created these opportunities; rather, it is the nation-states and multinational corporations that support unconstrained trade conditions, which are then exploited for criminal gain. In this regard, ethnic communities can be understood as potential resources for transnational criminal enterprises. They provide recruitment opportunities, as well as cover and support for criminal operations, and they serve as a pool of criminal activists prepared to engage in trafficking activities. Many immigrants in economically depressed ghettos are often tempted to participate in criminal enterprises. Unfortunately, even casual participation in criminal gang activities can sometimes yield greater rewards than can be obtained through legitimate work. Drug Trafficking and Organized Crime in the Americas: Major Trends in the TwentyFirst Century identifies eight major reasons that drug use and organized crime have been on the rise in the Americas:   1. The increasing globalization of drug consumption;   2. The limited or “partial victories” and unintended consequences of the U.S.led War on Drugs, especially in the Andes;

  3. The proliferation of areas of drug cultivation and of drug-smuggling routes throughout the hemisphere (“balloon effects”);  4. The dispersion and fragmentation of organized criminal groups or networks within countries and across subregions (“cockroach effects”);  5. The failure of political reform and state-building efforts (deinstitutionalization effects);   6. The inadequacies or failures of U.S. domestic drug and crime control policies (demand control failures);  7. The ineffectiveness of regional and international drug control policies (regulatory failures); and   8. The growth in support for harm reduction, decriminalization, and legalization policy alternatives (legalization debate). Though often associated with Mexican drug cartels and U.S. consumption of drugs, organized crime exists in Africa and throughout the rest of the world. There are many efforts to raise awareness of the activities of organized crime groups and the potential threat they pose to peace and stability in different areas of the world. The ongoing scourge of drug trafficking in West Africa and the increasingly sophisticated and complex operations launched and carried out by drug cartels acting on the global scene is an issue of great concern to many. The crime groups’ use of the Sahara Desert as transit route for illegal narcotics, in particular cocaine and marijuana, increases the insecurity levels in an already volatile region. Terrorist networks and rebel groups derive significant economic benefit from these criminal activities. According to the Global Commission on Drug Policy, the global war on drugs has

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failed, and it has had devastating consequences for both individuals and societies around the world. Enormous expenditures on measures to curtail drug producers, traffickers, and consumers have failed to curtail drug supply or consumption. Apparent victories in eliminating a source or organization are lost when other sources and traffickers emerge almost instantaneously. Fifty years after the UN Single Convention on Narcotic Drugs was passed, and 40 years after President Nixon launched the U.S. government’s War on Drugs, there is a need for fundamental reforms of global drug control policies. In response, the Global Commission on Drug Policy made recommendations on how international drug crimes could be reduced. They are:  1. End the criminalization, marginalization, and stigmatization of people who use drugs but who do no harm to others. Challenge rather than reinforce common misconceptions about drug markets, drug use, and drug dependence.  2. Encourage experimentation by governments with models of legal regulation of drugs to undermine the power of organized crime and safeguard the health and security of their citizens. This recommendation applies especially to cannabis, but we also encourage other experiments in decriminalization and legal regulation that can accomplish these objectives and provide models for others.  3. Offer health and treatment services to those in need. Ensure that a variety of treatment modalities are available, including not just methadone and buprenorphine treatment but also the heroin-assisted treatment programs that have proven successful in many

European countries and Canada. Implement syringe access and other harm reduction measures that have proven effective in reducing transmission of HIV and other blood-borne infections as well as fatal overdoses. Respect the human rights of people who use drugs. Abolish abusive practices carried out in the name of treatment— such as forced detention, forced labor, and physical or psychological abuse—that contravene human rights standards and norms or that remove the right to self-determination.   4. Apply much the same principles and policies stated above to people involved in the lower ends of illegal drug markets, such as farmers, couriers, and petty sellers. Many are themselves victims of violence and intimidation or are drug dependent. Arresting and incarcerating tens of millions of these people in recent decades has filled prisons and destroyed lives and families without reducing the availability of illicit drugs or the power of criminal organizations. There appears to be almost no limit to the number of people willing to engage in such activities to better their lives, provide for their families, or otherwise escape poverty. Drug control resources are better directed elsewhere.   5. Invest in activities that can both prevent young people from taking drugs in the first place and also prevent those who do use drugs from developing more serious problems. Eschew simplistic “just say no” messages and “zero tolerance” policies in favor of educational efforts grounded in credible information and prevention programs that focus on social skills and peer influences. The most successful prevention

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efforts may be those targeted at specific at-risk groups.  6. Focus repressive actions on violent criminal organizations, but do so in ways that undermine their power and reach while prioritizing the reduction of violence and intimidation. Law enforcement efforts should focus not on reducing drug markets per se but rather on reducing their harms to individuals, communities, and national security.   7. Begin the transformation of the global drug prohibition regime. Replace drug policies and strategies driven by ideology and political convenience with fiscally responsible policies and strategies grounded in science, health, security, and human rights—and adopt appropriate criteria for their evaluation. Review the scheduling of drugs that has resulted in obvious anomalies like the flawed categorization of cannabis, coca leaf, and MDMA. Ensure that the international conventions are interpreted and/or revised to accommodate robust experimentation with harm reduction, decriminalization, and legal regulatory policies. Robert J. Kelly, Joseph D. Serio, and Jesse L. Maghan See also: Drug Smuggling; Drug Trade; Drug Trafficking; Drug Trafficking Networks

Further Reading Bagley, B. 2012. “Drug Trafficking and Orga­ nized Crime in the Americas: Major Trends in the 21st Century.” Woodrow Wilson International Center for Scholars Latin American Program, August, 1–22. http://www .wilsoncenter.org/sites/default/files/BB%20 Final.pdf. Desroches, Frederick J. 2005. The Crime That Pays: Drug Trafficking and Org­ anized

Crime in Canada. Toronto: Canadian Scholars’ Press. Global Commission on Drug Policy. 2011. “War on Drugs.” http://online.wsj.com/ public/resources/documents/GlobalCommissionReport0601.pdf. United Nations Office for West Africa. “Drug Trafficking and Organized Crime.” http:// unowa.unmissions.org/Default.aspx?tabid= 800. U.S. Congress, House Committee on the Judiciary, Subcommittee on Crime. 2000: Threat Posed by the Convergence of Organized Crime, Drug Trafficking, and Terrorism: Hearing Before the Committee on Crime of the Committee on the Judiciary, House of Representatives, One Hundred Sixth Congress, Second Session. Washington, DC: Government Printing Office. U.S. Congress, Senate Committee on Finance, Subcommittee on International Trade. 1997. Threat to U.S. Trade and Finance from Drug Trafficking and International Organized Crime: Joint Hearings Before the Subcommittee on International Trade of the Committee on Finance and the Caucus on International Narcotics Control. Washington, DC: Government Printing Office.

Drug Trafficking Networks A drug-trafficking network is a highly sophisticated organizational form that can be more clearly understood as a group of entities or units (individuals, organizations) that are linked together and are working for a particular goal. The goals of drug networks are to transport illicit drugs between countries and through jurisdictions to the customers worldwide without being interrupted by law enforcement. Through the networks, both buyers and sellers succeed in their pursuits: either selling or buying illicit drugs. This has

Drug Trafficking Networks 

become much easier with the expansion of global trade, communication, and travel. Many networks exist. They vary in their size, their connections and purpose (goals) as well as their reach (i.e., local, national, international). They can expand or contract as needed, and can easily adapt to new situations. While they are loosely connected, they must have a core that provides leadership and direction for the rest of the network. International drug-trafficking organizations have extensive networks of suppliers and front companies that facilitate narcotics smuggling and the laundering of illegal earnings. In the Western Hemisphere, Mexican and Colombian trafficking organizations have dominated the drug trade. Colombian cartels supply most of the cocaine through Mexican transshipment syndicates that arrange distribution in the huge U.S. market. In the Asian source regions, large trafficking groups dominate heroin production. The Asian trafficking networks are more diffuse than their drug organization counterparts in Latin America: heroin shipments from Asian sources (southeast or central regions) typically change hands among many criminal organizations on their way to their destinations. Trafficking patterns in general are more like the Asian groups, which are capable of smuggling not only drugs but also people and other contraband. In general, the trends indicate that traffickers in many countries are rejecting traditional types of criminal partnerships with similar ethnic and racial groups and are increasingly collaborating in the purchase, transport, and distribution of illegal drugs with different types of organizations, including rebel armies, terrorist groups, and other ethnic criminal organizations that can protect turf and generate revenue. Taking advantage of more open borders and modern telecommunications technology, drug trafficking has quickly adapted to law enforcement pressures by finding new

methods for smuggling, new routes, and new mechanisms to launder money. In many of the major cocaine- and heroin-producing countries and states and among those that are transit routes for smuggling, traffickers have acquired significant power and influence through the use of violence, intimidation, and the bribing of corrupt officials. These states include Colombia, Peru, Albania, Bulgaria, Poland, Russia, Cuba, and Nicaragua. They have also experienced a significant rise in drug addiction that is a result of their direct or indirect involvement in the drug trade. In some countries, large segments of the population are also stricken by HIV/AIDS, which further undermines economic growth. The social, economic, and political stresses associated with these problems are felt across national borders and contribute to regional tensions and problems. Drug networking can also refer to drug cartel attempts to move drugs as cheaply as possible, for example, Mexican drug cartels’ attempts to move illegal drugs into the United States. Criminal networks allow for the easy flow of commodities from one place to the next. The networks can be flexible and dynamic and change to meet the needs of the organization. With an organized network, the individuals can remain hidden. These characteristics make them effective. On the other hand, there are many vulnerabilities to criminal networks. Trust is critical, but that can easily be broken. The more successful and larger the organizations become, the more they must sacrifice security, making them vulnerable to law enforcement. For years, law enforcement has had a difficult time disrupting and destroying the drug trafficking networks that have grown worldwide. They often do not fully understand or have a strong knowledge of the networks and their ability to circumvent the law.

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Often, law enforcement views drug cartels as having traditional, top-down organization. Law enforcement targets the individuals at the top of the organization, called the drug lords or kingpins. Because each network is so different, because the leaders are hard to identify, and because the connections between the players may be very loose, the networks are hard to identify and track. Law enforcement may be able to identify one entity, or group of individuals, but may be unable to trace the links to other players, or even the leadership. This all makes investigating and breaking up the network very difficult. The criminal networks are succeeding largely due to the increased consumption of drugs in all countries. While the United States remains the top consumer of illicit drugs, more and more countries are seeing dramatic increases in drug use. This proliferation in the demand for illicit drugs provides a market for criminal trafficking networks to thrive. Even though drug networks may be thriving and difficult to break, law enforcement continues to investigate them and make arrests. In fact, federal charges were filed on December 3, 2013, against 24 members and associates of Pasadena-based gangs and drug-trafficking organizations in California because of an alleged narcotics network operating there. Law enforcement task forces were able to seize over 60 pounds of drugs including methamphetamine, heroin, and powder cocaine in a sting they labeled “Operation Rosebud.” Police allege the existence of a network of drug suppliers that arranged for the delivery of pure methamphetamine from Mexico through southwest states, ultimately ending up in local sites. Robert J. Kelly, Joseph D. Serio, and Jesse L. Maghan See also: Drug Smuggling; Drug Trafficking; Drug Trafficking and Organized Crime

Further Reading “Drug Trafficking and Organized Crime in the Americas.” 2012. Woodrow Wilson International Center for Scholars. http://www .wilsoncenter.org/sites/default/files/BB%20 Final.pdf. Karadaku, Linda. 2013. “Police Cooperation Breaks Major Drug-Trafficking Network: A Four-Year Police Investigation Comes to an End, Bringing More Than 70 Arrests on Drug Charges.” Southeast European Times, April 11. http://www.setimes.com/cocoon/ setimes/xhtml/en_GB/features/setimes/ features/2013/11/04/feature-01 Morselli, Carlo. 2014. Crime and Networks. New York: Routledge. Ryan, Kennedy. 2013. “FBI: 24 Charged in Drug Trafficking Networks in Pasadena and Antelope Valley.” KTLA-5 News, http:// ktla.com/2013/12/12/fbi-24-charged-in -drug-trafficking-networks-in-pasadena -and-antelope-valley/#axzz2nPqSmxa9. United Nations Office on Drugs and Crime. 2013. “Drug Trafficking.” http://www .unodc.org/unodc/en/drug-trafficking/index .html. Van Doorn, Jan. 1993. “Drug Trafficking Networks in Europe.” European Journal on Criminal Policy and Research 1(2): 96–104. Wannenburg, Gail. 2006. America’s Pablos and Political Entrepreneurs: War, the State and Criminal Networks in West and Southern Africa. Johannesburg: SAIIA. Williams, Phil. 1998. “The Nature of Drug Trafficking Networks.” Current History 98 (394): 154.

Drug Typologies The American Psychiatric Association lists different typologies of drugs in its publication, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. In this

Drug Typologies 

source, there are 11 classes (typologies) of pharmacological agents or drugs listed. They include alcohol, amphetamines or similarly acting agents, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opiates, phencyclidine (PCP) or similar agents, sedatives, hypnotics, and anxiolytics. There is a 12th residual category for everything else, including anabolic steroids, nitrous oxide, etc. These are each described below.

Alcohol Beverage alcohol is a liquid obtained by fermenting or distilling various fruits, vegetables, or grains. Major types of alcoholic beverages include distilled spirits, beer, and wine. Like heroin, cocaine, and d-lysergic acid diethylamide (LSD), alcohol is a psychoactive substance. It is a central nervous system depressant that lowers inhibitions, impairs judgment, and is addictive. Alcohol affects the brain, coordination, judgment, reflexes, vision, and memory. Ingesting too much alcohol may cause blackout (memory loss), damage to every organ in the body, and increased risk for a variety of life-threatening diseases, including cancer. Drinking alcohol can lead to risky behaviors, including unprotected sex that may expose a person to HIV/AIDS and other sexually transmitted diseases or cause unwanted pregnancy. Amphetamines Amphetamines are a group of drugs that stimulate the central nervous system. The substances produce an increased state of arousal accompanied by a sense of confidence and euphoria. Users tend to appear in a state of hyperactivity, agitation, or exhaustion; when amphetamines are used over prolonged periods of time, irrational and paranoid behavior may be evidenced. Medically, these substances are used to treat depression, obesity, attention disorders, narcolepsy, and other

conditions. Most nonprescribed amphetamines, however, are produced in backyard laboratories and sold illegally. Presently, two substances tend to define this category of substances: methamphetamine and Ecstasy.

Caffeine Caffeine, one of the oldest stimulants known, affects the central nervous system. It is capable of reversing the effects of fatigue on both mental and physical tasks. It is present in coffee, tea, soft drinks, and over-the-counter drugs such as No-Doz, Anacin, and Excedrin. The symptoms of caffeine overdose (caffeinism) will vary according to individual differences and the amount consumed. If a person ingests excessive amounts of caffeine, defined as 250 to 750 milligrams (found in 2 to 7 cups of coffee) or more, they may experience restlessness, dizziness, nausea, headaches, tense muscles, sleep disturbances, irregular heartbeats, anxiety attacks, drowsiness, ringing ears, diarrhea, vomiting, light flashes, difficulty breathing, and convulsions. Cannabis (Marijuana and Hashish) Marijuana is the most commonly used illicit drug in the United States. When a person smokes marijuana, they are smoking the leaves and flowering tops of the Cannabis sativa plant. On the street, marijuana is also known as cannabis, pot, mary jane, dope, weed, and ganja, among other names. Somewhere around 60 cannabinoids (chemical compounds) are found in marijuana leaves. The cannabinoid that produces the psychoactive effect is tetrahydrocannabinol, or THC. The marijuana plant has been developed so that there is now a higher amount of THC in the plants than ever before. In the past, marijuana plants had less than 1 percent THC, but now there is as much as 17 percent THC found in the plants. Hashish is a resinous material that is extracted from the plant,

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processed, and pressed into different shapes. Hash oil also comes from the cannabis plant. Both marijuana and hashish can be smoked, but also added to cooked foods and ingested as food. Marijuana manufacture, possession, and sale is a criminal offense under U.S. federal law; however, many states have chosen to legalize it either for medical use or for recreational use. Thus, local and state enforcement of marijuana violations varies. Medically, marijuana has been reported to be beneficial in treating the symptoms of AIDS, cancer, multiple sclerosis, glaucoma, and other serious medical conditions. However, this has not been scientifically proven and debate continues over the effectiveness of marijuana as an accepted medical drug.

Cocaine Cocaine is a naturally occurring central nervous system stimulant that is extracted and refined from the coca plant. The plant is grown primarily in the Andean region of South America. The plant is processed in covert labs and turned into cocaine, a white powder with a bitter, numbing taste. The powder is most often snorted or inhaled by users, smoked, or converted into a liquid form so it can be injected into the body with a needle or syringe. Because of the high temperatures that are needed to smoke the drug, powder cocaine tends to burn rather than vaporize. For this reason, freebase cocaine, also known as crack, is created out of powder cocaine to allow for easier smoking. Crack vaporizes at lower temperatures, providing for a more intense effect with less of the drug. Smoking crack allows for a faster onset and a more intense feeling of being “high” than one has after using powder cocaine. People who use cocaine often do not eat or sleep regularly, and some users are able to remain awake for days without sleep. Among the symptoms experienced after us-

ing cocaine are increased heart rate, muscle spasms, and convulsions.

Hallucinogens Hallucinogenic drugs are those substances that, when ingested, distort the user’s perception of reality. Their time perception is affected, as are perceptions of space and color. A person who is under the influence of hallucinogens also has distorted perceptions of direction and distance. The effects of using the drug are often unpredictable, but users may exhibit erratic and violent behavior that may lead to serious injuries and death. Among the well-known hallucinogens is phencyclidine, otherwise known as PCP, angel dust, or love boat. LSD is a powerful synthesized psychoactive substance. LSD use is unlikely to cause addiction in most people, and there is no physical addiction or withdrawal. However, it can become psychologically habit forming. Other substances in this category are peyote, a small button-shaped cactus that is dried and eaten; peyotillo; tsuwiri; sunami; donana; dolichothele; and San Pedro, a cactus that has gained considerable attention for its hallucinogenic effects. The effects of these plants come from their main active alkaloid, mescaline. Inhalants Inhalants are chemical products that are intentionally inhaled by a user to cause an immediate feeling of being high. Because they affect the brain with greater speed and force than other drugs, they can cause irreversible physical and mental damage. Examples of inhalants include solvents (for example, gasoline, glues, nail-polish remover, lighter fluid, paint thinners, dry-cleaning fluid, markers, and correction fluid); gases and propellants used in butane lighters; and aerosols such as spray paints, hair spray, fabric

Drug Typologies 

protectants, refrigerants, and volatile nitrates found in room deodorizers. Chronic inhalant users may exhibit signs such as anxiety, excitability, irritability, or restlessness.

Nicotine Nicotine is a naturally occurring liquid alkaloid that is colorless and volatile, and is the drug found in the tobacco plant that causes addiction to smoking. Inhaling nicotine through smoking cigarettes is the most common cause of lung cancer and preventable death in the United States each year. Nicotine is found in cigarettes, cigars, pipe tobacco, and smokeless tobacco products. The pharmacological and biological processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. Among the risks associated with nicotine use are decreased senses of smell and taste, frequent colds, bleeding gums and frequent mouth sores, wheezing, coughing, bad breath, yellow-stained teeth and fingers, gastric ulcers, chronic bronchitis, increase in heart rate and blood pressure, emphysema, heart disease, stroke, and cancer of the mouth, larynx, pharynx, esophagus, lungs, pancreas, cervix, uterus, and bladder. Opiates Opiates are the substances that are derived from the opium poppy. The most commonly abused illegal substance that comes from the poppy plant is heroin. Other substances that are derived from the poppy plant include codeine, morphine, and oxycodone (that is, OxyContin and Percocet), each of which is used medically and legally for pain relief and other medical purposes. The opiate category of drugs may include synthetic substances such as methadone and levoalpha-acetylmethadol (LAAM), labeled “opioids” because of their ability to interact with opiate receptors in the brain.

Opiates may be eaten, but they are generally smoked, sniffed, or injected. Some users inject the drug under the skin in a process called subcutaneous injection, referred to as “skin-popping” on the street. This method of ingestion produces a slower absorption into the body, and a lower degree of euphoria. The effects of the drug when injected this way last longer. People who are under the influence of opiates appear calm, or even sometimes sleepy, and have a tendency to take everything in stride. Pure opiates cause relatively little body damage, but the substances sold on the streets as “opiates” usually contain a large amount of contaminants that can cause serious damage or even death to the user. Unlike stimulants, opiates do not produce a psychotic state when used in a pure form and have the ability to reduce or eliminate psychotic symptoms in mental patients.

Phencyclidine PCP is a synthetic substance that was developed in the 1950s as an intravenous anesthetic. It affects the user at different times as a stimulant, hallucinogen, analgesic, or sedative. PCP can be snorted, smoked, or eaten. When smoked, it is often applied to a leafy material such as marijuana, cigar tobacco, mint, parsley, or oregano. Among the names given for the substance are angel dust, wack, and rocket fuel. PCP is addictive, leading to psychological dependence, craving, and compulsive PCP-seeking behavior. Numbness or rigidity of extremities, large motor dysfunction, jerking eye movements, auditory hallucinations, nausea, drooling, dizziness, and memory loss have been reported as well. Sedatives, Hypnotics, and Anxiolytics This class of drugs when abused is commonly known as “downers.” They include

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prescription drugs used to reduce anxiety or facilitate sleep. The most commonly abused drugs in this class are benzodiazepines (Valium, Xanax, Ativan, Halcion, and others) and barbiturates (phenobarbital, Seconal, Nembutal, and Amytal). Other substances in this category have been referred to as “date rape drugs.” They include two substances: GHB and flunitrazepam (Rohypnol). GHB is a central nervous system depressant usually sold as an odorless, colorless liquid in spring water bottles or as a powder and mixed with beverages. In addition to being used in drug-assisted rapes, GHB is used as a muscle-stimulating growth hormone, sleep aid, and aphrodisiac. Flunitrazepam, a benzodiazepine that is smuggled into the United States primarily from Mexico because it is no longer sold in the United States, is used mostly with beer as an “alcohol extender” and disinhibitory agent. Richard E. Isralowitz See also: Alcohol; Amphetamines; Caffeine; Cannabis; Cocaine and Crack; Hallucinogens; Hashish; Inhalants; Marijuana; Nicotine; Phencyclidine; Sedatives, Hypnotics, and Anxiolytics

Further Reading Gahlinger, Paul M. 2004. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse. New York: Plume Books. Henderson, Harry. 2005. Drug Abuse. New York: Facts On File. Levinthal, Charles F. 2012. Drugs, Behavior, and Modern Society. Boston: Allyn and Bacon.

Drug Use Forecasting In 1987, the Drug Use Forecasting (DUF) Program began to collect self-reported drug

use information and urine specimens from juvenile and adult arrestees four times a year in 23 different sites. While the arrestee samples were not statistically representative, and no information was collected on alcohol use, drug access, or drug markets, the information gathered still showed some interesting trends in drug use and abuse around the country. In 1994, the DUF Program collected information from 20,015 adult males who had been arrested in 23 major metropolitan areas across the United States. Data from 7,839 adult female arrestees were collected at 21 of these sites. Moreover, 12 sites collected data from 4,558 juvenile male arrestees/ detainees. The 1994 DUF Annual Report differs from previous DUF reports in one important respect. Whereas earlier reports gave only the frequency distribution of offense at the time of the arrest, this new report also included results from a urinalysis (percentages positive for cocaine, marijuana, or any drug) by offense at arrest. The number of cases in a particular offense category is small for some sites. Eventually the DUF Program became the Arrestee Drug Abuse Monitoring (ADAM) Program in 2000, funding was halted in 2004, and it was restarted as ADAM II in 2007. The goal was to forecast drug use for five major drugs: PCP, cocaine, marijuana, opiates, and methamphetamine.

ADAM—Arrestee Drug Abuse Monitoring Program (1998–2003) The National Institute of Justice initiated ADAM in 1998 to replace the DUF Program. ADAM included a better design for sampling methods, data collection protocol, and instrumentation in order to get an improved drug use prevalence estimation strategy. ADAM sampled arrestees who had been admitted to booking facilities dur-

Drug Use Forecasting  331

ing the previous 24 hours, in proportion to those booked during the data collection shift and the group of arrestees who were booked prior to that. Interviewers collected basic arrest data from booking information to provide sufficient identifying information that the arrestee could be matched to census data representing all bookings into the jail. The questionnaire used by the researcher used a calendar with questions that helped arrestees remember more clearly the frequency of events surrounding their arrest, such as how often they used alcohol, marijuana, crack cocaine, powder cocaine, heroin, and methamphetamine (as primary drugs) and when. Information was collected for both the 12 months prior to the arrest and for the arrestee’s lifetime use. For each of the primary drugs used, information was collected on the drug market (where the drug was purchased). Other information concerning the transaction (cash versus noncash) was collected, as was details about the amount of drug purchased, the location of the purchase (e.g., public or private setting), and whether the drug dealer was a new one or regular contact. After the questionnaire was completed, a urinalyses was performed. This was used to estimate the prevalence of the arrestee’s drug use as well as to provide confirmation of the arrestee’s reporting. The urinalysis tested for 10 different illegal drugs. Arrestees were asked to self-report use of primary and secondary drugs (e.g., methadone and other prescription drugs) in the past three days, corresponding to the drug test. These data were collected in about 35 sites through 2003. All sites collected data quarterly from adult male arrestees; some also collected data from adult female arrestees and juveniles. Local coordinating committees helped develop special addenda to collect information of local importance,

such as methamphetamine, gangs, domestic violence, and other topics. In 2007, the Office of National Drug Control Policy initiated ADAM II. Ten of the original ADAM sites were chosen based on their geographic diversity. The researchers hoped to address questions regarding methamphetamine trends across the country. Thus, questions were added to the instrumentation specific to methamphetamine. Data were collected from adult male arrestees during a two-week period between April and September. With minor changes, the data-collection protocol was similar to ADAM. Statistically sampled, volunteer arrestees are interviewed and asked to provide urine specimens that are then tested for evidence of drug use. Urinalysis results are matched to arrestee characteristics to help monitor trends in drug use. ADAM provides an objective biological measure of drug use in addition to self-reported drug use among those arrested and charged with crimes. Each of the five ADAM II counties that were chosen to be part of the 2012 ADAM survey were part of the ADAM survey. Thus, they are a subset of the 10 participating sites during 2007–2011. The sites were: Atlanta, Georgia (Fulton County); Chicago, Illinois (Cook County); Denver, Colorado (Denver County); New York, New York (Borough of Manhattan); and Sacramento, California (Sacramento County). From 2007 to 2011, data were collected in two calendar quarters (April 1 to June 30 and July 1 to September 30) during 14 consecutive days within each quarter. In 2012, data were collected in one period of 21 consecutive days between April 1 and July 15. During that period, 1,938 interviews were conducted and 1,736 urine specimens were collected from a probability-based sample of adult male booked arrestees within 48 hours of their arrest. When

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weighted, the samples represented 14,155 persons arrested and booked in the five ADAM counties during the data collection period. Since 2007 in these five sites alone, almost 15,000 interviews have been conducted and almost 13,000 urine specimens tested, representing over 100,000 arrests. The overall response rate across all sites in ADAM II (60 percent) is calculated as the number of booked male arrestees interviewed relative to the total number sampled. The conditional response rate (92 percent) is calculated as the total number of booked male arrestees interviewed relative to the total number sampled and physically available to be interviewed. The overall response rate reflects the difficulty that the interview setting presents. Because ADAM II surveys booked arrestees within 48 hours of arrest, interviewers must be stationed in the active booking areas of jails. Consequently, offenders are continuously being brought in, processed, moved to court or housing, or released. For 2012, the overwhelming numbers of arrestees who were eligible, but were not interviewed, were those not physically available to be interviewed. Most frequently, this was due to the arrestee being given an early release, taken to court, or transferred out (30 percent of those sampled). In 2012, 3,229 cases were sampled. Of the 2,107 sampled cases who were physically in facilities and eligible to be interviewed, 92 percent were interviewed; of that, 90 percent provided a urine sample. Nancy E. Marion

Further Reading Office of National Drug Control Policy, Executive Office of the President. 2013. “Adam II: 2012 Annual Report.” http://www .whitehouse.gov/sites/default/files/ondcp/ policy-and-research/adam_ii_2012_annual_ rpt_web.pdf.

National Institute of Justice. 1995. “Drug Use Forecasting: 1994 Annual Report on Adult and Juvenile Arrestees.” https://www.ncjrs .gov/pdffiles/duf1994.pdf. National Institute of Justice. 2013. “NIJ’s Drugs and Crime Research: Arrestee Drug Abuse Monitoring Programs.” http://www .nij.gov/topics/drugs/markets/adam/Pages/ welcome.aspx.

Drug Watch International Drug Watch International (DWI) was founded September 14, 1991, in Chicago. It is a volunteer, nonprofit, drug network and advocacy organization that opposes drug legalization, and instead encourages the establishment of drug-free healthy cultures across the world. The DWI supports a comprehensive approach to drug issues that revolve around prevention, education, research, intervention, treatment, law enforcement, and interdiction. The DWI is also very active in advancing drug research by publishing articles on topics such as medical marijuana, methamphetamine, and teen marijuana use. The organization is overseen by a board of directors that coordinates delegates from across the United States and over 25 nations; a liaison network of representatives from international, national, and state prevention and treatment organizations; a board of advisors; and the International Drug Strategy Institute (described below). The goal of the DWI is to provide the public, policy makers, and the members of the media with current information and factual research that opposes groups who support drug legalization. The mission statement for the DWI is the following: “The illegal or harmful use of psychoactive or addictive drugs is a major threat to all world communities and to future generations. Drug

Drug Watch International 

Watch International is a network of prevention experts and community volunteers from a wide range of professions whose mission is to help assure a healthier and safer world through drug prevention efforts by: providing accurate information on both illicit and harmful psychoactive substances; promoting sound drug policies based on scientific research; and opposing efforts to legalize or decriminalize drugs.” The members of the DWI believe that preventing drug abuse is the most effective, humane, and cost effective way to address the consequences of illegal, harmful, and mind-altering drugs in our society. They believe that drug prevention works and needs to be reinforced, enhanced, and expanded in all nations and all cultures. However, effective drug abuse prevention will only take place where there are positive societal norms that support healthy drug-free attitudes, environment, and activities, while at the same time weakening attitudes of acceptance toward the presence of drugs and their destructive behavior. These societal norms must be reflected in the enforcement of legal, medical, educational, community, and personal standards in all cultures. In order for this to happen, all parts of the local and global communities need to unite together, bringing the strengths of their professional expertise, generational wisdom, and individual commitment to combat the drug problem. The International Drug Strategy Institute, a division of the DWI, is a bipartisan group of professions including physicians, attorneys, educators, law enforcement personnel, and drug prevention specialists, who provide expertise on national and international drug research. The institute pursues innovative research and public policy related to drug issues. The specific goals of the DWI are:

• Support clear messages and standards of no illegal use of alcohol, tobacco, and other drugs, (including “no use” under legal age) and no abuse of legal drugs or substances for adults or youth. • Support comprehensive and coordinated approaches that include prevention, education, law enforcement, research, and treatment in addressing issues regarding alcohol, tobacco, and other drugs. • Support strong laws and meaningful legal penalties that hold users and dealers accountable for their actions. • Support the requirement that any medical use of psychoactive or addictive drugs meet the current criteria required of all other therapeutic drugs. • Support adherence to the scientific research standards and ethics that are prescribed by the world scientific community and professional associations in conducting studies and reviews on alcohol, tobacco, and other drugs (without exception to illicit drugs). • Support efforts to prevent availability and use of drugs, and oppose policies and programs that accept drug use based erroneously on reduction or minimization of harm. • Support international treaties and agreements, including international sanctions and penalties against drug trafficking, and oppose attempts to weaken international drug policies and laws. • Support efforts to halt the legalization/ decriminalization of drugs. • Support the freedom and rights of individuals without jeopardizing the stability, health, and welfare of society. Ron Chepesiuk See also: Legalization

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Further Reading Drug Watch International. .drugwatch.org.

http://www

Drug-Facilitated Rape Rape is nonconsensual sexual intercourse, including vaginal, anal, or oral penetration. Drug-facilitated rape (DFR) is when a victim has been raped during or after consuming alcohol or drugs. DFR may not cause any bruises or injuries and the victim may be sleeping or passed out during the incident. The victim may not even remember the rape. Date rape drugs are substances that are used intentionally by the rapist to increase the victim’s vulnerability. They are often given to the victim or slipped into a drink without the victim’s knowledge. These drugs are odorless and tasteless so the victim may never know that one is in the drink. College students who have been raped reported that one-third of the rapes were DFR. The rapist could be a stranger but most of the time it is an acquaintance of the victim. Some victims have reported feeling paralyzed or unable to scream after consuming the drug. Among DFRs, alcohol is the most commonly used date rape drug used. Victims may or may not know that they are consuming the drug. Perpetrators may place alcohol in a nonalcoholic drink without the victim’s knowledge. Victims are unaware that they have consumed so much alcohol until they begin to feel intoxicated. Three other common drugs used in sexual assaults are Rohypnol, otherwise known as roofies, roaches, and the forget pill; GHB, otherwise known as Liquid E, Liquid Ecstasy, Ever Clear, Scoop, Cherry Meth, Georgia Homeboy, Gamma 10, and Grievous Bodily Harm; and Ketamine, otherwise

known as Special K, Vitamin K, Kit Kat, Ket, Cat Valium, and Blind Squid. These drugs can cause death if consumed in large quantities or with other substances. In 2000, GHB became an illegal Schedule I drug (Samantha Reid Date-Rape Drug Prohibition Act of 2000) after it was given to a 15-yearold Michigan girl, Samantha Reid. The drug was unknowingly slipped into Samantha’s Mountain Dew. She later died because she stopped breathing. While date rape drugs are by themselves dangerous, they are even more dangerous when mixed with alcohol. The effects of date rape drugs can occur within 15 minutes or up to one hour following ingestion. The effects may include confusion, slurred speech, an overly relaxed state, amnesia (memory loss of up to 24 hours), rapid heartbeat, or muscle cramps. Ketamine can also cause hallucinations (i.e., seeing and hearing things that are not real), paranoia, and paralysis (i.e., not being able to move your legs, arms, or body). Some victims have reported that as they begin consuming a drink, they start to feel confused or sick. Then they wake up hours later with no memory of what occurred. The effects of the date rape drugs often appear like voluntary alcohol consumption so others watching may not realize a drug is being used. Rape victims often delay or refuse to report their victimization to law enforcement. Victims of DFR are even more reluctant to report the offenses. This is because victims often experience memory loss, and do not know what really happened. They may also feel guilty or may blame themselves for the events. Statistics show that about 25 percent of raped women report that some kind of drug was a factor in the assault. Most of the rapes went unreported and therefore unsolved or unproven. The drug that is most often de-

Drug-Facilitated Rape  335

tected in victims of DFR is alcohol, and the second most frequent is marijuana. When people use the term “date rape drug,” they do not consider alcohol to be part of this general category of drugs. However, there is a strong association between sexual assault and alcohol consumption. It is especially true with college populations. According to the National Institute of Justice, about 55 percent of female students and 75 percent of male students involved in acquain­ tance rape admit to having been drinking or using some kind of drug when the incident occurred. Moreover, about 90 percent of all rapes that occur on a college campus happen after alcohol was ingested by either the assailant or the victim. About 70 percent of college students admit that they engaged in sexual activity primarily as a result of being under the influence of alcohol. Many also admit that they engaged in sex while under the influence that would not have occurred had they been sober. It is important that people become aware of how to protect themselves and reduce the risk of becoming a victim of DFR. Most important, it is important to keep any drinks with you at all times. If you must leave a drink for a few minutes, ask a friend to hold it. Do not drink to excess. Have a friend along, and if anyone begins to feel unusual, go to the hospital immediately. Only accept help from an employee, emergency personnel, or a friend. Alexandra Redcay See also: Alcohol to Subdue Victims; AlcoholFacilitated Sexual Assault; Date Rape Drugs

Further Reading Butler County (Ohio) Rape Crisis Program. “Drug-Facilitated Rape: Getting Help and Protecting Yourself If It Happens to You.” http://www.helpandhealing.org/Drug%20 Facilitated%20Rape.htm.

The Crisis Connection. “Drug-Facilitated Rape.” http://www.crisisconnectioninc.org/ sexualassault/drugrape.htm. Day One: The Sexual Assault and Trauma Resource Center. “Date Rape Drugs.” http:// www.dayoneri.org/FS-DateRape.pdf. Farias, Hillory J., and Samantha Reid. DateRape Drug Prohibition Act of 2000. 106th Cong., 1999–2000. Fitzgerald, N., and K. J. Riley. 2000. “DrugFacilitated Rape: Looking for the Missing Pieces.” National Institute of Justice Journal. http://www.ncjrs.gov/pdffiles1/jr000 243c.pdf. Florida Department of Health. “Violence Against Women: Date Rape Drugs.” http:// www.doh.state.fl.us/Family/wh/lifespan/ Young/daterape.html. Just Think Twice. “Your Drink Is Drugged.” http://www.justthinktwice.com/consequen ces/your_drink_is_drugged.html. Lawyer, S., H. Resnick, V. Bakanic, T. Burkett, and D. Kilpatrick. 2010. “Forcible, Drug-Facilitated, and Incapacitated Rape and Sexual Assault among Undergraduate Women.” Journal of American College Health 58(5): 453–60. McCauley, J., K. J. Ruggiero, H. S. Resnick, L. M. Conoscenti, and D. G. Kilpatrick. 2009. “Forcible, Drug-Facilitated, and Incapacitated Rape in Relation to Substance Use Problems: Results from a National Sample of College Women.” Addictive Behaviors 34(5): 458–62. National Institute of Justice. 2008. “DrugFacilitated Rape on Campus.” http://www .nij.gov/topics/crime/rape-sexual-violence/ campus/drug-facilitated.htm. Schwartz, R. H., R. Milteer, and M. A. Le­Beau. 2000. “Drug-Facilitated Sexual Assault ‘Date Rape.’” Southern Medical Journal 93(6): 558–61. U.S. Government Accountability Office. 2005. “Office of National Drug Control Policy—

336   Drug-Free America Act (1986) Video News Release.” http://www.csdp.org/ research/303495.pdf.

Drug-Free America Act (1986) The Anti–Drug Abuse Act of 1986 (P.L. 99570, 100 Stat. 3207) was a law that focused on eliminating drug use across the United States. To do this, the law gave the president the power to increase taxes on goods imported from those countries that were to be uncooperative in curbing drug production and trafficking. The law also created new provisions allowing law enforcement to seize the assets of drug dealers. New anti– money laundering provisions were established. Probably the most controversial part of the new law was to reestablish federal mandatory minimum guidelines for both drug possession and trafficking. The law was signed by President Reagan in October 1986. As he signed the law, he said, Well, today it gives me great pleasure to sign legislation that reflects the total commitment of the American people and their government to fight the evil of drugs. Drug use extracts a high cost on America: the cost of suffering and unhappiness, particularly among the young; the cost of lost productivity at the workplace; and the cost of drug-related crime. Drug use is too costly for us not to do everything in our power, not just to fight it but to subdue it and conquer it.

The Drug-Free America Act The new law comprised 6 titles (chapters) and numerous subtitles. The first title, the Drug-Free Federal Workplace Act of 1986, amended the Rehabilitation Act that established the Drug-Free Workplace. The 1986

law simply defined some terms more clearly. For example, a “handicapped individual” would no longer apply to a person who either used or was addicted to illegal drugs. A “handicapped individual” is also not, under the new law, “an alcoholic whose current use of alcohol prevents him or her from performing the duties of the job in question or whose employment, by reason of such current alcohol abuse, would constitute a direct threat to property or the safety of others.” The act also revised the Civil Service Reform Act so that an employer is not required to hire an applicant or keep an employee who uses controlled substances. Title II of the Drug-Free America Act was entitled the Drug-Free Schools Act of 1986, also referred to as the Zero-Tolerance Act. Under this chapter, the secretary of education was directed to implement national programs, either directly or through state or local educational organizations, that are designed to achieve and maintain drug-free environments that are conducive to learning. The law declared that it was not illegal for any educational institution (school) to make it a policy for a student to refrain from using illegal drug use as a condition of either admission or continued enrollment. It was also not illegal, according to the act, for schools to require and conduct drug testing of their students or applicants. Title III of the Drug-Free America Act was entitled the Substance Abuse Services Amendments. This section amended the Public Health Service Act to extend the authorization for the substance abuse services block grant program through FY 1992. Title IV of the Drug-Free America Act was called the Drug Interdiction and International Cooperation Act of 1986. This title had many subtitles as part of it. For example, Subtitle A, the International Forfeiture Enabling Act, declared that any property that was related to

Drug-Free America Act (1986) 

an unlawful drug activity, that was derived from the proceeds of the illegal activity, or was used in the commission of the activity (without the owner’s consent or knowledge) could be seized by the government. Other subtitles in this chapter included: Subtitle B, Mansfield Amendment Repeal Act: repealed the Mansfield Amendment to the Foreign Assistance Act of 1981 that required certain reports to Congress regarding international narcotics control activities. Subtitle C, Narcotics Traffickers Deportation Act: Revised the federal law regarding the deportation of people who were convicted of violating controlled substances laws. Subtitle D, Customs Enforcement Act of 1986: Revised the Tariff Act of 1930 regarding, among other things, the reporting of vessel arrivals, aviation smuggling, the seizure of conveyances, the exchange of information with foreign customs and law enforcement officers, and information regarding inspections and preclearance in foreign countries. The act increased the possible criminal and civil penalties for violations. The possible fine was set at up to $5,000, or a prison sentence of up to two years, or both. Moreover, the act amended the Controlled Substances Import and Export Act to make it unlawful for any U.S. citizen on board any aircraft to manufacture, distribute, or possess with intent to manufacture or distribute a controlled substance. Criminal penalties were established for someone who operated an aircraft without lights and for illegal fuel installations aboard aircraft. Subtitle E, Maritime Drug Law Enforcement Prosecution Improvements Act of 1986: This subtitle makes it illegal for a person on board a U.S. vessel to knowingly manufacture, distribute, or possess a controlled substance with the intent to manufacture or distribute. Anyone who does this faces penalties and possible property forfeiture.

Title V of the Drug-Free America Act was entitled the Anti-Drug Enforcement Act. This title was also comprised of many subtitles, such as the following: Subtitle A, Drug Penalties Enhancement Act of 1986: Amended the Controlled Substances Act to revise and increase the criminal penalties for violating the nation’s drug laws. Subtitle B, Drug Possession Penalty Act of 1986: Amended the Controlled Substances Act to establish a scale of minimum penalties for first and subsequent possession offenses. Subtitle C, Continuing Drug Enterprise Penalty Act of 1986: Amended the Controlled Substances Act to establish a minimum life sentence and multimillion-dollar fines for those individuals or organizations that engage in continuing criminal drug enterprises. If a killing results from a violation of the act, a procedure was described for the imposition of the death penalty. Subtitle D, United States Marshals Ser­ vice Act of 1986: Revised some provisions of federal law relating to the U.S. Marshals Service. Subtitle E, Controlled Substances Import and Export Penalties Enhancement Act of 1986: This subtitle amended the Controlled Substances Import and Export Act to increase the penalty for violations from a maximum of 15 years in prison to a minimum of five years and a maximum of 40 years in prison. In cases where a death results from substance use, the penalty would be set at 20 years to life in prison. The act also increases the fines for violators from $125,000 to $2,000,000 for an individual, and $5,000,000 for an organization. There were also enhanced penalties for subsequent offenses. Subtitle F, Juvenile Drug Trafficking Act of 1986: Amends the Controlled Substances

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Act to establish punishments for any person who was at least 21 years of age and employs a person who is under the age of 21 in the trafficking of a controlled substance. Subtitle G, Chemical Diversion and Trafficking Act of 1986: This subtitle amends the Comprehensive Drug Abuse Prevention and Control Act to require manufacturers, distributors, importers, and exporters of certain substances to maintain complete records of their transactions. The law also prohibits the distribution or export of such substances unless the recipient or purchaser presents the distributor with a certification of lawful use. The law also directs the attorney general to maintain an active system to curtail the diversion of precursor chemicals that are used to manufacture controlled substances, both domestically and internationally. Subtitle H, Money Laundering Crimes Act of 1986: Establishes criminal penalties for financial transactions involving the proceeds of some form of unlawful activity for the purpose of either facilitating such activity or concealing its nature. The act also sets forth procedures for the civil and criminal forfeiture of any property involved in such unlawful financial transactions. Subtitle I, Controlled Substances Technical Amendments of 1986: Makes technical amendments to the Controlled Substances Act. Subtitle J, Controlled Substances Analogs Enforcement Act of 1986: Amends the Controlled Substances Act to establish penalties for the manufacture or possession of a designer drug with the intent to distribute. The law also makes it illegal to knowingly or intentionally possess a designer drug. Subtitle K, Asset Forfeiture Amendments Act of 1986: Amends federal law concerning the forfeiture of assets involved in unlawful controlled substance activities.

Subtitle L, Exclusionary Rule Limitation Act of 1986: Amends the federal criminal code so that any evidence that was obtained as a result of a search or seizure shall not be excluded in a U.S. district court on the ground that it violated the Fourth Amendment to the Constitution, if the search or seizure was undertaken with a reasonable belief that it was legal. Title VI, Public Awareness and Private Sector Initiatives Act of 1986: The title of the act declares that an agency may contract for property or services that are designed to warn of the dangers of illegal drug use without complying with any requirement for competition in federal procurement, so long as at least 50 percent of actual, reasonable costs of providing the property or service is being donated to the federal government. Nancy E. Marion

Further Reading Library of Congress. S2849 Drug Free America Act (1986). https://www.govtrack.us/ congress/bills/99/s2849#summary. Reagan, Ronald. 1986. “Remarks on Signing the Anti–Drug Abuse Act of 1986.” October 27. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=36654. Sabet, K. A. 2011. “Anti–Drug Abuse Act (Drug-Free America Act).” In Encyclopedia of Drug Policy, ed. M. Kleinman and J. E. Hawdon. Thousand Oaks, CA: Sage. http:// knowledge.sagepub.com/view/drugpolicy/ n14.xml.

Drug-Free America Foundation Drug-Free America Foundation, Inc., (DFAF) is a conservative organization that is commit-

Drug-Free America Foundation 

ted to developing, promoting, and sustaining national and international policies and laws that have the intent of reducing the use of, and addiction to, illegal drugs. As a 501(c)(3), it is a nonprofit organization that describes itself as “committed to developing, promoting and sustaining global strategies, policies and laws that will reduce illegal drug use, drug addiction, drug-related injury and death.” The organization was founded by Betty and Mel Sembler in 1976. DFAF opposes ballot initiatives that seek to legalize drugs in any way, reduce the criminal penalties on illegal possession of drugs, or that would support harm reduction efforts. Through its publications, DFAF publicizes the dangers of and negative impacts of drug use on society. Melvin Sembler is a former U.S. ambassador to Italy (2001–2005) and former ambassador to Australia and Nauru (1989–1993). He was chairman of the board of Sembler Company, which developed shopping malls. In 2008, Sembler served as the national fundraising chair for Mitt Romney. Before that, he served on Reagan’s White House Conference for a Drug-Free America. Sembler and his wife founded Straight, Inc., a series of drug treatment centers for teens that quickly had 12 clinics in nine states. However, the program was criticized for some of its policies. In 1983, Straight, Inc., was convicted of false imprisonment after being sued by 20-year-old Fred Collins Jr., who charged that he was held against his will. The corporation was forced to pay $40,000 in compensatory damages and $180,000 in punitive damages to Collins. After a similar case in 1990, Straight, Inc., was forced to pay $721,000 in damages to Karen Norton, who claimed that she was denied health care by the organization. Some experts claim that about half of the teens in the program were abused in some way.

According to the organization, the objectives of DFAF include:  1. Oppose efforts that would legalize, decriminalize, or promote illicit drugs or promote illicit drug use;  2. Encourage citizens of all nations to strive for drug-free homes, schools, workplaces, and communities;   3. Advocate abstinence-based drug education in our schools and teaching our children healthy alternatives to drug use;   4. Educating employers about the dangers of illicit drug use in the workplace and the important role of drug-free workplace programs;   5. Supporting drug interdiction efforts;  6. Promoting cooperation between national and international leaders and governments to develop and implement policies and laws that will reduce drug use and abuse;   7. Improving global communication between scientists, researchers, and physicians to advance our knowledge of drug abuse, addiction and treatment; and  8. Sharing our knowledge, resources, and experience with others working to prevent or eliminate illicit drug use. Their vision is based on the notion that nations, through their leaders and their people, can create an environment where citizens live lives that are free of illicit drug use. They also support a nongovernmental organization in Special Consultative Status with the Economic and Social Council of the United Nations. DFAF has six divisions, each with its own purpose. They are:

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  1. The Institute on Global Drug Policy: an alliance of physicians, scientists, attorneys, and drug specialists who advocate for public policies to curtail the use of illicit and misuse of licit drugs and alcohol.   2. The International Scientific and Medical Forum on Drug Abuse: a brain trust of the world’s leading researchers who are involved in drug-related research and physicians concerned about the drug abuse problem. This group helps to dispel misinformation related to current drug issues in the media.   3. The International Task Force on Strategic Drug Policy: a network of professional and community leaders who support and promote drug demand reduction principles, develop community coalitions, and strive to advance communication and cooperation among nongovernmental organizations who are working to stem illicit drugs and promote sound drug policy around the world.   4. The Drug Prevention Network of the Americas: a coalition of nongovernmental organizations from North, Central, and South America dedicated to the promotion of effective demand reduction programs and policies in the Americas through the exchange of information and the development of alliances among NGOs working toward the same goals.   5. Students Taking Action Not Drugs: a growing, student-focused movement to disseminate accurate, sciencebased drug information on campuses to promote awareness among students.  6. National Drug-Free Workplace Alliance: a national network dedicated

to the prevention of substance abuse in the workplace, with a two-fold mission—to directly assist small businesses in the state of Florida in establishing comprehensive drug-free workplace programs and to support a national coalition of drug-free workplace service providers. On the advisory board for DFAF are former Florida governor Jeb Bush, former DEA administrator Karen Tandy, and Congressman Dan Lungren of California. Nancy E. Marion See also: Decriminalization; Drug-Free Federal Workplace

Further Reading Drug-Free America Foundation. “About Us.” http://www.dfaf.org/content/about-dfaf-inc.

Drug-Free Federal Workplace The Drug-Free Federal Workplace, Executive Order 12564, was signed by President Reagan on September 15, 1986. The DrugFree Workplace Act of 1988 requires that some federal contractors and all federal grantees will agree to provide drug-free workplaces as a condition of receiving that contract or grant from a federal agency. The provisions of the act do not apply to those people/organizations that do not have, nor intend to apply for, contracts/grants from the federal government. The act also does not apply to subcontractors. Further, according to the act, a person who works on any activity under the grant or contract, and who is on the payroll, is considered to be a covered employee, even if they are not paid directly from the grant funds or contract funds. A temporary employee is

Drug-Free School Zones  341

covered if he or she meets these criteria. A volunteer is someone who is not on the payroll, and hence is not covered under the rule. Under the act, a “drug-free workplace” refers to a federal site where employees are prohibited from engaging in the manufacture, distribution, dispensation, possession, or use of a controlled substance. As part of the law, employees must be notified that the workplace is a drug-free site, and details about possible actions that could be taken against an employee for violations. There must also be drug-free awareness programs created that should inform employees about the dangers of drug use and abuse in the workplace, the company’s policy of maintaining a drug-free workplace, any available drug counseling for those who might be in need of such, and any rehabilitation programs or employee assistance programs, if needed. Under the law, a federal agency cannot agree to contract with that individual unless the person agrees to no longer engage in the unlawful manufacture, distribution, dispensation, possession, or use of a controlled substance in the performance of the contract. If a contractor with the federal government does not maintain a drug-free workplace, the payment for that contract may be suspended and the contract terminated. Nancy E. Marion

Further Reading Cornell University Law School. 41 USC Chapter 81, Drug Free Workplace. http://www .law.cornell.edu/uscode/text/41/subtitle-IV/ chapter-81. Executive Order 12564. 1986. Drug-Free Federal Workplace. http://www.archives. gov/federal-register/codification/executive -order/12564.html. Reagan, Ronald. 1986. “Executive Order 12564—Drug Free Federal Workplace.”

September 15. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=36416. U.S. Department of Labor, Office of the Assis­ tant Secretary for Policy. “Drug Free Workplace Act of 1988.” http://www.dol.gov/ elaws/asp/drugfree/screen4.htm.

Drug-Free School Zones A drug-free school zone (DFSZ) is a welldefined area surrounding a school in which a drug dealer who is caught selling drugs receives severe, enhanced, criminal sanctions. For example, those found dealing drugs within 1,000 feet of school property usually receive a prison term without parole. Many urban cities have set up the drug-free zones as a way protect children and young people from being tempted to purchase drugs. The purpose of a DFSZ is to improve the safety of the environments where children and youth are likely to congregate, thus creating drug-free “safe havens” for them. This gives the young people a safe place to learn and grow, and a safe refuge from many of the risk factors that have been identified as undermining their personal health and their safety. Technically, all public and private elementary and secondary schools are protected by federal drug-free school zone laws as defined in the Federal Crime Control Act and the Controlled Substances Act. Additionally, as of May 1, 1991, 45 states and the District of Columbia have adopted specific provisions to enforce DFSZs in their individual state statutes. In some states, DFSZs have been mandated through both executive and legislative action. Local communities have joined the legislation to cooperate and attack the drug

342   Drug-Free School Zones

problem. Research shows that these zones help to mobilize communities and have successfully reduced drug abuse, trafficking, and related crime. Usually, the drug-free zone extends 1,000 feet in every direction from the property line of the school. This is about the length of three football fields around the school’s property. Many states have created zones that are more narrow, and include only the area immediately surrounding schools and other locations the children frequent. For example, lawmakers in Minnesota, North Carolina, and Rhode Island agreed that a 300-foot zone would adequately protect children. The drug-free zones established in Alaska and Wyoming extend 500 feet from schools, while the zones in Hawaii are set at 750 feet. The policymakers in Vermont opted to not create a specific “zone,” but to increase the possible penalties for drug deals that occur within the school’s property, in school-owned busses, or on adjoining property. Some states established longer drug-free zones for their students. Connecticut and Mississippi defined their drug-free zones at 1,500 feet from schools. Missouri and Oklahoma created their zones at 2,000 feet from the school property line. The zones in South Carolina extend to a half mile (2,640 feet) from the school. The legislature in Alabama took their zones to three miles outside of the schools, which they defined as including universities and colleges, as well as public housing projects. Other states have included buildings and areas other than schools as drug-free zones. In many states, the zone refers only to elementary and secondary schools. Other states, in particular Arkansas, includes public parks, public housing, day care centers, colleges and universities, recreation centers, skating rinks, Boys’ and Girls’ clubs,

substance abuse treatment facilities, and churches. Utah took a similar approach, including schools, parks, churches, parking lots, and shopping malls in their definition of a drug-free zone. The approach to a more comprehensive list of drug-free areas is sometimes referred to as a “super-zone.” The offenses that are included in a drugfree zone also vary from state to state. Most states include a prohibition against the manufacture and distribution (including attempting to distribute) of drugs in the drug-free zones. Some states’ statutes also include simple possession. So a person who simply is in possession of an illicit drug may be charged with extra penalties. The Connecticut statute imposes a mandatory prison sentence of two years for anyone convicted of simple drug possession within 1,500 feet of a school or day care center. Similarly, Arizona’s drug-free zone statute also establishes mandatory prison terms for any person who is caught with even personal-use quantities of drugs within a school zone. In some states, the enhanced penalties do not apply if the person is under 18 or enrolled in the school. Despite the good intention of the laws, critics of DFSZs argue that anyone caught and charged in a drug-free zone are being “sentenced” twice, a violation against the double jeopardy clause in the Constitution. Critics have also charged that the drug-free zones violate a defendant’s right to due process since they do not require the prosecution to prove that the defendant knowingly and intentionally violated the prohibition against conducting drug activities in a prohibited zone. Some defendants who have been charged for offenses in the drug-free zones have argued that that laws violate the constitutional guarantee of equal protection by subjecting them to harsher punishment than others convicted of similar conduct out-

Drug-Free Schools and Community Act (1988–1989)  343

side drug-free zones. Further, they argue that the laws establishing drug-free zones violate the equal protection clause of the U.S. Constitution because they are more likely to be used against people of color who tend to live in densely populated urban neighborhoods as opposed to lighter-skinned defendants who are more likely to live in suburbs and rural areas where the zones are less prevalent. Nancy E. Marion See also: Drug-Free Schools and Community Act

Further Reading Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. Greene, J., K. Pranis, and J. Ziedenberg. 2006. “Disparity by Design: How Drug-Free Zone Laws Impact Racial Disparity—and Fail to Protect Youth.” Justice Policy Institute, 1–51. http://www.drugpolicy.org/doc Uploads/SchoolZonesReport06.pdf. Guthrie, Patricia M. 2002. School-Based Practices and Programs That Promote Safe and Drug-Free Schools. Arlington, VA: Council for Children with Behavioral Disorders, Council of Administrators of Special Education. National Coalition for Drug Free Zones, The Chiefs of Police National Drug Task Force. “Drug-Free School Zones.” https://www .ncjrs.gov/pdffiles1/Digitization/140213 NCJRS.pdf. Noble, Patricia V. 2002. Safe and Drug-Free Schools. New York: Novinka Books. U.S. Department of Education, Office of Special Educational Research and Improvement, Office of Reform Assistance and Dissemination; Safe, Disciplined, and Drug-Free Schools Programs. 2001. “Exemplary and Promising Safe, Disciplined and Drug-Free Schools Programs, 2001.”

http://www2.ed.gov/admins/lead/safety/ exemplary01/exemplary01.pdf. U.S. Library of Congress. 2008. “Safe and Drug-Free Schools and Communities Act: Program Overview and Reauthorization Issues.” Washington, DC: Congressional Research Service.

Drug-Free Schools and Community Act (1988–1989) In the 1980s, the drug problem was a great concern to voters, and to President Reagan and his wife, Nancy. Congress addressed those concerns by passing the 1986 Anti– Drug Abuse Act (PL 99-570). This new law created new penalties for adults who trafficked in drugs, especially near a school. One part of this large bill was the Drug-Free Schools and Community Act. This bill provided $100 million to states for drug-free schools and prevention programs to teach kids to stay away from drugs and became the federal government’s major initiative to prevent drug abuse in schools. In 1988, Congress passed PL 100-690, the Anti-Drug Control Act, an omnibus anti­ drug bill that included numerous provisions designed to coordinate federal and state drug-fighting efforts, increase treatment and education options, and to strengthen law enforcement approaches toward drugs. This legislation was more popularly known for the creation of the drug czar and the Office of National Drug Control Policy. Part of this law authorized additional funding for the Drug-Free Schools and Community Act. Congress allocated $350 million for the program, including $16 million for grants to schools and colleges for teacher training programs regarding alcohol and drug abuse prevention, $15 million for grants to nonprofit private and public organizations to prevent

344   Drug-Free Schools and Community Act (1988–1989)

and reduce youth participation in gangs that engaged in drug-related activities, and $40 million for grants to state community youth activity programs. Any agency that received federal funds under the law was prohibited from using that money for any program that does not provide a “clean and consistent message” that the illegal use of alcohol and other drugs is wrong and harmful. More changes came in 1989 when President George H. W. Bush signed the Drug-Free Schools and Community Act Amendments of 1989 (PL 109-226) on December 1. The legislation changed the name of the program to the Safe and Drug-Free Schools and Community Act. Section 22 of the amendment was included to place a clear emphasis on prevention and “zero tolerance,” which meant a “clear and firm enforcement of the laws and rules against drug use and drug dealing in schools, and expulsion of violators.” Under the new amendment, all schools and colleges were required to provide documentation to the Federal Department of Education that they had implemented a plan to prevent their students and staff from using illegal drugs or alcohol. As part of this, the schools were required to disseminate a copy of the code of conduct every year that clearly prohibits the possession, use, or distribution of illicit drugs. The document must also clearly state the possible penalties that could be imposed for those behaviors, including expulsion, firing, or otherwise prosecuting the offender criminally. Those schools that chose to not comply with the standards would face possible loss of federal funding. In 2001, the Safe and Drug-Free Schools and Communities Act was again amended and reauthorized by the No Child Left Behind Act (PL 107-110). The Safe and Drug-Free Schools and Communities acts are not without their critics. One criticism revolves around the con-

cept of zero tolerance and total abstinence for drug use. The laws require schools to base their programing on these ideas in order to get federal funds. Some feel that this standard prevents honest and forthright discussion about drugs and the effect of drugs on the body. This approach to education, some feel, is “unrealistic and close-minded” and may not be the best way to teach today’s young people about illicit drug use. Another group of critics point to the costs of the program and how the money is allocated to the local school districts. They argue that while Congress spent millions of dollars for drug abuse education, inner-city schools received only about $13.7 million, or 4 percent, of that money. On the other hand, those inner-city districts compose about 12 percent of the nation’s elementary and high school enrollment, most of whom are at a high risk for drug use. On average, the federal government spent $9 per student on antidrug education, but only $3.50 on each urban student. Nancy E. Marion See also: Bush, George H. W.; Drug Czar; Drug Use; Drug-Free School Zones; Forcasting; Office of National Drug Control Policy; Ronald, and Nancy Reagan; Zero Tolerance Policy Program

Further Reading “Election-Year Anti-Drug Bill Enacted.” 1989. In CQ Almanac 1988, 44th ed., 85–111. Washington, DC: Congressional Quarterly. http://library.cqpress.com/cqalmanac/ cqal88-1141196. Gray, James P. 2012. Why Our Drug Laws Have Failed and What We Can Do about It. Philadelphia: Temple University Press. “H.R. 3614—101st Congress: Drug-Free Schools and Community Act Amendments of 1989.” 1989. http://www.GovTrack.us/ congress/bills/101/hr3614.

Drugged Driving  345 Reagan, Ronald. 1988a. “1988 Legislative and Administrative Message: A Union of Individuals.” January 25. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=36046. Reagan, Ronald. 1988b. “Statement on the Recommendations of the National Drug Policy Board.” June 30. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=36063. Reuter, Peter, and P. Michael Timpane. 2001. “Options for Restructuring the Safe and Drug-Free Schools and Communities Act.” Washington, DC: Rand, Drug Policy Research Center. Sharp, Elaine B. 1994. The Dilemma of Drug Policy in the United States. New York: Harper Collins. U.S. Department of Education. 1989. DrugFree Schools and Communities Act Amendments of 1989. Washington, DC: Government Printing Office. U.S. Department of Education. 1993. DrugFree Schools and Communities Act. Washington, DC: Government Printing Office.

Drugged Driving Driving under the influence (DUI) or driving while intoxicated (DWI) means operating a motor vehicle while under the influence of any drug that alters perception, impairs reflexes or attention, skews judgment, or affects balance and coordination. Drivers using any such substance or combination of substances, even if the drugs are legal or prescribed by a physician, are dangerous on the roadways and may be subject to severe penalties if they break driving laws or are involved in accidents. According to the National Highway Traffic Safety Administration, car and truck

accidents are the leading cause of death of teens and young adults ages 15 to 21. Drunk and drugged drivers kill over 16,000 people a year in the United States, and anywhere between 10 to 22 percent of drivers involved in accidents have been using drugs, including alcohol. Roughly 5 percent of the population over 15 years old and 14 percent of young adults are reported to have been driving under the influence of illicit drugs in the past year. According to President Obama’s Office of National Drug Control Policy, one in eight Americans who are driving on a typical weekend night will test positive for an illicit drug. Fortunately, through the efforts of many law enforcement organizations and groups like Mothers Against Drunk Driving and Students Against Destructive Decisions (formerly Students Against Driving Drunk), there has been a decline in fatalities and other injuries associated with drugged driving. State laws vary regarding the penalties for driving under the influence. In 12 states (Arizona, Georgia, Indiana, Illinois, Iowa, Michigan, Minnesota, Nevada, Pennsylvania, Rhode Island, Utah, and Wisconsin), it is illegal to operate a motor vehicle with any detectable level of a prohibited drug in the bloodstream. Other state laws define drugged driving as driving when a drug “renders the driver incapable of driving safely” or “causes the driver to be impaired.” Since even a small amount of marijuana, alcohol, or other drug—especially if two or more are combined—can produce significant impairment and incapacity, states are likely to interpret their penalty laws to suit the crime. In all 50 states and the District of Columbia, the legal drunk limit for driving under the influence of alcohol is a 0.08 blood-alcohol concentration (BAC), the point at which people feel euphoric and powerful despite impaired coordination, balance, and reflexes. The states differ in terms of policies regard-

346   Drugged Driving

ing license suspensions, vehicle forfeiture if the driver is guilty of multiple offenses, and open containers.

States in Which Licenses Can Be Suspended for First Offense • All states except Kentucky, Michigan, Montana, New Jersey, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee States That Restore Driving Privileges During Suspension (When Certain Requirements Are Met) • All states except Alabama, Delaware, Kansas, Massachusetts, Mississippi, Missouri, New Hampshire, Utah, Vermont, Virginia Open Container Laws • None: Arkansas, Connecticut, Delaware, Mississippi, Missouri, Virginia, West Virginia

• Apply to driver only: Alaska, Kansas, Oklahoma, Rhode Island, Tennessee • Apply to both driver and passengers: All other states

States That Forfeit Vehicles for Multiple Offenses • Do not forfeit: Alabama, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Iowa, Kansas, Maryland, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, South Dakota, Utah, West Virginia, Wyoming • Forfeit: All Others Driving Under the Influence of Drugs Other Than Alcohol Determining the level of impairment of someone driving under the influence and assigning appropriate penalties is not as clear-cut a process as penalizing alcoholrelated driving infractions, in part because

The wreckage of an automobile in which the driver was killed after choosing to drink alcohol and then drive. (Gwinnett County Police Department/Centers for Disease Control and Prevention)

Drugged Driving  347

there is no established legal limit for drugs. A driver affected by such drugs must be evaluated based on the degree of his or her intoxication—whether the driver lacks sober judgment or is unable to drive in a prudent manner consistent with the way an unimpaired person would drive. The evidence is of necessity partly circumstantial, based on observations of the driver’s coordination and balance on sobriety tests. Blood chemical analyses may also be used to verify observed evidence. Although state motor vehicle departments are not likely to have the jurisdictional authority to suspend or revoke licenses, the courts can and do impose penalties, sometimes more severe than those imposed for similar alcohol-related offenses. Those penalties could result in suspension of driving privileges.

Teen Drivers According to the Centers for Disease Control (CDC), motor vehicle crashes are the top cause of death for U.S. teens, accounting for 36 percent of all deaths in this age group. However, research suggests that the most strict and comprehensive graduated drivers licensing programs are associated with reductions of 38 percent and 40 percent in fatal and injury crashes, respectively, of 16-yearold drivers. The CDC has also indicated that: • The risk of motor vehicle crashes is higher among 16- to 19-year-olds than among any other age group. In fact, per mile driven, teen drivers ages 16 to 19 are four times more likely than older drivers to crash. • The presence of teen passengers increases the crash risk of unsupervised teen drivers; the risk increases with the number of teen passengers.

• In 2004, the motor vehicle death rate for male drivers and passengers ages 16 to 19 was more than 1.5 times that of their female counterparts (19.4 per 100,000 compared with 11.1 per 100,000). • Crash risk is particularly high during the first year that teenagers are eligible to drive. • Teens are more likely than older drivers to underestimate or fail to recognize hazardous or dangerous situations. • Teens are more likely than older drivers to speed and allow shorter distance from the front of one vehicle to the front of the next. The presence of male teenage passengers increases the likelihood of these risky driving behaviors by teen male drivers. • Among male drivers between 15 and 20 years of age who were involved in fatal crashes in 2005, 38 percent were speeding at the time of the crash and 24 percent had been drinking. • At all levels of BAC, the risk of involvement in a motor vehicle crash is greater for teens than for older drivers. • In 2005, 23 percent of drivers ages 15 to 20 that died in motor vehicle crashes had a BAC of 0.08 or higher. • In a national survey conducted in 2005, nearly 30 percent of teens reported that within the previous month, they had ridden with a driver who had been drinking alcohol. One in 10 reported having driven after drinking alcohol within the same one-month period. • In 2005, among teen drivers who were killed in motor vehicle crashes after drinking and driving, 74 percent were unrestrained. • In 2005, half of teen deaths from motor vehicle crashes occurred between 3 P.M. and midnight, and 54 percent

348   Drugged Driving

occurred on Friday, Saturday, or Sunday.

Facts about Drugged Driving • In 2005, 16,885 people died in alcoholrelated motor vehicle crashes, accounting for 39 percent of all traffic-related deaths in the United States. • An alcohol-related motor vehicle crash kills someone every 31 minutes and nonfatally injures someone every two minutes. • Drugs other than alcohol (e.g., marijuana and cocaine) are involved in about 18 percent of motor vehicle driver deaths. These drugs are generally used in combination with alcohol. • Each year, alcohol-related crashes in the United States cost about $51 billion. • Most drinking and driving episodes go undetected. In 2005, nearly 1.4 million drivers were arrested for driving under the influence of alcohol or narcotics, which is less than 1 percent of the 159 million self-reported episodes of alcohol-impaired driving among U.S. adults each year. Occurrence and Consequences • More than half of the 414 child passengers ages 14 and younger that died in alcohol-related crashes during 2005 were riding with the drinking driver. • In 2005, 48 children age 14 years and younger who were killed as pedestrians or pedal-cyclists were struck by impaired drivers. Groups at Risk • Male drivers involved in fatal motor vehicle crashes are almost twice as likely as female drivers to be intoxicated with a BAC of 0.08 percent

•

•

•

•

•

•

or greater. It is illegal to drive with a BAC of 0.08 percent or higher in all 50 states, the District of Columbia, and Puerto Rico. At all levels of BAC, the risk of being involved in a crash is greater for young people than for older people. In 2005, 16 percent of drivers ages 16 to 20 who died in motor vehicle crashes had been drinking alcohol. Young men ages 18 to 20 (under the legal drinking age) reported driving while impaired more frequently than any other age group. Among motorcycle drivers killed in fatal crashes, 30 percent have BACs of 0.08 percent or greater. Nearly half of the alcohol-impaired motorcyclists killed each year are age 40 or older, and motorcyclists ages 40 to 44 have the highest percentage of fatalities with BACs of 0.08 percent or greater. Of the 1,946 traffic fatalities among children ages 0 to 14 in 2005, 21 percent involved alcohol. Among drivers involved in fatal crashes, those with BAC levels of 0.08 percent or higher were 9 times more likely to have a prior conviction for DWI than were drivers who had not consumed alcohol. Kathryn H. Hollen

See also: Alcohol Use; Drug Screening and Testing

Further Reading Centers for Disease Control and Prevention. http://www.cdc.gov/ncipc/duip/spotlite/3d .htm. Friedman, Lauri S. 2008. Drunk Driving: An Opposing Viewpoints Guide. Detroit: Greenhaven Press.

Drug-Related Asset Seizures  Insurance Institute for Highway Safety. http:// www.iihs.org. Kiesbye, Stefan. 2011. Drunk Driving. Detroit: Greenhaven Press. Parks, Peggy J. 2010. Drunk Driving. San Diego, CA: Reference Point Press. Thompson, Tamara. 2008. Drunk Driving. Detroit: Greenhaven Press. U.S. Department of Transportation, National Highway Traffic Safety Administration. 1996. “National Drunk and Drugged Driving Prevention Month Program Planner: Campaign Safe and Sober Impaired Driving Program Planner.”

Drug-Related Asset Seizures Asset forfeiture refers to the process by which an individual’s property may be seized by the U.S. government if the property was used to commit a crime, or purchased with the profits from a crime. Forfeiture also applies to property that was used to facilitate the offense or that was involved in money laundering. Property that officials can seize includes cash and/or personal property (e.g., cars, weapons, jewelry, art, collectibles, boats, airplanes, or homes). If a defendant is convicted of a drug offense, a judge may decide that the property in question can be forfeited by the government. The property must be related to the crime for which the defendant is convicted, and the forfeiture can be considered to be part of the offender’s sentence. The government must show a connection between the property being seized and the crime. Asset seizure is a relatively new punishment for those convicted of drug-related crimes. It began after Congress passed the Comprehensive Drug Abuse Prevention and Control Act in 1970. This new law included

a provision that authorized government officials to seize any drugs, drug manufacturing and storage equipment, and other items that were used to transport illegal drugs. Congress also passed legislation that broadened criminal forfeiture laws so they would include any profits from drug transactions as well as any real property related to the drug offenses. Congress made additional changes in 1984 when they passed the Comprehensive Crime Control Act. This new law again expanded federal prosecutors’ ability to seize assets related to drug offenses. At this point, the authority for a seizing agency to start an administrative forfeiture action is found in 19 U.S.C. §1607. The asset forfeiture programs increase public safety and security by disrupting or dismantling the ability of criminals and criminal organizations to function. Forfeiture programs remove the organization’s ability to transport illicit drugs, preventing the drugs from being put into society. The funds can also be used to pay victims restitution for damages related to the crimes. The program also helps to increase public safety by encouraging cooperation among federal, state, and local law enforcement agencies through equitable sharing of the proceeds. When a state or federal agency takes part in the seizure and forfeiture of property, a portion of that profit can be transferred to that agency to be used for law enforcement purposes. On the federal level, the Asset Forfeiture and Money Laundering Section of the Criminal Division of the Department of Justice oversees the property seized from drug dealers and traffickers. The office provides legal support to the U.S. attorneys’ offices, which are responsible for the prosecution of individuals charged with the offenses. The office also coordinates seizures that involve multiple jurisdictions, acts on petitions for

349

350   Drug-Related Asset Seizures

remission, and develops training seminars for all levels of law enforcement on issues regarding asset forfeiture. Many federal agencies are involved with asset forfeiture. The Bureau of Alcohol, Tobacco, Firearms and Explosives seizes firearms, ammunition, explosives, alcohol, tobacco, currency, conveyances, and other property that were associated with drugrelated offenses. The Drug Enforcement Administration is directly involved in the battle against drug networks and cartels, and they are often involved in seizing drug-related property. The Federal Bureau of Investigation investigates many crimes related to the drug trade such as white collar crime, organized crime, and terrorist activities. They have created the Investigative Programs Asset Forfeiture Program to help assist them in their goals. There are other federal agencies that are involved with asset forfeiture. One of those is the U.S. Postal Inspection service, which oversees mail fraud, money laundering, and drug trafficking through the mail. The Food and Drug Administration makes seizures related to health care fraud, counterfeit pharmaceutical drugs, the distribution of adulterated food, and product tampering. The Bureau of Diplomatic Security within the Department of State oversees investigations of passport and visa fraud. As the investigative arm of the Inspector General of the Department of Defense, the Defense Criminal Investigative Service looks into allegations related to homeland security/terrorism, contract fraud, public corruption, computer crimes, and illegal technology transfers. The U.S. Marshals Service is the agency that is primarily responsible for the custody of the property and cash seized from offenders. They manage and dispose of the property as needed. They often sell the seized merchandise or transfer it to other law enforce-

ment agencies for use in investigations or other law enforcement activities. In 2013, the Marshals managed $2.4 billion in seized assets. This included 23,122 assets. The agency shared about $616 million with state and local law enforcement agencies in 2012, and distributed $1.5 billion to victims of crimes. Property seized from asset forfeiture can be sold, placed into official use, destroyed, or transferred to another agency. When the property is sold, the profits from the sales, along with any cash seized from offenders, are placed into the Assets Forfeiture Fund, held within the Department of Justice. The fund was established by Congress in the Comprehensive Crime Control Act of 1984. The money is used to pay for costs associated with seizing property, managing it, and disposing of it. The fund is also used to support investigative activities by law enforcement. Seized property (such as cars) is sometimes made available for other federal law enforcement activities. Some property may be returned to the owner if it is deemed the person charged did not commit the crime, or the property was not related to the offense at hand. In FY 2011, there was $1.7 billion in net assets in the fund. By FY 2012, that amount had risen to almost $4.2 billion. Analysis of state forfeiture programs indicates that state and local law enforcement agencies also collect significant cash and property through forfeiture programs. From 2001 to 2002, forfeitures of cash in only nine states totaled more than $70 million. This figure does not include forfeited cars and other property. In 2000, the Civil Asset Forfeiture Reform Act (CAFRA) (Pub. L. No. 106-185) was passed by Congress. The new law increased the due-process protections for property owners facing asset forfeiture. Prior to CAFRA, the burden of proof fell on property owners to show that the property was not re-

Drug-Related Asset Seizures 

lated to criminal activities. Under CAFRA, the burden of proof is now on the government to show the relationship between the property and the criminal activity. Nancy E. Marion See also: Comprehensive Drug Abuse Prevention and Control Act (1970); Drug Enforcement Administration; Drug Abuse

Further Reading Cassella, Stefan D. 2007. “Overview of Asset Forfeiture Law in the United States.” United States Attorneys’Bulletin. Columbia, SC, November. http://www.justice.gov/usao/eousa/ foia_reading_room/usab5506.pdf. Get the Facts: Drug War Facts. 2008. “Asset Forfeiture.” http://www.drugwarfacts.org/ cms/forfeiture§hash.sd5nfxnl.dpbs. Maguire, Kathleen, ed. Sourcebook of Criminal Justice Statistics, Table 4.45. Albany, NY: University of Albany, School of Criminal Justice, Hindelang Criminal Justice Research Center. http://www.albany.edu/ sourcebook/pdf/t4452010.pdf. Moores, Eric. 2009. “Reforming the Civil Asset Forfeiture Reform Act,” Arizona Law Review 51(3): 792–93. http://www.arizonalawreview .org/pdf/51-3/51arizlrev777.pdf. U.S. Department of Justice. “Asset Forfeiture Program.” http://www.justice.gov/jmd/afp/ index.html. U.S. Department of Justice. “Participants and Roles.” http://www.justice.gove/jmd/afp/ 05participants.

U.S. Department of Justice, Criminal Division. 2009. Guide to Equitable Sharing for State and Local Law Enforcement Agencies, “Asset Forfeiture and Money Laundering Section.” Washington DC: U.S. Justice Department. http://www.justice.gov/usao/ri/ projects/esguidelines.pdf. U.S. Department of Justice, Office of the Inspector General, Audit Division. 2013. “Assets Forfeiture Fund and Seized Asset Deposit Fund Annual Financial Statement Fiscal Year 2012.” Audit Report 13-07, January. http://www.justice.gov/jmd/ afp/01programaudit/fy2012/afs_report. U.S. Marshals Service. “Asset Forfeiture Program.” http://www.usmarshals.gov/assets/ index.html. Williams, Marian R., Jefferson H. Holcomb, Tomislav V. Kovandzic, and Scott Bullock. 2010. Policing for Profit: The Abuse of Civil Asset Forfeiture. Arlington, VA: Institute for Justice. http://www.drugwarfacts.org/ cms/forfeiture§hash.sd5nfxnl.dp. Worrall, John L. 2008. Problem-Oriented Guides for Police Response Guides Series No. 7: Asset Forfeiture. Washington, DC: U.S. Department of Justice, Office of Community Oriented Policing Services, Center for Problem-Oriented Policing. http://www .cops.usdoj.gov/files/RIC/Publications/ e1108-Asset-Forfeiture. Worrall, John L., and Tomislav V. Kovandzic. 2008. “Is Policing For Profit? Answers from Asset Forfeiture.” Criminology and Public Policy 7(2): 224. http://www.ncjrs.gov/App/ publications/abstract.aspx?ID=245729.

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Drugs in American Society

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Drugs in American Society an encyclopedia of history, politics, culture, and the law Volume 2: E–P

Nancy E. Marion and Willard M. Oliver, Editors

Copyright © 2015 by ABC-CLIO, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, except for the inclusion of brief quotations in a review, without prior permission in writing from the publisher. Library of Congress Cataloging-in-Publication Data   Drugs in American society : an encyclopedia of history, politics, culture, and the law / Nancy E. Marion and Willard M. Oliver, editors.    volumes ; cm   ISBN 978-1-61069-595-4 (alk. paper) — ISBN 978-1-61069-596-1 (ebook) 1. Drug abuse— United States. 2. Drugs—United States. 3. Drug utilization—United States. I. Marion, Nancy E., editor. II. Oliver, Willard M., editor. HV5825.D848 2015 363.290973—dc23   2014017383 ISBN: 978-1-61069-595-4 EISBN: 978-1-61069-596-1 19 18 17 16 15  1 2 3 4 5 This book is also available on the World Wide Web as an eBook. Visit www.abc-clio.com for details. ABC-CLIO, LLC 130 Cremona Drive, P.O. Box 1911 Santa Barbara, California 93116-1911 This book is printed on acid-free paper Manufactured in the United States of America

Contents

Guide to Related Topics,  xv

Alcohol Use,  32

Preface, xxiii

Alcohol-Facilitated Sexual Assault,  37

Introduction, xxv

Alcoholics Anonymous (AA),  39

Chronology: Significant Events in Drug and Alcohol Use through History,  xxxvii

Alcoholism, 42 Alpert, Richard,  47 Alternative Addiction Treatment,  49

VOLUME 1

American Association for the Study and Cure of Inebriety (AASCI),  51

Addiction, 1 Addiction Liability,  7

American Society of Addiction Medicine (ASAM), 53

Addiction Medications,  7

American Temperance Society (ATS),  56

Addictive Personality,  11

Amphetamines, 58

Adolescent Tobacco Use,  13

Analgesics, 60

Advisory Commission on Narcotic and Drug Abuse,  16

Andean Trade Preference Act (1991),  63

African Americans and Drug Use,  17

Anslinger, Harry J.,  65

Al-Anon, 20

Antidepressants, 68

Alateen, 22

Anti–Drug Abuse Acts,  71

Alcohol Bootlegging and Smuggling,  24

Anti-Saloon League (ASL),  73

Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (1992), 27

Anxiety Disorders,  76 Armstrong, Lance,  77 Asset Forfeiture,  80

Alcohol Mutual Aid Societies,  28

Association Against the Prohibition Amendment (AAPA),  82

Alcohol to Subdue Victims,  30 v

vi  Contents

Authors and Drug Use,  84

Bush, George W.,  140

Aviation Drug-Trafficking Control Act (1984), 86

Cabinet Committee on International Narcotics Control,  145

Bad Boys,  89

Caffeine, 146

Barbiturates, 91

Cali Drug Cartel,  148

Barnes, Nicky,  93

Califano, Joseph, Jr.,  153

Barry, Marion S.,  95

Camarena Salazar, Enrique,  154

Bath Salts and Synthetic Cannabis (“K2” or “Spice”), 97

Campaign against Marijuana Planting (CAMP), 156

Beatniks, 99

Cannabis, 157

Behavioral Addictions,  100

Carter, Jimmy,  159

Belushi, John,  103

Center for Substance Abuse Prevention (CSAP), 161

Bennett, William,  106 Betty Ford Center,  107 Bias, Len,  109

Center on Addiction and Substance Abuse (CASA), 163

Binge Drinking,  110

Centers for Disease Control and Prevention (CDC), 164

Biological and Psychological Reasons for Substance Abuse,  114

Central Intelligence Agency (CIA), United States, 166

Black Tar Heroin,  115

Child Sexual Abuse and Substance Abuse, 168

Blanco, Griselda,  117 Blood-Alcohol Content (BAC),  119 Blow,  122 Boggs Act (1951),  124 Boylan Act (1914),  126 Brown, Bobby,  129 Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF),  130

Children of Alcoholics,  170 China and the Chinese and Drugs,  173 Cigarettes, 175 Cigars, 178 Cipollone v. Liggett Group, Inc. et al.,  182 Clinton, Bill,  185 Cobain, Kurt,  188

Bureau of Drug Abuse Control,  134

Coca, 190

Bureau of International Narcotics and Law Enforcement Affairs,  135

Coca-Cola, 193

Bush, George H. W.,  136

Cocaine and Crack,  194 Cocaine Anonymous (CA),  197

Contents  vii

Cocaine Cowboys,  198

Date Rape Drugs,  242

Codeine, 200

Decriminalization, 244

Codependency, 201

Demand Reduction,  245

Colombian Cartels,  202

Dependence, 248

Combat Methamphetamine Act (2005), 204

Depressants, 250

Commission on Marihuana and Drug Abuse, 206 Committee on Drug Addiction (1928–1938), 210 Committee on Drug Addictions (1921–1928), 211 Common Sense for Drug Policy,  213 Compassionate Use Act (1996),  214 Comprehensive Drug Abuse Prevention and Control Act (1970),  216 Comprehensive Methamphetamine Control Act (1996),  218 Compulsions and Impulses,  219 Conant v. Walters,  220 Controlled Substances Act (CSA) (1970), 222 Council for Tobacco Research,  224 The Counterculture and Drugs,  226 Crack Epidemic,  228 Crime Control Act (1990),  230 Crime Victims and Drugs,  232

Designer Drugs,  252 Dimethyltryptamine (DMT),  255 Disease Model of Addiction,  256 Dole, Vincent,  257 Domestic Abuse and Alcohol,  259 Domestic Abuse and Drugs,  262 Drug Abuse,  264 Drug Abuse and Treatment Act (1972),  267 Drug Abuse Control Amendments (1965), 269 Drug Abuse Resistance Education (DARE), 271 Drug Abuse Warning Network,  273 Drug Addiction and Public Policy,  275 Drug Cartels,  279 Drug Classes,  285 Drug Courts,  288 Drug Czar,  290 Drug Enforcement Administration (DEA), 292

Crop Eradication,  234

Drug Interdiction and International Cooperation Act (1986),  295

Cross-Addiction and Cross-Tolerance,  236

Drug Intervention Programs,  296

Dadeland Massacre (Miami, Florida) (1979), 239

Drug Kingpin Death Penalty Act (1988, 1994), 298

Dai, Bingham,  240

Drug Nomenclature,  299

viii  Contents

Drug Paraphernalia,  300

Eighteenth Amendment,  357

Drug Policy Alliance Network,  303

Eisenhower, Dwight D.,  359

Drug Possession,  304

Elders, Joycelyn,  360

Drug Purity,  305

Electronic Dance Music (EDM/House Music), 361

Drug Reform Act (1986),  308 Drug Screening and Testing,  309 Drug Sentencing,  311 Drug Smuggling,  314 Drug Tolerance,  316 Drug Trade,  317 Drug Trafficking,  318 Drug Trafficking and Organized Crime, 321 Drug Trafficking Networks,  324 Drug Typologies,  326 Drug Use Forecasting,  330

Employment Division, Department of Human Resources of Oregon v. Smith,  363 Energy Drinks,  365 Engle v. R.J. Reynolds,  367 Entertainers and Drug Use,  369 Ephedrine and Pseudoephedrine,  372 Escobar, Pablo,  373 European Committee to Combat Drugs, 375 Extradition, 376 Fair Sentencing Act (2010),  379

Drug Watch International,  332

Families Against Mandatory Minimums (FAMM), 381

Drug-Facilitated Rape,  334

Farley, Chris,  383

Drug-Free America Act (1986),  336

Fast and Furious,  386

Drug-Free America Foundation,  338

Federal Alcohol Administration Act (1935), 389

Drug-Free Federal Workplace,  340 Drug-Free School Zones,  341 Drug-Free Schools and Community Act (1988–1989), 343

Federal Bureau of Investigation (FBI),  391 Federal Bureau of Narcotics (FBN),  394 Female Alcohol Use,  396

Drugged Driving,  345

Female Tobacco Use,  399

Drug-Related Asset Seizures,  349

Ferguson v. City of Charleston,  401 Fetal Alcohol Syndrome (FAS),  403

VOLUME 2

Fisher, Guy,  408

E-Cigarettes, 353

Flashbacks, 409

Ecstasy (MDMA),  355

Florida v. Jardines,  411

Contents  ix

Food and Drug Administration (FDA),  413

Hemp, 476

Food, Drug, and Cosmetic Act (1938),  415

Hendrix, Jimi,  478

Ford, Betty,  417

Heroin, 480

Ford, Gerald R.,  419 Four Loko,  421

High-Intensity Drug-Trafficking Areas (HIDTAs), 483

French Connection,  423

Hip-Hop and Drugs,  486

Freud, Sigmund,  424

Hippies, 488

Gateway Drugs,  429

HIV/AIDS and Drug Use,  489

Gateway Hypothesis,  433

Hoffman, Philip Seymour,  491

Ginsberg, Allen,  434

Hofmann, Albert,  493

Global Commission on Drug Policy (2011), 436

Hookah, 495

Golden Crescent,  437 Golden Triangle,  440 Grateful Dead,  443 Green Rush,  446 Guadalajara Cartel,  447 Guillot-Lara, Jaime,  449 Gulf Cartel,  450 Gutka, 454

Hoover, J. Edgar,  496 Ibogaine, 499 Inhalants, 500 International Narcotics Control Act (1989), 503 International Narcotics Research Conference (INRC),  504 Intervention, 505 Intoxication, 507

Hague Convention,  457

Investigational New Drug Program,  509

Haight-Ashbury, 460

Jackson, Michael,  511

Hallucinogens, 462

Jazz Culture,  513

Hangovers, 464

Jellinek, E. Morton,  515

Hard Drugs vs. Soft Drugs,  465

Johnson, Lyndon Baines,  517

Harm Reduction Programs,  467

Jones, Marion,  519

Harrison, Francis,  469

Joplin, Janis,  521

Harrison Narcotics Act (1914),  470

Juárez Cartel,  523

Hashish (Hash),  473

Jung, George,  525

Hazelden Foundation,  474

Kennedy, John F.,  527

x  Contents

Ketamine, 528

Meth Labs,  594

Khat, 531

Methadone, 597

Koop, C. Everett,  534

Methadone Treatment Programs,  598

The La Guardia Report,  539

Methamphetamine, 599

Labeling and the Criminalization Process, 541

Mexican Drug Trade,  603

Latinos and Drug Use,  543 Leary, Timothy,  544 Legalization, 546 Legalized Marijuana,  550 Leonhart, Michele M.,  552 LifeRing, 553 Lincoln, Abraham,  555 Linder v. United States,  557

Military and Drug Use,  606 Minnesota Model,  607 Minorities and Drug Use,  608 Moncrieffe v. Holder,  609 Monitoring the Future Survey,  611 Monroe, Marilyn,  613 Morality Policy,  615 Morphine, 616

Lindesmith, Alfred R.,  558

Mothers Against Drunk Driving (MADD), 617

Long-Term Potentiation,  559

Mullen, Francis,  619

LSD (Lysergic Acid Diethylamide),  560

Nadelmann, Ethan,  621

Lucas, Frank,  563

Naltrexone, 622

Mandatory Treatment,  567

Narcotic Addict Rehabilitation Act (1966), 624

Marihuana Tax Act (1937),  568 Marijuana, 570 Marijuana Businesses,  573 Master Settlement Agreement (MSA), 577 McCaffrey, Barry R.,  580 McCoy, Bill,  584 Medellín Cartel,  585 Medical Marijuana,  588 Meese, Edwin,  592 Mescaline, 593

Narcotic Clinics,  626 Narcotic Control Act (1956),  628 Narcotic Drugs Import and Export Act (1922), 630 Narcotics, 631 Narcotics Anonymous (NA),  632 Nation, Carrie,  635 National Association of State Alcohol and Drug Abuse Directors,  638 National Clearinghouse for Alcohol and Drug Information (U.S.),  639

Contents  xi

National Council on Alcoholism and Drug Dependence (NCADD),  640 National Drug Control Strategy,  643 National Drug Policy Board,  645 National Household Survey on Drug Abuse, 647 National Institute on Alcohol Abuse and Alcoholism (NIAAA),  649 National Institute on Drug Abuse (NIDA), 651 National Minimum Drinking Age Act (1984), 653

Obama, Barack,  696 Office for Drug Abuse Law Enforcement, 699 Office of National Drug Control Policy (ONDCP), 700 Opiates, 703 Opium, 705 Opium Control Act (1942),  708 Opium Dens,  709 Opium Trade,  711 Opium Wars,  715

National Narcotics Border Interdiction System (NNBIS),  655

Organized Crime Drug Enforcement Task Force Program,  716

National Organization for the Reform of Marijuana Laws (NORML),  657

Over-the-Counter Drugs,  717

National Research Council Report on Drug Enforcement Activities,  659

Parents Resource Institute for Drug Education (PRIDE) Surveys,  721

National Treasury Employees Union v. Von Raab,  660

Partnership for the Drug-Free America,  723

National Youth Anti-Drug Media Campaign, 661

Oxycodone/OxyContin, 719

Patent Medicines,  725 Peyote, 726

Native Americans and Substance Abuse, 663

Pharmacology, 729

Needle Exchange Programs,  671

Phoenix House,  732

Neurotransmitters, 673

Pizza Connection,  734

Nicotine, 677

Popular Culture,  736

Nixon, Richard M.,  686

Porter, Stephen G.,  739

Noriega, Manuel Antonio,  688

Porter Narcotic Farm Act (1929),  741

Nutt, Levi G.,  691

Predatory Drugs,  744

Nyswander, Marie,  692

Prescription Drugs,  747

Oakland Cannabis Buyers’ Cooperative, 695

President’s Advisory Commission on Narcotic and Drug Abuse (1963),  749

Phencyclidine (PCP),  730

xii  Contents

President’s Drug Advisory Council (George H. W. Bush),  751 Presley, Elvis,  752 Prevention, 755 Prison Inmates and Drug Use,  759 Prohibition, 762 Prohibition Party,  764

Rockefeller Drug Laws,  802 Rodriguez, Alex,  804 Ruffin, David,  806 Rural Drug Use,  808 Rush, Benjamin,  810 Scarface, 813

Prohibition Unit,  766

Schedule of Controlled Substances (I–V), 815

Prometa, 768

Secondhand Smoke,  817

Psilocybin and Psilocin (Mushrooms),  769

Sedatives, Hypnotics, and Anxiolytics,  818

Psychedelic Drugs,  771

Seniors and Drug Use,  819

Psychotherapeutic Drugs,  773

Sentencing Disparities,  820

Public Health Service Narcotic Hospitals, 775

Sertürner, Friedrich,  822

Public Opinion and Drug Use,  777 Pure Food and Drug Act (1906),  779

Shisha, 823 Shulgin, Alexander “Sasha,”  824 Skinner v. Railway Labor Executives’ Association,  826

VOLUME 3

Smith, Robert Holbrook (“Dr. Bob”),  827

Quaalude, 781

Smokers’ Rights,  829

Raich v. Ashcroft,  783

Smoking Opium Exclusion Act (1909), 831

Randall, Robert,  784 Raytheon v. Hernandez,  785 Reagan, Ronald, and Nancy Reagan,  787 Recovery, 790 Recovery Circles,  792 Recreational Use of Drugs,  794

Sonora Cartel,  832 Soros, George,  833 Special Action Office of Drug Abuse Prevention, 835 Special Narcotic Committee,  836

Reefer Madness,  795

State Drug and Alcohol Control Laws, 837

Ribbon Reform Clubs,  797

STDs and Drug Use,  839

Risk Factors for Drug Use,  799

Steroids, Anabolic,  841

Robinson v. California,  800

Steroids and Sports,  843

Contents  xiii

Steroids in Baseball,  846 Stimulants, 848 Students Against Destructive Decisions (SADD), 850 Studio 54,  852 Substance Abuse and Mental Health Services Administration (SAMHSA),  853 Substance Abuse Services Amendments of 1986, 858 Substance Addiction,  859 Supply-Side Strategy,  864 Surgeon General’s Reports on Tobacco, 866 Synanon, 868 Synthetic Drugs,  870 Syrup, 871 Television and Drugs,  875 Temperance Movement,  879 Terrorism and Illicit Drugs,  882 Terry, Luther,  884 “Texas Heroin Massacre” and Drug Use in the 1990s,  885 THC (Tetrahydrocannabinol),  890 Theories of Drug Addiction,  891 Tijuana Cartel,  894 Tobacco, 897 Tobacco Institute,  899 Tranquilizers, 901 Treatment, 902

Undocumented Immigrants and Drug Use, 913 United Nations Commission on Narcotic Drugs, 914 United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988),  916 United Nations Convention on Psychotropic Substances (1971),  917 United Nations International Conference on Drug Abuse and Illicit Trafficking (1987), 918 United Nations International Day Against Drug Abuse and Illicit Trafficking, 919 United Nations Office on Drugs and Crime, 920 United Nations Single Convention on Narcotic Drugs (1961),  921 United Nations Surveys on Crime Trends and the Operations of Criminal Justice Systems (UN-CTS),  922 United States Bureau of Narcotics and Dangerous Drugs (BNDD),  923 United States Coast Guard,  924 United States Customs and Border Protection, 926 United States Immigration and Customs Enforcement (ICE),  929 United States International Drug Control Efforts, 932 United States National Narcotics Control Act (1956),  934

Truman, Harry S.,  907

United States v. Doremus and Webb et al. v. United States,  934

Twelve-Step Programs,  909

United States v. Flores-Montano (2004),  937

xiv  Contents

United States v. Jin Fuey Moy (1916),  938 Urinalysis, 940 Violent Crime Control and Law Enforcement Act (1994),  943 Vollmer, August,  944 Volstead, Andrew,  946

Appendix: Documents Related to Drug Use in America 1. The First Drug Law in America, 1875, 985 2. Pure Food and Drug Act (1906),  985 3. Harrison Narcotics Act (1915),  990

Volstead Act (Eighteenth Amendment),  948

4. Eighteenth Amendment to the U.S. Constitution (1920–1933),  996

War on Drugs,  951

5. Porter Narcotic Farm Act (1929),  997

Webb et al. v. United States,  952

6. Marihuana Tax Act (1937),  999

Webb-Kenyon Act (1913),  953

7. Richard Nixon’s Special Message to the Congress on Drug Abuse Prevention and Control (1971),  1009

Whiskey Rebellion,  955 White, Walter,  957 White House Conference for a Drug-Free America, 958

8. “Just Say No” Speech by Ronald and Nancy Reagan (1986),  1019

White House Conference on Narcotics and Drug Abuse,  959

9. Executive Order 12564: Drug-Free Federal Workplace (1986) (Ronald Reagan), 1024

Wilson, William G. (“Bill W.”),  960

10. Anti–Drug Abuse Act (1986),  1029

Withdrawal from Drug Use,  961

11. Anti–Drug Abuse Act (1988),  1041

Woman’s Christian Temperance Union (WCTU), 962

12. George Bush: Address to Nation on the National Drug Control Strategy (1989), 1089

Women, Pregnancy, and Drugs,  964 Women, Victimization, and Substance Abuse, 968 Women’s Organization for National Prohibition Reform (WONPR),  971 World Federation Against Drugs,  972

13. Executive Order 12880: National Drug Control Program (1993) (Bill Clinton),  1095 14. Memorandum for Selected United States Attorneys (Medical Marijuana) (2009), 1097

World Narcotics Conference,  973

15. Cole Memorandum (Marijuana Dispensary Raids) (2011),  1100

Wright, Hamilton,  973

Recommended Resources,  1103

Youths and Illicit Drug Use in the United States, 977

About the Editors and Contributors,  1113

Zero Tolerance Policy Program (U.S.), 983

Index, 1117

Guide to Related Topics

Following are entries in this encyclopedia, arranged under broad topics, for enhanced searching. Readers should also consult the index at the end of the encyclopedia for more specific subjects.

Fetal Alcohol Syndrome (FAS) National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Minimum Drinking Age Act Whiskey Rebellion

Addiction/Use Addiction Addiction Liability Addiction Medications Addictive Personality Behavioral Addictions Compulsions/Impulses Disease Model of Addiction Drug Abuse Drug Addiction and Public Policy Substance Addiction Theories of Drug Addiction

Commissions and Boards Advisory Commission on Narcotic and Drug Abuse Bureau of Drug Abuse Control Bureau of International Narcotics and Law Enforcement Affairs Cabinet Committee on International Narcotics Control Campaign against Marijuana Planting (CAMP) Center for Substance Abuse Prevention Center on Addiction and Substance Abuse (CASA) Commission on Marihuana and Drug Abuse Committee on Drug Addiction (1928–1938) Committee on Drug Addictions (1921–1928) European Committee to Combat Drugs Global Commission on Drug Policy National Drug Policy Board National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Institute on Drug Abuse (NIDA) President’s Advisory Commission on Narcotic and Drug Abuse President’s Drug Advisory Council

Alcohol Alcohol Bootlegging and Smuggling Alcohol to Subdue Victims Alcohol Use Alcohol-Facilitated Sexual Assault Alcoholism American Association for the Study and Cure of Inebriety (AASCI) Binge Drinking Blood-Alcohol Content (BAC) Children of Alcoholics Domestic Abuse and Alcohol Female Alcohol Use xv

xvi   Guide to Related Topics

Special Action Office for Drug Abuse Prevention Special Narcotic Committee United Nations Commission on Narcotic Drugs White House Conference for a Drug-Free America White House Conference on Narcotics and Drug Abuse White House Drug Abuse Policy Office

Court Cases Cipollone v. Liggett Group, Inc. et al. Conant v. Walters Employment Division, Department of Human Resources of Oregon v. Smith Engle v. R.J. Reynolds Ferguson v. City of Charleston Florida v. Jardines Linder v. United States Moncrieffe v. Holder National Treasury Employees Union v. Von Raab Oakland Cannabis Buyers’ Cooperative Raich v. Ashcroft Raytheon v. Hernandez Robinson v. California Skinner v. Railway Labor Executives’ Association United States v. Doremus and Webb et al v. United States United States v. Flores-Montano United States v. Jin Fuey Moy Webb et al. v. United States Drug Trafficking Cali Drug Cartel Colombian Cartels Dadeland Massacre (Miami, Florida) Drug Cartels French Connection Golden Crescent Golden Triangle Guadalajara Cartel

Gulf Cartel Juárez Cartel Medellín Cartel Mexican Drug Trade Sonora Cartel Tijuana Cartel

Drugs Amphetamines Anabolic Steroids Analgesics Antidepressants Barbiturates Bath Salts and Synthetic Cannabis Black Tar Heroin Caffeine Cannabis Coca Coca-Cola Cocaine and Crack Codeine Crack Epidemic Date Rape Drugs Depressants Designer Drugs Dimethyltryptamine (DMT) Drug Classifications Ecstasy (MDMA) Ephedrine and Pseudoephedrine Gutka Hallucinogens Hashish Hemp Heroin Ibogaine Inhalants Ketamine Khat LSD Mescaline Methadone Methamphetamine Morphine Naltrexone

Guide to Related Topics  xvii

Narcotics Nicotine Opiates Opium Over-the-Counter Drugs Oxycodone/OxyContin Phencyclidine (PCP) Patent Medicines Peyote Predatory Drugs Prescription Drugs Prometa Psilocybin and Psilocin (Mushrooms) Psychedelic Drugs Psychotherapeutic drugs Quaalude Sedatives, Hypnotics, and Anxiolytics Shisha Stimulants Synthetic Drugs Syrup THC Tobacco Tranquilizers

Entertainment Bad Boys Blow Cocaine Cowboys Electronic Dance Music (EDM/House Music) Entertainers and Drug Use Grateful Dead Haight-Ashbury Hip-Hop and Drugs Hoffman, Philip Seymour Jazz Culture National Youth Anti-Drug Media Campaign Popular Culture Reefer Madness Scarface Television and Drugs White, Walter

Interest Groups Common Sense for Drug Policy Drug Free America Foundation Drug Policy Alliance Network Families Against Mandatory Minimums Mothers Against Drunk Driving (MADD) National Association of State Alcohol and Drug Abuse Directors National Organization for the Reform of Marijuana Laws Students Against Destructive Decisions (SADD) International Bureau of International Narcotics and Law Cabinet Committee on International Narcotics Law Cali Drug Cartel China (Chinese) and Drugs Colombian Cartels Crop Eradication Demand Reduction Drug Cartels Drug Smuggling Drug Trade Drug Trafficking Drug Trafficking and Organized Crime Drug Trafficking Networks Drug Watch International European Committee to Combat Drugs Global Commission on Drug Policy Guadalajara Cartel Gulf Cartel Hague Convention Illicit Drugs and Terrorism Juárez Cartel Medellín Cartel Mexican Drug Trade National Narcotics Border Interdiction System Opium Trade Opium Wars Organized Crime Drug Enforcement Task Force Program

xviii   Guide to Related Topics

Pizza Connection Psychotropic Substances Sonora Cartel Supply-Side Strategy Tijuana Cartel United Nations Commission on Narcotic Drugs United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances United Nations Convention on Psychotropic Substances United Nations International Conference on Drug Abuse and Illicit Trafficking United Nations International Day Against Drug Abuse and Illicit Trafficking United Nations Office on Drugs and Crime United Nations Single Convention on Narcotic Drugs United Nations Surveys on Crime Trends and Operations of Criminal Justice Systems United States International Drug Control Efforts World Federation Against Drugs World Narcotics Conference

Law Enforcement Asset Forfeiture Bureau of Alcohol Tobacco, Firearms and Explosives (ATF) Camarena Salazar, Enrique Central Intelligence Agency (CIA) Drug Czar Drug Enforcement Administration (DEA) Extradition Fast and Furious Federal Bureau of Investigation (FBI) Federal Bureau of Narcotics (FBN) Food and Drug Administration (FDA) High-Intensity Drug-Trafficking Areas (HIDTAs) National Narcotics Border Interdiction System

Office for Drug Abuse Law Enforcement Organized Crime Drug Enforcement Task Force Program United States Bureau of Narcotics and Dangerous Drugs (BNDD) United States Coast Guard United States Customs and Border Protection United States Immigration and Customs Enforcement (ICE)

Legislation Alcohol, Drug Abuse, and Mental Health Reorganization Act (1992) Andean Trade Preference Act (1991) Anti–Drug Abuse Acts Aviation Drug-Trafficking Control Act (1984) Boggs Act (1951) Boylan Act (1914) Combat Methamphetamine Act (2005) Compassionate Use Act (1996) Comprehensive Drug Abuse Prevention and Control Act (1970) Comprehensive Methamphetamine Control Act (1996) Controlled Substances Act (1970) Crime Control Act (1990) Drug Abuse and Treatment Act (1972) Drug Abuse Control Amendments (1965) Drug Interdiction and International Cooperation Act (1986) Drug Kingpin Death Penalty Act (1988, 1994) Drug Reform Act (1986) Drug-Free America Act (1986) Drug-Free Schools and Communities Act (1988–1989) Fair Sentencing Act (2010) Federal Alcohol Administration Act (1935) Food, Drug, and Cosmetic Act (1938) Harrison Narcotics Act (1914) International Narcotics Control Act (1989) Marihuana Tax Act (1937)

Guide to Related Topics  xix

Narcotic Addict Rehabilitation Act (1966) Narcotic Control Act (1956) Narcotic Drugs Import and Export Act (1922) National Minimum Drinking Age Act (1984) Opium Control Act (1942) Porter Narcotic Farm Act (1929) Pure Food and Drug Act (1906) Smoking Opium Exclusion Act (1909) Substance Abuse Services Amendments (1986) United States National Narcotics Control Act (1956) Violent Crime Control and Law Enforcement Act (1994) Volstead Act (Eighteenth Amendment) Webb-Kenyon Act (1913)

Marijuana/Medical Marijuana Campaign Against Marijuana Planting Cannabis Conant v. Walters Legalized Marijuana Marihuana Tax Act (1937) Marijuana Marijuana Businesses Medical Marijuana Oakland Cannabis Buyers’ Cooperative Reefer Madness THC Movies. See Entertainment Music Brown, Bobby Cobain, Kurt Electronic Dance Music (EDM/House Music) Grateful Dead Haight-Ashbury Hendrix, Jimi Hip-Hop and Drugs Jazz Culture

Jackson, Michael Joplin, Janis Popular Culture Presley, Elvis

People Alpert, Richard Anslinger, Harry J. Armstrong, Lance Barry, Marion S. Bennett, William Bias, Len Blanco, Griselda Brown, Bobby Bush, George H. W. Bush, George W. Clinton, Bill Cobain, Kurt Dai, Bingham Dole, Vincent Eisenhower, Dwight C. Elders, Joycelyn Escobar, Pablo Farley, Chris Ford, Betty Ford, Gerald R. Freud, Sigmund Ginsberg, Allen Guillot-Lara, Jaime Harrison, Francis Hendrix, Jimi Hoffman, Philip Seymour Hofmann, Albert Hoover, J. Edgar Jackson, Michael Jellinek, E. Morton Johnson, Lyndon B. Jones, Marion Joplin, Janis Jung, George Kennedy, John F. Koop, C. Everett Leary, Timothy Leonhart, Michele M.

xx   Guide to Related Topics

Lincoln, Abraham Lindesmith, Alfred McCoy, Bill Meese, Edwin Mullen, Francis Nadelmann, Ethan Nixon, Richard M. Noriega, Manuel Antonio Nutt, Levi G. Nyswander, Marie Obama, Barack Porter, Stephen G. Presley, Elvis Randall, Robert Reagan, Ronald, and Nancy Reagan Ruffin, David Rush, Benjamin Sertürner, Friedrich Shulgin, Alexander Smith, Robert “Dr. Bob” Holbrook Soros, George Terry, Luther Truman, Harry S. Vollmer, August Volstead, Andrew White, Walter Wilson, William “Bill” Griffith Wright, Hamilton

Prevention Drug Abuse Resistance Education (DARE) Intervention Prevention Drug-Free School Zones Research Centers for Disease Control and Prevention Drug Abuse Warning Network International Narcotics Research Conference Investigational New Drug Program National Clearinghouse for Drug Abuse Information and Education

National Council on Alcoholism and Drug Dependence National Household Survey on Drug Abuse National Research Council on Drug Enforcement Activities Substance Abuse and Mental Health Services Administration (SAMHSA)

Social and Cultural Issues African Americans and Drug Use Alcohol-Facilitated Sexual Assault Biological and Psychological Reasons for Substance Abuse Child Sexual Abuse and Substance Abuse Children of Alcoholics Codependency Counterculture and Drugs Domestic Abuse and Drugs Drug Intervention Programs Drug-Facilitated Rape Fetal Alcohol Syndrome (FAS) Intervention Hippies Latinos and Drug Use Military and Drug Use Native Americans and Substance Abuse Popular Culture Prison Inmates and Drug Use Public Opinion and Drug Use Recreational Use of Drugs Rural Drug Use Seniors and Drug Use Steroids in Baseball Steroids and Sports Women, Pregnancy, and Drugs Women, Victimization, and Substance Abuse Youth and Illicit Drug Use in the United States Temperance American Temperance Society Anti-Saloon League

Guide to Related Topics  xxi

Association Against Prohibition Amendment Eighteenth Amendment Prohibition Prohibition Party Prohibition Unit Temperance Volstead Act Woman’s Christian Temperance Union Women’s Organization for National Prohibition Reform (WONPR)

Tobacco Adolescent Tobacco Use Cigarettes Cigars Cipollone v. Liggett Group, Inc. et al. E-Cigarettes Master Settlement Agreement Nicotine Female Tobacco Use Secondhand Smoke Smokers’ Rights Tobacco Tobacco Institute Treatment Addiction Medications Al-Anon Ala-Teen Alcoholics Anonymous Alcohol Mutual Aid Societies Alternative Addiction Treatment American Society of Addiction Medicine

Betty Ford Center Cocaine Anonymous Drug Courts Drug Intervention Programs Harm Reduction Programs Hazelden Foundation Intervention LifeRing Mandatory Treatment Methadone Methadone Treatment Programs Minnesota Model Narcotics Anonymous Needle Exchange Programs Phoenix House Public Health Service Narcotic Hospitals Recovery Recovery Circles Synanon Treatment Twelve-Step Programs Urinalysis

Youth Adolescent Tobacco Use Child Sexual Abuse and Substance Abuse Electronic Dance Music (EDM/House Music) Hip-Hop and Drugs National Youth Anti-Drug Media Campaign Parents Resource Institute for Drug Education (PRIDE) Surveys Youths and Illicit Drug Use in the United States

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E circuit appeals court in January 2011, but the court chose not to review the decision. According to the FDA, any e-cigarette product that is marketed for therapeutic purposes can be regulated by the FDA Center for Drug Evaluation and Research. The FDA Center for Tobacco Products currently regulates cigarettes, cigarette tobacco, roll-yourown tobacco, and smokeless tobacco. In addition to federal legislation, many states have passed laws regarding electronic cigarettes. Many of the state laws prohibit sales of the product to minors. Other state legislatures are considering similar laws. There are many arguments in favor of electronic cigarettes. These products provide a smoker with the feeling that they are smoking: a deep inhale, something to do with their hands. But there is no tobacco and no smoke. Thus, the electronic cigarettes are safer not only to the smoker, but also to those in the same vicinity because there is no secondhand smoke. In the end this will save money, as the United States spends millions in public health costs each year. The e-cigarettes, while containing highly addictive nicotine, do not contain other compounds such as tar, carbon monoxide, and other toxic compounds that cause lung disease. There are some initial studies that show that the ecigarettes contain less nicotine than regular cigarettes. Because of that, the U.S. Cen­ ters for Disease Control and Prevention has stated that there is enough evidence to show that electronic cigarettes are less harmful than smoking. In fact, some initial research seems to show that electronic cigarettes may

E-Cigarettes E-cigarettes, “electronic cigarettes,” or “electronic delivery systems” are batterypowered devices that provide nicotine extract in a vaporized form to the user. The device uses a heating element that is hot enough to vaporize a liquid solution. The solution usually contains nicotine, but can also include flavorings. The solution is heated, vaporized, and inhaled by the user, similar to a traditional cigarette. Most e-cigarettes look like traditional cigarettes, but some do not. Because a user is not “smoking,” this is sometimes referred to as “vaping.” Electronic cigarettes have been on the market since the early 2000s. Because they are so new, their safety is still in question. When the products first appeared on the U.S. market, the Food and Drug Administration (FDA) classified them as drug delivery devices, and regulated them under the Food, Drug and Cosmetic Act. This decision was legally challenged, and in 2010 the federal district court judge Richard J. Leon overruled the FDA regulation. Instead, he ruled that e-cigarettes should be regulated as tobacco products. The decision was appealed to the U.S. Court of Appeals for the District of Columbia in March 2010. In the case, the FDA argued that e-cigarettes should be regulated by the FDA as are nicotine gum and patches. On December 7, 2010, the appeals court ruled against the FDA. They decided that electronic cigarettes should be regulated as tobacco products. The case was appealed to the District of Columbia

353

354  E-Cigarettes

E-cigarettes often look like tobacco cigarettes, but the user inhales water vapor that may include nicotine. The long-term safety of e-cigarettes has not been fully determined. (Pamela Panella/ Dreamstime.com)

actually help people quit smoking and may even be more effective than traditional pharmacotherapy, as the physical stimuli of holding and puffing on the electronic cigarette may be better at improving short-term craving. Moreover, at this point, electronic cigarettes are cheaper because they are not taxed as cigarettes (yet a tax could be imposed at any time). And smokers will not have to go outside to smoke, especially when it is cold or otherwise inconvenient. Smokers will be able to enjoy themselves at bars, restaurants, and even sporting events that are all now smoke-free. On the other hand, there is growing evidence that e-cigarettes are not as safe as first thought. Many of the electronic devices contain just as many harmful chemicals and compounds as cigarettes. There are concerns over the purity of the ingredients as well as the ease with which these devices can be modified to add more ingredients. At

this point, there is little regulation and oversight over the manufacturing process, marketing, or quality control. This raises many concerns about the safety of the product. As a result, many questions remain as to the overall safety of electronic cigarettes. This has prompted the attorneys general from 40 states to send a letter to the FDA asking to classify e-cigarettes as tobacco products, even though they do not contain any tobacco. Many local governments are considering banning them in the same locations where cigarette smoking is currently banned. Others argue that electronic cigarettes may be a gateway to cigarettes, meaning that those teenagers who use e-cigarettes will get addicted to the feeling of having a cigarette and will be more likely to use traditional cigarettes. This is even more a concern for those products that use large amounts of nicotine. Because the electronic cigarettes contain nicotine, many teens may get addicted to the drug.

Ecstasy (MDMA)  355

Because of the lack of evidence as to the harmfulness of the product, the World Health Organization issued a statement in July 2013 that noted that the effectiveness of electronic cigarettes in smoking cessation has not yet been demonstrated, and recommended that consumers not use the products until they have been proven safe. On the other hand, the American Association of Public Health Physicians recommended e-cigarettes as a safe alternative for people who are not able or willing to quit using tobacco. Nancy E. Marion See also: Cigarettes; Cigars; Nicotine; Tobacco

Further Reading Dale, Lowell. 2011. “What Are Electronic Cigarettes?” Mayo Clinic. http://www.mayoclinic.com/health/electronic-cigarettes/ AN02025. Eyb, Lynette. 2013. “The Global Battle over E-Cigarettes.” Global Post, December 26. http://www.salon.com/2013/12/26/the_ global_battle_over_e_cigarettes_partner/. Holmes, Rick. 2013. “E-cigarettes: Savior or Menace?” MetroWest Daily News, December 15. http://www.metrowestdailynews .com/editorspick_mobile/x915453088/Hol mes-E-cigarettes-Savior-or-menace. Sohn, Emily. 2011. “How Safe Are E-Cigarettes?” ABC News, January 30. http://abcnews.go.com/Technology/safe -cigarettes/story?id=12789204. U.S. Food and Drug Administration, Department of Health and Human Services. “Electronic Cigarettes.” http://www.fda .gov/NewsEvents/PublicHealthFocus/ucm 172906.htm.

Ecstasy (MDMA) Closely related to methamphetamine in terms of its chemical composition, 3,4-meth-

ylenedioxymethamphetamine (MDMA), or Ecstasy, is an illegal, synthetic hallucinogen that has become a commonly used drug among young people, many of whom falsely believe it is safe. Users of the drug feel a sense of euphoria and sensual arousal. There is also an energizing effect after ingesting the drug that can last from three to four hours. It is estimated that 18 million people around the world take Ecstasy, making it a $65-billion-dollar-a-year industry. Ecstasy was first synthesized in Germany in 1912. As a recreational drug, MDMA first became available in the United States in the 1970s after the psychiatric community discovered its value in treating patients. The drug was usually imported from clandestine labs found in European or Canadian laboratories, although a few U.S. labs have started to manufacture the drug as well. The drug soon became popular among adolescents who attended weekend-long raves or nightclubs. Its use increased steadily for several years, but then began to level off among high school students. Other reports show it is increasingly used by African Americans in their twenties and thirties and by college students. There is also evidence that gay and bisexual males are using Ecstasy to a greater degree, raising concerns that this could lead to high-risk sexual activities that increase the chances of spreading sexually transmitted diseases. Ecstasy is usually marketed with colorful logos as a way to appeal to young users. The typical dosage is one tablet or capsule, and the pills ranges from 50 to 200 milligrams. The usually cost only about $10 a pill— making it a very cheap drug to use. The drug can also be snorted as a powder. The use of MDMA was on the decline for a short time, but has recently surged again with the rise of a new powdered form of the drug known as “Molly.” Once ingested, the drug takes about 30–60 minutes to work, or to “come up.”

356   Ecstasy (MDMA)

The drug is often mixed with other psychoactive adulterants such as caffeine, cocaine, or dextromethorphan. By making slight modifications to the basic chemical structure of the drug, several other psychoactive chemicals can be made—such as MDA (3,4-methylenedioxyamphetamine), MDEA (3,4-methylenedioxyethylamphetamine), and PMA (para-methoxyamphetamine)— that can vary considerably in potency and action. This makes the drug highly dangerous, particularly if users mix it with other drugs such as marijuana or alcohol, as they frequently do. Because of this, thousands of people have died from using it. After the use of Ecstasy seemed to level off in the early 2000s, MDMA abuse again appears to be on the rise, with the Drug Abuse Warning Network reporting a 123 percent increase in emergency room visits related to MDMA between 2004 and 2009, in line with an overall increase in hospitalizations due to hallucinogen use. Most recently, a form of the drug thought to be almost entirely pure (although this is often far from the case) called Molly has become extremely popular in the nightclub and music festival scenes. A slang term for the chemical composition, MDMA, Molly is said to be composed of pure MDMA, but as with many synthetic drugs these claims are often false. Another concern with this novel form of the drug is similar to earlier concerns with Ecstasy tablets: the environment in which the drug is taken. Concert venues and nightclubs filled with people, combined with the inability of the drug user to regulate their own body temperature after ingesting MDMA, can easily result in overheating, brain damage, or even death. The drug comes from the oil found in sassafras trees from Southeast Asia. The trees are chopped down, and the roots taken to secret labs where the oil is removed. It is then shipped to other labs in China and other

locations (even other countries) to be made into Ecstasy. The lab required to make the drug can be very small, even in a home. But they can also be very dangerous, as many volatile chemicals are needed. A Schedule I drug under the Controlled Substances Act, Ecstasy causes the brain to flood with serotonin, or the body’s “happy chemical.” Thus, the drug can make the user feel euphoric. At the same time, the drug interferes with the body’s ability to regulate its internal temperature, leaving users vulnerable to overheating, dehydration, and organ damage. The drug may also resist metabolizing within the body, meaning that it builds up in the body. The drug can accumulate to toxic levels in a short period of time. Since Ecstasy is chemically similar to stimulants such as cocaine, a user will commonly clench his or her jaw and experience blurred vision as well as a fast heart rate and elevated blood pressure. The psychological effects of Ecstasy include anxiety and depression that may exist long after the user has stopped using the drug. Research in animals indicates that Ecstasy is a neurotoxin that can cause long-term damage to brain circuitry, particularly serotonin neurons. Many scientists believe that the drug could have the same effect on human neurons. However, in very carefully regulated doses, it has been shown to have potential in treating those patients who suffer from posttraumatic stress disorder (PTSD). Research and study trials into the effects of Ecstasy are still ongoing. Even though the government has decided that Ecstasy has no viable medical purpose, it is sometimes used secretly for psychotherapy. Patients, under the guidance of their doctors, take a pure form of MDMA. The therapy seems to work well for soldiers suffering from PTSD. Those addicted to Ecstasy find it very difficult to stop using the drug, especially

Eighteenth Amendment 

if they have been using it for a long time. Most often, a user will need some kind of treatment program to help them refrain from further use. Since Ecstasy affects the level of serotonin in the body, some long-term users of the drug have reported that they are unable to feel happy without using the drug. This makes them want to continue their use of the drug. On a different level, Ecstasy is often taken in social situations, and it is difficult to refuse to take the drug when others are. Treatment options for those addicted to Ecstasy should begin with a detoxification program to rid the body of the drug. Withdrawal symptoms for Ecstasy include fatigue, loss of appetite, depression, and trouble with concentration. After the detoxification is complete, a user will typically require some other treatment to prevent them from using the drug again. This can be behavioral treatment programs or support groups. There are no pharmacological treatments for Ecstasy. That being said, those found to be in possession of Ecstasy can be sentenced to a prison term of up to one year. The drug goes by a number of street names, including Adam, Beans, Hug, Love Drug, MBDB, MDEA, Molly, X, and XTC. Kathryn H. Hollen

Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books.

See also: Controlled Substances Act; Designer Drugs

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. 2011. “National Estimates of Drug-Related Emergency Department Visits.” http://samhsa.gov

Further Reading Abadinsky, Howard. 2010. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Wadsworth Publishing. Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale.

Kuhn, Cynthia, Scott Swartzwelder, Wilkie Wilson, with Leigh Heather Wilson and Jeremy Foster. 2008. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. New York: Norton. Miller, Malinda. 2013. Ecstasy: Dangerous Euphoria. Broomall, PA: Mason Crest. Schroeder, Brock E. 2004. Ecstasy. Philadelphia: Chelsea House Publishers. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. Research Report Series: Hallucinogens and Dissociative Drugs. NIH Publication No. 01-4209, March 2001. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006. Research Report Series: MDMA (Ecstasy) Abuse. NIH Publication No. 06-4728. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www .samhsa.gov.

U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Eighteenth Amendment The Eighteenth Amendment to the U.S. Constitution, which created Prohibition, was passed by Congress on December 18, 1917, then ratified by 36 states on January

357

358   Eighteenth Amendment

16, 1919. The law became effective one year later on January 16, 1920. The amendment made the sale, manufacture, and distribution of alcohol illegal, a social experiment on a national scale that would last for 13 years before being repealed by the Twenty-First Amendment in 1933. The effects of prohibition continue to be debated through the present day, resurfacing most prominently in the current debate on drug policy and the merit of harm-reduction approaches versus outright prohibition of drugs. Some would argue that the Eighteenth Amendment was the result of one social class dominating over another social class and imposing their mores on them. They point out that the temperance movement was supported by native-born, middle-class, rural Protestants who were threatened by the workingclass immigrants coming to the United States and settling in the cities at the time. These immigrants, particularly German, Irish, and Italian, brought with them and continued long-standing drinking practices, despite the Protestant norms against them. Prohibition was a way for “White Anglo-Saxon Protestants” to impose behavioral norms on the immigrants. The prohibitionists claimed that alcohol was the cause of much of the poverty in the United States. It also caused moral degeneracy, broken homes, and unemployment. On October 28, 1919, members of Congress passed the Volstead Act, over President Woodrow Wilson’s veto. The act, named after Andrew Volstead, the Minnesota congressman who introduced the legislation, provided details for the implementation of the Eighteenth Amendment. The act detailed penalties and put the IRS in charge of investigating and charging anyone who violated Prohibition. President Hoover described Prohibition as a “noble experiment” and for the most part

supported it. However, he was embarrassed by the increasing crime associated with it. To end the violence, he put out an order to “get” Al Capone, the head of the underground crime organization in Chicago. Franklin D. Roosevelt, as a candidate for a second term as governor of New York before becoming the next president, called for a repeal of the Eighteenth Amendment and Prohibition. He sought to allow states the option of allowing consumption of alcohol. It was Roosevelt who signed legislation to end Prohibition in America. The amendment itself was rather short, and consisted of only three short sections. In Section 1, the manufacture, sale, or transportation of intoxicating liquor was made illegal, as was the importation and exportation of alcohol into and out of the United States and all of its territories. Section 2 mandated that Congress and the states both had the power (concurrent power) to enforce the law. The final section informed people that the amendment would become effective upon ratification by enough states within seven years. The Eighteenth Amendment was repealed by the Twenty-First Amendment in 1933. During the time it was in effect, there was a nationwide increase in crime, violence, corruption, and death. It also resulted in the expansion of organized crime groups across the nation. Nancy E. Marion See also: Prohibition; Prohibition Unit; Volstead Act

Further Reading Engdahl, Sylvia. 2012. Prohibition. Detroit: Greenhaven Press. Gordon, Ernest B. 1943. The Wrecking of the Eighteenth Amendment. Francestown, NH: Alcohol Information Press.

Eisenhower, Dwight D. (1890–1969)  359 Gusfield, Joseph R. 1963. Moral Crusade: Status Politics and the American Temperance Movement. Urbana: University of Illinois Press. Hamm, Richard F. 1999. Shaping the Eigh­ teenth Amendment: Temperance Reform, Legal Culture and the Policy, 1880–1920. Boulder, CO: NetLibrary. Mappen, Marc. 2013. Prohibition Gangsters: The Rise and Fall of a Bad Generation. New Brunswick, NJ: Rutgers University Press. Peck, Garrett. 2009. The Prohibition Hang­ over: Alcohol in America from Demon Rum to Cult Cabernet. New Brunswick, NJ: Rutgers University Press.

Eisenhower, Dwight D. (1890–1969) Born in 1890 in Texas, Dwight D. Eisenhower served as the 34th president of the United States from 1953 to 1961. The Eisenhower administration was notable for its strong antidrug policies. Precedent for such policies had been set by the time Eisenhower entered office in 1953 with the 1951 passage of the Boggs Act, which established the first federal mandatory minimum sentences in drug-related cases. During his presidency, Eisenhower signed into law enhancements to the Boggs Act and a multitude of states adopted measures similar to those at the federal level. In 1956, President Eisenhower signed into law the Narcotic Control Act, furthering the mandatory minimum sentencing policy of the earlier Boggs Act, as well as establish the use of the death penalty for certain drug offenses. On November 27, 1954, President Eisenhower took time out of a golfing vacation he was enjoying in Georgia to demand a “new war on narcotics addiction at the local, na-

tional and international level.” In order to learn more about the addiction problem, Eisenhower then appointed a special cabinet committee composed of five members that would be responsible for coordinating a national campaign against illegal narcotics across the United States. The committee was given the task of conducting a national survey of both addiction and law enforcement needs. In 1953, Eisenhower signed H.R. 3307 (PL 83-76) that would provide for the treatment of those living in the District of Columbia who used narcotics regularly. This measure, for the first time, made a civil procedure for the commitment of narcotic drug users in hospitals for treatment and rehabilitation rather than terms in a prison. Eisenhower believed this legislation was the first step toward addressing the problem of drug addiction in the nation. At the same time, the president understood that the country was in need of additional treatment programs geared toward controlling drug abuse. In 1955, he talked about the importance of the international approach to the traffic in narcotics and the need for increased cooperation with state and local agencies necessary to combat additional narcotic addicts. During his presidency, overall illegal drug use levels remained relatively low compared with the next decade. During this time, however, the rise of amphetamine, barbiturate, and heroin use began to cause alarm in many quarters. To combat this, the federal government under Eisenhower pursued a policy of deterrence. Penalties for illegal drug use were high, with the intent of dissuading potential users from continuing. Whether or not this tactic works is still a topic of disagreement among those in the legal field. Nancy E. Marion

360   Elders, Joycelyn (1933– )

Further Reading Eisenhower, Dwight D. 1954. “Letter to Heads of Departments Constituting the Interdepartmental Committee on Narcotics.” November 27. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=10145. Gill, Molly M. 2008. Correcting Course: Lessons from the 1970 Repeal of Mandatory Minimums. Washington, DC: Families Against Mandatory Minimums. Kleiman, Mark, and James Hawdon. 2011. Encyclopedia of Drug Policy. Thousand Oaks, CA: Sage Publications. Shaffer, H. B. 1956. Control of Drug Addiction. Washington, DC: CQ Press. http:// library.cqpress.com.

Elders, Joycelyn (1933– ) Born in Arkansas in 1933, Joycelyn Elders was the 16th surgeon general of the United States and the first African American to be appointed to that position. The U.S. surgeon general is the head of the U.S. Public Health Service Commissioned Corps and is responsible for overseeing the general public’s overall health. The surgeon general answers to the assistant secretary for health, who in turn is a principal advisor to the secretary of health and human services. It is the responsibility of the surgeon general to educate the public about better lifestyle choices, or to issue warnings about products that could be dangerous to consumers.

Dr. Joycelyn Elders, former U.S. surgeon general, speaks in favor of a legislative proposal during a hearing of the House Committee on Public Health, Wealth, Welfare and Labor in 2003. The bill would allow for the medical use of marijuana. (AP Photo/Mike Wintroath)

Electronic Dance Music (EDM/House Music)  361

Appointed by President Bill Clinton in January of 1993 and confirmed in September of that year after a lengthy confirmation process, Elders served for only a brief period of time and resigned amid controversy due to her progressive views on topics such as the role of contraceptives in sexual education and drug legalization. Prior to becoming surgeon general, Elders served in the U.S. Army and then attended medical school in her home state of Arkansas. Upon graduating from medical school, Elders practiced in Arkansas with a focus on pediatric endocrinology. Acting as the surgeon general from 1993 to 1994, Elders was in favor of medical marijuana. She said, “The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting and other symptoms caused by such illnesses as multiple sclerosis, cancer and AIDS—or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day.” Joycelyn Elders’s short tenure as surgeon general of the United States was punctuated by two controversies that ultimately led to her dismissal from the post in December of 1994. First among these was her statement that drug legalization should be considered with other options to help curb urban violence. The timing of this statement, just days before her son was arrested for selling cocaine to an undercover police officer, caused even more criticism from the right once her son’s arrest became public. The second remark, and the one that ultimately led President Clinton to fire her, was given at a UN conference on HIV/AIDS. When asked if masturbation should be considered as an option to prevent the spread of HIV and other sexually transmitted disease,

Elders answered in the affirmative, and she was forced to resign shortly thereafter. Nancy E. Marion See also: Clinton, Bill; Medical Marijuana

Further Reading “Biography, Dr. M. Joycelyn Elders.” National Library of Medicine, National Institutes of Health. http://nlm.nih.gov. Elders, M. Joycelyn, and David Chanoff. 1996. Joycelyn Elders, M.D.: From Sharecropper’s Daughter to Surgeon General of the United States of America. New York: Morrow. “Joycelyn Elders (1933–).” Encyclopedia of Arkansas History and Culture. http:// encyclopediaofarkansas.net. “M. Joycelyn Elders (1993–1994).” SurgeonGeneral.gov, U.S. Department of Health & Human Services. surgeongeneral.gov/ about/previous/bioelders.html. “Myths About Medical Marijuana.” 2004. Providence Journal, March 26. http://www .november.org/stayinfo/breaking2/Elders .html.

Electronic Dance Music (EDM/ House Music) EDM is a particular genre of music that has struggled to gain a large foothold in the United States. Although it has been popular in Europe for years, the genre is just now finally starting to gain popularity in American colleges and radio stations. While Americans often associate rap and rock music with drugs, EDM has a perceived drug culture that many people believe rivals the other two genres. The genre has become associated with the rave scene, which has also been long associated with drugs. For most festival followers

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around the world, MDMA, also known as Ecstasy (“X”), “Molly,” and other terms, has become the drug of choice. At these raves it is easy to find X, and many people take advantage of the drug’s availability. Many people choose to take the drug for the energy rush it provides, which allows them to dance for many hours. Other drugs are also commonly associated with electronic dance music. These include acid (LSD), ketamine, cocaine, and others. The number of reported incidents of drug consumption has increased rapidly within the EDM culture in the last decade. Users report that the drugs help them feel the music and makes dancing for long times more enjoyable. This drug problem recently became public at a September 2013 Electric Zoo festival in New York after two people died. Afterwards, the New York City medical examiner determined that one of the two deaths at the festival was caused by a chemical other than Ecstasy ingested by the user. The deceased was Jeffrey Russ, 23 years old. His death, according to the coroner, was caused in part by his use of methylone, a chemical frequently found in “bath salts” and “Molly.” His death, along with other medical emergencies, forced the festival to cancel its third and final day. Methylone was also suspected in the deaths of concertgoers at a Zedd show in Boston. Toxicology results showed that one young woman died as the result of acute intoxication after taking pure MDMA. Because of repeated incidents of drug use and injuries and deaths resulting from the drug use, the EDM genre has started to make young people aware of the dangers of drug use. A nonprofit educational organization created Dancesafe.org, and decided to cooperate with a popular promo/apparel company, Rave Ready, to take a stand against drugs at these events. On the Rave Ready Web site, customers are now able to purchase a Dance­

Safe Adulterant Testing Kit. These are not designed as a way to determine the potency of the drugs, but are designed to educate users about the true contents of the drugs, the potential dangers of the drugs, and how to ingest substances safely and carefully. The goal of the organization is to help users make better choices. Volunteers from the groups set up informational booths at EDM events and educate attendees about the harm of taking drugs like Ecstasy and Molly. DJs and others who are part of the EDM genre are trying to change its image and show that the genre should not be associated with drugs, as it currently is. Swedish DJ and EDM producer Sebastian Engrosso has said that drugs are a problem throughout youth culture, and EDM is just a part of that youth culture. The DJ Kaskade took to Twitter after the University of Massachusetts canceled two EDM concerts (Above & Beyond and Pretty Lights) because of the genre’s connection with recent drug deaths. UMass had canceled another concert five days earlier as well—Return to Fantazia was scheduled to perform on September 21. Kaskade contended excessive alcohol at big events such as professional football games also pose danger, yet they weren’t cancelled. Finally, well-known DJ and performer Zedd, who had a person die of a drug overdose at one of his concerts, had this to say about drugs and EDM: “I don’t do drugs, so I would just tell people not to do it. That’s the safest way to enjoy music—enjoy the music, and use that as your drug and not any other substances. If you take drugs, you’re very egotistic, because besides your life, you might ruin a lot of other people’s lives— families and friends who will really suffer from what could happen” (Lancaster 2013). Adam Stilgenbauer See also: Bath Salts and Synthetic Cannabis; Cocaine and Crack; Ecstasy; Ketamine

Employment Division, Department of Human Resources of Oregon v. Smith (1990)  363

Further Reading DanceSafe.Org: Drug Information and Harm Reduction Resources. DanceSafe: Promoting Health and Safety Within the Rave and Night Club Community. http://www.dance safe.org/. DeuPree, H. 2013. “EDM Culture: It’s Time to Talk About the Drugs.” Magnetic, October 3. http://www.magneticmag.com/2013/10/ edm-culture-its-time-to-talk-about-drugs/. Lancaster, E. 2013. “Afrojack, Kaskade and More DJs Insist Molly Has Nothing to Do with EDM: Sebastian Ingrosso and Flosstradamus Tell MTV News Drug Abuse Also Has Connections to Cultures Like Frat Parties and Football Games.” MTV. http://www . m t v. c o m / n e w s / a r t i c l e s / 1 7 1 4 7 9 7 / molly-edm-afrojack-kaskade.jhtml. Mason, K., and Z. McCarthy. 2013. “Dancing with Molly: The EDM Community Has an Honest Conversation about Drugs.” Billboard. http://www.billboard .com/articles/columns/code/5719296/ dancing-with-molly-the-edm-communityhas-an-honest-conversation-about. NIDA for Teens. 2014. “Drug Facts: MDMA (Ecstasy or Molly).” http://teens.drugabuse .gov/drug-facts/mdma-ecstasy-or-molly. Sanchez, M. “Beats, Drugs and EDM: DJ Culture and Dance Music Demystified.” Song Writing: Musical Musings from Journalists, Authors, and Members of the Songwriting Community. http://www.songfacts.com/blog/ writing/beats_drugs_and_edm_dj_culture_ and_dance_music_demystified/.

Employment Division, Department of Human Resources of Oregon v. Smith (1990) Alfred Smith and Galen Black were fired from their counseling jobs at a drug rehabilitation clinic for using peyote, a hallu-

cinogenic drug, for religious purposes at a function in a Native American church. The State of Oregon refused to provide them with unemployment compensation under a state law that disqualifies those who have been fired because of misconduct. The case, 494 U.S. 872 (1990), had a long history in the courts. The Oregon Court of Appeals reversed the ruling of the Employment Division on First Amendment free exercise of religion grounds; the Oregon Supreme Court agreed in result, though on the alternative argument that the weight of the burden on religious practice outweighed the state’s justification that the law preserved the integrity of the worker’s compensation fund. On appeal, the U.S. Supreme Court vacated the decision (485 U.S. 660 [1988]). The U.S. Supreme Court refused to decide whether the free exercise clause protected Smith’s peyote use and instead chose to remand to the Oregon Supreme Court to determine if sacramental use of the drug violated Oregon’s drug laws. On remand, the Oregon Supreme Court found that although state law did prohibit the religious use of illegal drugs, the free exercise clause rendered that prohibition invalid. The state again appealed to the U.S. Supreme Court, which would hear the case for the last time. Justice Scalia, with whom Justices Rehnquist, White, Stevens, and Kennedy joined, wrote the opinion of the court reversing the Oregon Supreme Court. Beginning by separating religious beliefs, which are protected, from religious acts, Scalia differentiates laws that affect those acts. Noting that the free exercise clause invalidates laws that expressly prohibit acts of a solely religious purpose, he concludes that the clause does not protect acts that violate otherwise generally applicable laws not directed at religious practice.

364   Employment Division, Department of Human Resources of Oregon v. Smith (1990)

In particular, he said that the free exercise clause only barred application of neutral laws when it coincided with the potential violation of some other communicative or parental right. Smith had argued that claims for religious exemption from laws were rightfully evaluated under a balancing test that required that there be a compelling governmental interest in substantially burdening religious practice (Sherbert v. Verner, 374 U.S. 398 [1963]). Characterizing this test as solely applicable to unemployment compensation matters where individualized assessments were permitted by legislative design, Scalia indicated that the penal law could not be so individualized and that the test was therefore unusable. In closing, he argued that although generally applicable laws might disproportionately harm minority religions, it is in the nature of a democratic government, which decides on religious exemptions as it chooses, that this should be so. Justice O’Connor wrote a concurrence in which she approved of the judgment, but not with its reasoning—Justices Marshall, Brennan, and Blackmun joined in her disapproval of Scalia’s opinion (parts I and II of the concurrence), but not with the judgment (part III). In the concurrence, O’Connor commented that Scalia had disregarded free exercise precedent, particularly Wisconsin v. Yoder, where belief and action were held indistinct and therefore both presumptively protected (406 U.S. 205 [1972]). O’Connor further noted that the First Amendment applied to all laws, not merely laws targeting specific religious practices, and that the compelling interest test was the correct test to use. The distinctions Scalia had made regarding the restriction of the free exercise clause to cases of unemployment compensation only and his limitation of the clause to necessarily coincide with potential violations of other rights—these she reasoned

were invalid. Finally, she disagreed with Scalia’s premise that restrictions on the rights of those practicing minority religions were a necessary result of democracy by noting that the founders intended that the First Amendment should shield as many divergent opinions as possible. Despite her disagreement with Scalia’s opinion, O’Connor came to the same judgment. Using the compelling interest test, she determined that Oregon had a compelling interest in controlling drugs. O’Connor then determined, on the issue of whether an exemption would unduly interfere with Oregon’s interest, that uniform application of the law was essential to accomplishing its purposes and that accommodation by Oregon was not required. Dissenting to Scalia’s opinion, Justice Blackmun, along with Justices Brennan and Marshall, first noted the correctness of O’Connor’s defense of the compelling interest test. Blackmun viewed Oregon’s interest more narrowly—instead of a broad interest in the war on drugs, Oregon had only a narrow interest in refusing to make a religious exception. Since Oregon had not stated its grounds for this interest in concrete terms, Blackmun thought that it was symbolic only and insufficient to outweigh the need to secure individual religious freedom. Further, the church forbade nonreligious use of peyote and had advocated values congruent with what Oregon sought to promote through its laws. Finally, the existence of religious exceptions elsewhere negated the state’s argument that an exception would fatally undermine the uniform application of the drug law. Neither the public nor Congress agreed with the outcome of the case, and the latter passed the Religious Freedom Restoration Act (RFRA) in 1993 (42 U.S.C.A. § 2000bb). The RFRA meant to restore the compelling interest test. The Supreme Court,

Energy Drinks  365

however, constrained the act to the federal government only (City of Boerne v. Flores, 521 U.S. 507 [1997]). In response, Congress passed the Religious Land Use and Institutionalized Persons Act in 2000, which retained the compelling interest test for land use regulations (42 U.S.C.A. § 2000cc). Nancy E. Marion See also: Mescaline; Peyote

Further Reading “Employment Division, Department of Human Resources of Oregon, et al., Petitioners v. Alfred L Smith et al.” Legal Information Institute. http://www.law.cornell.edu/ supremecourt/text/494/872. “Employment Division v. Smith.” Oyez. http:// www.oyez.org/cases/1980-1989/1989/ 1989_88_1213/. “Employment Division, Department of Human Resources of Oregon v. Smith.” CaseBriefs. com. http://www.casebriefs.com/blog/law/

constitutional-law/constitutional-law -keyed-to-cohen/religion-and-the-constitution/employment-division-department-of -human-resources-of-oregon-v-smith-2/.

Energy Drinks Energy drinks are a type of beverage that are often marketed as safe and effective means of increasing energy levels, improving mental function, and losing weight. Most brands of energy drinks contain high levels of caffeine, sweeteners, vitamins, and herbal supplements. Since many energy drinks are marketed not as beverages, but as dietary supplements, the U.S. Food and Drug Administration (FDA) has no regulatory oversight of the safety of the ingredients. This means that energy drinks that are classified as dietary supplements are not legally required to disclose the total amount of caffeine on product labels. Often when lev-

Examples of energy drinks now popular with many people. These drinks provide users with extreme amounts of sugar and caffeine to provide a quick jolt of energy. They have also been linked to heart palpitations and even death in some users. (Showface/Dreamstime.com)

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els of caffeine are listed, the amount of caffeine found in some of the ingredients (e.g., guarana and yerba maté) is not included. Although caffeine is a common dietary substance worldwide—i.e., it is found in coffee, tea, cola, and chocolate—many do not think of it as a drug. In reality, caffeine alters performance, is addictive, and is toxic at high concentrations. For healthy adults, a daily dose of no more than 400 milligrams of caffeine is generally considered safe; a regular 8-ounce cup of coffee contains between 100 and 200 milligrams of caffeine. For children and teens, however, the consumption of caffeine is highly discouraged, especially in the form of energy drinks. Some reports have shown that up to half of children and young adults in the United States consume energy drinks or energy shots. These beverages may contain three to five times the caffeine found in a can of soda of an equivalent size. A 2013 Substance Abuse and Mental Health Services Administration (SAMHSA) report indicated that the number of emergency room visits involving energy drinks had doubled between 2007 (approximately 10,000 visits) and 2011 (more than 20,000 visits). Symptoms included arrhythmia, increases in blood pressure, and, in rare cases, cardiac arrest. These hospital visits were precipitated by either the use of energy drinks alone or from a combination of energy drinks and pharmaceuticals (e.g., Adderall, Ritalin), alcohol, or illicit drugs (SAMHSA 2013). A study published in the February 2013 issue of Pediatrics in Review provides a summary of existing research and concludes that beverages laden with caffeine can cause rapid heartbeat, high blood pressure, obesity, and other medical problems in teens. The authors note that when combined with alcohol the potential harm posed by energy drinks can be severe. The study cites surveys

that suggest that the teens who consume energy drinks are often in search of a hefty dose of caffeine to help them wake up, stay awake, or to simply get a caffeine buzz. The researchers explained that energy drinks are often served cold or with ice, which makes them easier to drink more quickly than hot coffee. Of increased concern is the mixing of energy drinks with alcohol. A survey of students at 10 universities in North Carolina indicated that 25 percent had consumed a mixture of energy drinks and alcohol within the past month. In 2010, 23 college students in New Jersey and nine college students in Washington were hospitalized after drinking an energy drink and alcohol cocktail. An unnamed alcoholic energy drink contains the equivalent of six beers and five cups of coffee in a 23.5-ounce can. Studies on the negative effects of energy drinks are often disputed by the American Beverage Association (ABA), which counts energy drink manufacturers among its members. The ABA maintains that energy drinks contain roughly half the amount of caffeine found in a similar size serving of coffeehouse coffee, and has issued a recommendation that total caffeine amounts should be clearly stated on package labels along with a warning that consumption of energy drinks is not recommended for children, women who are pregnant or nursing, and people who have a sensitivity to caffeine. Stacy O’Hara Leiter See also: Caffeine; Four Loko

Further Reading American Academy of Pediatrics. 2011. “Sports Drinks and Energy Drinks for Children and Adolescents: Are They Appro­ priate?” Pediatrics 127(6): 1182–89. http:// pediatrics.aappublications.org/content/127

Engle v. R. J. Reynolds (2000)  367 /6/1182.full?sid=1af2837a-6401-426a -a9fa-cc73b9321c39. Health Day News. 2013. “Energy Drinks Pose Risks to Teens, Study Finds.” February 1. http://www.healthfinder.gov/News/Article .aspx?id =673034. Heneman, K., and S. Zidenberg-Cherr. “Nutrition and Health Info-Sheet for Health Professionals: Some Facts about Energy Drinks.” http://cns.ucdavis.edu/content/ FactSheets/EnergyDrinks.pdf. Malinauskas B. M., V. G. Aeby, R. F. Overton, et al. 2007. “A Survey of Energy Drink Consumption Patterns among College Students.” Nutr J 6: 35–42. Seifert, S. M., J. L. Schaechter, E. R. Hershorin, et al. 2011. “Health Effects of Energy Drinks on Children, Adolescents, and Young Adults.” Pediatrics 127(3): 511–28. Society for Cardiovascular Angiography and Interventions. “Energy Drinks and the Heart: Know the Risks.” http://www .scai.org/SecondsCount/Disease/detail.aspx ?cid=135410fb-a293-43e0-82c6-ec0bcc 47125f. Substance Abuse and Mental Health Services Administration. 2013. “Update on Emergency Department Visits Involving Energy Drinks: A Continuing Public Health Concern.” The DAWN Report. http://www. samhsa.gov/data/2k13/DAWN126/sr126 -energy-drinks-use.htm. U.S. Food and Drug Administration. 2012. “Dietary Supplements.” http://www.fda.gov /Food/DietarySupplements/default.htm. Wolk, B. J., M. Ganetsky, and K. M. Babu. 2012. “Toxicity of Energy Drinks.” Current Opinion in Pediatrics 24: 243–51.

Engle v. R. J. Reynolds (2000) Howard A. Engle, M.D. et al. v. R. J. Reynolds Tobacco et al., generally known as “the

Engle case,” was a class-action lawsuit filed in 1994 on behalf of all Floridians injured by, or addicted to, cigarettes. The Engle case was the first class-action suit against the tobacco industry that went to trial, the first class-action suit against the tobacco industry to go to verdict, and the longest trial in the history of civil litigation, and it also featured the largest figure for punitive damages ($145 billion) in legal history. These punitive damages were eventually overturned by the Florida Supreme Court, but the court still maintained the jury’s verdict that the tobacco companies were responsible for smokingrelated diseases. Upon being filed in 1994 in Dade County, Florida, the Engle case stated an initial intent to sue the tobacco companies on behalf of addicted smokers throughout the country. This massive scope was diminished by the Third Circuit Court of Appeals, which ruled that the suit could only be brought in the name of Florida’s smokers. Though limited to Floridians, the Engle case was still estimated to cover approximately 700,000 ill smokers in the state and their heirs. The Engle case was filed by Stanley and Susan Rosenblatt, a Miami-based, husbandand-wife legal team that previously led another major class-action lawsuit against the tobacco industry. In Broin v. Philip Morris, the Rosenblatts filed suit on behalf of Norma Broin, an American Airlines flight attendant who had never smoked but still contracted lung cancer at an early age, and approximately 60,000 other nonsmoking flight attendants who sought roughly $5 billion in redress from big tobacco as a result of illnesses and injuries suffered from their exposure to secondhand smoke. Facing a difficult case, the tobacco companies avoided admitting to secondhand smoke’s health risks to nonsmokers by settling, out of court, to the tune of a $349 million settle-

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ment, which consisted of $49 million for the Rosenblatts’ fees and $300 million to fund a research center dedicated to smoking-related illnesses or diseases. When the Rosenblatts filed the Engle case, therefore, they had experienced success in suing the tobacco industry, but they had not yet brought a class-action lawsuit against tobacco to trial. The Engle case would constitute the first class-action suit against the tobacco industry to make it to trial, and the judge presiding over it determined that it would be tried in three separate phases. The first stage of the Engle case concluded in July 1999, when the jury ruled that the tobacco companies were liable for punitive damages as a result of making a defective product that caused a variety of serious illnesses, including lung cancer. When the jury further concluded that the tobacco industry committed fraud, misrepresentation, and breach of warranties, it was clear that big tobacco’s oft-repeated claim—that science had not proven a link between smoking and cancer—no longer held water with the American public. The second and third phases of the Engle case dealt with determining the amount of money the plaintiffs should receive after the jury initially found the tobacco industry liable. After a very long process, the jury granted the plaintiffs approximately $145 billion in punitive damages, which constituted the largest punitive damages award in the nation’s history by a very large margin. As a point of reference for this massive figure, the largest punitive damages awards prior to the Engle case came in the wake of the Exxon Valdez oil spill in Alaska. For that disaster, Exxon was found liable for $5 billion in damages. But the Engle case was history-making not just because of this extremely large payout, though, for the $145 billion was not awarded to the

plaintiffs until July of 2000, thus making the case the longest trial in the history of civil litigation. In response to this historic verdict, the tobacco companies argued that such a large monetary award could bankrupt the industry. The Florida State legislature consequently agreed to cap awards at $100 million per defendant. The tobacco companies ultimately paid even less than that to the plaintiffs, as in May 2003, the Third District Court of Appeals decertified the class-action suit and revoked the $145 billion award. The plaintiffs appealed to the Florida Supreme Court, which in July 2006 agreed with the Third District Court of Appeals, thus nullifying the punitive damages award. The Florida Supreme Court did, however, determine that the findings of the jury in phase one of the lawsuit were valid and binding, and that individual plaintiffs could pursue litigation on those grounds. That meant that although big tobacco had avoided paying $145 billion in punitive award damages, the Engle case legally established the tobacco industry’s liability for selling a defective, dangerous, and addictive product. As a result, the Engle case paved the way for individual suits against the tobacco industry that, unlike Cipollone v. Liggett Group, Inc. et al., had good chances of success. Howard Padwa and Jacob A. Cunningham See also: Cipollone v. Liggett Group, Inc., et al.; Secondhand Smoke; Tobacco

Further Reading Alters, Sandra. 2007. Alcohol, Tobacco, and Illicit Drugs. Detroit: Gale. “Behind the Smoke Screen: Facts about Tobacco Use.” 2005. New York: Films Media Group. Brandt, Allan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly Persistence of

Entertainers and Drug Use  369 the Product That Defined America. New York: Basic Books. Cordry, Harold V. 2001. Tobacco: A Reference Handbook. Santa Barbara, CA: ABC-CLIO. Goodman, Jordan, ed. 2005. Tobacco in History and Culture: An Encyclopedia. Detroit: Thomson Gale.

Entertainers and Drug Use The entertainment media, including books, movies, and television, commonly portrays drug use. It began with a movie called Reefer Madness in 1938 that was intended to show young people the dangers of marijuana use, which has become a cult classic among followers. Since then, there have been many movies and television shows in which drugs

and drug use are portrayed. For the most part, the media mirrors society’s outlook on marijuana. Over time, this image has changed from a crazy weed to a socially accepted drug. In movies such as Detroit Rock City, produced in 1999, Dude, Where’s My Car? in 2000, and Half Baked in 1999, marijuana use is one of the main themes. Other films in which drug use was portrayed were Harold and Kumar Go to White Castle (2004), Harold and Kumar Escape Guantanamo Bay (2008), and A Very Harold and Kumar 3D Christmas (2011). The actors are portrayed as less than capable of making an educated decision. Marijuana use in today’s movies is often shown as casual and cool, and can be used to unwind after a stressful event or enhance a good time. The “down side” of

Ashton Kutcher and Seann William Scott star in the movie Dude, Where’s My Car? The pair lose their car after a night of abusing drugs. (20th Century Fox/Tracy Bennett/Photofest)

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marijuana (its addictive properties) is not part of these films. In real life, many entertainers have been arrested for marijuana and drug use, including Robert Mitchum, Bob Denver, Oliver Stone, Matthew McConaughey, and Whitney Houston. Drug use is also very common in music themes. It has been mentioned in music lyrics for decades by artists such as the Beatles, Jimi Hendrix, Bob Marley, or Tom Petty and the Heartbreakers. It is also a major theme in hip-hop and rap music, which has more of a teenage audience. Marijuana is not the only drug commonly portrayed in the media. A Princeton study in 2010 found several different shows, which aired in prime time slots for television shows involved some form of drug use. Shows included: 24, CSI, CSI: Miami, The Good Wife, House, Law & Order, Law & Order: Los Angeles, Law & Order: SVU, NCIS, and NCIS: Los Angeles. It should be noted, however, that shows such as 24, Law and Order: Los Angeles, and House are no longer on the air. But, in all of television, cable, basic, network, etc., NCIS is the number one drama and the highest-rated show. It has also beaten Dancing with the Stars and American Idol a few times in the weekly ratings. The study also released four major findings discussing the relationship between drug use and television. In TV storylines about the War on Drugs, drug users tend not to be arrested, whereas drug suspects are often portrayed as morally ambiguous or even heroic. In these TV shows, 65 percent of drug suspects are white, accurately reflecting that the vast majority of drug users (and likely offenders) in the United States are white. Despite the predominance of African Americans and other minorities in U.S. prisons for drug violations, most drug manufacturers and dealers in the television shows were

white. Prescription drug abuse and methamphetamines were depicted three times more often than recreational marijuana. Drug use has been particularly prominent in music. For example, many prominent jazz musicians have died of drug-related causes, or used drugs during their time spent in the jazz culture. In a study performed by Geoffrey Wills, 52 percent of respondents were addicted to heroin at one time or another, and heroin addiction was felt to be a contributing factor to early death in five of the subjects. Eleven subjects (27.5 percent) were dependent on alcohol and six (15 percent) abused alcohol at some stage during their lives. Eleven subjects (27.5 percent) were comorbid for other disorders, such as heroin and/or cocaine dependence, at certain times in their lives. Five of the alcohol-dependent subjects eventually overcame their dependence. Three musicians (Miles Davis, Art Pepper, and Bill Evans) developed a dependence on cocaine. In each case it followed the cessation of heroin use. In the case of Bill Evans, there was a 10-year abstinence before the commencement of cocaine use. Other musicians known to use cocaine were Thelonious Monk and Chet Baker. There are numerous examples of jazz musicians who died at a young age, and at one time or another suffered from drug-related issues. For example, “Fats” Navarro, who died of tuberculosis, suffered from a heroin addiction. Another example of a jazz musician who used drugs would be Charlie Parker. Parker played the alto saxophone, but was also addicted to both alcohol and heroin, which eventually led to the worsening of his health and ultimately his death from pneumonia. However, jazz musicians also spoke out against drug use. Researchers at the University of Pittsburgh School of Medicine examined 297 songs that made it to the top of the Billboard charts in 2005 and found that 93 (33 percent) of them

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portrayed drug or alcohol use. Some 86 percent of hit rap tunes had drug references, followed by 37 percent of country tunes, 29 percent of R&B/hip-hop songs, 14 percent of rock songs, and 12 percent of pop songs. Twenty-four percent of drug use references were to alcohol, 14 percent were to marijuana, and only 3 percent were to tobacco; 12 percent were to drugs the researchers could not identify. Drugs in pop culture have a heavy influence in society; it is commonplace for drug and alcohol references and outright usage to occur in popular music, movies, and literature. Children see drugs in pop culture references in cartoons and movies all the time though they may not realize it; kids emulate the behavior using ordinary items such as candy. Kids may think that drug and alcohol use helps to relieve stress, and drugs in pop culture give kids an “image” that is very appealing and cool. Shows like Jersey Shore show young adults drinking excessively while having fun; often people believe that they need to drink to have a good time or to “fit in.” Shows make it seem glamorous, sending the message that it is possible to get away with such activity and live well because of it, and do not show the negative repercussions and accidents that can occur because of usage. Song lyrics in pop culture often depict drug use; in fact many of the most popular songs in contemporary pop culture contain lyrics involving specific drug use. A major drug in song lyrics in pop culture today is the drug Molly, also known as Ecstasy. For example in the Miley Cyrus song “We Can’t Stop” there are lyrics such as “Everyone in line in the bathroom, Trying to get a line in the bathroom,” and “We like to party, Dancin’ with molly, Doin’ whatever we want.” Other examples include Kanye West, “Mercy”; Tyga ft. Wiz Khalifa and Mally Mal, “Molly”; Rihanna, “Diamonds”;

Nicki Minaj ft. 2 Chainz, “Beez in the Trap”; Cedric Gervais, “Molly”; and Eminem, “Drug Ballad.” There have been many other songs about drugs and drug use throughout the history of pop culture; songs about drug use is not a phenomenon known only to the 2000s. Some examples include “Heroin” by the Velvet Underground (1967), “Lucy in the Sky with Diamonds” by the Beatles (1967), “Cocaine” by Eric Clapton (1980), “Comfortably Numb” by Pink Floyd (1979), “Smoke Two Joints” by Sublime (1992), “Sister Morphine” by the Rolling Stones (1971), “Cocaine Blues” by Johnny Cash (1968), “Under the Bridge” by the Red Hot Chili Peppers (1992), “Rehab” by Amy Winehouse (2006), “Mr. Brownstone” by Guns N’ Roses (1987), “Master of Puppets” by Metallica (1986), and “Mary Jane’s Last Dance” by Tom Petty and the Heartbreakers (1993), just to name some examples. Nancy E. Marion See also: Hip-Hop and Drugs; Jazz Culture; Reefer Madness

Further Reading Frater, J. 2009. “Top 10 Jazz Artists Who Died Young.” Listverse. http://listverse .com/2009/07/08/top-10-jazz-artists-who -died-young/. O’Brian, T. “How Are Drugs Portrayed in Prime Time?” Digital Journal. http://www .digitaljournal.com/article/323313. Sparks, Glenn G. 2013. Media Effects Research: A Basic Overview. Boston: Wadsworth Cengage Learning. Starks, Michael. 1982. Cocaine Fiends and Reefer Madness: An Illustrated History of Drugs in the Movies. New York: Corwall Books. Strasburger, Victor C., Barbara J. Wilson, and Amy B. Jordan. 2009. Children, Adolescents and the Media. Los Angeles: Sage.

372   Ephedrine and Pseudoephedrine Straubhaar, Joseph D., Robert LaRose, and Lucinda Davenport. 2013. Media Now: Understanding Media, Culture, and Technology. Boston: Wadsworth Cengage Learning. Stromberg, Peter G. 2009. Caught in Play: How Entertainment Works on You. Stanford, CA: Stanford University Press. Stromberg, Peter G. 2009. “Entertainment Culture and Addiction: Our Way of Life Promotes Addiction.” Psychology Today, http://www.psychologytoday.com/blog/sex -drugs-and-boredom/200907/entertainment -culture -and-addiction.

Ephedrine and Pseudoephedrine Ephedrine is a stimulant that affects the central nervous system. It is derived from the ephedra plant, an evergreen shrub of the American Southwest. It is known primarily as a precursor drug that is a key ingredient needed to manufacture methamphetamine. This means that ephedrine is used to produce other drugs. In its natural state, ephedrine is known to enhance a user’s performance and improve their attention span. It also has medical value as a decongestant. However, when the drug is concentrated and synthesized, it can be very dangerous for the user, especially if the drug is used in combination with either prescription or illicit drugs. It has been known to produce anxiety, tension, excitation, insomnia, and, in larger doses, cause a dangerously elevated heart rate, high blood pressure, trouble breathing, nausea and vomiting, tremor, and dizziness. Hallucinations and paranoid psychoses have been reported at very high doses. The Food and Drug Administration (FDA) banned ephedra, the precursor to ephedrine, as a synthetic dietary supplement in 2004. The FDA cited increased risk of cardiovascular complications in those using ephe-

dra in addition to its use worsening kidney disease and diabetes, and causing seizures, among other side effects also associated with its derivative, ephedrine. Also, within the previous two years, two high-profile deaths associated with ephedra undoubtedly influenced the FDA decision. Steve Belcher, pitcher with the Baltimore Orioles, and Korey Stringer, offensive tackle with the Minnesota Vikings, both died during practices after taking ephedra supplements. Most cold medications are manufactured with pseudoephedrine as the active ingredient because of its decongestant properties. However, because pseudoephedrine has been diverted by drug manufacturers from legitimate therapeutic uses to make methamphetamine, both ephedrine and pseudoephedrine are now categorized as Category I chemicals under the Controlled Substances Act (CSA). It is now considered to be a “precursor” drug that is needed to make meth. In order to control the manufacture of methamphetamine, Congress passed the Combat Methamphetamine Epidemic Act of 2005. This allows the government to monitor and, if need be, limit the accessibility and sale of cold products that contain ephedrine and pseudoephedrine. Under the new law, it is required that pharmacies maintain records of the names and addresses of people who purchasing cold products containing these drugs. The pharmacies must also outline packaging and display specifications, and limit the quantities of the drug that may be purchased at any one time. Other countries have instituted similar controls to reduce the ability of drug producers to make meth. It is estimated that about one-third of the cough and cold products purchased were used to make meth. In order to skirt such regulations, a practice known as “smurfing” became common almost immediately after the 2005 law was passed. Groups of people working for

Escobar, Pablo (1949–1993)  373

methamphetamine producers would attempt to circumvent the purchase limits by working together, going into a pharmacy and buying their limit of pseudoephedrine, and then repeating the process at several pharmacies in order to obtain large amounts of the drug. Because ephedrine is sometimes used as a performance enhancer, energy booster, and weight-loss pill, the NCAA added the drug to its drug-testing program. A 2001 survey done by the NCAA discovered that 3.9 percent of athletes reported they had used the drug in the 12 months prior to the survey. The possible penalty for a positive result on a drug test is a minimum one-year suspension of eligibility. Street names for ephedra include effies, mini-thins, and trucker speed. Kathryn H. Hollen See also: Controlled Substances Act; Methamphetamine

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Goetz, Andrew C. 2007. “One Stop, No Stop, Two Stop, Terry Stop: Reasonable Suspicion and Pseudoephedrine Purchases by Suspected Methamphetamine Manufacturers.” Michigan Law Review 105(7). Gunter, Tracy. 2007. “Control of Methamphetamine Misuse.” BMJ: British Medical Journal 334(7605). Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books.

U.S. Department of Health and Human Se­r­ vices, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www .samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Escobar, Pablo (1949–1993) Escobar was a Colombian drug lord who, at the height of his powers, was said to control more than 80 percent of the world’s supply of cocaine. He is perhaps the ultimate example of powerful men who have gained almost unbelievable wealth and power by trafficking in illegal substances, moving such substances, in almost all cases, from poor, developing nations to wealthy, developed nations, such as the United States. At one point, Fortune magazine listed Escobar as the seventh richest man in the world. Pablo Emilio Escobar Gaviria was born in the Medellín suburb of Envigado in 1949 (various biographies give different dates in that year). He fell into crime early in his life, stealing gravestones from cemeteries in order to resell them as new stones, according to one report. In the 1970s, he added drug running to his criminal activities, obtaining coca paste from Bolivia and Peru, having it refined, and then shipping it to the United States. In 1975, he reached the zenith of his power when a rival, Fabio Restrepo, was murdered (perhaps at Escobar’s behest), leaving a power vacuum into which Escobar stepped. For the next 15 years, Escoabar ruled the trade in cocaine in Colombia virtually without competition. At its height, the Medellín Cartel smuggled 15 tons of cocaine, worth an

374   Escobar, Pablo (1949–1993)

estimated $500 million, into the United States every day. He controlled the cocaine trade into the United States by using business strategies to mass-market the drug and controlling virtually all aspects of the cocaine business. Escobar invested much of his profits into aircraft so that he could deal directly with source countries like Peru and Bolivia, and then ship directly to the United States. He would transport coca paste from Bolivia and Peru to Colombia, Ecuador, and Panama, where it would be converted into cocaine powder in secret jungle labs. It was then moved to hidden warehouses in Mexico, the Bahamas, and the Turks and Caicos islands. In order to get away with this, he often paid off officials in Colombia and the United States. Escobar worked closely with Carlos Lehder. Where Escobar relied on violence to get what he wanted, Lehder was more of an “idea man.” They made a good pair and together they became extremely rich and powerful. Escobar was also well liked in his home country. He built homes for the poor, and a hospital in a downtrodden area. The media supported his good actions and gave him positive coverage. The people of Colombia liked him so much, they elected him as an alternative representative to the Colombian Congress in 1982. In this position, Escobar had immunity from arrest. Although Escobar was very popular with the common people, he stopped at virtually nothing to gain and strengthen his control over the drug trade. He launched a full-scale attack on the country and waged an all-out war on the government as a way to force the government to join the cartels and share power with them. They bombed public facilities and newspaper offices. They kidnapped members of the country’s prominent families. He is said to have been responsible for a bomb attack on the Colombian Supreme

Court in which 11 of the 25 justices on the court were killed. He was also implicated in the bombing of Avianca Airlines flight 203 while in midflight in 1989, an apparent effort to kill one of his political opponents. When he was arrested in 1976 with 39 pounds of cocaine, the arresting officer was murdered. In 1992, he orchestrated a bombing campaign against government officials and rival gangs, setting off 300 devices, killing many people. In 1993, his men murdered 178 local policemen. It is rumored that he had thousands of people killed, including members of rival cartels, government officials, police, and innocent bystanders. As national and international efforts to bring Escobar under control increased, he withdrew from public attention and retired to his private homes throughout the country. Then, in 1991, Escobar surrendered to the Colombian government, fearing that he would be captured and extradited to the United States. Escobar actually used his own money to build his own private prison, a palatial home called La Catedral. Under the agreement, he would stay “imprisoned” for a period of five years, after which he was to be declared immune from extradition. The “prison” had a king-sized water bed, cell phones, a private bath, Jacuzzi, a soccer field, and a disco to which he was allowed to invite friends for special occasions. Escobar was even allowed to choose his own guards. While ensconced at La Catedral, Escobar apparently continued his ruthless campaign against opponents and is thought to have been responsible for the deaths of a number of “visitors” to his “prison.” In July 1993, Escobar tortured and killed two of his best friends while they were visiting him in his “prison.” The Colombian government soon decided it was time to move him to another prison. During the moving process, Escobar escaped. While he was on

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the run, he had many Colombian citizens who helped hide him or give him money. Escobar became the world’s most wanted fugitive. The United States and the Colombian governments offered an $8 million reward for his capture. A vigilante squad known as the People Persecuted by Pablo Escobar (Los Pepes) began killing associates of Escobar. They provided the Colombian police information about Escobar and tips as to his location. They finally helped law enforcement track Escobar down. On December 2, 1993, Escobar phoned his family in Bogotá, Colombia, and stayed on the line long enough to allow U.S. officials to trace the call. They traced it to a hideout in Medellín. Seventeen men went to the house and surrounded the building. A young boy entered the home, bringing lunch to Escobar. As Escobar opened the door, the officers entered the home, shooting Escobar twice in the head. After more than a year of intense searching by Colombian and American forces, Escobar was dead. Thousands of mourners came to Escobar’s funeral. Police had to be called in to keep calm. In Colombia, many citizens still view him as someone who reached out to the poor and helped them. However, the rest of the world knows him as a ruthless drug dealer who trafficked tons of cocaine to users throughout the world. Nancy E. Marion See also: Cali Drug Cartel; Colombian Cartels; Drug Cartels; Medellín Cartel

Further Reading Bowden, Mark. 2002. Killing Pablo: The Hunt for the World’s Greatest Outlaw. New York: Penguin Books. Clawson, Patrick L., and W. Lee Rensselaer III. 1998. The Andean Cocaine Industry. New York: St. Martin’s Press.

Drug Wars: The Rise and Fall of the World’s Largest Cartels. 2005. New York: Benz Street. Gaviria, Roberto, and David Fisher. 2010. The Accountant’s Story: Inside the Violent World of the Medellín Cartel. New York: Grand Central Publications. Keane, David. 2002. The True Story of Killing Pablo. History Channel. New York: A&E Television Network. Mollison, James. 2007. The Memory of Pablo Escobar. London: Chris Boot.

European Committee to Combat Drugs First proposed by former French president Francois Mitterrand in 1989, the European Committee to Combat Drugs (CELAD) was the first coordinated effort by European Community (EC) members to address the international drug trafficking that came with tighter economic cooperation between the European Community member states. The heads of state of the 12 nations of the European Community set up this committee in December 1989 as a body that would be responsible for coordinating the fight against drug trafficking in the EC. CELAD authored the first European Plan to Combat Drugs, which was adopted by the EU Council of Ministers in December 1990. Although it came into being prior to any real institutional ability to fight drug trafficking on a continent-wide basis, CELAD was significant because many of its recommendations became the policy of the European Union regarding drug policy once the Maastricht Treaty came into force in 1993 and the European Union was given the power to enforce its drug policies between member states. Ron Chepesiuk

376  Extradition See also: Drug Trafficking

Further Reading European Commission, Press Release Database. 1991. “The European Commission Proposes The Creation of a European Drugs Monitoring Centre (EDMC).” europa.eu/rapid/ press-release_P-91-84_en.htm?locale=en. European Monitoring Center for Drugs and Drug Addiction. 2012. “EMCDDA | History of the EMCDDA.” http://www.emcdda.europa.eu/html.cfm/index1713EN.html. Jamieson, Alison. 1994. Terrorism: Drug Trafficking in Europe in the 1990s. London: Dartmouth Publishing.

Extradition “Extradition” refers to the act of surrendering or turning over an alleged criminal, usually under the provisions of a treaty or statute, by one state or jurisdiction to another, to try the charge. It is the process under which one country, on the request of another, sends a person to the first country to stand trial and be punished for an act that is a crime in the requesting country. The two countries involved usually have established a formal agreement, but not always, that spells out the specific extradition procedures. Forty-three members of the United Nations signed an international convention against drug trafficking and drug abuse, which contains a provision guaranteeing that all signatories will extradite suspected drug dealers and confiscate their assets. The first extradition treaty in the United States was between the United States and Great Britain in 1795. The two countries entered into a Treaty of Amity, Commerce, and Navigation (the Jay Treaty). Provisions of the treaty allowed for the extradition of

anyone charged with murder or forgery. However, the Congress did not pass any legislation to implement the treaty. If an extradition treaty exists between two countries, it means there are mutual obligations on the part of both countries to extradite anyone whom officials in the requesting country have charged with, or found guilty of, an extraditable offense. The extradition court does not have to make a judgment or decision regarding the facts of the case. Instead, it only has to rely on a certified copy of the conviction in the other country. International law recognizes the right to extradite an offender only if there is a treaty or agreement between two countries. If there is a question regarding the extradition of an offender, the court must look to the original treaty. Thus, the right to extradite someone internationally is solely the creature of the treaty. The conditions under which a fugitive can be surrendered to foreign officials should be determined by nonjudicial branches of the government (i.e., legislative and executive branches). At the same time, if there are questions regarding whether the offenses charged are extraditable offenses, an extradition court must first decide if the treaty is in effect and that the crimes charged are under the purview of the treaty. When the court is determining if an offender can be extradited, only a limited evidentiary finding is needed. They must only evaluate whether there was any evidence to warrant the finding of a reasonable ground to believe the accused is guilty of the offense charged. Generally, an act charged should be considered to be a criminal offense by both countries. It is not necessary that the specific name or title of the crime is the same in both countries, or that the scope of liability be the same. This is because some behaviors (crimes) are so universally condemned

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that the offenders are equally as bad in both countries, or by all people. The United States has tried to have important drug dealers extradited for trial in the United States, where it believes there will be a greater likelihood of conviction, as well as tougher sentencing. While the United States considers extradition to be an essential weapon in the War on Drugs, Colombia, Mexico, Myanmar, and other countries that produce the illicit drugs consider extradition to be a form of imperialism and an affront to their sovereignty. Moreover, drug crops provide an important source of income for many poor farmers, and they regard the illegal drug trade as vital to their survival. Moves to extradite traffickers have sparked strong protest and even violence in many countries. For example, people staged anti-American protests on the streets of Tegucigalpa when drug trafficker Juan Ramon Matta Ballesteros was extradited to the United States in 1988. Drug traffickers, moreover, have taken the initiative and have tried to intimidate governments and influence popular opinion. In November 1985, for example, the Medellín Cartel reportedly paid guerrillas in M-19 (the April 19 Movement, a Colombian guerrilla group that has been fighting the Colombian government for more than three decades) between $1 and $5 million to take over the Palace of Justice in Bogotá, destroy records that could be used in extradition proceedings, and hold the Colombian Supreme Court justices hostage. When Senator Luis Carlos Gala, the leading candidate in the 1990 Colombian presidential election and a strong opponent of drug trafficking, was killed at a Bogotá rally in August 1989, Colombian president Virgil Banco Argas made a major television speech in which he said he would begin extradition proceedings of Colombian traffickers wanted abroad. Six days later, when Colom-

bia changed its extradition policy, members of the Medellín Cartel started calling themselves the Extraditables and launched a vicious terrorist bombing campaign to force the Colombian government to change its policy. Under intense pressure the Colombian government wilted and changed its position in the mid-1990s. In 1997 the Colombian government restored extradition, but prevented it from being applied retroactively. The move has prevented the extradition to the United States of the Cali Cartel godfathers, the brothers Gilberto and Miguel Rodriguez Orejuela. U.S. attorney general Janet Reno had made a formal request to the Colombian government for the godfathers’ extradition. The United States has extradition treaties with many countries, including Bulgaria, Romania, Malta, Latvia, Estonia, Israel, Canada, Peru, Belize, and many others. Usually a president will negotiate a treaty, but then it must be approved by the U.S. Senate. The president will send a message to the Congress similar to the following by George W. Bush: To the Senate of the United States: With a view to receiving the advice and consent of the Senate to ratification, I transmit herewith the Extradition Treaty between the United States of America and the Republic of Peru, signed at Lima on July 26, 2001. In addition, I transmit for the information of the Senate, the report of the Department of State with respect to the Treaty. As the report explains, the Treaty will not require implementing legislation. The provisions in this Treaty follow generally the form and content of modern extradition treaties recently concluded by the United States and will replace the outdated extradition treaty in force between

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the two countries signed in 1899. The Treaty will, upon entry into force, enhance cooperation between the law enforcement communities of the two countries. It will make a significant contribution to international law enforcement efforts against serious offenses, including terrorism, organized crime, and drug trafficking. I recommend that the Senate give early and favorable consideration to the Treaty and give its advice and consent to ratification. In many cases, even if there is not a formal treaty, the two countries involved will work together to solve the problem. This is indicated in the following quote by President Obama regarding Mark Snowden: “I was disappointed because even though we don’t have an extradition treaty with them [Russia], traditionally we have tried to respect if there’s a law-breaker or an alleged lawbreaker in their country, we evaluate it and we try to work with them.” Ron Chepesiuk

Bush, George W. 2002. “Message to the Senate Transmitting the Peru-United States Extradition Treaty.” 2002. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=65035. Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. “Colombia Contemplates Extraditing Its Drugsters.” 1997. The Economist, May 29. http:// www.economist.com/node/150184. Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. Obama, Barack. 2013. “Interview of the President by Jay Leno on the Tonight Show in Burbank, California.” August 6. Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=104064. “Unextraditable?” 1997. The Economist, September 20. http://www.economist.com/ node/157083. U.S. Legal. “Extraditable Offenses.” http:// extradition.uslegal.com/extraditable -offenses/.

Further Reading

Zanotti, Isidoro. 2006. Extradition in Multilateral Treaties and Conventions. Boston: Martinus Nijhoff Publishers.

Abbell, Michael. 2010. Extradition to and from the United States. Leiden: Martinus Nijhoff Publishers.

Zimmer, Brenden. 2011. Extradition and Rendition: Background and Issues. New York: Nova Science Publishers.

See also: Escobar, Pablo

Botting, Gary. 2009. Canadian Extradition Law Practice. Markham, ON: Lexis Nexis.

F possessed 10 grams of crack cocaine could face a 10-year mandatory sentence, while another defendant would need 1,000 grams of powder cocaine to receive the same sentence. Those defendants who were arrested for possession of crack cocaine faced much longer penalties than those who possessed powder cocaine at the time of arrest. This disparity meant that street dealers of crack would be treated the same as large-scale cocaine distributors for sentencing purposes, while lowlevel dealers of powder cocaine usually would escape any mandatory minimum term. Opponents to the sentencing differences argued that the 100:1 ratio was racially biased and in the long run only contributed to the disproportionate number of African Americans who were sentenced to prison for crack cocaine offenses. There were many calls for changing the sentencing structure set up in the 1986 Act. There was little evidence to support the fear that crack cocaine was more dangerous to the general public when compared to powder cocaine. Other reporters questioned the close connection between crack and violent crime. Many observers started to believe that crack was not a new drug that posed unprecedented threats to the public’s health and safety, but instead just a different form of cocaine that produced a rush that was more intense but shorter lived than that created by powder cocaine. But in the 1990s, Congress seemed to be more concerned with methamphetamine because its use was quickly spreading across the country and having a devastating effect on communities. This concern put cocaine sentencing on the back burner for a time.

Fair Sentencing Act (2010) President Barack Obama signed the Fair Sentencing Act (Public Law 111-220) on August 3, 2010, with the goal to improve the overall fairness of the drug sentencing system with regard to cocaine. This measure eliminated the five-year mandatory minimum prison sentence that had previously been established for federal defendants who were convicted for possession of five grams or more of crack cocaine. It also reduced the mandatory sentences for crack cocaine possession to bring them more in line with the possible punishments for conviction of powder cocaine. The goal of the Fair Sentencing Act was to reduce the disparity between the amount of crack cocaine and powder cocaine needed to impose federal criminal penalties. The initial disparity for sentencing of crack and powder cocaine possession was created in the Anti–Drug Abuse Act of 1986. Congress created mandatory sentences for those defendants who were convicted of possessing cocaine. At the time, members of Congress believed that crack cocaine was a more dangerous and harmful drug than powder cocaine, despite expert witnesses who testified that the differences between the effects of the two drugs were exaggerated and the sentencing disparity was unnecessary. As a result of the new law, a person arrested while possessing five grams of crack cocaine could face a five-year mandatory minimum prison sentence, whereas a person who was arrested while in possession of powder cocaine could receive the same sentence only if he or she possessed 500 grams of cocaine. In other words, defendants who 379

380   Fair Sentencing Act (2010)

Support for amending the sentencing policies for cocaine emerged in 2001 when Senator Jeff Sessions (R-Ala.) introduced the Drug Sentencing Reform Act. His proposal would have increased the amount of crack needed to trigger the five-year mandatory minimum sentence to 20 grams from 5 grams. At the same time, his proposal would have lowered the trigger for powder cocaine to 400 grams from 500 grams. Sessions’s proposal was key because it showed that there was Republican support for reducing possible unfairness in crack cocaine sentencing. In following Congresses, other proposals were introduced in Congress. Senator Orrin Hatch (R-Utah) and Senator Joseph Biden (DDel.) also introduced legislation that would either reduce or eliminate the sentencing disparity between crack and powder cocaine. In the House of Representatives, Representative Sheila Jackson Lee (D-Tex.) introduced a companion bill to Biden’s proposal. Representative Charles Rangel (D-N.Y.) introduced the Crack-Cocaine Equitable Sentencing Act, which had bipartisan support. The Fair Sentencing Act reduced the disparity between crack and powder cocaine from the existing 100:1 weight ratio to an 18:1 weight ratio. It also eliminated the five-year mandatory minimum sentence for simple possession of crack cocaine. The Fair Sentencing Act is expected to benefit about 3,000 defendants a year, with an average sentence reduction of 27 months. Defen­ dants who are convicted of possessing as little as five grams of crack (the weight of two pennies) will no longer receive a mandatory five-year prison term. The Fair Sentencing Act required the U.S. Sentencing Commission to take four actions:  1. Review and amend its sentencing guidelines to increase sentences for those convicted of committing violent

acts in the course a drug trafficking offense;   2. Incorporate aggravating and mitigating factors in its guidelines for drug trafficking offenses;   3. Announce all guidelines, policy statements, and amendments required by the act no later than 90 days after its enactment; and   4. Study and report to Congress on the impact of changes in sentencing law under this act. The act is applied retroactively to reduce the sentences of certain offenders already sentenced for federal crack cocaine offenses before November 2, 2011. When Congress passed the Fair Sentencing Act, it was the first time in 40 years that Congress eliminated a mandatory minimum sentence. The Sentencing Commission estimates that in about 10 years, the overall federal prison population will decline by 3,800 because of the reform. Nancy E. Marion See also: Families Against Mandatory Minimums

Further Reading Federal Crack Cocaine Sentencing. The Sentencing Project: Research and Advocacy for Reform. http://sentencingproject.org/doc/ publications/dp_CrackBriefingSheet.pdf. Gotsch, K. 2011. “Breakthrough in U.S. Drug Sentencing Reform the Fair Sentencing Act and the Unfinished Reform Agenda.” http:// sentencingproject.org/doc/dp_WOLA_Article.pdf. Lesniewski, Niels, and Keith Perine. 2010. “Senate Votes to Narrow Disparity in Cocaine Sentences, But Some Black Caucus Members Aren’t Satisfied.” CQ Weekly (March 22): 700. http://library.cqpress.com/ cqweekly/weeklyreport111-000003618148.

Families Against Mandatory Minimums (FAMM)  381 Mauer, M. 2010. “Beyond the Fair Sentencing.” The Nation, December 27, 1–2. http://mfile.narotama.ac.id/files/Jurnal/ Jurnal%20Berkeley%20University%20 2010-2011%20(pdf)/Beyond%20the%20 Fair%20Sentencing.pdf. Perine, Keith. 2009. “Sentencing Disparity Proves Hard to Crack.” CQ Weekly (October 19): 2348. http://library.cqpress.com/ cqweekly/weeklyreport111-000003225314. “S 1410: Smarter Sentencing Act of 2013.” https://www.govtrack.us/congress/bills/113 /s1410/text. “Sentencing Reform Starts to Pay Off.” 2013. New York Times, August 1. http:// www.nytimes.com/2013/08/02/opinion/ sentencing-reform-starts-to-pay-off.html? adxnnl=1&adxnnlx=1385743247-NgP-56 G7AsqeEpceb4mE7gA. Stern, Seth. 2006. “Meth vs. Crack: Different Legislative Approaches.” CQ Weekly (June 5): 1548–54. http://library.cqpress.com/ cqweekly/weeklyreport109-000002240935. Stern, Seth. 2007. “Lighter Crack Penalties: Much Support, No Action.” CQ Weekly (November 19): 3464–65. http://library. cqpress.com/cqweekly/weeklyreport110 -000002630674. Stern, Seth. 2009. “Bill to Equalize Sentencing for Crack Cocaine Approved.” CQ Weekly (August 3): 1856. http://library.cqpress.com/ cqweekly/weeklyreport111-000003184530. Stern, Seth. 2010. “Cleared Bill Would Reduce Disparity In Crack, Powder Cocaine Sentences.” CQ Weekly (August 2): 1877. http://library.cqpress.com/cqweekly/ weeklyreport111-000003716172.

Families Against Mandatory Minimums (FAMM) FAMM (Families Against Mandatory Minimums) is a nonprofit, nonpartisan organization that fights for smarter sentencing laws

that maintain public safety. They challenge many of the mandatory sentencing laws that currently exist on the state and federal levels. FAMM works to create a country where criminal sentencing is individualized, humane, and sufficient to impose a fair punishment while not abusing the rights of the defendant. FAMM supporters include taxpayers, families, prisoners, law enforcement, attorneys, judges, criminal justice experts, and concerned citizens. Started by Julia Stewart, a former employee of the more conservative think tank Cato Institute in Washington, D.C., FAMM consists of a nationwide network of people concerned with abuses related to sentencing. Many members are concerned with the abusive sentencing practices related to those convicted of drug charges. The group’s mission is to be a “national voice for fair and proportionate sentencing laws. We shine a light on the human face of sentencing, advocate for state and federal sentencing reform, and mobilize thousands of individuals and families whose lives are adversely impacted by unjust sentencing laws.” The group has about 33,000 members, including 10,000 inmates in federal and state prisons. The national office is located on 1100 H Street NW, Suite 1000, Washington, D.C. 20005. Through advocating for sensible state and federal sentencing reform, FAMM helps:   1. Mitigate the taxpayer burden of overcrowded prisons;  2. Shift resources from excess incarceration to law enforcement and other programs proven to reduce crime and recidivism; and  3. Mobilize the thousands whose lives are adversely affected by unfair sentences to work constructively for change.

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Federal statutes that define mandatory minimum sentences act to limit the discretion of a sentencing judge to hand down sentences that do not involve a term of imprisonment or the death penalty. The most commonly imposed federal mandatory minimum sentences are based on provisions in the Controlled Substance and Controlled Substance Import and Export Acts, the provisions punishing offenders who have a firearm in connection with a crime of violence or drug trafficking offense in the Armed Career Criminal Act, and various sex crimes that involve child pornography and aggravated identity theft. Judges may choose to not impose an otherwise required statutory mandatory minimum sentence if requested by the prosecution on the basis of substantial assistance toward the prosecution of others. First-time, lowlevel, nonviolent offenders may be able to avoid the mandatory minimums under the Controlled Substances Acts, if they are completely forthcoming. In some places, a judge must provide written documentation as to why they veered from the minimum sentence. Critics, such as FAMM, argue that mandatory minimums undermine the rationale and operation of the federal sentencing guidelines, which are designed to eliminate unwarranted sentencing disparity. Supporters argue that mandatory minimum guidelines help to protect defendants against unfair sentencing by judges or prosecutors who abuse their discretion. According to FAMM, they have had numerous accomplishments, and the group has successfully helped thousands of inmates who were unfairly punished by mandatory minimum sentences. The group claims that over 200,000 people have benefited from sentencing reforms supported by FAMM since 1991, including over 85,700 federal

prisoners who received sentences below the mandatory minimum term. Over 23,500 offenders sentenced under federal crack cocaine laws received sentence reductions after FAMM’s advocacy convinced the U.S. Sentencing Commission to make retroactive its changes to crack sentencing guidelines. Over 5,800 offenders received lower sentences for crack cocaine offenses under the Fair Sentencing Act of 2010, a reform FAMM helped push through Congress. Over 5,400 federal offenders charged with offenses related to crack cocaine who had pending appeals became eligible to benefit from the Fair Sentencing Act of 2010 because of FAMM’s advocacy. Sixty-five elderly federal prisoners were released early because of the elderly offender release program in the Second Chance Act of 2007. On the state level, over 8,200 people received more equitable sentences since FAMM lobbied the Michigan state legislature to repeal mandatory minimum drug sentences. Over 2,900 people received sentences below the mandatory minimum term based on reforms proposed by FAMM related to reforms to New Jersey’s drug free school zone law. FAMM supported 550 county drug offenders in Massachusetts who received parole after FAMM advocated for passage of a reform bill in the state legislature. The work done by FAMM related to smarter sentencing policies has been recognized by a diverse group of prestigious organizations including: • Certificate of Achievement for Reforming Federal Crack Cocaine Laws from the Congressional Black Caucus Foundation, 2011 • Citizen Activist Award from the Gleitsman Foundation, 2006 • Ford Foundation Leadership for a Changing World Award, 2002

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• Champion of Justice Award from the National Association of Criminal Defense Attorneys, 2001 • Thomas Szasz Award for Outstanding Contributions to the Cause of Civil Liberties, 1994 There are six people on the board of directors of FAMM, all with extensive backgrounds in criminal justice, sentencing reform economics, or business management. Julie Stewart is the president, a position she has held since starting the group in 1991. She has a decade of experience in sentencing reform policies, and serves on the board of the Public Defender Services of Washington, D.C. Stewart was a member of the DC Sentencing Advisory Commission, which developed sentencing guidelines for inmates held in the District of Columbia. Ron Chepesiuk See also: Fair Sentencing Act; Rockefeller Drug Laws; Sentencing Disparities

Further Reading “About FAMM.” http://famm.org/about/. Doyle, C. 2013. “Federal Mandatory Minimum Sentencing Statutes.” Congressional Research Service. http://www.fas.org/sgp/ crs/misc/RL32040.pdf. Gill, Molly M. 2013. “Pardon Humans, Not Just Turkeys.” Huffington Post, November 24. http://www.huffingtonpost.com/molly-m -gill/pardon-humans-not-just-tu_b_ 4325978.html. Lankford, Ronald D. 2012. Alternatives to Prisons. Detroit: Greenhaven Press. Merino, Noel. 2009. Prison. Detroit: Greenhaven Press. Moore, John W. 1995. “A Lobbyist Who Packs Real Passion.” National Journal, February 25. www.Famm.org.

Stewart, Julie. 2013. “Family Members Fight for Reform.” Nation 297 (20): 22–27.

Farley, Chris (1964–1997) Christopher Crosby Farley was born in Madison, Wisconsin, on February 15, 1964. His father, Thomas Farley Sr., owned an oil company and struggled with alcoholism. The family belonged to the Roman Catholic faith. Farley had four siblings: Tom, Kevin, John, and Barbara. Farley attended Catholic schools in his hometown, where he always tried to make his classmates laugh. He graduated from Marquette University, a Catholic Jesuit University located in Milwaukee, Wisconsin, in 1986 where he majored in communications and theater. After graduating from college, Farley worked with his father at the Scotch Oil Company in Madison for a short time. While in Madison, Farley began his professional career in comedy at the Ark Improv Theatre, and at the Improv Olympic theater in Chicago. Farley also performed at Chicago’s Second City Theatre, initially as part of Second City’s touring group. Approximately four years into his career, Farley made it to the mainstream when he was hired as one of two new cast members for Saturday Night Live (SNL), alongside Chris Rock. On SNL, Farley also collaborated with other cast members Adam Sandler, Rob Schneider, and David Spade. This group of three men came to be known as the “Bad Boys of SNL.” Farley had many popular characters on the show. In one, he portrayed himself and acted as a talk show host on “The Chris Farley Show” in which he “interviewed” the guest. His character would get very nervous and asked naïve or unassuming questions of the guests. Another favorite character was Matt Foley, a motivational speaker. Farley was also known for

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Chris Farley, right, was an actor and comedian who appeared on Saturday Night Live and in the movies Tommy Boy and Billy Madison. Farley died in December 1997, of a drug overdose (cocaine and morphine) at the age of 33. (AP Photo/Lennox McLendon)

doing a Chippendale’s dance skit along with Patrick Swayze. On SNL, Farley developed a physical brand of comedy that played on his large body size. While Farley was succeeding on SNL, he also chose to act in some popular movies. He had roles in the comedy films Wayne’s World (1992), Coneheads (1993), Airheads (1994), and Billy Madison (1995). Farley also appeared in the Red Hot Chili Peppers’ music video for “Soul to Squeeze,” a song featured on the soundtrack for the movie Coneheads. After Farley and most of his fellow cast members were released from their contracts at SNL following the 1994–1995 seasons (some reported that they were fired by NBC because of some of their off-air antics),

Farley focused on his film career. His first two major films co-starred his fellow SNL colleague and close friend David Spade, Tommy Boy (1995) and Black Sheep (1996). These were a success at the domestic box office, earning around $32 million each. These two films made Farley a bankable star. He was then given the title role in Beverly Hills Ninja (1997), which finished in first place at the box office on its opening weekend. However, Farley battled drug and alcohol problems throughout his career. The production of his final films, Almost Heroes (1998) and Dirty Work (1998), was held up several times in order for Farley to attend rehab and drug treatment. During this time, Farley attended AA meetings each day. He

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was put under 24-hour watch while recording a voice-over for the animated film Shrek. When he returned to SNL to guest-host one show, he reportedly arrived for rehearsals drunk. After a while, the times he could stay sober were becoming more rare. Because they were so worried about him, the producers at SNL forced Farley to enter a drug-rehab clinic. Farley returned to the show, but continued drinking and eating too much. Farley eventually checked into Exodus, a rehab clinic in Marina del Rey, California. After that, he was able to remain sober for three years. In the final years of his life, Farley had sought treatment for obesity and drug abuse 17 times. However, Farley could not stay away from drugs and alcohol for long. On the Sunday before his death, Farley partied until late into the night, then returned to his condo at the John Hancock Center in Chicago where the party continued. Farley freebased cocaine until 9 a.m. on Monday, according to a friend who was there. Farley continued to drink and take drugs at a holiday party on Monday night, followed by more late-night club hopping with more cocaine and alcohol. On Wednesday, Farley hired an exotic dancer to entertain him at his condo while using cocaine, after which he went to his favorite after-hours spot, the Hunt Club, to party more. The dancer claims to have left Farley asleep on the floor in his apartment at 3 a.m. on Thursday. Farley’s younger brother John then discovered Farley on the floor of his apartment 11 hours later. It was December 18, 1997. An autopsy later revealed that Farley had died of a cocaine and morphine overdose early that morning. Chris also suffered from advanced atherosclerosis (heart disease), which was a contributing factor to his death. Oddly, Chris died in a similar way to his comic idol, John Belushi.

Tom Farley, Chris’s elder brother, is the director of the Chris Farley Foundation, an organization dedicated to educating young people about the dangers of drug use and addiction. The foundation tells kids, “Do not be that guy.” The Chris Farley House is another way to help those suffering from alcohol problems. As part of the Catholic Charities company in Madison, the house helps those who are transitioning from treatment into the community. The house treats 16 residents at a time through residential treatment, case management, and assistance with a job search. In November 2013, Chris Farley was likened to be the best character actor for Toronto’s mayor Rob Ford. This comparison started when his brother Kevin Farley tweeted, “I think it’s safe to say that my brother would have crushed playing the Rob Ford guy on SNL.” Nancy E. Marion See also: Alcohol; Cocaine and Crack; Heroin

Further Reading “Chris Farley Biography (1964–1997).” http:// www.filmreference.com. Chris Farley. Filmography: http://www.fandango .com/chrisfarley/filmography/p22696. Chris Farley Foundation: http://www.thatguy .com/comedy-club/farley.php#. Farley, Tommy, and Tanner Colby Jr. 2008. The Chris Farley Show: A Biography in Three Acts. New York: Penguin Books. Fredericks, Bob. November 20, 2013. “Crack Mayor a Dead Ringer for ‘SNL’ Great Chris Farley.” http://nypost.com/2013/11/20/crack -mayor-a-dead-ringer-for-snl-great-chris -farley/. Goldblatt, Henry. 2008. “‘Chris Farley Show’ Stuffed With Gossip.” CNN.com, May 7.

386   Fast and Furious Mohr, Jay. 2004. Gasping for Airtime: Two Years in the Trenches of Saturday Night Live. New York: Hyperion. “People: Chris Farley.” http://www.tv.com/ people/chris-farley/. Shales, Tom, and James Andres Miller. 2003. Live from New York: An Uncensored History of Saturday Night Live. Back Bay.

Fast and Furious Between 2009 and 2011, the U.S. government intentionally sold assault weapons to Mexican gun cartels, which then used the weapons to kill many others, including a U.S. law enforcement officer. The events became known as “Fast and Furious,” after the 2001 movie about gangsters stealing and racing cars. U.S. Department of Justice (DOJ) officials met on October 26, 2009, to discuss the increasing level of violence in Mexico. After determining that the Mexican drug cartels had become one of the leading gun trafficking organizations in the Southwest region, officials in the Phoenix branch of the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) devised a plan to provide around 2,500 assault weapons and other firearms to the Mexican drug cartels as a way to track the guns and collect information about the activities of the cartel (with the approval of Washington officials). The guns would be “sold” to low-level buyers (called “straw purchasers”) who were believed to be acquiring guns illegally for Mexican drug cartels through legitimate Arizona gun dealers. The gun dealers were asked to sell hundreds of AK-47–type semiautomatic rifles and 50-caliber rifles to suspicious buyers, even if the buyers did not have any form of ID as required by law. If the guns were taken into Mexico illegally (allowed to “walk” into

Mexico), the purchaser would be stopped at the border. Instead of intercepting the weapons when they were taken across the border, Operation Fast and Furious stipulated that ATF agents would let the guns “walk” into Mexico and wait for them to surface there. Through a GPS system embedded in the weapon, officials were to track where the guns were taken. Federal agents could then trace the guns to drug smugglers and cartel leaders. In the end, the federal government would have evidence to stop the flow of guns into Mexico and reduce the power of the cartels. The ultimate goal was to uncover larger criminal conspiracies in Mexico. The plan, however, was not told to Mexican authorities. The Obama administration did not inform Mexican officials about their plan nor did they seek the assistance of Mexican officials when it came to arresting and prosecuting the recipients of the illegal weapons. In November 2009, ATF special agent John Dodson and his colleagues watched as Uriel Patino and Jaime Avila, known to be two of the most notorious people in the gun trafficking ring, purchased automatic weapons from the gun dealers in the operation. The ATF agents did not stop them from purchasing the weapons. More weapons were purchased at later dates. While the aim of the operation was to follow the path of the guns from the straw-purchasers to the drug cartels, especially the Sinaloa Cartel, in order to be used as evidence to attribute more serious crimes to the heads of the cartel, according to later whistleblowers and investigators, agents never made the effort to actually trace the guns. So, very quickly, the ATF lost track of the guns. While there were claims that a GPS device, which was purchased from Radio Shack, had been used and failed, regardless, the ATF

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officials lost track of the weapons. At the time of the gun sales, the violence between rival drug cartels was at its peak. The two cartels, the Sinaloa and Juárez drug trafficking organizations and the Zetas, had been clashing. The availability of these weapons had a big impact in the war between these groups. In January 2010, because the operation had grown in size, additional agents from the Organized Drug Enforcement Task Force were brought in to help coordinate the ATF’s efforts. The task force brought in additional agents from Homeland Security, the Internal Revenue Service, and the Drug Enforcement Administration. The task force took to naming the operation “Fast and Furious” after the popular movie because some of the suspects were believed to be operating out of an auto-repair shop and engaged in street racing. By March 2010, the first concerns for the operation were raised by ATF agents who became concerned that the guns being walked across the border might be used in the commission of a crime in Mexico. Worse, they grew gravely concerned that the weapons might come back across the border and be used in the commission of a crime in the United States. It was soon discovered that some of the weapons were used in a shooting on September 2, 2009, in which 18 young men were killed in a rehabilitation center. On January 30, 2010, in Juárez, 14 young men and women were killed and 12 others wounded when hit men broke into a house and opened fire on a gathering of teenagers at a birthday party when the gunmen mistook the group for members of a rival cartel. Two more of the guns were later found in December 2010 at the scene of a shootout that took place on the border between Mexico and Arizona in which an agent from the U.S. Customs and

Border Protection, Brian A. Terry, was killed by a member of one of the Mexican gangs. In late December 2011, because of Agent Terry’s death, several ATF agents anonymously spoke with Senator Charles Grassley (R-Iowa) about the operation. Grassley was the ranking minority member of the Senate Judiciary Committee, which oversees the DOJ and the ATF. The agents asked the senator to stop Operation Fast and Furious before more people were killed by the gun walking operation. Senator Grassley did make several contacts regarding the case, and on January 25, 2011, U.S. Attorney Burke made the first public announcements regarding the operation. He stated that the operation would cease and that indictments were forthcoming. Two days later, Grassley opened up an inquiry by requesting information on the operation from Kenneth Melson, the director of ATF. In February 2011, Attorney General Holder asked the DOJ inspector general to open an investigation. The report blamed officials in the ATF headquarters, the DEA’s Phoenix field office, and the U.S. attorney’s office in Arizona. Further, the report found that 14 employees of the ATF and the DOJ were responsible for the management failures regarding the failed operation. The inspector general referred the 14 people for possible disciplinary action but did not go so far as to recommend criminal charges be brought. Two of the 14 employees faulted in the report left their positions in the DOJ. Jason Weinstein, deputy assistant attorney general in the criminal division, resigned, and the former acting director, Ken Melson, retired. When questioned about the operation, the White House and the DOJ deflected questions on the subject. At first, President Obama, through his press secretary, denied knowing about the operation. On March 27,

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2011, when Obama was asked about the Fast and Furious operation while on a visit to Mexico, he quickly denied that either he or Attorney General Holder knew about it. Even the director of ATF, who watched the gun sales on a video in his office and who was briefed about the operation on a weekly basis, would not directly answer questions posed to him by members of Congress. In June 2011, Congress decided to hold hearings on the “gun walking” operation. Darrel Issa (R-Calif.), as head of the House Oversight and Government Reform Committee, oversaw the hearings in the House, while Senator Grassley oversaw the hearings in the Senate. Congressional investigators issued numerous subpoenas for related documents from Attorney General Eric Holder that would help explain the details relating to Operation Fast and Furious, but Holder would not comply with the requests. President Obama asserted executive privilege over the documents and also would not allow them to be released. As the hearings continued, officials from the ATF responded to questions by denying all of the allegations being made by members of Congress. Holder was asked to testify multiple times before Congress. In one of those appearances, Holder admitted that gun walking occurred but he did not apologize to the Terry family (he did later). He claimed that he only heard about Fast and Furious in the few weeks prior to the hearings. However, in October 2011, memos were produced that were addressed to Holder regarding Fast and Furious. They were dated nearly a year before he admitted knowing about the gun-walking scandal. At first, the DOJ wrote a letter to Congress in which it denied ever permitting guns to fall into the hands of the Mexican drug cartels. Later, the DOJ retracted that letter after documents and the testimony of

whistleblowers indicated that the statement was false. In their retraction, the DOJ explained that it did not know the details of the operation when it issued the original letter. Congressional Republicans argued that the officials in the DOJ were lying to cover up the botched operation and voted to cite Holder for contempt. Holder became the first sitting member of the president’s cabinet to be held in criminal contempt of Congress by the House of Representatives because of his decision to refuse to disclose internal DOJ documents after being served with a subpoena. The vote was 255–67 along party lines. On July 31, 2012, Representative Darrell E. Issa, the chairman of the Committee on Oversight and Government Reform, and Senator Charles E. Grassley, the ranking member of the Senate Committee on the Judiciary, published the first part of three titled, Fast and Furious: The Anatomy of a Failed Operation. The report reviews the flawed operation from the perspective of the U.S. Attorney’s Office and the ATF. The second part will look at the failure of supervision and leadership by those officials in the DOJ, while the third part will look at the obstruction of the investigation by the DOJ and the attorney general himself. In August 2011, three ATF supervisors who were overseeing Operation Fast and Furious in Phoenix were offered jobs at the Washington, D.C., headquarters. The whistleblower who exposed the operation, Vince Cefalu, was fired from his job. Another whistleblower, Agent John Dodson, will release a book on Operation Fast and Furious in 2014, although some of the material will be redacted and it is questionable as to whether or not he will be able to profit from the book. Eric Holder has remained as attorney general. The family of Agent Brian Terry sued government officials and a gun

Federal Alcohol Administration Act (1935) 

shop involved in the operation for negligence and wrongful death. In November 2011, a federal grand jury in Arizona issued an 11-count indictment that stated there were five individuals involved in the shootout with Border Patrol agents when Agent Terry was murdered. The five men were Manuel Osorio-Arellanes, Jesus Rosario Favela-Astorga, Ivan Soto-Barraza, Heraclio Osorio-Arellanes, and Lionel Portillo-Meza. They are each charged with firstdegree murder, second-degree attempted murder, conspiracy to interfere with commerce by robbery, carrying and using a firearm during a crime of violence, attempted interference with commerce by robbery, assault on a federal officer, and possession of a firearm by a prohibited person. The indictment was initially sealed, but on July 9, 2012, it was unsealed and made public. Since Agent Terry’s death, three suspects have been placed under arrest for his murder. Manuel Osorio-Arellanes was arrested on the night of the murder. He pleaded guilty to murder in order to avoid the death penalty. Jesus Leonel Sanchez-Mesa was arrested in September 2012 in Mexico, and it is anticipated he will be extradited to the United States. Ivan Soto-Barraza was arrested through a joint operation of Mexican Police, the Federal Bureau of Investigation, and Interpol in September 2013. He is also being held by Mexican authorities, but the plan is to also extradite him to the United States. Nancy E. Marion and Willard M. Oliver See also: Bureau of Alcohol, Tobacco, Firearms and Explosives; Mexican Drug Trade

Further Reading “ATF Gunwalking Scandal Timeline.” CBS Evening News. http://www.cbsnews.com/ pictures/atf-gunwalking-scandal-timeline/1/.

Attkisson, Sharyl. 2011. “Documents: ATF Used ‘Fast and Furious’ to Make the Case for Gun Regulations.” CBS Evening News, December 7. http://www.cbsnews.com/ news/documents-atf-used-fast-and-furious -to-make-the-case-for-gun-regulations. “Attorney General Held in Contempt Over Flawed Gun-Tracking Effort.” 2013. CQ Almanac 2012, 68th ed., 10–3-10–4. Washington, DC: CQ-Roll Call Group. http://library.cqpress.com/cqalmanac/cqal12-1531 -87297-2553293. Mascaro, Lisa. 2011. “Documents Subpoenaed from Attorney General Holder in ‘Fast and Furious’ Probe.” Los Angeles Times, October 12. http://www.latimes.com/news/nationworld/ nation/la-na-atf-guns-20111013,0,6169639 .story#axzz2n5tWO6SA. Neubauer, Chuck. 2012. “Firings Advised for 4 ATF Leaders Tied to Fast and Furious.” Washington Times, December 6, 1:1. U.S. Congress. 2012. Part I of III: Fast and Furious: The Anatomy of a Failed Operation. http://oversight.house.gov/wp-content/ uploads/2012/07/7-31-12-FF-Part-I-FINAL -REPORT.pdf. U.S. Department of Justice, Office of Inspector General. 2012. A Review of ATF’s Operation Fast and Furious And Related Matters. http://permanent.access.gpo.gov/ gpo28445/s1209.pdf.

Federal Alcohol Administration Act (1935) The Twenty-first Amendment to the Constitution repealed Prohibition, and was ratified on December 5, 1933. President Franklin D. Roosevelt established the Federal Alcohol Control Administration (FACA) by an executive order (number 6474), as an interim measure to manage the growing legitimate alcohol industry, and placed it under the aus-

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pices of the National Industrial Recovery Act (NIRA). FACA, along with the departments of Agriculture and the Treasury, provided guidance and assistance to those who owned and operated wineries and distilleries using a system based on brewers’ voluntary codes of fair competition. In 1935, the Supreme Court decided the case of Schechter Poultry Co v. United States, in which they effectively ruled NIRA unconstitutional and thereby also making FACA unconstitutional. After the ruling, FACA was disbanded and was followed by the Federal Alcohol Administration (FAA), under the National Labor Relations Board. Although Prohibition was legally ended, the lingering effects of the law continued to shape federal policies towards alcohol for decades afterwards. On March 10, 1934, the Prohibition enforcement duties of the Justice Department were transferred to the Alcohol Tax Unit (ATU), the Bureau of Internal Revenue, and the Department of the Treasury. While this was going on, the FAA continued to function independently as part of the Treasury Department by carrying out its mandate to collect data, to establish necessary license and permit requirements, and define regulations to help ensure that there was an open and fair marketplace for those involved in the legitimate alcohol industry. Part of their mandate was also to protect the consumer. In 1940, the FAA merged with the ATU. The FAA established a number of general provisions. One had to do with expenditures. Appropriations were established that would allow the administration to carry out its duties and could pay for, among other things, personnel services and rent, travel, law books, reference books, magazines, periodicals, newspapers, stenographic reporting services, library services, and to purchase samples for analysis or to be used as

evidence. The Secretary of the Treasury was also given the power to utilize the services of any government department or agency to the extent needed to carry out his responsibilities and duties under the law. The act also required different organizations such as importers, domestic producers, blenders, wholesalers, state agencies, and individuals to be issued a permit before being legally able to distribute alcohol. Without such a permit, groups and individuals could not import, sell, or distribute any alcoholic beverages. These requirements applied to both foreign and domestic organizations. In order to commercially distribute alcohol, various requirements had to be met. These requirements included that the distributor, importer, or other personnel had not been convicted of a felony within five years prior to the application date, or been convicted of a misdemeanor relating to a federal law about liquor within the past three years. The FAA was given the power to require a permit for anyone who sought to engage in the alcohol business as a producer, importer, or wholesaler of alcohol beverages. Those permits could also be revoked as needed. Those people who were not likely to operate a business legally could be prohibited from entering into the business. As a way to protect consumers of alcoholic beverage, the FAA was given the power to ensure that products were labeled lawfully and that advertising of alcohol beverages provided adequate information to the consumer about the product. Further, any misleading labels or deceptive advertising would be illegal. There were also provisions related to unfair trade practices. Today, measures of the FAA Act are carried out under the Bureau of Alcohol, Tobacco, and Firearms, which is found in the Department of Justice. Nancy E. Marion

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Further Reading Cornell University Law School. Federal Alcohol Administration Act. http://www.law .cornell.edu/uscode/text/27/chapter-8. Executive Order No. 6474, Creation of the Federal Alcohol Control Administration. December 1933. http://www.presidency. ucsb.edu/ws/?pid=14569. Federal Alcohol Control Administration. 1935. “Legislative History of the Federal Alcohol Administration Act.” http://archive.org/ stream/legislativehisto00unit/legislativehisto00unit_djvu.txt. Schechter Poultry Co. v United States 295 U.S. 495 (1935). U.S. Department of the Treasury, Alcohol and Tobacco Tax and Trade Bureau. 2013. Federal Alcohol Administration Act of 1935 Historical Background. http://www.ttb.gov/ trade_practices/historical_bg.shtml. U.S. National Archives and Records Administration. Online Public Access Full Organization Authority Record Bureau of Alcohol Tabaco and Firearms. http://research .archives.gov/organization/1164174.

Federal Bureau of Investigation (FBI) The Federal Bureau of Investigation (FBI) is the primary law enforcement and domestic investigative agency within the U.S. Department of Justice. Historically, the office of the FBI can be traced back to the late 19th century. At this time, special investigators working for the Justice Department were given the assignment to enforce federal criminal statutes. In 1907, President Theodore Roosevelt asked the members of the U.S. Congress to establish a new law enforcement agency that would be found within the Justice Department. When Congress would not support the idea, Roosevelt instead decided to create the

Bureau of Investigation by executive order in 1980. The word “federal” was added later, in 1935. In the beginning, the jurisdiction of the Bureau of Investigation included only a limited number of federal crimes that covered issues related to interstate commerce. Yet the bureau would rapidly rise to become the most important federal law enforcement organization in the United States, especially as it was assigned to enforce new federal criminal statutes. One of those was the Mann Act, passed in 1912, which prohibited the interstate transportation of females for prostitution or other immoral purposes, and the National Motor Vehicle Theft Act of 1919. By the early 1920s, the bureau was damaged by allegations of scandal and incompetence, along with a lack of professionalism. In order to turn the bureau into a more accountable and professional organization, in 1924 J. Edgar Hoover was appointed the bureau’s new director, a position that he would hold until his death in 1972. During his nearly five decades as FBI director, Hoover was one of the most powerful public officials in the United States. Under his direction, the FBI became a modern law enforcement agency that acquired world fame. However, it was also rumored that politicians and other leaders feared Hoover because of the information that the FBI collected about them. Not until several years after Hoover’s death was it uncovered that the FBI under Hoover’s direction had collected vast amounts of personal information about political leaders and community activists, among them Dr. Martin Luther King Jr. whom Hoover accused of having ties with the Communist Party. The gangster era of the 1930s provided an important impetus for the bureau’s public image as a top law enforcement organi-

392   Federal Bureau of Investigation (FBI)

zation. The bureau’s involvement in some heavily publicized criminal cases captured the public’s imagination and garnered political support as well. The bureau also became increasingly responsible for cross-border and international crimes, such as violations of immigration laws and transporting women for prostitution. To successfully accomplish its broadened functions, the FBI hired more personnel, expanded its evergrowing budget, and advanced its technological means. They began to collect crime statistics such as the Uniform Crime Reports, created a Scientific Crime Detection Laboratory, and an elaborate fingerprint system for offenders. The events surrounding World War II were critical for the further advancement of the FBI. In 1934, President Roosevelt had issued a secret order for bureau personnel to investigate the American Nazi movement, and shortly after the outbreak of war in Europe in 1939 the FBI was formally charged with investigating violations of neutrality laws as well as espionage, sabotage, and subversive activities. During the war the FBI would drastically expand its powers as the bureau’s budget and personnel increased more than fivefold. After World War II, the FBI further solidified its position. The FBI became responsible for the enforcement of hundreds of federal criminal statutes regarding gambling, civil rights legislation, and racketeering. The bureau was also very actively involved in government actions against the threat of communism in the United States during the 1950s, as well as the violent protests against the Vietnam War in the 1960s and 1970s. With the ever-broadening powers of the FBI, its activities would occasionally also touch on legitimate forms of dissent, but the abuses of the FBI would not be exposed until several years after Hoover’s death. Since

then, the FBI’s activities in matters of domestic security and counterintelligence have often been questioned as a result of their potential to harm constitutional rights. Traditionally, the FBI has also been heavily involved in international police work. In 1938 the FBI became the official U.S. representative on the International Criminal Police Commission, the organization today known as Interpol. In the late 1950s, the FBI left Interpol and from then on pursued a more independent international course. The bureau became responsible for investigating violations of federal law with international dimensions, such as terrorism and drug trafficking. The FBI also maintains an extensive system of agents abroad, the so-called legal attachés, and oversees training programs of foreign police. Besides its usual federal duties, the FBI, beginning in the late 1980s, turned its attention to the rising crime problems in the former communist countries in Eastern Europe when suddenly new domestic issues emerged. In 1992 the FBI was involved in a standoff with a criminal suspect in Ruby Ridge, Idaho, that left a woman, a child, and a law enforcement agent dead. Less than a year later, the FBI could not prevent the deaths of some 80 members of the Branch Davidians, a religious sect in Waco, Texas, whose compound burned down after a 51day standoff. These events led to congressional inquiries about the FBI’s ability to respond to emergencies. During the 1990s, the FBI was further exposed to public criticisms because of mistakes that had been made in investigations involving the bureau’s crime laboratory. Although the FBI had begun to accord higher priority to the challenges of terrorism during the 1990s, the tragic events of September 11, 2001, launched a new phase in the bureau’s development. In the months

Federal Bureau of Investigation (FBI)  393

following the terrorist events in September 2001, the FBI assigned about 4,000 of its 11,500 special agents to investigate possible counterterrorist activities. Since June 2002 the FBI has been reformed as the leading counterterrorism agency in the United States. The FBI, in collaboration with local and state agencies, oversees various joint terrorism task forces across the United States. Independent from the Department of Homeland Security, the FBI has also been given increased intelligence and investigative powers by the USA PATRIOT Act. Thus, as was the case during other momentous social disturbances such as World War II and the Cold War, the events of 9/11 have brought about important changes for the FBI, the impact of which may last for a considerable time to come. Since 9/11 the FBI has made various changes to its organization as seen by December 3, 2001, reorganization of FBI headquarters announcement. Four high-level executive assistant director positions were created as well as Cyber and Security Divisions established, along with the Office of Intelligence, to execute FBI intelligence functions in the field. Post-9/11, the FBI has not only expanded its traditional partnerships with law enforcement overseas and in other agencies throughout federal government, but has also developed new, closer relationships with industry, academia, and the public. These many partners contribute significantly to the success of the FBI. Today the FBI remains as an intelligencedriven and a threat-focused national security organization that has both intelligence and law enforcement responsibilities. As stated by the agency, the mission of the FBI is “to protect and defend the United States against terrorist and foreign intelligence threats, to uphold and enforce the criminal laws of the United States, and to provide leadership and

criminal justice services to federal, state, municipal, and international agencies and partners.” As of May 31, 2013, there were about 36,000 employees who worked at the FBI. This number includes 13,785 special agents and 22,117 support professionals, including intelligence analysts, language specialists, scientists, information technology specialists, and other professionals. The director of the FBI is James B. Comey, who was sworn in September 4, 2013. In fiscal year 2012, the total FBI budget was approximately $8.1 billion, including $119.2 million in program increases to enhance counterterrorism, computer intrusions, and other programs. Major priorities of the FBI include: • Protect the United States from terrorist attack • Protect the United States against foreign intelligence operations and espionage • Protect the United States against cyber-based attacks and high-technology crimes • Combat public corruption at all levels • Protect civil rights • Combat transnational and national criminal organizations and enterprises • Combat major white-collar crime • Combat significant violent crime • Support federal, state, local, and international partners • Upgrade technology to successfully perform the mission In 2012 the FBI made 25,186 arrests, 15,274 convictions, and seized $1.125 billion in drugs. The headquarters of the FBI is located in Washington, D.C., but there are 55 other offices, known as field offices. Some of these offices are located in places such as Cleveland; Boston; Albany, NY; Dallas;

394   Federal Bureau of Narcotics (FBN)

Los Angeles; Miami; and San Juan, Puerto Rico. There are also FBI offices throughout the world including offices in places such as Brazil, China, Kenya, South Korea, Kenya, Ethiopia, Germany, England, Belgium, and Russia. Steven Harmon Wilson See also: Drug Enforcement Administration; Federal Bureau of Narcotics; Hoover, J. Edgar

Further Reading Cunningham, David. 2004. There’s Something Happening Here: The New Left, the Klan, and FBI Counterintelligence. Berkeley: University of California Press. Deflem, Mathieu. 2002. Policing World Society: Historical Foundations of International Police Cooperation. Oxford: Oxford University Press. Federal Bureau of Investigation, U.S. Department of Justice. http://www.fbi.gov. Powers, Richard Gid. 2004. Broken: The Troubled Past and Uncertain Future of the FBI. New York: Free Press. Ricciuti, Edward R. 2011. Federal Bureau of Investigation. New York: Chelsea House. Theoharis, Athan G. 2004. The FBI and American Democracy: A Brief Critical History. Lawrence: University Press of Kansas. Ungar, Sanford J. FBI. 1976. Boston: Little, Brown.

Federal Bureau of Narcotics (FBN) The Federal Bureau of Narcotics (FBN) was the organization that oversaw the federal government’s enforcement of the nation’s narcotics laws from 1930 through 1968. Its creation in 1930 marked the first time that domestic and international narcotic control

efforts were united under one agency. In its 38 years of existence, the FBN was driven by the harsh, law-and-order approach of its longtime leader, Harry J. Anslinger, in its campaign against narcotics. The idea of establishing a separate agency to oversee the federal government’s narcotic control efforts came from Pennsylvania representative Stephen G. Porter. As alcohol prohibition became increasingly unpopular over the course of the 1920s, Porter believed that narcotics prohibition could become more effective and less controversial if administered by a different agency. Charges of corruption within the Narcotic Division of the Prohibition Unit under Levi G. Nutt also highlighted the need for a new administrative body to oversee drug control in the United States. The cumbersome nature of the Federal Narcotic Control Board, which had been established in 1922 to govern narcotic imports and exports, also necessitated a change to become more efficient. Porter believed that since a good amount of the narcotics that caused America’s drug problem were being smuggled in from overseas, it was important for domestic and international efforts at drug control to be harmonized under one organizational umbrella. In 1930, Porter’s vision was realized with the creation of the FBN, under the leadership of a narcotics commissioner, former Narcotic Division head Harry J. Anslinger. In addition to overseeing domestic efforts to control narcotics and enforce the provisions of the Harrison Narcotics Act and the Narcotic Drug Import and Export Act, the FBN also sent represen­ tatives to join the U.S. delegations at international drug control conferences. To help with efforts to detect and prevent drug smuggling, the FBN had the power to assign agents to international ports and borders. The Federal Narcotics Control Board was dissolved, and its power to control imports and exports of

Federal Bureau of Narcotics (FBN)  395

narcotic drugs was transferred to the FBN. The head of the FBN was also authorized to advise individual states on their own drug policies and help them draft their own anti­ drug laws. Under Anslinger’s leadership, the FBN was conservative at first, choosing its battles prudently in order to avoid running into many of the problems that had plagued officials charged with enforcing alcohol prohibition. For one, the FBN worked to limit the number of substances it was charged with controlling, since the more widespread the use of drugs it needed to control, the more difficult and unpopular enforcement would become. Therefore the FBN under Anslinger resisted calls to add substances such as barbiturates and amphetamines to the list of substances controlled under the Harrison Act, though it did become active in propaganda to limit marijuana use in the lead-up to the passage of the 1937 Marihuana Tax Act. The FBN also knew that federal judges were less likely to convict individuals brought up on charges related to use and possession, so it made a concerted effort to bring drug law offenders to local courts where they were more likely to be given a sentence. FBN agents in the 1930s focused their enforcement efforts neither on individuals who used drugs because they were suffering from illness nor on individuals who had become addicted to drugs while using them as medicines; instead it cracked down on individuals it considered to be recreational users, and people involved in illicit trafficking and dealing. The main policy of the FBN was to cut off the illicit drug traffic at its source by curbing the smuggling of illicit drugs into the United States, while also attacking the domestic trafficking of controlled substances. In the early going, the FBN struggled, seeing its budget cut from $1.7 million to $1

million in its first three years of operations. The funding cuts hurt the FBN’s ability to carry out enforcement activities, as in 1934 it was unable to catch any major smugglers. In 1935, the FBN was almost swallowed by an agency within the Treasury Department, and some in the government began to question if the FBN’s policies on opiates were pushing opium smokers to harder forms of the drug like heroin. With the growing concern about marijuana in the mid-1930s, however, the FBN returned to prominence, helping lead the charge against the drug with a propaganda campaign that eventually led to the passage of the 1937 Marihuana Tax Act. By expanding the gamut of controlled substances, the Marihuana Tax Act gave the FBN more work to do, as from 1937 through 1942 it seized about 60,000 tons of marijuana and arrested about a thousand individuals per year for violating marijuana laws. During World War II, smuggling and domestic addiction decreased, thanks in large part to the disruption of commerce and the cutting off of trafficking routes over the course of the conflict. When the war ended in 1945, FBN officials feared that when trade was reestablished, smuggling would resume, and that returning soldiers could come home addicted to narcotics they received on the battlefield or during their off-duty time in Europe and Asia. To deter use and smuggling, Anslinger advocated for mandatory minimum sentences for individuals convicted of violating drug laws, a wish that was granted with the passage of the Boggs Act in 1951. Not only did the Boggs Act serve as a deterrent for would-be users and dealers, but it also forced judges, some of whom had been reluctant to sentence drug-law violators to prison, to actually mete out prison sentences for drug-law offenders. To strike fear into Congress and get increases in its budget,

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the FBN, under Anslinger’s leadership, also made strong allegations linking drug smuggling to communist China, thus making the cause of narcotics control seem like one that not only dealt with addicts at home, but also with America’s enemies abroad. In large part due to agitation from the FBN, a more severe set of federal drug laws took force in 1956 with the passage of the Narcotic Control Act. According to some critics, the FBN’s activities helped accelerate the growth of the black market for narcotics, as by making them less available, it increased the profitability of smuggling and trafficking. In the 1950s, rigid enforcement by the FBN led many in both the medical and legal professions to question the actions of the agency, criticizing FBN agents for intimidating physicians and suggesting that crime could be reduced by providing addicts with drugs instead of interning them in prisons or Public Health Service narcotic hospitals. The FBN responded with brochures aimed at discrediting its critics, and highlighting the dangerousness of outpatient maintenance treatment and other alternatives to its lawand-order approach to narcotics control. In some cases, the FBN went to extreme measures to silence its opponents. In the early 1960s, for example, the FBN tried to intimidate addiction researchers Marie Nyswander and Vincent Dole, who had pioneered the use of methadone treatment for weaning addicts off of opiates. When that failed, they resorted to spreading rumors about them, stealing their professional records, and spying on them. When Anslinger retired in 1962, he was succeeded by Harry Giordano, a pharmacist, who was not as outspoken in his support of the FBN’s harsh policies. Pressure to modify national drug policies from outside the agency also led to some major changes for the FBN. In 1963, the Presi-

dential Commission on Narcotic and Drug Abuse issued a report recommending the relaxation of mandatory minimum sentences, the dismantling of the FBN, and the reallocation of its funding to the departments of Justice and Health, Education, and Welfare. Scandals and allegations of corruption within the FBN increased pressures to dissolve the agency. In 1968, the FBN was transferred from the Treasury Department to the Justice Department, joined with the Bureau of Drug Abuse Control, and renamed the Bureau of Narcotics and Dangerous Drugs. Howard Padwa and Jacob A. Cunningham See also: Anslinger, Harry J.; Dole, Vincent; Marihuana Tax Act; Nutt, Levi G.; Nyswander, Marie; Porter, Stephen G.

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America. Westport, CT: Greenwood Press. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. McWilliams, John C. 1990. The Protectors: Harry J. Anslinger and the Federal Bureau of Narcotics, 1930–1962. Newark: University of Delaware Press. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Female Alcohol Use According to the Centers for Disease Control, women compose about 15 million of the alcohol-abusing or alcohol-dependent individuals in the United States, which is approximately 4.6 million people. Females

Female Alcohol Use 

compose about one-third of the people who abuse alcohol. According to the National Institute on Alcohol Abuse and Alcoholism, women tend to drink less alcohol and have fewer alcohol-related problems and symptoms of dependency than do men. However, when an analysis is done on just the heaviest drinkers, females equal or surpass men in the number of problems that result from their excessive drinking. Excessive drinking patterns among females differ depending on the abuser’s age, role, and marital status. In general, a female’s drinking patterns resemble that of her husband, siblings, or close friends. Moreover, younger females tend to have higher rates of excessive drinking than do older women; but middle-aged women aged 35–49 have an even higher incidence of alcohol dependency than either of those groups. Females who have never been married or who have been divorced or separated from their husbands are more likely to drink heavily and experience alcohol-related problems than are women who are married or widowed. Single women living with a significant other are at high risk of heavy drinking, and thus more likely to develop drinking problems. When it comes to treatment for their drinking patterns, female alcoholics have different incentives and obstacles than do males. Female alcoholics are more likely to seek treatment after experiencing family problems due to their drinking, and they are often encouraged by their parents or their children to seek treatment. On the other hand, male drinkers are more typically encouraged to pursue therapy by their spouses. Fewer women than men are in treatment programs because of contact with the criminal justice system or through employeeassistance programs at their places of work. When women do not seek treatment for alcohol problems, they are likely to cite a lack

of childcare for the reason why they cannot attend. According to the Centers for Disease Control, some additional facts about women and alcohol use include the following: • Forty-five percent of females aged 12 or older report current (past-month) alcohol use, 8 percent are binge drinkers (defined as five or more drinks on the same occasion at least once in the past month), and 2 percent drink heavily. Young people who begin drinking before age 15 have a 40 percent higher risk of developing alcohol abuse or alcoholism some time in their lives than those who wait until age 21 to begin drinking. This increased risk is the same for young girls as it is for boys. • Current alcohol use is heaviest among women aged 26 to 34; binge and heavy drinking is highest among 18-to 25-year-olds. • Women may be at higher risk for developing alcohol-related problems at lower levels of consumption than men. • Nearly 4 million American women aged 18 and older can be classified as alcoholic or problem drinkers—this is one-third the number for men; of these women, 58 percent are between the ages of 18 and 29. • Compared with men, women with drinking problems are at increased risk for depression, low self-esteem, alcohol-related physical problems, marital discord or divorce, a history of sexual abuse, and drinking in response to life crises. • Among the personal and environmental factors that increase women’s risks for problem drinking are the influence of a husband’s or partner’s drinking; depression; sexual experience, including

397

398   Female Alcohol Use

alcohol expectancies and reported effects of drinking on sexual behavior, sexual orientation, and sexual dysfunction; and violent victimization, including physical and sexual victimization in childhood as well as in adulthood. • Never-married, divorced, and separated women generally have the highest rates of heavy drinking and drinking-related problems, widowed women the lowest rates, and married women intermediate rates. • Alcohol is present in more than onehalf of all incidents of domestic violence, with women most likely to be battered when both partners have been drinking. One critical aspect of female alcohol use involves alcohol use during pregnancy. When a pregnant woman chooses to drink alcohol, it passes onto her unborn baby. Alcohol in the mother’s blood passes through the placenta and then to the baby through the umbilical cord. It is known that if a woman drinks alcohol during a pregnancy, it can cause miscarriage, stillbirth, and a range of lifelong disorders for the child. This is known as fetal alcohol spectrum disorders (FASDs). Children with FASDs might have the following characteristics and behaviors: • Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum) • Small head size • Shorter-than-average height • Low body weight • Poor coordination • Hyperactive behavior • Difficulty paying attention • Poor memory

• Difficulty in school (especially with math) • Learning disabilities • Speech and language delays • Intellectual disability or low IQ • Poor reasoning and judgment skills • Sleep and sucking problems as a baby • Vision or hearing problems • Problems with the heart, kidney, or bones There is no known safe time to drink alcohol during pregnancy. Drinking alcohol in the first three months of pregnancy can cause the baby to have abnormal facial features. Growth and central nervous system problems (e.g., low birth weight, behavioral problems) can occur from drinking alcohol anytime during pregnancy. The baby’s brain is developing throughout pregnancy and can be damaged at any time. Richard E. Isralowitz See also: Alcohol Use; Female Tobacco Use; Fetal Alcohol Syndrome

Further Reading Centers for Disease Control and Prevention. 2010. “Fetal Alcohol Spectrum Disorders.” http://www.cdc.gov/ncbddd/fasd/alcohol -use.html. Kirkpatrick, Jean. 1986. Goodbye Hangovers, Hello Life: Self-Help for Women. New York: Atheneum. Parker, Robert Nash. 2013. Alcohol and Violence: The Nature of the Relationship and the Promise of Prevention. Lanham, MD: Lexington Books. Stein, Amanda L. 2010. Alcohol Use and Health Outcomes Among Women Victims of Intimate Partner Violence. Cincinnati: University of Cincinnati. U.S. Department of Health and Human Ser­ vices, National Institute on Alcohol Abuse

Female Tobacco Use  and Alcoholism. 2008. Alcohol: A Women’s Health Issue. http://pubs.niaaa.nih .gov/publications/brochurewomen/women .htm#drinking. U.S. Department of Health and Human Ser­ vices, Substance Abuse and Mental Health Services Administration. 2007. “Effects of Alcohol on Women: What You Need to Know.” Washington, DC. U.S. National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health, U.S. Department of Health and Human Services. 2011. “Women and Alcohol.” Washington, DC.

Female Tobacco Use Tobacco smoke contains thousands of compounds, many of which are toxic to the human body and cause injury to the person who chooses to smoke or otherwise ingest it. According to the American Lung Association and the Centers for Disease Control, women who smoke tobacco have a high risk of death and disease. Each year, cigarette smoking kills about 175,000 women in the United States. Fewer women than men choose to smoke cigarettes. In 2008, about 21.1 million (18.3 percent) females chose to smoke, compared to 24.8 million (23.1 percent) males. Although fewer women smoke than men, the percentage difference between them has decreased. More women are choosing to smoke, and, along with that, they have more smoking-related diseases. Like men who smoke tobacco, females who smoke cigarettes suffer from a variety of health problems. One of the most common health problems is cancer. Smoking is responsible for about 80 percent of lung cancer deaths in women in the United States each year. More women die of lung cancer

than breast cancer each year. Another common smoking-related disease is chronic obstructive pulmonary disease (COPD), which is emphysema and chronic bronchitis. Females who smoke are about 13 times more likely to die from COPD than are women who do not smoke. In 2009, about 70,490 women died of lung and bronchial cancer. Smoking is the cause of over 90 percent of COPD deaths each year. In 2006, about 52 percent of all deaths from COPD were female. Smoking is the cause of other types of cancer, including cancers of the oral cavity, pharynx, larynx (voice box), esophagus, pancreas, kidney, bladder, and uterine cervix. Women who smoke also double their risk for developing coronary heart disease. Women who are postmenopausal and smoke cigarettes tend to have lower bone density than women who do not smoke. Women who smoke also have an increased risk for hip fractures when compared to those who do not smoke. Cigarette smoking also causes the skin to wrinkle earlier and deeper, making smokers appear older. Many females begin to smoke when they are teenagers. Many do so to look “cool” or to fit in with peers. Some smoke as a form of rebellion against their parents or society. Others, especially females, smoke as a way to maintain a low weight because cigarettes dull the taste sensations. For many years, the rate of teen smoking among females was declining, but in recent years, the decline in smoking patterns among high school females has slowed. Between 1999 and 2003, cigarette smoking among high school females decreased by 37 percent. However, between 2003 and 2007, there was only a 2.3 percent decrease in cigarette use by high school girls. The highest percentage of smoking was found by middle-school-aged white females.

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An especially bad habit for females is to smoke during a pregnancy. Most women are aware of the harm that tobacco use can have on a fetus and choose not to smoke. However, this is not true of all women. In 2005, 10.7 percent of women smoked during a pregnancy. This was a decrease of almost 42 percent from 1990. Those women who were more likely to smoke during pregnancy were of American Indian/ Alaska Native descent. About 17.8 percent of these females reported that they smoked when pregnant. Only 13.9 percent of pregnant non-Hispanic white women chose to smoke during their pregnancies, compared with 8.5 percent of pregnant non-Hispanic black women who smoked while pregnant. Since 1990, pregnant teenagers and young adults were more likely to smoking during pregnancy. In 2005, 16.6 percent of female teens aged 15–19 and 18.6 percent of women aged 20–24 smoked while they were pregnant. A 2013 study by the Women’s Health Initiative showed that smoking led to an increased risk of spontaneous abortion, stillbirth, and tubal ectopic pregnancy (when the fertilized egg implants into the fallopian tube instead of the uterus). The effect that smoking can have on a fetus is dangerous. Smoking during pregnancy accounts for 20 to 30 percent of low-birthweight babies. Smoking also accounts for about 14 percent of premature births and about 10 percent of all infant deaths. More­ over, smoking by a pregnant female is linked to asthma among infants and young children. In fact, the chances of a child developing asthma are twice as high among children whose mothers smoked more than 10 cigarettes a day. Smoking during pregnancy can also lead to Sudden Infant Death Syndrome (SIDS). Nancy E. Marion

See also: Female Alcohol Use; Nicotine; Tobacco

Further Reading American Congress of Obstetricians and Gynecologists. 2011. “Tobacco Use and Women’s Health,” Number 503. http://www.acog .org/~/media/Committee%20Opinions/ Committee%20on%20Health%20Care%20 for%20Underserved%20Women/co503.pdf ?dmc=1&ts=20131114T1456437926. American Lung Association. 2013. “Women and Tabaco Use.” http://www.lung.org/ stop-smoking/about-smoking/facts-figures/ women-and-tobacco-use.html. Centers for Disease Control and Prevention. 2007. Women and Tobacco: Seven Deadly Myths. New View Films, Academy for Educational Development. Chollat-Traquet, Claire. 1992. Women and Tobacco. Geneva: World Health Organization. National Institutes of Health, National Cancer Institute. 2006. “Women, Tobacco and Cancer: An Agenda for the 21st Century.” Washington, DC: U.S. Department of Health and Human Services. Samet, Jonathan. 2014. “Large Study Shows Smoking Harms Fetuses.” The Conversation, March 3. http://www .laboratoryequipment.com/news/2014/03/ large-study-shows-‑smoking-harms-fetuses. Samet, Johathan M., and Soon-Young Yoon. 2010. Gender, Women and the Tobacco Epidemic. Geneva: World Health Organization. U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. 2008. “Tobacco Control Policies: Do They Make a Difference for Low Socio­ economic Status Women and Girls? Executive Summary of a Report by the Low Socioeconomic Status Women and Girls Project.” World Health Organization. “Female Tobacco Use.” http://www.who.int/tobacco/en/atlas6 .pdf.

Ferguson v. City of Charleston (2001)  401

Ferguson v. City of Charleston (2001) The Ferguson v. City of Charleston case has been considered by many as the victory of Fourth Amendment rights in the Constitution. The case bordered on the constitutionality of government policy in a hospital in South Carolina, where pregnant women were unknowingly tested for cocaine use, and those who tested positive to the drug were handed over to police authority. The case was first taken to the Court of Appeals and was ruled in favor of the city because the tests were considered reasonable under the reasoning of special needs. It was then taken to the U.S. Supreme Court, which ruled that such searches were unconstitutional and violated the Fourth Amendment rights of the pregnant women. It also addressed the issue of circumstances that could be counted as exceptions to special needs under the Fourth Amendment.

Dilemma The staff of the Medical University of South Carolina (MUSC) were worried about the ever-increasing use of alcohol and illicit drugs among pregnant women, and the majority of them often test positive to drugs that doctors and other experts in the medical field agree affect unborn babies. There is a high chance of miscarriage in these pregnancies, and the babies might develop disabilities and disorders. Also bad is the fact that there is a high chance of abuse and neglect and no normal maternal-infant bonding due to these addictions. The legal question then was, does the Fourth Amendment permit the state to secretly perform drug tests on these pregnant women who came to this public hospital to get prenatal care or not? Was there an infringement on the Fourth Amendment rights of these pregnant women?

In the case of Ferguson v. City of Charleston in 2002, the court ruled that nothing could be done to these pregnant women.

The Case Summary It started in the late 1980s when the staff of the MUSC in Charleston became concerned about the growing number of pregnant women who were using cocaine and tested positive to this drug, which adversely affected the fetus in the womb. They decided among themselves that the best way to curb this crisis was to institute a policy to test pregnant women who came to receive prenatal care at the hospital for drug use. Those who tested positive were being asked to join a drug treatment program for the well-being and safety of themselves and their babies. The program took a different turn when in August 1989, MUSC’s obstetrics case manager, Shirley Brown, found out that in Greenville, South Carolina, women who tested positive to cocaine use were being arrested by the law enforcement officers and charged with child abuse. He recounted the case to the hospital’s general counsel, Joseph C. Good Jr., who upon hearing this report solicited the help of a local lawyer, Charles Condon. Condon organized and worked with the staff of the hospital, the Charleston police, the Charleston County Substance Abuse Commission, and the Child Protective Services to come up with the policy “M-7,” which outlined the procedures for identifying pregnant drug users, secretly conducting urine tests on patients who met the nine criteria for conducting the screening (which included no or minimal prenatal care, unexplained preterm labor, birth defects or poor fetal growth, separation of the placenta from the uterine wall, a history of drug or alcohol abuse, or intrauterine fetal death), for reporting these pregnant drug users to the police and for using this arrest and charges of child abuse as a

402   Ferguson v. City of Charleston (2001)

deterrent to drug use, and to foster drug treatment among these pregnant women. At first the M-7 policy had two protocols. The first stipulated that when a pregnant woman first tested positive for cocaine, she would not be reported to the police, but if she tested positive the second time and refused to undergo treatment, then she would be reported to the police. The second protocol, however, stated that women who tested positive for cocaine after giving birth would immediately be arrested. Later in 1990, the policy’s second protocol was revised to give the women an opportunity to avoid arrest by agreeing to drug treatment and counseling. Crystal Ferguson, who went to MUSC for her prenatal checkup, tested positive in the drug test, agreed to go for the treatment, but was arrested when she tested positive to cocaine again on August 4, 1991, when she had her child at MUSC. Ferguson was arrested when she refused a residential treatment program. She was the first of the 10 women who with the help of the Center for Reproductive Law and Policy (CRLP) in New York later filed a petition (42 U.S.C. 1983) against the City of Charleston, after they were arrested for testing positive for cocaine when receiving obstetrical care at MUSC. Four of the women were arrested prior to the modification of the policy and so were not given the opportunity to receive treatment as an alternative to arrest. The other six were arrested after the policy had been modified in 1990, and did not agree to the treatment program or tested positive a second time. Those indicted included the City of Charleston, the Police Department who helped with the policy, and MUSC.

The Proceedings The case filed by CRLP on behalf of Ferguson and the other petitioners against MUSC, the City of Charleston, and others was a

class action suit in South Carolina’s federal district court. The petitioners’ complaint cited the fact that testing urine by the staff of MUSC was unconstitutional and constituted an unlawful search, violating the Fourth Amendment that states, “the right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by Oath or affirmation.” The attorneys of the petitioners, Simon Heller and Julie Rikelman, argued that the MUSC and the other defen­ dants did not have a search warrant from the judge or grand jury. Also the searches were done secretly without the consent of the parties involved and the result handed over to law enforcement officers. The federal district court favored the stance of MUSC and the other defendants, which was that, by signing MUSC’s consent to medical treatment form, the patients actually consented to the searches and so MUSC was not going against the right to individual privacy laws. The case was then taken to the U.S. Court of Appeal for the Fourth Circuit in Richmond, Virginia, to appeal the decision of the district court. Here also, the decision of the district court was affirmed and sustained by the Court of Appeal, as MUSC also argued that its decision to test the pregnant patients was within special needs, which was an exception to the Fourth Amendment right and could also excuse the need for warrant. The defendant also argued that the test was justified as it was conducted out of concern to protect the fetuses. The U.S. Fourth Circuit decision on the case was that the searches were reasonable, because the Supreme Court had in similar previous cases ruled that special needs justified nonconsensual searches in some exceptional circumstances, and

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these cases of pregnant patients testing positive for cocaine qualified as a special needs circumstance that outweighed the tested patient’s right to privacy. Even with all the setbacks and without giving up, Ferguson’s lawyers went further to appeal the Circuit Court’s decision to the Supreme Court, hoping for a favorable judgment this time. Luckily for them, the law was in their favor. In achieving this success, Ferguson’s lawyers argued that the Fourth Circuit Court had wrongly applied the special needs exception to the Fourth Amendment in the Ferguson v. City of Charleston case in which there was nonconsensual drug testing of pregnant patients, and the results of patients who tested positive were handed to police officers who arrested and charged such patients. The Supreme Court’s decision overturned that of the Circuit Court in a 6–3 vote, and concluded that though the Ferguson v. City of Charleston case was similar to the other Supreme Court cases that dealt with special needs, this did not qualify as a special need because these searches under MUSC policy, unlike the others, were meant for law enforcement purposes and not just for medical purposes. Also, the police did not get these test results independently, but with the help of MUSC. In fact, there was an agreement between them to share these test results, which constituted unlawful search as the patients gave out the urine sample in good faith. Justice John Paul Stevens, together with Justices Sandra Day O’Connor, David Souter, Ruth Bader Ginsburg, and Stephen Breyer, wrote the majority opinion for the court, in which they concluded that the criminal evidences obtained by MUSC were meant to be used to later charge the patients with criminal conduct. Justice Stevens also debunked the argument by MUSC that the searches were minimally invasive as

the patients consented to the urine test and the test was needed to provide medical care to the patients. He opined that, if anything, the searches were very invasive due to the fact that the MUSC is supposed to treat test results with confidentiality in its duty of providing health care to patients. Justice Anthony Kennedy was in agreement, while Justices Antonin Scalia, Clarence Thomas, and Chief Justice William Rehnquist dissented. Nancy E. Marion See also: Cocaine and Crack; Female Alcohol Use; Female Tobacco Use; Fetal Alcohol Syndrome

Further Reading American Civil Liberties Union. 2000. “Ferguson v. City of Charleston: Social and Legal Contexts.” https://www.aclu.org/reproductive-freedom/ferguson-v-city-charleston -social-and-legal-contexts. Center for Reproductive Rights. 2003. “Crystal M. Ferguson et al., Petitio­ ners v. City of Charleston et al.” http:// reproductiverights.or/sites/crr.civicactions .net/files/documents/fergusondecision.pdf. “Dilemma of Ferguson v. City of Charleston.” http://essays24.com/print/Dilemma-Ferguson-Vs-City-Charleston/23861.html. “Ferguson v. Charleston.” Justia, U.S. Supreme Court. http://supreme.justia.com/ cases/federal/us/532/67/case.html. Legal Information Institute, Cornell University Law School. “Ferguson v. Charleston.” http://www.law.cornell.edu/supremecourt/ text/99-936.

Fetal Alcohol Syndrome (FAS) There are several competing opinions on the dangers of alcohol use during pregnancy, resulting in some confusion among the public.

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A mother in Alaska helps her adopted son with his daily routine. The young man suffers from the effects of fetal alcohol syndrome. (AP Photo/Bill Roth)

The U.S. National Institute of Alcohol Abuse and Alcoholism has reported that consumption of alcohol during pregnancy is a public health problem, due to the range of harmful consequences to the developing fetus, resulting in serious birth defects. The most serious condition caused by prenatal alcohol use is fetal alcohol syndrome. Fetal Alcohol Syndrome (FAS) is a pattern of behavioral, growth, and facial abnormalities that can occur in children born after exposure to alcohol before birth. The term was first used clinically in 1973. Although the terms “fetal alcohol effects” (FAE) and “alcohol-related birth defects” (ARBD) have also been employed by scholars, scientists, and physicians in subsequent years, FAS is still used to refer to a set of symptoms that can include low birth weight, an undersized

head, heart malformations, a cleft palate, and cognitive and behavioral anomalies and limitations, among many other things. It is estimated that FAS is a primary cause of mental retardation in the United States, with a rate of occurrence that may be anywhere between 1 birth per 750 and 1.95 births per 1,000. This problem is characterized by deformed facial features, smaller heads, abnormal joints and limbs, growth retardation, and developmental abnormalities in the central nervous system that often include mental retardation as well as poor coordination, short memories, and learning problems. Other FAS characteristics that often exist are mental health problems, inappropriate sexual behavior, disrupted school experience, trouble with the law, alcohol and drug

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problems, homelessness, and difficulty caring for themselves and their children. In the United States, estimates of FAS range from 0.5 to 2 cases per 1,000 live births. In highrisk populations, reported rates are 9.8 per 1,000 live births. People have been aware of the dangers of consuming alcohol while pregnant for centuries, but it was not until the gin epidemic of the 1750s—when gin, for the first time, became inexpensive and prevalent enough for large numbers of lower-income women to be able to purchase it—that a greater reckoning of the impact of a mother’s drinking upon her child’s health took place. Still, it would take over 200 years before science developed the term FAS to refer to the set of abnormalities resulting from prenatal exposure to alcohol, with Jones, Smith, Ulleland, and Streissguth’s foundational article, “Pattern of Malformation in Offspring of Chronic Alcoholic Mothers after Prenatal Exposure to Alcohol,” identifying the major traits of the syndrome in 1973. Soon after the term FAS was offered, the terms FAE and ARBD were introduced to describe individuals who had some, but not all, of the components of FAS. As a result of these terminological developments, some diagnostic murkiness entered the field. Though defining exactly what constitutes FAS is difficult and debatable, a picture of its symptoms can nonetheless be painted with a fairly fine brush. A child with FAS will likely experience growth deficiencies that can be manifest in the form of being underweight, shorter than normal, or possessing a small head size or circumference (microcephaly). Beyond these general growth deficiencies, a more particular set of physical problems is commonly associated with FAS, as afflicted children may have eye-slit fissures, hollow lower chests, permanently curved fingers, scoliosis, cleft lips or palates, the fusion of

the radius and ulna at the elbow, heart defects, or kidney malformations. Cognitive and memory defects are also components of FAS, and common abnormalities of this type are developmental delays, hyperactivity, sleep disturbances, and difficulties understanding cause and effect. It has been difficult for physicians and scientists to determine what exactly causes FAS or what a mother can safely do, beyond maintaining complete abstinence, to guarantee her child does not get FAS. The Centers for Disease Control and Prevention argues that there is no known safe level of alcohol consumption during pregnancy, citing a meta-analysis of previous studies, published in 2013 in the journal Alcoholism: Clinical and Experimental Research. This study concluded that low to moderate consumption could cause behavioral problems, and that binge drinking is linked to impaired cognition. There is no scientific support for the excessive concern surrounding FAS. Many people falsely believe that if a woman has a single drink while pregnant it can cause FAS. If this were true, the majority of the population around the world would suffer from the effects of FAS. Some pregnant women have become frantic once they realize that they have mistakenly eaten a salad with wine vinegar dressing, for the fear that their child would be born with FAS. Of course, wine vinegar, being vinegar, contains no alcohol. In reality, there is no clear evidence that light drinking, even if done daily, will lead to fetal alcohol syndrome. Even so, most women who are typically light or moderate drinkers will choose not to drink alcohol while they are pregnant. The real problem is in frequent or heavy drinkers, who are most often alcoholics, who ingest high amounts of alcohol on a daily basis throughout their

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pregnancies. These infants are more at risk of being born with FAS. Moreover, those who give birth to children who exhibit symptoms of FAS usually also smoke cigarettes, use illegal drugs, are frequently not eating a healthy diet, and rarely receive adequate medical care while pregnant. Patterns of alcohol use during pregnancy have not declined among such women over time. Because of their addiction, these women are virtually immune to our current educational approach. This may also be because so many of these women are poorly educated and often lead marginal lives. It is largely understood that the timing of a woman’s drinking during pregnancy is a determining factor. For instance, consuming alcohol during the first trimester can lead to major physical abnormalities in the child (such as damage to various organs and facial anomalies), while drinking in the second trimester increases the chances of more subtle physical abnormalities and the mother undergoing a spontaneous abortion. The consumption of alcohol in the third trimester is associated with low birth weights and can lead to pre- and postnatal growth retardation. Central nervous system damage can occur as a result of drinking at any point in the pregnancy. The only way to ensure that a child will not be born with FAS is for the mother to abstain from all drinking, but a pregnant mother who drinks will not necessarily damage the embryo. The level at which a mother’s drinking becomes a risk factor in the appearance of FAS has been studied, and the minimum number of drinks consumed in the span of one occasion during pregnancy that has been found to cause FAS is five. More specifically, it has been shown that imbibing five drinks in the course of one night (even if that is all the drinking a mother does in one

week) is more damaging to the fetus than consuming a single drink per night for five different nights over the span of one week. Even having five drinks on one occasion does not guarantee FAS will ensue, as relatively few of the 2 to 3 percent of pregnant women who drink at this level have children with FAS. This suggests that other factors in addition to alcohol consumption are at play in FAS. Poverty, and the poor nutrition and high levels of stress that often come with it, are widely seen as factors that make FAS more likely. Smoking, too, can contribute to FAS’s appearance, as it, by itself, is capable of producing birth defects. A mother’s smoking means less oxygen reaches cells that are critical for normal central nervous system development, and it can generate respiratory illnesses and a low birth weight, with some studies showing that the babies of smoking mothers weigh, on average, 200 grams less than the infants of nonsmoking mothers. Smoking thus seems to elevate the risk of FAS occurrence for mothers who also drink. Drugs—particularly those taken intravenously—similarly expose the fetus to a variety of risks, and maternal drug use is also associated with an increased risk of FAS occurrence for the children of pregnant women who consume alcohol. Regardless of what exactly is necessary to cause the syndrome, FAS is estimated to be the single greatest cause of mental retardation in the United States. The numbers vary a bit, but somewhere between 1 out of 750 and 1.95 out of 1,000 babies born in the United States are considered to have FAS. This figure is about twice that of the overall rate of FAS in the industrialized world, which stands at 0.97 births per 1,000. In comparison with Europe, American FAS rates appear even higher, as only 0.08 births per 1,000 in Europe are considered to have FAS.

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The high rates of FAS in the United States have generated a fairly substantial public awareness of the perils of drinking during pregnancy. Not only are most Americans generally cognizant that abstinence during pregnancy is the best means of preventing FAS, but all alcoholic beverages have labels that alert consumers to the fact that alcohol can cause birth defects. However, the drinking behavior of pregnant women, and particularly that of women who consume at particularly dangerous levels, seems to have changed little as a result of this knowledge. FAS thus remains a serious public health issue. Fetal Alcohol Syndrome Disorders (FASDs) is the term that refers to the whole range of possible effects that can happen to a person whose mother drank alcohol while they were pregnant. These conditions can affect each person in different ways, and can range from mild to severe. A person with an FASD might have: • Abnormal facial features, such as a smooth ridge between the nose and upper lip (this ridge is called the philtrum) • Small head size • Shorter-than-average height • Low body weight • Poor coordination • Hyperactive behavior • Difficulty paying attention • Poor memory • Difficulty in school (especially with math) • Learning disabilities • Speech and language delays • Intellectual disability or low IQ • Poor reasoning and judgment skills • Sleep and sucking problems as a baby • Vision or hearing problems • Problems with the heart, kidneys, or bones

Different terms are used to describe FASDs, depending on the type of symptoms.

Fetal Alcohol Syndrome (FAS) FAS represents the severe end of the FASD spectrum. Fetal death is the most extreme outcome from drinking alcohol during pregnancy. People with FAS might have abnormal facial features, growth problems, and central nervous system problems. People with FAS can have problems with learning, memory, attention span, communication, vision, or hearing. They might have a mix of these problems. People with FAS often have a hard time in school and trouble getting along with others. Alcohol-Related Neurodevelopmental Disorder (ARND) People with ARND might have intellectual disabilities and problems with behavior and learning. They might do poorly in school and have difficulties with math, memory, attention, judgment, and poor impulse control. Alcohol-Related Birth Defects (ARBD) People with ARBD might have problems with the heart, kidneys, bones, or hearing. They might have a mix of these. FASDs last a lifetime. There is no cure for FASDs, but research shows that early intervention treatment services can improve a child’s development. There are many types of treatment options, including medication to help with some symptoms, behavior and education therapy, parent training, and other alternative approaches. No one treatment is right for every child. Good treatment plans will include close monitoring, follow-ups, and changes as needed along the way. Also, “protective factors” can help reduce the effects of FASDs and help people with these conditions reach their full potential.

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Protective factors include: • Diagnosis before 6 years of age • Loving, nurturing, and stable home environment during the school years • Absence of violence • Involvement in special education and social services Howard Padwa and Jacob A. Cunningham See also: Female Alcohol Use; Women, Pregnancy, and Drugs

Further Reading Abel, Ernest L. 1998. Fetal Alcohol Abuse Syndrome. New York: Plenum Press. Blocker, Jack J. Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Centers for Disease Control and Prevention. 2010. “Alcohol Use in Pregnancy.” http:// www.cdc.gov/ncbddd/fasd/alcohol-use.html. Centers for Disease Control and Prevention. 2013. “Fetal Alcohol Spectrum Disorders.” http://www.cdc.gov/ncbddd/fasd/index.html. Hanson, David J. “Fetal Alcohol Syndrome.” Alcohol: Problems and Solutions. http:// www2.potsdam.edu/hansondj/FetalAlcohol Syndrome.html#.UkWpqNI3vTg. Jones, Kenneth L., David W. Smith, Christy N. Ulleland, and Ann Pytkowicz Streissguth. 1973. “Pattern of Malformation in Offspring of Chronic Alcoholic Mothers after Prenatal Exposure to Alcohol.” Lancet 301: 1267–71. Streissguth, A. P., F. L. Bookstein, H. M. Barr, P. D. Sampson, K. O’Malley, and J. K. Young. 2004. “Risk Factors for Adverse Life Outcomes in Fetal Alcohol Syndrome

and Fetal Alcohol Effects.” Developmental and Behavioral Pediatrics 5(4): 228–38. Streissguth, A. P., H. M. Barr, J. Kogan, and F. L. Bookstein. 1996. “Understanding the Occurrence of Secondary Disabilities in Clients with Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE).” Final Report to the Centers for Disease Control and Prevention (CDC). Seattle: University of Washington, Fetal Alcohol & Drug Unit. Tech. Rep. No. 96-06.

Fisher, Guy (1947– ) Guy Fisher is a convicted drug kingpin who was born in the South Bronx, New York, in 1947. He was raised in the Patterson housing projects by his mother who was a pediatric nurse. Fisher’s father, on the other hand, was an alcoholic and gambling addict who was abusive to Fisher, his mother, and his four younger siblings. Before reaching his teen years, Fisher’s father abandoned the family. Fisher became protective of his mother and the younger children, always looking out for them. When he was a teenager, Fisher’s predilection for fighting led to a two-year incarceration at the Elmyra Reformatory for assault. Upon his release, Fisher—by now a high school dropout—made money by hustling on the street. His new girlfriend introduced him to the infamous drug kingpin Leroy “Nicky” Barnes, who began mentoring the young Guy Fisher. By the time he was 25, Fisher had worked his way into the Council, the innermost circle of Barnes’s secret organization. The Council’s membership was limited to seven of Barnes’s closest associates. These associates managed their own distribution networks. Each crew supplied smaller dealers with heroin, then collected the money and

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distributed the profits. As part of the Council, Fisher developed a close relationship with Barnes. The two eventually branched out into other sectors, becoming partners in many businesses. At one point the pair owned two housing complexes worth millions of dollars. In 1974, police stopped Fisher for a routine traffic violation. In addition to a fake driver’s license, police also found $100,000 hidden in Fisher’s trunk. In an unsuccessful attempt to avoid arrest, Fisher offered the money to the police officers as a bribe; Fisher instead received a nine-month prison sentence. While behind bars, an undercover investigation into the dealings of Barnes’s Council had begun. A few years later, a New York Times magazine article christened Barnes “Mr. Untouchable” (Guy Fisher Biography). This angered President Jimmy Carter, who pressured federal agents to take apart Barnes’s Council. Barnes and the Council were arrested and placed on trial in September 1977. The bulk of the prosecution’s evidence had been gathered while Fisher was incarcerated. This allowed Fisher’s lawyer to argue that his client was not a part of the conspiracy at the heart of the federal case. Of all the members of Barnes’s Council, Fisher was the only one to avoid prison after the jury was unable to render a verdict. Following the trial, Fisher decided to go straight and, in 1978, with money he had earned while dealing heroin, bought the Apollo Theater in Harlem. To renovate the historic building, Fisher hired residents of the neighborhood. A few months later, the revived Apollo Theater opened with performances by artists such as Gladys Knight and the Temptations. Although Fisher had found success through a legitimate business, he neverthe-

less returned to Barnes and the Council. The relationship, however, began to sour for a couple of reasons. First, Barnes saw his wealth dwindling while Fisher’s was growing. The resentment Barnes felt for Fisher and his outside success grew intense. Second, and most importantly, Fisher began dating one of Barnes’s girlfriends. This propelled Barnes to turn on Fisher and the Council and become an informant. With information supplied by Barnes, in March 1983 federal agents were finally able to gather enough evidence to put Fisher and several associates on trial for running a criminal enterprise. This time the jury delivered a guilty verdict, and Fisher was given a life sentence with no possibility for parole. Since beginning his sentence at the Marion Federal Prison in Illinois, Fisher has earned degrees in sociology (he completed his PhD in 2008), written many novels, and mentored fellow inmates. He remains in prison despite filing several appeals. Stacy O’Hara Leiter See also: Drug Trafficking

Further Reading “Guy Fisher Biography.” http://www.biogra phy.com/people/guy-fisher-495246.

Flashbacks People who use hallucinogenic drugs, particularly lysergic acid diethylamide (LSD), may have flashbacks, which are perceptual distortions that emerge after the use of the drug has stopped. They may occur without warning, and may occur months after the drug was originally ingested. It is not known why they occur in people who have used hallucinogenic drugs, although there is some evidence they might be a form of seizure or

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the result of neuronal destruction caused by drug use. Such flashbacks may or may not be triggered by a particular sight or sound. In the most extreme cases, flashbacks with strong visual hallucinations can occur without warning, often causing great alarm by the user. Most flashbacks are episodes of visual distortion, time distortion, physical symptoms, or relived intense emotion lasting a few seconds to a few minutes. While flashbacks will usually stop over time, some can be prolonged, recurrent, and even unpleasant or upsetting. When flashbacks are unpleasant and upsetting, it can be considered to be symptoms of a hallucinogen persisting perception disorder (HPPD). These can be associated with panic, anxiety, and depression, either as a direct result of the perceptual distortions or as triggering factors that provoke the hallucinations. Unlike the auditory and visual hallucinations that can be associated with psychosis, a person with HPPD is aware that the altered perceptions are not real, but this does not mean they are any less distressing. Some anxiolytic drugs have been shown to alleviate this relatively rare syndrome. Some medical experts deny that druginduced flashbacks or hallucinations actually occur at all. Psychologists have long known that any vivid experience, druginduced or not, can later give rise to momentary memory flashes of sights or sounds from that original experience. These experts suggest that flashbacks are nothing more than a memory flash of the original experience. However, there is also a substantial set of literature that refutes this idea. In fact, the American Psychiatric Association has listed HPPD in its Diagnostic and Statistical Manual of Mental Disorders. Some believe that even though a drug is no longer having an impact on the body, at least a trace amount of that drug remains

present in the body. Upon its release, another short burst of intense hallucinations will occur. However, others say this is unlikely. Any drug residue is unlikely to be present in sufficient amounts in the body to bring on strong hallucinations such as flashbacks. Furthermore, if such flashbacks were caused by a chemical released by the body, the duration of the flashback should be as long as the initial trip itself, usually lasting between 2 to 12 hours. A more plausible theory is that, as a result of the initial drug use, there has been a permanent change to the neurophysiologic processes that help a person see and remember images. It is believed some drugs, such as chlordiazepoxide, can change how a person retains images such that they can spring into consciousness in a similar way to those who experience epileptic seizures. The types of flashbacks lend some support to this theory, such as spiral shapes of a whirlpool, radiating lines of an animal or person, and broken glass or surfaces—all of which occur during migraines, epileptic fits, and electric stimulation. There are different types of flashbacks, which can be categorized by particular images and distortions. These are described below.

Spontaneous Return of Perceptual Distortions During a flashback an individual suddenly sees a familiar object in a way he or she remembers seeing while hallucinating. This may be the glowing stripe on a road or auras around people’s heads. Increased Susceptibility to Spontaneous Imagery This is similar to spontaneous return of perceptual distortions but involves seeing or thinking about visual imagery regularly.

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People who have them also say their imagery takes on a different quality—it is more vivid, seems to just spring from an unknown source, and is less readily suppressed than formerly. Such flashbacks can be very vivid, involving disturbing images of animals or people. Though the distortions can live with a person for a long time, the stronger images tend to lessen with time.

Recurrent Unbidden Images Unbidden images are those that repeatedly force themselves into a person’s awareness, demanding attention and resisting efforts to dispel them. Unlike spontaneous images, these tend to be more lifelike and personally threatening. Those who experience them have described them as having “a will of their own.” Some people are frightened by not being able to dispel the images. Anxiety reactions, even psychotic reactions, may result. Kathryn H. Hollen See also: Hallucinogens; Ketamine; LSD; Phencyclidine

Further Reading Amsterdam, Jan van, Antoon Opperhuizen, and Wim van den Brink. 2011. “Harm Potential of Magic Mushroom Use: A Review.” Regulatory Toxicology and Pharmacology 59(3): 423–29. Cohen, Lee M., Frank L. Collins, Alice M. Young, Dennis E. McChargue, Thad R. Leffingwell, and Katrina L. Cook. 2009. Pharmacology and Treatment of Substance Abuse: Evidence- and Outcome-Based Perspectives. New York: Routledge/Taylor & Francis Group. Flashbacks. DrugScope. http://www.drugs cope.org.uk/resources/drugsearch/drugse archpages/flashbacks. Psychedelics and Hallucinogens. 2005. New York: Films Media Group.

Florida v. Jardines (2013) On November 3, 2006, the Drug Enforcement Administration (DEA) received an anonymous tip that Joelis Jardines’s home was being used to grow marijuana. Early in the morning of December 6, 2006, several DEA agents carried out a warrantless surveillance of Jardines’s home to determine the truth of the allegations. A canine officer and his drug detection dog, Franky, soon joined the agents. Franky began to track the smell of marijuana, which he signaled to the officers. A DEA agent, Detective William Pedraja, knocked on Jardines’s door several times and claims to have smelled the odor of live marijuana coming from the home. He also noticed that the air conditioner was running constantly for over 15 minutes, which, in his experience in dealing with grow houses, is a common practice needed to counteract the heat produced from high-intensity light bulbs that must be used to grow the marijuana plants. Later that day, Pedraja obtained a search warrant for the house and returned to carry out the search. With the search, Pedraja confirmed that the house was being used as a marijuana grow house. Jardines was arrested and charged with trafficking in excess of 25 pounds of cannabis, a first degree felony. He was also charged with grand theft for stealing over $5,000 of electricity from Florida to grow the marijuana, a third degree felony. During his trial, Jardines’s attorneys filed motions to suppress the evidence against his client because, he argued, the use of the dog to sniff and detect marijuana outside of Jardines’s home constituted an unreasonable search under the Fourth Amendment. The trial court agreed that the use of a drug detector dog outside of the home was an illegal search, and it granted the motion to suppress

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the evidence. The court also disagreed with Agent Pedraja’s claim that he smelled marijuana outside of the home because it was only a confirmation of what the dog had already revealed. Further, the court stated that the anonymous tip and Pedraja’s observation of the air conditioner running constantly was not sufficient to establish probable cause to issue a search warrant. Upon receiving the decision, the State of Florida appealed. The appellate court then reversed the holding of the lower court, ruling that a “dog sniff” is not a search under the Fourth Amendment and that the dog and officer were legally present at Jardines’s front door. The court explained that a dog sniff only detects contraband and, because an individual does not have a legitimate privacy interest in contraband, a dog sniff is not a legal search. The case was appealed to the Florida Supreme Court, which reversed the appellate court’s decision and held that, in this case, a dog sniff was a form of government intrusion into the sanctity of an individual’s home. Therefore, it constituted a search under the Fourth Amendment. The justices on the Florida Supreme Court argued that the sanctity of a citizen’s home is a basic tenet of Anglo-American jurisprudence and that probable cause must be established before a search is conducted at a private residence such as a home. After the court’s decision was announced, the State of Florida filed a petition for a writ of certiorari with the U.S. Supreme Court to have the case reviewed there. In agreeing to review the case, the U.S. Supreme Court considered whether using a drug-sniffing dog on a homeowner’s porch to investigate the contents of the home is a “search” within the meaning of the Fourth Amendment. In other words, the Supreme Court justices decided that the use

of a drug-detecting dog on a person’s porch was a search, and therefore required either the consent of the owner or a search warrant. In the majority opinion, written by Justice Scalia, the justices noted that the Fourth Amendment provides a “right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures.” When the government obtains information by physically intruding on people, their homes, papers, or effects, a “search” within the original meaning of the Fourth Amendment has “undoubtedly occurred.” Thus, when the police were collecting evidence in the area that belonged to Jardines and immediately surrounding his house by physically entering and occupying the area to carry out a search that was not explicitly or implicitly permitted by the homeowner, it was a violation of the Fourth Amendment. Simply, the government’s use of trained police dogs to investigate the home and its immediate surroundings is a “search” within the meaning of the Fourth Amendment. Thus, the judgment of the Florida Supreme Court was affirmed. Supreme Court Justice Harlan wrote a concurring opinion. He used an analogy of a stranger who comes to the front door of your home carrying super-high-powered binoculars. He doesn’t knock or say hello. Instead, he stands on the porch and uses the binoculars to peer through your windows, into your home’s furthest corners. It doesn’t take long (the binoculars are really very fine): In just a couple of minutes, his uncommon behavior allows him to learn details of your life you disclose to no one. Has your “visitor” trespassed on your property, exceeding the license you have granted to members of the public to, say, drop off the mail or distribute campaign

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flyers? Yes, he has. And has he also invaded your “reasonable expectation of privacy,” by nosing into intimacies you sensibly thought protected from disclosure? Yes, of course, he has done that too. Harlan explained that in this case, police officers approached the door to Jardines’s home with a supersensitive instrument that they used to detect things inside that they could not see unassisted. But this is not significant in determining whether a search occurred. Detective Bartlett’s dog was not a neighbor’s pet who approached the home for a leisurely stroll. Instead, the police used a highly trained tool of law enforcement that is trained to respond in distinctive ways to specific scents as a way to convey clear and reliable information to their human partners. Like binoculars, detection dogs are a specialized device for discovering objects not in plain view (or plain smell). And, similar to the hypothetical case provided, that device was aimed at a home—one of the most private of all the places the Constitution protects. It was an invasion of the homeowner’s property. In a dissenting opinion, Justice Alito noted that a reasonable person would understand that odors emanating from a home may be detected from places that are open to the public, and a reasonable person will not count on the strength of those odors remaining within the range that, while detectible by a dog, cannot be smelled by a human. Because of that, Alito stated that he would hold that there was no search within the meaning of the Fourth Amendment place in this case, and the decision should be to overturn the lower court’s ruling. Adam Stilgenbauer See also: Drug Enforcement Administration; Marijuana

Further Reading Florida v. Jardines, 590 U.S. 2013. Legal Information Institute, Cornell University Law School. http://www.law.cornell.edu/supct/ cert/11-564#discussion.

Food and Drug Administration (FDA) The Food and Drug Administration (FDA) is the federal agency charged with ensuring the safety and efficacy of ingredients and products. The primary focus of the FDA in its earliest years was upon food regulation, but the regulation of drugs like patent medicines, prescription-only drugs, and narcotics became a greater concern for the agency over the course of the ensuing decades. More recently, the FDA has taken an interest in regulating tobacco as well. Today the FDA is part of the Department of Health and Human Services, and there are five different offices under the FDA: Office of the Commissioner, Office of Foods and Veterinary Medicine, Office of Medical Products and Tobacco, Office of Global Regulatory Operations and Policy, and the Office of Operations. The FDA emerged from the development of other government agencies responsible for ensuring the public safety of consumer products. Originally called the Division of Chemistry, which was established in 1862, the group’s name was changed to the Bureau of Chemistry in 1901. The Pure Food and Drug Act of 1906 gave the Bureau of Chemistry new powers, enabling it to regulate the interstate commerce in adulterated or mislabeled foods, enforce purity stan­ dards laid out in the U.S. Pharmacopoeia and National Formulary, and ban the making of false or misleading claims about foods and drugs. Under the leadership of Harvey Washington Wiley, the chief chemist of the

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Department of Agriculture, the Bureau of Chemistry enthusiastically enforced the law. Following Wiley’s resignation in 1912, drug regulation became a greater concern for the agency, and seizures of mislabeled drugs escalated in the 1920s and 1930s. In 1927, its name was changed to the Food, Drug, and Insecticide Administration, and the nonregulatory research functions of the group were transferred to other government agencies. In July of 1930, the organization’s name was changed again to its current title—the Food and Drug Administration. The FDA’s 1938 Food, Drug, and Cosmetic Act targeted a new generation of bogus products, tonics, and cures. Effectively replacing the somewhat outdated 1906 legislation, the new act not only brought cosmetics and medical devices under the purview of the agency, but also increased the agency’s regulatory power over drugs. Under the terms of the new law, all drugs were required to be labeled with directions for safe usage, and manufacturers needed to prove to the FDA that their drugs were safe before they could be sold on the market. In a related move, the FDA established requirements for prescription-only (non-narcotic) drugs. Drug abuse became a central concern of the FDA in ensuing decades. In fact, between the 1940s and the 1960s, the illegal sale and abuse of amphetamines and barbiturates required more regulatory effort by the FDA than all other drug problems in the nation combined. Dealing with this level of drug abuse required the FDA to go well beyond its origins in a chemistry lab, as the agency’s interdiction efforts sometimes involved the work of undercover inspectors. Congress, too, recognized the seriousness of the situation, and granted the FDA increased authority over drugs including amphetamines, barbiturates, and hallucinogens with the passage of the 1965 Drug Abuse Control Amendments. In

1940, the FDA was moved from the Department of Agriculture to the Federal Security Agency, and in 1953, it was transferred again, to the Department of Health, Education, and Welfare. The FDA was then transferred to the Public Health Service within the Department of Health, Education, and Welfare in 1968, before being transferred to its current home, within the Department of Health and Human Services. The FDA became interested in the possibility of regulating tobacco in early 1994, and a letter from FDA commissioner David Kessler later that year made public the agency’s view that such regulation could be warranted if cigarettes were viewed as nicotine-delivery devices. With the inside information of whistleblower Jeffrey Wigand, Kessler determined that the tobacco industry used nicotine as a drug, intentionally enhanced the addictive properties of cigarettes, and marketed their products to children. After receiving President Clinton’s approval, Kessler invoked the Food, Drug, and Cosmetic Act in announcing that since cigarettes were essentially a drug-delivery system, the FDA would henceforth regulate all nicotine-containing products. The FDA’s pronouncement also included resolutions regarding tobacco advertising and the sale of tobacco products to minors. For instance, tobacco advertisements in publications that children might read would only be allowed to appear in black and white, thus ostensibly making them less appealing to youths. In response to Kessler’s announcement, the FDA was sued by the tobacco industry, which claimed that only Congress had the authority to regulate tobacco because cigarettes did not fit the Food, Drug, and Cosmetic Act’s definition of a drug or drugdelivery device. The case ultimately wound up in the Supreme Court, which ruled, 5–4, that the FDA did not have the jurisdiction

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to regulate tobacco. The FDA gained regulatory control over tobacco when Congress granted it this authority in the Family Smoking Prevention and Tobacco Control Act, passed in 2009. Today the FDA is one of the largest orga­ nizations in government, and as of 2012 had over 12,000 employees, and annual (2012) budget of $4.336 billion. The FDA also regulates a variety of different products and procedures. When it comes to protecting the safety of the nation’s foods, the FDA oversees the truthful labeling of all food products (except livestock meat and poultry products, which are regulated by the U.S. Department of Agriculture), including dietary supplements (i.e., vitamins). They also oversee the safety of venison and other game meat, bottled water, food additives, and formulas for infants. The FDA oversees the safety, effectiveness, quality, and labeling of both prescription and nonprescription (over-the-counter) medications and drugs and their manufacturing standards. Personnel from the FDA ensure the safety of the nation’s blood supply, as well as other medical devices including simple items like tongue depressors to more complex equipment including heart pacemakers. They oversee the premarket approval of new devices, and then track those devices that malfunction or result in adverse reactions to patients. Electronic products that may give off radiation, such as microwave ovens and X-ray equipment, are also overseen by the FDA. This includes diagnostic equipment such as laser products, sunlamps, and even mammography machines. FDA personnel ensure that cosmetics are safe and labeled well. They even oversee livestock food and pet food. Howard Padwa and Jacob A. Cunningham

See also: Drug Enforcement Administration; Pure Food and Drug Act

Further Reading Blocker, Jack J. Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Brandt, Allan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America. New York: Basic Books. CNN.com. 2009. “House Passes Bill Giving FDA Power Over Tobacco Ads, Sales.” http://www.cnn.com/2009/POLITICS/ 04/02/tobacco.regulation/index.html. Cordry, Harold V. 2001. Tobacco: A Reference Handbook. Santa Barbara, CA: ABC-CLIO. Lender, Mark Edward. 1984. Dictionary of American Temperance Biography: From Temperance Reform to Alcohol Research, the 1600s to the 1980s. Westport, CT: Greenwood Press. Swann, John P. “History of the FDA.” http:// www.fda.gov/oc/history/historyoffda/ default.htm. U.S. Food and Drug Administration. http:// www.fda.gov/.

Food, Drug, and Cosmetic Act (1938) The 1938 Food, Drug, and Cosmetic Act was a key piece of regulatory legislation passed by Congress as a way to protect the food supply, the quality of legal drugs, and related substances in the United States. The law, supported by consumer protection organizations, was based on policies that ensured that products were labeled in a way to reflect their true contents, not only saving the user’s health but also their pocketbooks.

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The act also established food standards to ensure the “value expected” by consumers. One way this was done was by the elimination of the “distinctive name proviso” and requiring instead that the label of a food product “bear its common or usual name.” The food would be considered to be misbranded or mislabeled if it was represented as a standardized food, unless it conformed to that standard. There were three kinds of food standards defined in the law: standards (or definitions) of identity, standards of quality, and standards regulating the fill of the container. Regulators had the discretion to set or alter the standards “whenever in the judgment of the Secretary such action will promote honesty and fair dealing in the interests of consumers.” Because of the law, there were now legally mandated standards to ensure the quality and the identity of foods and medicines. This included the prohibition of false or exaggerated therapeutic claims by products advertising for foods, drugs, cosmetics, and medical devices. To ensure this, the FDA’s had the power to carry out inspections of factories. The proposed law was not a popular one in Congress. Besides consumer groups, the FDA was largely behind the bill. One way the group convinced Congress of the need for the new legislation was by displaying products that were currently on the market that were harmful to those who used them. It included Banbar, a product that was labeled as a cure for diabetes that had been protected under the then-current law; an eyelash dye called Lash-Lure that caused eye injuries to those who used it, even permanent blindness; many examples of foods that were packaged or labeled deceptively; Radithor, a product that contained radium that caused users to suffer from a slow and painful death; and the Wilhide Exhaler, a product that was

falsely labeled as a cure for tuberculosis and other pulmonary diseases. One reporter covering the presentation described the exhibit as “The American Chamber of Horrors.” The bill was debated in Congress for five years, but was finally passed after a tragedy that occurred in 1937. At the time, a drug company in Tennessee marketed and sold a form of a new sulfa drug, Elixir Sulfdanilide, that was used for pediatric patients. However, the solvent used in the product turned out to be a highly toxic chemical closely related to antifreeze. Over 100 people died from using the drug, many of whom were children. The public outcry from the drug helped show Congress the need to rewrite the drug provisions of the new law to prevent such an event from happening again. The event gave the bill’s sponsors enough support to propel it through Congress. President Franklin Roosevelt signed the Food, Drug, and Cosmetic Act on June 25, 1938. The new law protected the quality of food and outlawed mislabeling of food products. In doing so, it protected the quality of food by mandating legally enforceable food standards. The law established factory inspections and other enforcement tools that allowed the FDA to carry out its new regulatory responsibilities. The law brought not only drugs and food products but also cosmetics and medical devices under control. Because of the law, all drugs had to be labeled with adequate directions for safe use and misleading labels were banned. It also required premarket approval of all new drugs by the FDA. As such, all manufacturers would then have to prove to the FDA that a new drug was safe for use before it could be sold to the public. It prohibited a manufacturer from making false therapeutic claims about a drug (although the power to enforce this provision of the law was assigned to the Federal Trade

Ford, Betty (1918–2011)  417

Commission because of its jurisdiction over drug advertising). In 1962, additional legislation was passed by Congress that required manufacturers to establish the safety and effectiveness of all drugs that were already on the market. Called the Kefauver-Harris Act, the new law required the FDA to oversee the entire drug industry. Today, all new drugs can be developed by many sources, including indepen­ dent researchers, university medical centers, governmental researchers, university medical centers, government research centers, and private organizations, but they must all receive premarket approval. Nancy E. Marion

Further Reading “Food, Drug and Cosmetic Act of 1938.” Washington, DC: Great Neck Publishing. Hillstrom, Kevin. 2012. U.S. Health Policy and Politics: A Documentary History. Washington, DC: CQ Press. Kleinfeld, Vincent A. 1949. “Federal Food, Drug, and Cosmetic Act: Judicial and Administrative Record, 1938–1949.” Chicago: Commerce Clearing House. “The 1930 Food, Drug and Cosmetic Act.” U.S. Food and Drug Administration. http://www .fda.gov/AboutFDA/WhatWeDo/History/ ProductRegulation/ucm132818.htm. U.S. Food and Drug Administration. “FDA History—Part II: The 1938 Food, Drug and Cosmetic Act.” http://www.fda.gov/ aboutFDA/WhatWeDo/History/origin/ ucm054826.htm.

Ford, Betty (1918–2011) Serving as First Lady of the United States from 1974 to 1977, Betty Ford, a popular and outgoing woman, began to develop a

dependence on painkillers after they had been prescribed during the 1960s to relieve discomfort from a pinched nerve in her neck. She also drank occasional cocktails during that period, although there is little indication that she was, at that time, an alcoholic. When she and her husband moved into the White House in August of 1974, her drug use was under apparent control. However, with the increasing pressures of her position and a diagnosis of breast cancer, she again developed problems with a pinched nerve. Although she was candid with the press and the public about the mastectomy she endured that cured her cancer—a frankness that earned her the gratitude and admiration of a nation—she began to drink more heavily and rely on painkillers for the recurrent pinched nerve and related arthritis. The combined effect of the drugs became evident; she was filmed, on occasion, with slurred speech and an impaired gait. Shortly after losing a disappointing election, the Fords left the White House, and Mrs. Ford began to drink more heavily. Her alarmed family arranged an intervention in which they urged her to seek help. Initially devastated, she agreed to enter therapy and later credited the intervention and her subsequent treatment with saving her life. Soon thereafter, she founded a prestigious alcoholism rehabilitation center, the Betty Ford Treatment Center, in Rancho Mirage, California, which today is one of the most respected in the nation on which many others are modeled. For years, whenever possible, Mrs. Ford would personally greet incoming patients as they entered the treatment program at the center, which is based on the Minnesota model. Among her other accomplishments, Mrs. Ford is highly regarded for the honesty and courage with which she faced her illnesses. She is particularly esteemed for the valuable

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Former First Lady Betty Ford, wife of U.S. president Gerald Ford, waves to the crowd as she leaves the Naval Hospital in Long Beach, California, in 1978. Ford was admitted and received treatment for her addictions to both alcohol and medications. She later formed the Betty Ford Center to help others afflicted with similar addictions. (AP Photo)

role she has played in promoting greater openness and education about addiction. Until declining health related to advanced age began to curtail her activities, she remained actively involved with the board of the Betty Ford Center, spoke frequently to the public about alcoholism and other drug addiction, and worked steadily to improve treatment opportunities for all addicts. In her later years Betty Ford became outspoken on the government’s lack of involvement in stopping alcoholism. Mrs. Ford opposed President George H. W. Bush’s drug policies, because they put more attention on cocaine use and less attention on alcoholism, even though it was the nation’s top drug problem. She was also

opposed to Bush’s proposition that there was not a strong link between drug addiction and crime because it gave insurance companies a reason to refuse covering drug treatment programs for those with drug problems. Upon completing a treatment program for chemical dependency at the U.S. Naval Hospital in Long Beach, California, Betty Ford and her friends discussed the need for a drug treatment center that focused on the special needs of women who had drug addictions. Her very good friend, Ambassador Leonard Firestone, believed in what Mrs. Ford wanted to do. So in 1982, the two friends co-founded the Betty Ford Center in Rancho Mirage, California, a nonprofit treatment

Ford, Gerald R. (1913–2006)  419

center devoted to treating women and men who are suffering from some kind of chemical dependency. Today the Betty Ford Center offers programs for the entire family, since addiction by one person affects the whole family unit. Each patient is assigned a treatment team that is composed of a physician, nurse, psychologist, primary counselor, case manager, spiritual care counselor, family counselor, dietician, fitness trainer, chemical dependency technician, and alumni services representative. This team works with each patient and creates an individualized care plan for each person’s needs. Betty Ford remained active in the Betty Ford Center and in feminist causes until her death in July 2011 in Rancho Mirage, California, at the age of 93. Her husband Gerald Ford had died in 2006. Kathryn H. Hollen See also: Alcohol Use; Alcoholism; Betty Ford Center; Dependence; Intervention; Minnesota Model; Treatment

Further Reading Ashley, Jeffrey S. 2003. Betty Ford: A Symbol of Strength. New York: Nova History Publishers. Betty Ford Center. “Alcohol and Drug Rehabilitation.” http://www.bettyfordcenter.org/ programs/index.php. Betty Ford Center. “A Brief History of the Betty Ford Center.” http://www.bettyfordcenter .org/welcome/ourhistory.php. DuPont, Robert L. 2000. The Selfish Brain: Learning from Addiction. Forward by Betty Ford. Center City, MN: Hazelden. Ford, Betty, 2003. Healing and Hope: Six Women from the Betty Ford Center Share Their Powerful Journeys of Addiction and Recovery. New York: Putnam. Ford, Betty, with Chris Chase. 1987. Betty, A Glad Awakening. New York: Doubleday.

Gerald R. Ford Presidential Library and Museum. “Betty Ford Biography.” http://www .fordlibrarymuseum.gov/grf/bbfbiop.asp. Greene, John Robert. 2004. Betty Ford: Candor and Courage in the White House. Lawrence: University Press of Kansas. National First Ladies’ Library. “First Lady Biography: Betty Ford.” http://www.firstladies.org/biographies/firstladies.aspx ?biography=39. West, James W. 1997. The Betty Ford Center Book of Answers: Help for Those Struggling with Substance Abuse and for the People Who Love Them. New York: Pocket Books.

Ford, Gerald R. (1913–2006) Gerald Ford was president of the United States from 1974 until 1977 (the first vice president to succeed to the office because of the resignation of a president). The Ford administration continued the interdiction strategy begun by Richard Nixon. From the 1930s to 1975, Mexico supplied nearly all the marijuana used in the United States, but in a joint effort, U.S. and Mexican authorities began using the potent herbicide paraquat to fumigate and eradicate the Mexican crop. The program created an uproar in the United States because paraquat poisoned—but did not destroy—the marijuana crop, and many Americans who used Mexican marijuana got sick. The program did prove successful, though, in that many American marijuana users became reluctant to smoke Mexican marijuana, and its overall use declined. By 1979 Mexico supplied about 11 percent of the marijuana for the U.S. market, a figure that declined to just 4 percent by 1981. Ford differed from his predecessor, Richard Nixon, in opposing the creation of an executive-level office pertaining to drug abuse prevention. But, as the President’s Commission

420   Ford, Gerald R. (1913–2006)

U.S. president Gerald Ford appears before the House of Representatives Judiciary Committee to discuss the pardon of former president Richard Nixon in the days after the Watergate scandal and Nixon’s subsequent resignation. (Library of Congress)

on Organized Crime later pointed out, “Ford did not veto the 1976 amendment creating ODAP (Office of Drug Abuse Policy). However, President Ford did not staff ODAP, even though a specific line-item authorization had been made for it” (President’s Commission on Organized Crime 1986, 251). The ODAP came into being in 1977 under Ford’s successor, President Jimmy Carter. In a 1976 speech to Congress, President Ford spoke on the effects that drug use was having on American society. The cost of drug abuse to this Nation is staggering. More than 5,000 Americans die each year from the improper use of drugs. Law enforcement officials estimate that as much as one half of all “street crime”— robberies, muggings, burglaries—are com-

mitted by drug addicts to support their expensive and debilitating habits. In simple dollar terms, drug abuse costs us up to $17 billion a year. In the same speech Ford criticized the government for losing its focus on stopping drug use, and called for the government to take further action. “The time has come to launch a new and more aggressive campaign to reverse the trend of increasing drug abuse in America. And this time we must be prepared to stick with the task for as long as necessary.” Ford believed it was the responsibility of all levels and branches of governments to be involved in the rising drug use during the 1970’s. “Drug abuse is a national problem. Our national well-being is at stake. The Federal Government—the Congress, the

Four Loko  421

Executive Branch and the Judicial Branch— state and local governments, and the private sector must work together in a new and far more aggressive attack against drugs.” In 1974, Gerald Ford signed H.R. 9456, the Alcohol and Drug Abuse Education Act Amendments of 1974. Later, in 1974, Ford designated October 20 through October 26 to be “Drug Abuse Prevention Week.” It was Ford’s hope that this would help spur national awareness at the local level of the need for local leaders and communities to fight drug abuse. In 1976 Ford said that “drug abuse is one of the most serious and tragic problems in this country. Its cost to the Nation in terms of ruined lives, broken homes, and divided communities is staggering. In addition to this toll, it is a major cause of crime.” Ford also believed that one of his greatest accomplishments as president was appointing Peter Besninger as head of the Drug Enforcement Administration. President Ford also supported mandatory minimum sentences for drug offenders, and met with other world leaders on how to stop illicit drug trade worldwide. “I sent a special message up to Capitol Hill. ‘For too long,’ I said, ‘the law has centered its attention more on the right of the criminal than on the victim of crime. It is high time that we reverse this trend.’” While serving in the House of Represen­ tatives prior to becoming vice president, Ford co-sponsored H.R. 5946, the Heroin Trafficking Act of 1973. The new law increased potential penalties for the manufacturing, distribution, or possession of a mixture or substance that contained any amount of heroin or morphine. Under the law, if a person was convicted of an offense with less than 4 ounces of such substance, he or she would be sentenced to a mandatory minimum sentence of not less than 5 years nor more than 15 years in prison, and could also be fined not more than $50,000. Further, if a person

was convicted of the offense with respect to 4 ounces or more of such substance, he or she would be sentenced to a mandatory minimum sentence of not less than 10 years, or for life, and could be fined not more than $100,000. Finally, if a person is convicted of an offense involving less than 4 ounces and had been convicted of a felony relating to heroin or morphine before this, he or she would be subject to a minimum mandatory sentence of not less than 10 years and may be fined not more than $100,000. Ron Chepesiuk See also: Carter, Jimmy; Ford, Betty; Marijuana; Nixon, Richard M.

Further Reading Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. Ford, Gerald. 1974. Proclamation 4328 Drug Abuse Prevention Week, 1974. http://www .presidency.ucsb.edu/ws/index.php?pid =23880. Ford, Gerald. 1976. Gerald R. Ford’s Special Message to the Congress on Drug Abuse. Speech Presented at the White House, April. http://www.fordlibrarymuseum.gov/ library/speeches/760368.htm. “Gerald Ford on Drugs.” 2013. On the Issues: Every Political Leader on Every Issue, July 11. http://www.ontheissues.org/celeb/ Gerald_Ford_Drugs.htm. President’s Commission on Organized Crime. 1986. America’s Habit: Drug Trafficking and Organized Crime.

Four Loko Four Loko, a beverage manufactured by Chicago-based Phusion Projects, in its original formulation was a mixture of alcohol, caffeine, guarana, and taurine. The malt-liquor–

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based concoction contained up to 12 percent alcohol and came in eight fruity flavors. Five years after its launch it was voluntarily pulled from the market following numerous reports from university campuses around the United States that the drink was adversely affecting the health of students resulting in hospitalizations, even death. Doctors said Four Loko’s caffeine masked its alcoholic effects, leading drinkers to consume more than they normally would. As of March 2014, after further lawsuits, Phusion announced it would halt production and sales. In 2005, after observing their fellow Ohio State University students mix alcohol and caffeine, Chris Hunter, Jason Freeman, and Jeff Wright created Four Loko. The “four” in the name refers to its four primary ingredients: alcohol, caffeine, taurine, and guarana. The three students created Phusion LLC, and began selling 23-ounce cans of Four Loko at locations around the college. As the drink became popular around colleges in the Midwest, there were many concerns about the product’s health risks. Between 2007 and 2009, the drink became available in 46 states and Europe. Meanwhile, Four Loko had gained its unofficial slogan: “Horny, hyper, and happy.” By November 2009, the Federal Drug Administration (FDA) notified Phusion and other small makers of alcoholic caffeinated drinks that it would begin investigating the safety of their products. A year earlier, large manufacturers such as Miller (Sparks energy drink) had agreed to stop selling their versions of alcohol/caffeine drinks. Despite the FDA investigation, Four Loko’s popularity grew. In the summer of 2010, rap artists such as Killah Kid Kriz (“Loko Is My Liquor”) and Ricosuave glorified the drink in their lyrics. Ricosuave’s “So Loko (4 Loko Anthem)” included the line: “I know Jesus turned water into wine/ But he

woulda turned it into Four Loko at a party of mine.” The drink’s popularity began to falter in September 2010 after a Four Loko–infused party at New Jersey’s Ramapo College made 17 students and six visitors sick. The following month nine students at Central Washington State University were hospitalized after mixing Four Loko with other alcoholic drinks. Two months after Ramapo College banned Four Loko from its campus, other schools followed suit including Boston University and the University of Maryland. Reports of deaths attributed to the consumption of Four Loko began to mount. The parents of a Florida man who killed himself blamed their son’s death on Four Loko and filed suit against Phusion. Four Loko was also blamed for a fatal auto accident in Maryland. This resulted in the product’s removal from store shelves in Washington, Michigan, Utah, and Oklahoma. In an effort to stanch lost revenue, Phusion sent letters to the presidents and deans of student life at various colleges around the country. The company offered to fund oncampus alcohol education programs, which would include instruction on how to use Four Loko responsibly. This plan had no effect as states such as New York and Kansas banned shipment of the drink. On November 17, 2010, Phusion announced it would remove caffeine from Four Loko. In March 2014, the company agreed to stop production, after it had been sued by the attorneys general of 20 states. Stacy O’Hara Leiter See also: Caffeine; Energy Drinks

Further Reading The Week Staff. 2010. “The Rise and Fall of Four Loko.” November 24. http:// theweek.com/article/index/209434/the-rise -and-fall-of-four-loko.

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French Connection The “French Connection” refers to one of the largest and most important heroin-trafficking rings ever established. Founded by French criminal Jean Jehan, this French-Italian drug syndicate operated from the 1930s to the 1970s and was responsible for supplying an estimated 95 percent of the heroin to U.S. streets. According to the arrangement, the Italian criminals guaranteed the U.S. market to the French, promising to stay out of drug trafficking if the French criminals restricted their heroin sales to their Italian American counterparts in the United States. Marseilles, France, was the base of operation for the French Connection’s heroin laboratories, which converted the raw opium base imported from Turkey into heroin before it was smuggled into the United States by French Corsican gangsters, members of the Sicilian Mafia, and Italian American Mafia counterparts. A concerted international law enforcement effort smashed the French Connection in 1973, but many believed it continued to operate. As evidence, authorities pointed to the number of clandestine heroin laboratories in France and Italy that they uncovered until 1980. In that year, French police arrested the 82-year-old Jehan in Marseilles, but released him in December 1980 for health reasons. The scandal began in April 1971 when Lynn Pelletier, a U.S. Customs official, searched a Volkswagen camper-bus that had been shipped to Port Elizabeth, New Jersey, from Le Havre. In the van she found 96 pounds of pure heroin that had been hidden behind the wall of the bus. Pelletier also noticed that the owner of the bus, Roger de Louette, had been acting nervous when filling out the required customs forms. As he waited on the pier for the car, he was arrested

by Customs officials. De Louette claimed that he had been a spy with the Service de Documentation et de Contre-Espionnage (the French version of the CIA), but after losing his job, he was in desperate need of some cash. It was then that he accepted an offer to earn $60,000 simply by smuggling heroin. According to de Louette, the man who set up the shipment was Colonel Paul Fournier, who had been the official in charge of French espionage activities in North America. In sworn statements supported by liedetector tests, de Louette claimed that Fournier gave him money to buy the camper, which he drove to Pontchartrain, outside of Paris, where another man delivered the heroin and helped hide it inside the car. De Louette arranged for shipment of the car while he flew to New York. After his arrest, he asked for help from a staff member of the French consulate. De Louette did so, he said, because Fournier had given him the name for use as a contact in the event American police caught him. Ron Chepesiuk See also: Drug Trafficking and Organized Crime

Further Reading Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. Derks, Hans. 2012. History of the Opium Problem: The Assault on the East, 1600–1950. Boston: Brill. “The French Connection.” 1971. Time 98(22): 40. Friesendorf, Cornelius. 2007. U.S. Foreign Policy and the War on Drugs: Displacing the Cocaine and Heroin Industry. New York: Routledge. Maran, A. 2010. Mafia: Inside the Dark Heart, the Rise and Fall of the Sicilian Mafia. New York: St. Martin’s Press.

424   Freud, Sigmund (1856–1939) Moore, Robin. 1972. The French Connection. Boston: Little Brown.

Freud, Sigmund (1856–1939) Born in what is now the Czech Republic, Sigmund Freud is best known for his development of psychoanalysis for the treatment of psychological and emotional disorders. Sigmund Freud, MD, was an eminent Austrian neurologist and psychiatrist of Jewish origin. Freud is undoubtedly one of the critical thinkers who have most influenced the thought of his century. Sigmund Freud was born Sigismund Schlomo Freud on May 6, 1856, in Freiberg, Austria, today called Prˇíbor and part of Czech Republic. Freud is the father of psychoanalysis, a

widely famous approach to cure neuroses by psychological analysis, which he defined as not only a method of investigation of mental processes, as well as a therapeutic method, but also a theory of psychic functioning. Freud was an atheist who fought against religion, which he considered an obstacle to human intelligence and its development. Psychoanalysis as a theory of psychic workings allowed Freud to give an explanation of collective phenomena such as the prohibition of incest, in Totem and Taboo (1913), and a potent analysis of religion in The Future of an Illusion (1927). Freud taught at the University of Vienna from 1883 until he had to move to London in 1938 to escape anti-Semitism. In 1883, German physician Theodor Aschenbrandt administered cocaine to mem-

Austrian psychoanalyst Sigmund Freud in his office in 1938. Freud prescribed cocaine use for his patients and sometimes used it himself for his depression. (AP Photo/Sigmund Freud Museum)

Freud, Sigmund (1856–1939)  425

bers of the Bavarian Army. It was found that the drug enhanced their endurance on maneuvers. Freud, who was at the time a young neurologist, read the report and experimented with the substance. He played a significant role in the development of the Western cocaine industry, reporting, “I take very small doses of it regularly and against depression and against indigestion, and with the most brilliant success.” Drug giants Merck and Parke Davis (now Pfizer) paid Freud to endorse their rival brands. He wrote several enthusiastic papers on cocaine, most notably Uber Coca (About Cocaine) in 1884, reporting

addictive than when administered intravenously. Euphoric effects are delayed and less intense. In the 1880s, however, hypodermic needles started becoming more widely available, and morphine addicts found that subcutaneous injections of cocaine yielded a quick, potent, and addictive high. Before long, many users became hooked on both substances. By 1887, Freud had changed his position about cocaine and reported that it was more dangerous for public health than morphine (Grinspoon and Bakalar 1985). In the Cocaine Papers, Freud goes into much more depth about the use of cocaine as a drug:

exhilaration and lasting euphoria, which in no way differs from the normal euphoria of the healthy person. . . . You perceive an increase of self-control and possess more vitality and capacity for work.  .  .  . In other words, you are simply normal, and it is soon hard to believe you are under the influence of any drug.  .  .  . Long intensive physical work is performed without any fatigue. . . . This result is enjoyed without any of the unpleasant aftereffects that follow exhilaration brought about by alcohol. . . . Absolutely no craving for the further use of cocaine appears after the first, or even after repeated taking of the drug.

The first time I took 0.05cg. of cocaïnum muriaticum in a 1% water solution was when I was feeling slightly out of sorts from fatigue. This solution is rather viscous, somewhat opalescent, and has a strange aromatic smell. At first it has a bitter taste, which yields afterwards to a series of very pleasant aromatic flavors. Dry cocaine salt has the same smell and taste, but to a more concentrated degree. A few minutes after taking cocaine, one experiences a sudden exhilaration and feeling of lightness. One feels a certain furriness on the lips and palate, followed by a feeling of warmth in the same areas; if one now drinks cold water, it feels warm on the lips and cold in the throat. On other occasions the predominant feeling is a rather pleasant coolness in the mouth and throat. During this first trial I experienced a short period of toxic effects, which did not recur in subsequent experiments. Breathing became slower and deeper and I felt tired and sleepy; I yawned frequently and felt somewhat dull. After a few minutes the actual cocaine euphoria began, introduced by repeated cooling eructation. Immedi-

Freud concluded the paper by recommending cocaine pharmacotherapy for seven conditions: as a mental stimulant, possible treatment for digestive disorders, appetite stimulant in case of diseases such as cancer, treatment for morphine and alcohol addiction, treatment for asthma, aphrodisiac, and local anesthetic. Cocaine was, at that time, neither illegal nor prescribed. Freud had envisioned taking cocaine in an oral solution that was less likely to be

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ately after taking the cocaine I noticed a slight slackening of the pulse and later a moderate increase. I have observed the same physical signs of the effect of cocaine in others, mostly people of my own age. The most constant symptom proved to be the repeated cooling eructation. This is often accompanied by a rumbling which must originate from high up in the intestine; two of the people I observed, who said they were able to recognize movements of their stomachs, declared emphatically that they had repeatedly detected such movements. Often, at the outset of the cocaine effect, the subjects alleged that they experienced an intense feeling of heat in the head. I noticed this in myself as well in the course of some later experiments, but on other occasions it was absent. In only two cases did coca give rise to dizziness. On the whole the toxic effects of coca are of short duration, and much less intense than those produced by effective doses of quinine or salicylate of soda; they seem to become even weaker after repeated use of cocaine. The effect of a moderate dose of coca fades away so gradually that, in normal circumstances, it is difficult to define its duration. If one works intensively while under the influence of coca, after from three to five hours there is a decline in the feeling of well-being, and a further dose of coca is necessary in order to ward off fatigue. The effect of coca seems to last longer if no heavy muscular work is undertaken. Opinion is unanimous that any feeling of lassitude or other state of depression does not follow the euphoria induced by coca. I should be inclined to think that after moderate doses (0.05– 0.10g) a part at least of the coca effect lasts for over twenty-four hours. In my

own case, at any rate, I have noticed that even on the day after taking coca my condition compares favorably with the norm. I should be inclined to explain the possibility of a lasting gain in strength, such as has often been claimed for coca by the totality of such effects. It seems probable, in the light of reports, which I shall refer to later, that coca, if used protractedly, but in moderation, is not detrimental to the body. Von Anrep treated animals for thirty days with moderate doses of cocaine and detected no detrimental effects on their bodily functions. It seems to me noteworthy—and I discovered this in myself and in other observers who were capable of judging such things—that a first dose or even repeated doses of coca produce no compulsive desire to use the stimulant further; on the contrary, one feels a certain unmotivated aversion to the substance. In 1933, the Nazis publicly burnt a number of Freud’s books. In 1938, shortly after the Nazis annexed Austria, Freud left Vienna for London with his wife and daughter. Freud had been diagnosed with cancer of the jaw in 1923, and underwent more than 30 operations. He died of cancer on September 23, 1939. Richard E. Isralowitz See also: Addiction; Addictive Personality; Cocaine and Crack

Further Reading Carter, David, ed. 2011. Freud on Cocaine. London: Hesperus. “Freudian Slips: From the Cocaine Papers.” http://www.heretical.com/freudian/freud -cp.html. Grinspoon, Lester, and James B. Bakalar, 1985. Cocaine: A Drug and Its Social Evolution. New York: Basic Books.

Freud, Sigmund (1856–1939)  427 Markel, Howard. 2011. An Anatomy of Addiction: Sigmund Freud, William Halsted and the Miracle Drug, Cocaine. New York: Pantheon Books.

“Sigmund Freud 1859–1936.” British Broadcasting Channel History. http://www .bbc.co.uk/history/historic_figures/freud_ sigmund.shtml.

“Sigmund Freud—Biography.” European Graduate School Graduate and Post Graduate Studies. http://www.egs.edu/library/ sigmund-freud/biography/.

Thornton, E. M. 1983. Freud and Cocaine: The Freudian Fallacy. London: Blond and Briggs

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G future addiction because the drugs play such a role in the adolescent’s development. Before a young person begins using alcohol, tobacco, or marijuana, he or she may be susceptible to prevention techniques to stop drug use before it starts. Some of these methods include pro-use messages and images, increasing exposure to anti-use messages and images, and educating young people on how to review and critique messages that imply that youth substance use is widespread and safe. Sadly, once drug use starts, often, primary prevention efforts will not work. Their continued use puts them at higher risk for initiating use of other substances. This has created the need for new prevention programs. For those already regularly using drugs, programs that focus on the dangers of drug use are also unlikely to work. While sometimes these programs will work, many times without some form of individual intervention by family, friends, and/or substance abuse treatment professionals, treatment will be unsuccessful. Therefore beginning regular use of a gateway substance is a very significant step, leading to higher risk of later problems such as trying other substances, a lower chance of success of general preventive messages, and increasing need for intervention. Assuming that these youth will only continue to use the gateway drug is not fair to the user, family and friends, and community. There are a multitude of reasons to try to stop young people before the gateway, at the gateway, or after he or she has just passed the gateway.

Gateway Drugs Gateway drugs are drugs that are believed to cause one to begin using more dangerous drugs. For example, one may argue that marijuana is a gateway drug for heroin. Many people have thought for years that drugs such as alcohol and tobacco were a gateway into the use of illegal drugs like marijuana and then to more extreme drugs like cocaine or heroin. Despite these assumptions, the information suggests otherwise. The American Psychiatric Association, in a 2006 study, found that people whose drug use advances from alcohol to marijuana are just as likely to develop an addiction to drugs as those who use marijuana and then quit using marijuana to use alcohol. Though gateway progression is not unusual, researchers report, it is not wholly predicative of future drug use, and many drug use factors depend on individual, social, and environmental factors. Those internal and external factors, along with drug availability, are the main reasons as to whether or not an individual is more likely to use and/or abuse drugs. Yet, some studies suggest that people were more likely to use cocaine if they used drugs as adolescents, but there is some controversy as to whether this supports the gateway hypothesis, or that these young individuals were predisposed to future drug use. As a result, some argue in support of the gateway hypothesis, while some choose to emphasize certain factors. What many do agree is that in vulnerable individuals, particularly teenagers, some drugs are likely to be a way to

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Gateway drugs are not just tobacco, marijuana, and alcohol. Often young people can access prescription drugs, as opposed to illegal drugs such as marijuana, more easily in 2014. Because of this, a decade into the 21st century, there is legitimate claim that prescription drugs are now, or are becoming, a gateway drug. Prescription drug abuse has increased exponentially in the last decade, coinciding with the availability and distribution of prescription drugs. Prescription drugs seem to act as intermediate gateway drugs and speed up the process from alcohol or marijuana moving toward methamphetamine or heroin. While some youth may use prescription drugs without having used any illicit drugs, today it is still unusual to find a young person who abused a prescription drug before he or she began using alcohol regularly. Unfortunately, using both alcohol and prescription drugs is very dangerous and can have severe consequences for anyone, particularly young people. Many people have argued that the legalization of marijuana would lead to other drugs becoming legal. Luckily, many studies have been performed and almost every researcher who has studied the question has determined that marijuana does not have a causal relationship with other drug use. Instead, marijuana is the first (or, probably, third after alcohol and cigarettes) in a normal progression of drugs, for those who have certain risk factors that already make he or she likely to abuse drugs. Some researchers even argue that it is marijuana’s illegality that acts as the real gateway to other drugs. Because marijuana is illegal, those who want it must buy it from drug dealers who often possess other drugs and then try and sell these drugs to marijuana customers. This exposure can result in individuals using more dangerous drugs.

Researchers point to socioeconomic factors including employment and educational attainment as influences to the likelihood of substance abuse. A national survey conducted by Gary N. Siperstein, Neil Romano, Gizem Iskenderoglu, Anthony Roman, Floyd J. Fowler, and Max Drascher, which was funded by the Baseball Hall of Fame, the Taylor Hooton Foundation, and the Professional Baseball Athletic Trainers Society, examined steroid use in young Americans. Appearance- and performance-enhancing drugs (APEDs) are a wide range of substances used to alter physical appearance and improve athletic performance. A number of psychological and behavioral risk factors may increase the likelihood of using APEDs. Anabolic-androgenic steroids (AAS) have been used by approximately 3 percent of young Americans. Using the gateway hypothesis, the use of illicit APEDs also follows a linear progression: legal APEDs (e.g., nutritional supplements) precede illegal APED use. A study examined the relationship between nutritional supplement use, beliefs about APEDs, and APED use in 201 male (n = 100) and female (n = 101) undergraduates. Different physical and psychological tests such as examinations of muscle dysmorphia, body checking, eating disorder symptoms, perfectionism, and positive beliefs about the efficacy and safety of AAS use and APED use patterns were performed. Models showed that certain factors such as body image disturbance, compulsive exercise, illicit drug use, and perfectionism, independent of gender, were statistically significant predictors of positive feelings toward AAS. Individuals who used fat-burning and muscle-building supplements reported the strongest beliefs in AAS, and this correlated with a higher likelihood of current illicit APED use. For policy purposes, future prevention efforts

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may benefit from targeting legal APED drugs. According to a survey by the Substance Abuse and Mental Health Association, in 2012, approximately 2.9 million persons 12 and older used an illicit drug for the first time within the last year, an average of 7,900 new users per day, which was not much different from 2011 (3.1 million). Over half of initiates were 18 or younger when they first used, and surprisingly to some, 53.7 percent of new users were female. The 2012 average age at initiation among persons aged 12 to 49 was 18.7 years, which was similar to the 2011 estimate (18.1 years). Of the estimated 2.9 million persons aged 12 or older in 2012 who used illicit drugs for the first time within the past 12 months, a majority reported that their first drug was marijuana (65.6 percent). Over 25 percent started with nonmedical use of prescription drugs. A notable proportion reported inhalants (6.3 percent) as their first illicit drug, and a small proportion used hallucinogens (2.0 percent). A study of children 12–17 performed by the Center on Addiction and Substance Abuse at Columbia (CASA) showed that young people who used tobacco, alcohol, and marijuana are up to 266 times, and adults who use such drugs are up to 323 times, more likely to use cocaine than those who don’t use any of the aforementioned gateway drugs. If an individual only used one gateway drug, children were 77 times, and adults 104 times, more likely to use cocaine. The president of CASA, Joseph A. Califano, had this to say about the study performed: This study—the most comprehensive national assessment ever undertaken— reveals a consistent and powerful connection between the use of cigarettes

and alcohol and the subsequent use of marijuana, and between the use of cigarettes, alcohol and marijuana and the subsequent use of cocaine and other illicit drugs. An increasing number of American children and teens believe there is little risk in chugging a beer or smoking a tobacco or marijuana cigarette. With the recently reported rise in drinking and using marijuana by children and teenagers, this report is a wake-up call for parents to discourage their children from smoking and drinking and for governors and mayors to enforce the laws prohibiting the sale of cigarettes, beer, wine coolers and other alcoholic beverages to minors. No matter how we looked at the numbers, whether the user was white, black, male or female, the statistical connection between smoking, drinking or using marijuana and subsequent illicit drug use is clear. The study supposedly establishes a clear relationship relating to the gateway hypothesis theory. Nearly 90 percent of people who experiment with cocaine used marijuana, alcohol, and tobacco first, and over 50 percent progressed from smoking to alcohol, and finally to cocaine use. Another conclusion of this study was depending on how early or often gateway drugs are used, this can impact the progression to harder drugs. For example, children who smoke regularly (daily) are 13 times more likely to use heroin than children who do not smoke cigarettes every day. The following are specific findings of CASA’s study: • Using marijuana as a child meant that he or she would be 85 times more likely to use cocaine than non–marijuana

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•

•

•

•

users. (Ninety percent of children who used marijuana smoked or drank first.) Children who drink are 50 times more likely to use cocaine than their nondrinking counterparts. Young smokers are 19 times more likely to use cocaine than children who do not smoke. Adults who used marijuana when they were younger were 17 times more likely to use cocaine regularly, and 91 percent of adults who used marijuana as children smoked or drank before using marijuana. If an adult drank throughout his or her childhood, he or she was six times more likely to be a regular cocaine user.

same survey, this time of nearly 15,000 young adults, 20 percent had drank more than five alcoholic drinks in one sitting at least once. Perhaps most disturbingly, nearly 20 percent had consumed alcohol before the age of 13. The high school youth risk behavior survey also found that out of approximately a 14,900 sample size, around 21 percent had used marijuana at least one time. Out of 15,031 high school students, 8.1 percent had used marijuana more than once. Kathryn H. Hollen See also: Amphetamines; Cocaine and Crack; Gateway Hypothesis; Heroin; Marijuana

Further Reading Califano pointed out that the CASA investigation discovered a much more convincing relationship between gateway drugs cocaine and other illicit drug use than the 1964 surgeon general’s report found between smoking and lung cancer, the 1968 Framingham study found between cholesterol and heart disease, and the 1981 Selikoff study found between asbestos and lung cancer. “Each of those studies led not only to major investments in biomedical research, but to major changes in personal conduct among millions of Americans,” said Califano. Although alcohol, tobacco, and marijuana are illegal for children, these drugs are still accessible to children. In a 2011 high school risk behavior survey, performed by the Cen­ters for Disease Control, of approximately 14,000 high school students, at least 70 percent had had at least “one sip” of alcohol. The survey also found that of approximately 5,000 young people, nearly 40 percent drank alcohol that was provided to them by someone else. In the

Centers for Disease Control and Prevention. National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Division for Adolescent and School Health. 2011. High School Youth Risk Behavior Survey (2011). http://apps.nccd.cdc.gov/ youthonline/App/QuestionsOrLocations .aspx?CategoryID=3. Evans, N. A. 1997. “Gym and Tonic: A Profile of 100 Male Steroid Users.” British Journal of Sport Medicine 31: 54–58. Hildebrandt, T., J. K. Lai, J. W. Langenbucher, M. Schneider, R. Yehuda, and D. W. Pfaff. 2011. “The Diagnostic Dilemma of Pathological Appearance and Performance Enhancing Drug Use.” Drug and Alcohol Dependence 114: 1–11. Hyde, Margaret O. 2003. Drugs 101. Minneapolis: Twenty-First Century. Marijuana Policy Project. “Is Marijuana a ‘Gateway Drug’?” http://www.mpp.org/ assets/pdfs/library/GatewayDebunked.pdf. Markwood, A. 2011. “Gateway” Drug Use. http://www.jointcommission.org/assets/1 /6/Gateway_Drug_Use_bhc.pdf.

Gateway Hypothesis  433 Merino, Noel. 2008. Gateway Drugs. Detroit: Greenhaven Press. Siperstein, G. N., N. Romano, G. Iskenderoglu, A. Roman, F. J. Folwer, and M. Drascher. 2013. “The American Public’s Perception of Illegal Steroid Use: A National Survey, 2013.” Center for Social Development and Education Publications. Paper 2. http:// scholarworks.umb.edu/csde_pubs/2. Substance Abuse and Mental Health Services Administration. 2013. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/data/ NSDUH/2012SummNatFindDetTables/ Index.aspx.

Gateway Hypothesis The gateway hypothesis argues that using drugs such as marijuana, alcohol, and tobacco make one much more likely to use drugs such as cocaine and heroin. The theory has been used as cause to pass strict laws involving marijuana possession and trafficking since the 1930s. Federal Narcotics Bureau director Harry Anslinger also used the hypothesis in his three-decade fight against marijuana and other “soft” drugs. In testimony in front of the Kefauver Commission in 1951 it was argued that the people who use drugs follow a progression that moves from alcohol, to smoking marijuana, to snorting cocaine and injecting heroin. The arguments of the testimony went for the most part unchallenged. This resulted in increasingly tough antidrug laws in the 1950s that imposed the controversial mandatory minimum sentences for marijuana possession and trafficking. Because of increased

marijuana use in the 1960s and 1970s, the parents’ movement in the 1980s influenced Ronald Reagan to use the hypothesis as the foundation for both his War on Drugs and Nancy Reagan’s “Just Say No” drug prevention campaign. There is a lot of research disagreement as to the validity of the hypothesis, but if there were not high-profile research support for the hypothesis it would have, by now, been dismissed as political banter. But that is not the case. Recent studies suggest there is some validity to the gateway hypothesis, that the impact of gateway drugs such as marijuana may not be as robust as previously thought, and may be influenced by a number of external factors. The question then arises, if not the gateway hypothesis, then what, and what exactly is the role of the gateway hypothesis? One theory is that there are certain mental factors that make some marijuana users more susceptible to cocaine and heroin use. Some studies performed on animals have, in fact, demonstrated that this may very well be what is happening. A competing sociological theory argues that because illegal drugs must be purchased on the black market, this brings people in contact with drug dealers who also possess drugs such as cocaine and heroin. This in turn exposes the person to these harder drugs and makes them more likely to try the drugs. These competing explanations are not simply academic theories on drug use, but also have real implications for future drug prevention policy development and implementation. The very types of policies that are developed often hinge on what particular theory is in favor at that time. For example, if neurological factors are believed to be the main issue, then there may be strict laws on possessing marijuana. On the flip side, if the illegal drug market explanation is more cor-

434   Ginsberg, Allen (1926–1997)

rect, then legalizing marijuana makes more sense, because it would allow people to purchase marijuana from people legally who will not also be attempting to sell cocaine, heroin, or MDMA. Countries have taken different policy routes using these two theories. For example, countries such as Portugal and the Netherlands have focused more on legalization and decriminalization, while the United States continues to support harsh drug possession penalties and jail time. James A. Swartz See also: Anslinger, Harry J.; Gateway Drugs

Further Reading Coomber, Ross. 2013. Key Concepts in Drugs and Society. London: Sage. Kandel, Denise B. 2002. Stages and Pathways of Drug Involvement: Examining the Gateway Hypothesis. New York: Cambridge University Press.

Ginsberg, Allen (1926–1997) Allen Ginsberg is a U.S. poet who is famous for being the first “Beat” poet to gain popular attention when he read his poem “Howl” at a poetry reading in 1955. He became enamored with drug use, particularly during the 1960s, as part of the “hippie movement,” when he worked with Timothy Leary to publicize LSD and took part in Ken Kesey’s Acid Test festivals in San Francisco. He found his interest in poetry in high school, where he frequently read poems by Walt Whitman, but he originally chose to ignore this interest and pursue being a lawyer, as his dad wished. Becoming a lawyer was the plan when he enrolled at Columbia University, but he became part of a free-spirited group, and close friends with students Lu­ cien Carr and Jack Kerouac and nonstudent

friends William S. Burroughs and Neal Cassady. These young men, who were aspiring philosophers, were as obsessed with drugs, crime, and sex as they were with philosophy. Ginsberg, who was the youngster of the group, aided them in the development of their literary abilities, while they helped rid him of his naiveté. As a poet, he is remembered most for two lengthy masterworks: “Howl,” especially the opening line: “I saw the best minds of my generation destroyed by madness and relentless, rhythmic litany of lines devoted to the celebration of those minds.” One other masterful piece was “Kaddish,” which is a biography of his mother, Naomi Ginsberg, who spent most of her adult life in mental anguish. “Howl” would become almost a manifesto of the beatnik culture. “Howl” established Ginsberg as an important U.S. poet. But it would be one year later that Ginsberg would achieve international notoriety due to the highly publicized “Howl” obscenity trial in San Francisco, as well as the publication of Jack Kerouac’s On the Road. Kerouac, one of Ginsberg’s close friends and his mentor since the mid-1940s, had written a poem that sought to define a young, enthusiastic, and spirited generation in a boring, bland, and spiritless society. Kerouac, who carried the title “King of the Beats,” was an unwilling and unenthused spokesperson for the beatnik culture. Ginsberg used his marketing and business skills from his childhood to become a spokesperson for it instead. The “Howl” obscenity trial was a pivotal moment in Ginsberg’s life, and spurred him to be an outspoken activist of the First Amendment. Ginsberg used his fame as an avenue to speak out on a multitude of issues at the time including drugs, the Vietnam War, and gay rights. More than occasionally, his outspokenness got him in trouble. He

Ginsberg, Allen (1926–1997) 

Poet Allen Ginsberg, creative writer in the “Beat” generation, praised the effects of LSD and discounted its alleged dangers during testimony in front of the Senate Subcommittee on Juvenile Delinquency in 1966. (AP Photo)

was expelled from Cuba and Czechoslovakia in the 1960s and had an extensive dossier in the FBI. Though he was controversial, many people often asked for his opinion because of his knowledge on many subjects. For example, he testified before Senate subcommittee hearings on drugs, and many people cited his political essays. He is credited with inventing the popular term “Flower Power,” and eventually Ginsberg became an important figure of not just the beatnik society, but of the global youth culture. During the 1960s, Ginsberg tried many drugs, because he thought that under the influence of drugs he could create a new kind of poetry, similar to a belief shared by jazz musicians. By using LSD, peyote, and marijuana he tried to broaden his consciousness. He wrote many books under the influence of

drugs, including Yage Letters. His drug usage played a role in his status as a figurehead in the “rebel movement.” Unlike many poets, and more so than any other, Ginsberg used his fame to spur change. By just coining the phrase “Flower Power,” Ginsberg encouraged protesters of the 1960s to use nonviolent methods. By the 1970s, his fame had grown enormously, and he stopped using drugs to study and practice Buddhism and yogic practices, but he was still an important figure to the youth movement of the 1960s and 1970s. Allen Ginsberg died of liver cancer in 1997 (which may be related to his drug use), and his works are still of interest today. Almost all of his books remain in print. Four books of writings and interviews have been posthumously published, and new

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volumes of journals and correspondence are forthcoming. His poems appear regularly in anthologies around the world, and his photographs are constantly recycled in books and magazines. Because of his role in history, many universities offer classes on Ginsberg and the Beat Generation. Ron Chepesiuk See also: Beatniks; Hippies; Leary, Timothy; LSD

Further Reading The Allen Ginsberg Project. http://www .allenginsberg.org/. Ginsberg, Allen. 2002. Spontaneous Mind: Selected Interviews, 1958–1996. New York: Perennial. Ginsberg, Allen. 2007. Collected Poems, 1947–1997. New York: Harper Perennial. Ginsberg, Allen. 2009. The Selected Letters of Allen Ginsberg and Gary Snyder. Edited by Bill Morgan. Berkeley: Counterpoint. Jonnes, Jill. 1996. Hep-Cats, Narcs and Pipe Dreams: A History of America’s Romance with Illegal Drugs. Baltimore: Johns Hopkins University Press. Morgan, Bill. 2008. The Letters of Allen Ginsberg. Philadelphia: Da Capo Press. PBS. “Allen Ginsberg.” American Masters. http://www.pbs.org/wnet/americanmasters/ database/ginsberg_a.html. Rosenberg, Anton. 1998. “A Hipster Ideal Dies at 71.” New York Times, February 22. www .nytimes.com/1998/.  .  ./anton-rosenberg-a -hipster-ideal-dies-at-71.html.

Global Commission on Drug Policy (2011) The “War on Drugs” was first officially declared in June 1971 by President Richard

Nixon. Befitting its status as the world’s sole superpower, the United States has been influential in how that war has been waged internationally. The effort has been marked by a heavy reliance on the criminal justice system, tough legal sanctions, interdiction at the borders, and crop eradication in source countries. To a far lesser extent, there has been support for treatment, prevention, and rehabilitation. European countries have mostly followed the lead of the United States but have been more liberal with respect to their implementation of harm reduction measures such as needle exchange programs, supervised injection sites, prescription heroin, and the decriminalization of marijuana. The Global Commission on Drug Policy is an international group of 22 members that includes former world heads of state, former UN secretary general Kofi Annan, former U.S. Federal Reserve chairman Paul Volcker, other governmental leaders, businesspeople, and writers. Their report on the War on Drugs, issued in June 2011 on the 30th anniversary of Nixon’s declaration, is highly critical of U.S. and international policies. It cites a number of statistics to support its contention that the punitive emphasis of drug policy has been a failure, causing more harm than good and recommends policy changes. Excerpts from the commission’s report include:  1. End the criminalization; marginalization and stigmatization of people who use drugs but who do no harm to others. . . .  2. Encourage experimentation by governments with models of legal regulation of drugs to undermine the power of organized crime and safeguard the health and security of their citizens. . . .

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 3. Offer health and treatment services to those in need. Ensure that a variety of treatment modalities are available, including not just methadone and buprenorphine treatment but also the heroin-assisted treatment programs that have proven successful in many European countries and Canada.   4. Apply much the same principles and policies stated above to people involved in the lower ends of illegal drug markets, such as farmers, couriers and petty sellers. . . .   5. Invest in activities that can both prevent young people from taking drugs in the first place and also prevent those who do use drugs from developing more serious problems. . . .  6. Focus repressive actions on violent criminal organizations, but do so in ways that undermine their power and reach while prioritizing the reduction of violence and intimidation. . . .  7. Replace drug policies and strategies driven by ideology and political convenience with fiscally responsible policies and strategies grounded in science, health, security and human rights—and adopt appropriate criteria for their evaluation. . . . (“War on Drugs: Report of the Global Commission on Drug Policy” 2011) Through the Office of National Drug Control Policy, the United States issued a terse press release to rebut the report’s findings, but former president Jimmy Carter wrote in agreement of the commission’s recommendations, in an editorial in the New York Times (2011), saying that the commission’s recommendations were very similar to his own administration’s policies in the late 1970s. James A. Swartz

See also: Crop Eradication; Nixon, Richard M.; War on Drugs

Further Reading Branson, Sam. 2013. “Time to Break the Taboo on the World’s Longest Running War.” Huffington Post, November 4. http://www .huffingtonpost.com/sam-branson/time-to -break-the-taboo_b_4174858.html. Carter, Jimmy. 2011. “Call Off the Global Drug War.” New York Times, June 16. http://www .nytimes.com/2011/06/17/opinion/17carter .html?_r=2&. Global Commission on Drug Policy. http:// www.globalcommissionondrugs.org/. “Global Commission on Drug Policies.” 2011. The War on Drugs, January 25. http://newslanc.com/2011/01/25/global -commission-on-drug-policies/. Hetzer, Hannah. 2013. “Uruguay on Verge of Becoming First Country in World to Legalize Marijuana.” Huffington Post, December 3. http://www.huffingtonpost .com/hannah-hetzer/uruguay-marijuana -legalization_b_4379706.html. “War on Drugs: Report on the Global Commission on Drug Policy.” 2011. http://www .globalcommissionondrugs.org/reports/.

Golden Crescent An area that includes Iran, Afghanistan, and Pakistan, the Golden Crescent has produced a large amount of the world’s opiates since the late 1970s. Many have asked why this is, and there are several reasons. First, the area produces a highly pure form that is also cheap. Second, there is an estimated population of 500,000 that are addicted to heroin. Third, antigovernment groups in the region, which are also very powerful, control much of the Golden Crescent. Opium can be sold for profit and then these profits can be used

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to purchase guns and ammunition. Opium is transported from the Golden Crescent to Europe, the United States, India, and Turkey, by way of commercial planes and cargo ships. A UN drug report found that in total nearly 90 percent of the world’s illegal opiates originate in the two main production areas: the Golden Crescent and the Golden Triangle. The opium industry in the Golden Crescent dates back to the 1500s with the distribution of opium along the Silk Road and of Arab maritime trade. Areas including Kunduz and Kabul in Afghanistan; Peshawar, Pakistan; and the coast of Pakistan served as hubs for merchants to trade opium centuries ago. The opiate production has become so severe that it has left a damaging mark on the region, and has become a major concern for governments there. For example, during the 1950s the drug problem became so extreme that steps were taken designed to ban growing opiates. During this time, Iran was the region’s leading opiate producer and consumer. Despite this important step, over a decade later the ban on the cultivation and production of opium was removed and cultivation was restarted, but under heavy government regulation. Because of the chaos caused by the sudden and unexpected collapse of the USSR, there was a resulting loss of Soviet and military economic support for much of the region. This loss of monetary support caused numerous groups to seek other sources of revenue, and many turned to the production of opiates. As globalization has increased, it has only spurred international opiate trading. During the 1990s transnational organized crime became one of the major international security focuses, because these groups threaten the stability of governments, particularly of de-

veloping countries. Transnational organized crime is a global issue relating to global commerce and state security, to human rights, and the regulation of nuclear material to criminal groups. However, transnational crime has become most focused on drug smuggling. It is estimated that the monetary amount of drug smuggling ranges from US$100–400 billion each year. There is still not much known about drug smuggling, not just within the Golden Crescent, but throughout the world, and even less is known about the organizational structure of these groups and the possible interrelationships to international terrorist actors. The networks of these organizations are very hard to penetrate, and combined with the adaptability of these organizations, data is hard to find. Networks may not have a constant structure; often the groups only network when it is convenient for both parties. On top of all this, the nature of these activities along with the possibility of government involvement or indifference makes hard evidence very difficult to acquire. For example, in many instances in Southeast Asia, the government at best ignores, and more often supports and takes part in, smuggling illegal drugs. In many cases, governments simply lack the ability to fight the illegal drug trade within their borders. Afghanistan is a prime example of a country that is unable to combat the illegal drug trade. Many of its government officials are involved in the drug trade. This has resulted in Afghanistan being the world’s largest producer of heroin. There also appears to be a relationship between the illegal drug trade in Afghanistan, the Taliban, and Al Qaeda. For example, Al Qaeda has used the heroin trade to help fund terrorist acts. In 2001, when the Taliban banned opiate production, the cultivation slowed down; however, when the

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United States invaded because of the 9/11 attacks, it appears the invasion resulted in renewed opiate cultivation efforts. The amount of drug cultivation and selling has got the attention of China. Over the last 10 years, Chinese law enforcement officials have become concerned about heroin and other illegal drugs being sold from Afghanistan as well as the greater “Golden Crescent” region into parts of west China. The illegal drug situation in the Central Asia region already constitutes an ongoing threat to Xinjiang. The CNA researched the impact of Golden Crescent drug trade in China, which produced the following key findings. • Chinese law enforcement officials and analysts are now aware of the Golden Crescent trafficking, and see it as a major and rapidly growing threat to Chinese security. This is a major shift from how China has previously viewed areas such as the Golden Crescent and Golden Triangle. • Chinese law enforcement analysts do not blame the rise in Golden Crescent drug smuggling on Chinese demand; rather, they blame international (Western Europe and U.S.) demand. However, these same analysts and enforcement officials forget that Chinese domestic problems, such as police corruption, ethnic tensions, and rising drug prices and demand, make China an easy drug port for drug commerce. • Chinese analyses of popular Golden Crescent smuggling routes emphasize highway, air, and rail routes through Pakistan, Kyrgyzstan, Tajikistan, and Kazakhstan. If these beliefs are accurate, then this may show that these four key security partners of China may not

be able to stop trafficking into China across its territory. • Chinese law enforcement indicate that China has major issues with its counternarcotics intelligence capabilities and is anxious to overcome them. These problems include a lack of solid intelligence on Asian drug networks, little and unreliable data on trafficking by ethnic separatists, and poor intelligence networking and sharing among different jurisdictions and agencies. • Traffickers have become very capable, and along with cultural and language barriers between Chinese enforcement and traffickers are frustrating Chinese law enforcement officials. This results in traffickers being very difficult to investigate and question. • There seems to be a disagreement between law enforcement officials and research studies on the relationship between drug groups and terrorism. Law enforcement see a clear link between drug traffickers and terrorism, while Chinese researchers are not as convinced. Ron Chepesiuk See also: Drug Trafficking; French Connection; Golden Triangle; Heroin; Opium

Further Reading Booth, M. 1996. Opium: A History. New York: St. Martin’s Press. Curtis, G. 2005. “Afghanistan’s Opium Economy.” Asian Development Bank (ADB). http://www.adb.org/Documents/ Periodicals/ADB_Review/2005/vol37–6/ opium-economy.asp#Cultivation. Jamieson, Alison. 1994. Terrorism and Drug Trafficking in the 1990s. Brookfield, VT: Dartmouth.

440   Golden Triangle Lamour, C., and M. R. Lamberti. 1974. The International Connection: Opium from Growers to Pushers. New York: Pantheon Books. Martin, J. M., and A. T. Romano. 1992. Multinational Crime: Terrorism, Espionage, Drug & Arms Trafficking. Newbury Park, CA: SAGE Publications. Shanty, F. “The Taliban, Al Qaeda, the Global Drug Trade, and Afghanistan as a Dominant Opium Source.” University of South Australia, School of International Studies. http://www.picj.org/docs/issue3/The%20 Taliban.pdf. Tanner, M. S. 2011. “China Confronts Afghan Drugs: Law Enforcement Views of ‘The Golden Crescent.’” CNA China Studies. http://www.cna.org/sites/default/files/ research/china%20confronts%20afghan %20drugs. . .%20d0024793.a1_1.pdf. United Nations. “World Drug Report: Hig­ hlights.” http://www.un.org/ga/20special/wdr /e_hilite.htm. Williams, S., and M. Carlos. 1999. “The Globalization of the Drug Trade.” Sources 111 (April). http://www.unesco.org/most/ sourdren.pdf.

Golden Triangle The Golden Triangle is a particular area in Southeast Asia known for its production of opium and heroin. Though nobody is really sure how much opium is produced in the area, many people believe it to be around 70 percent of global supplies. The Golden Triangle is approximately 150,000 square miles area (about the size of Greece), extending from Myanmar, China’s Yunan province, and into Laos and Thailand. The excellent climate, fertile soil, cheap labor, and a ready market provide the Golden Triangle with the ideal conditions. In this area opium is also a

cultural and medicinal drug. There are up to 40,000 insurgents in the area, which makes policing the triangle very difficult. France’s intelligence and the CIA in the United States are credited with igniting the growth of the Golden Triangle’s economy through encouragement and support of the area’s independent warlords, because it was thought that the warlords would fight communism in the region. Over the years Myanmar has tried to stop the opium crop production through Operation Hellflower. The operation employed thousands of soldiers, police, and civilian personnel to manually destroy the opium. Despite its lofty goals, Operation Hellflower has had only limited success. Asia has a long history of having to deal with drugs and drug conflict, and many make the claim that drug production is correlated with poverty and conflict. On top of this conflict, drugs have in some places become incredibly ingrained into society. Issues in the Golden Triangle today threaten the health and safety of citizens, and political stability within these countries. Mercantilism has controlled the drug war, which preys on the fertile and complex terrain of poverty and armed conflicts. In fact a direct relation between drug production, poverty, and war appears to exist. Therefore, drug production and trafficking has been heavily influenced by culture and economics. The Asian drug trade has historical roots in the Silk Road and the early Chinese maritime trade thousands of years ago. However, the opium poppy is probably native to Europe and spread throughout Asia through Arab traders who brought it to India in the 600s ce, and to the Chinese. It is debatable, however, if Arab traders brought the opium poppy to these places, because early Indian traders and Buddhist pilgrims may also be at fault. However, Arab traders undoubtedly

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were the main contributors to opium becoming a cash crop. After Arab traders initiated the drug trade, European colonial powers were able to spread the drugs to China and other parts of the world. This was done first by the Venetians, later the Portuguese and Dutch, and finally the British from the seventeenth century forward, who used the East India Company. The British brought opium to China that was grown in the poppy fields of India. This resulted, in the mid-nineteenth century, in China’s two Opium Wars. The first war was with the British and the second with a combined British-French force. The Treaty of Nanjing (1842), which ended the first war, gave Hong Kong to the British, which soon became the world’s largest heroin hub. China, confronted with exploding opium consumption, eventually fostered local poppy production as a way to balance its growing trade deficit. After opium poppy growers began to move farther south because of pressure by imperial political repression and, later, by the enforcement of communist prohibition, opium production moved from China into Southeast Asia. This is a simple explanation how the Golden Triangle (Burma, Laos, Thailand) became a major drug hub. The Golden Triangle was a precursor to the Golden Crescent (Afghanistan, Iran, Pakistan). Opium poppy growing expanded to almost every corner of Asia, from Turkey to Japan in the Far East; along the mountains of Iran, Afghanistan, and Pakistan; to India, Burma (Myanmar), Laos, Thailand, Vietnam, and China. Opium cultivation even reached parts of Russia and countries such as Kazakhstan and Turkmenistan. However, the opium poppy is not the only thriving drug in this region; marijuana is also thriving in Asia. Lebanon, Turkey, Afghanistan, Pakistan, India, Nepal, Thailand, Cambodia,

and Kazakhstan are some of the most prominent worldwide producers and exporters of cannabis. The drug production, trade, and consumption of opiates in Asia has always combined national and international issues and events. Some of the major events have included international and national attempts at prohibition, which has rarely worked. Prohibition in Afghanistan and Pakistan in 1955 resulted in increased opiate cultivation. The prohibition in these two countries had international ramifications, which reached as far as the Golden Crescent. In a second example, Turkey took part in a difficult legal and power struggle with the United States in the early 1960s. In Turkey, poppies could be grown legally for pharmaceutical purposes, but large quantities were smuggled to France, where it was converted into heroin and then shipped to the U.S. drug market. The United States pressured Turkey to enforce a national prohibition against opium production, which Turkey eventually put in place in 1972. Turkey’s compliance in 1972 had deep repercussions in Asian trade, spurring the Golden Crescent’s production and further linking Asia’s various poppy-growing areas. The 1960s and 1970s saw two major events that shaped the way all narcotic phenomena were addressed. The first major event was in 1961 with the UN Single Convention on Narcotic Drugs, which reinforced former multinational agreements that had followed the 1909 Shanghai Convention, which was primarily concerned about heroin. Secondly, in 1971 U.S. president Richard Nixon declared a “war on drugs.” This brought the U.S. attention to the issue as well U.S. financial aid on drug eradication. While the United States and many other countries attempted to stop drug cultivation and trafficking worldwide, the CIA was not

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following the same notion. In many cases the CIA supported drug lords who promised to fight communism, or help finance anticommunism efforts. Considering the involvement of different groups in the drug trade such as the Hmong in Laos and the mujahideen in Afghanistan, CIA support implied that the agency would allow drug cultivation and growing in Asia. This has had lasting effects as seen in the Golden Triangle and the Golden Crescent, which remain the world’s two major opium production areas. Opium production in these two areas can be attributed to the protracted civil wars and the larger overarching conflict of the Cold War. Low-end estimates in Iran and Pakistan show 2 million opiate addicts per country, and the amount continues to grow each year. Afghanistan, best known as a producer, is now becoming a major consumer. However, Iran, previously the major trading route, has somewhat succeeded in diverting Afghan smuggling toward Central Asia. Thailand has similar problems and has changed trading routes with China, Laos, and Vietnam. Thailand is now becoming an innovator in drug consumption patterns as amphetamine-type stimulants surpass heroin, as Myanmar is massively producing such synthetic drugs in its country. Asian drug production and trade is very adaptable to market mechanisms. It does not matter if the drug be opium, heroin, amphetamines, or Ecstasy: the market survives. The drug trade and commerce has undoubtedly benefited from globalization. Fostered by poverty and grown by war, the drug trade seems to thrive off of the interstate instability and conflict in the region. The Golden Triangle, (in particular Myanmar) is China’s primary source of foreignproduced drugs. Even though many believe

there has been an overall decline in opium poppy cultivation in the Golden Triangle in areas like Myanmar, the crop has seen a resurgence of cultivation in other regions, and may not really be in decline in Myanmar. Laos in 2011 saw a 37 percent increase in production over the previous year. The United Nations Office on Drugs and Crime (UNODC) believes the total area used for opium poppy cultivation in Myanmar in 2011 was 43,600 hectares compared to 21,600 hectares in 2006—over a 100 percent increase. The UNODC believes that threefourths of Myanmar drug production supplies Chinese demand, and seizure statistics from the World Customs Organization show that nearly 70 percent of the heroin seized in China has its roots in Myanmar. Even though Chinese demand is high, the United States is the world’s largest consumer of narcotics, many of which come from the Golden Triangle. Opium and heroin often passes through China and into U.S. markets. The amount of heroin in the United States from the Golden Triangle more than doubled from 1977 to 1993. However, since 2005, competition from the Golden Crescent has limited the influx of drug from the Golden Triangle. Many believe that the adaptability of the Golden Triangle means that producers have realized that they may not be able to compete with the Golden Crescent in opium production, and may instead just be in a hibernation period of sorts, and finding ways to produce synthetic drugs because of the high demand of the international drug market. The U.S. Drug Enforcement Administration has already discovered methamphetamines in the United States from Myanmar. Ron Chepesiuk See also: Drug Trafficking; French Connection; Golden Crescent; Heroin; Opium

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Further Reading Chouvy, P. 2002. “The Drug Trade in Asia.” In Encyclopedia of Modern Asia, vol. 2, edited by D. Levinson and K. Christensen. Chicago: Scribners http://geopium.org/183/ the-drug-trade-in-asia. Jamieson, Alison. 1994. Terrorism and Drug Trafficking in the 1990s. Brookfield, VT: Dartmouth. National Narcotics Control Commission (NNCC). “Annual Report on Drug Control in China, 2008; UN Office on Drugs and Crime. 2009. Addiction, Crime and Insurgency: The Transnational Threat of Afghan Opium. Vienna: UNODC. UN Office on Drugs and Crime. 2009. Opium Poppy Cultivation in South-East Asia. Vienna: UNODC. UN Office on Drugs and Crime. 2010. “World Drug Report 2010.” https://www.unodc .org/documents/wdr/WDR_2010/World_ Drug_Report_2010_lo-res.pdf UN Office on Drugs and Crime. 2011. “South-East Asia Opium Survey 2011, Lao PDR, Myanmar.” http://www.unodc.org/ documents/crop-monitoring/sea/ SouthEastAsia_2011_web.pdf. U.S. Department of State, Bureau for International Narcotics and Law Enforcement Affairs. 2010. “International Narcotics Control Strategy Report: Volume I, Drug Control and Chemical Control.” http://www.state.gov /documents/organization/137411.pdf. Wiant, Jon. 1985. “Narcotics in the Golden Triangle.” Washington Quarterly (Fall): 125–40. Yong-an, Z. 2012. “Asia, International Drug Trafficking and U.S.-China Counternarcotics Cooperation.” The Brookings Institution Center for Northeast Asian Policy Studies. http://www.brookings.edu/~/media/research/files/papers/2012/2/drug%20 trafficking%20zhang/02_drug_trafficking_ zhang_paper.pdf.

Grateful Dead The Grateful Dead were probably the definitive rock and roll band of the psychedelic era. The Dead, who were notorious for being societal rebels, moved from playing local shows in ballrooms to huge stadium arenas at the peak of their fame. Jerry Garcia was the guitarist and front man for the group, and possessed amazing improvisational abilities making him the leader of the largest musical cult following in the United States, a worldwide network of fans who referred to themselves as “Deadheads.” Both the Grateful Dead and the Deadheads played a pivotal role in different movements in the 1960s. Like many rock bands of the time, the Grateful Dead were heavily influenced by bluegrass and jazz music. Jazz taught the Grateful Dead how to mix improvisational concepts within their music. From the culture of psychedelia the Dead were shown how using drugs could expand one’s improvisational abilities. Fronted by Garcia’s guitar, the Dead would dive into blues, folk, jazz, R&B, and avant-garde music arenas for extended periods of time. The group’s most renowned song was “Dark Star,” which the group played over 200 times, and because of their amazing improvisational abilities, never played “Dark Star” the same way twice. Besides being peace activists through music, perhaps what the Grateful Dead are best known for is their drug use, or at least reported drug use, of which there are multiple instances. In the late 1960s two members of the band, and several others affiliated with the Dead, were arrested for drug use. This event included two band members, two managers, and several women who followed and lived with the band. They were handcuffed and arrested by police on Oc-

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The members of the Grateful Dead, a rock and roll band that originated in the mid-1960s, were often linked to drug use, a trend that continues today. (AP Photo)

tober 2, 1967. San Francisco narcotics officers made the arrest based on information provided by an informant, and confiscated more than a pound of marijuana. The story made the front page of a local newspaper, which was followed by a band press conference. Band lawyers argued that the group was unfairly targeted; however, most of those arrested were only subject to minor fines. The group’s involvement with drugs runs clear back to the beginning of the group, when they were known as the Warlocks. Using electric instruments, the Warlocks first appeared in July 1965 and became the main band at Ken Kesey’s Acid Tests, playing at many public LSD parties. When the group became the Grateful Dead, they were

even bankrolled by an LSD chemist, Owsley Stanley. Drug use at Grateful Dead concerts, particularly by Deadheads, has been long understood to be a regular occurrence. Deadheads regularly used large quantities of drugs, including LSD. For example, in 1971 at the Winterland Arena in San Francisco, the Grateful Dead performed a two-night concert. On the first night of the concert around 1,000 fans at the show were given what was believed to be apple cider; however, the apple cider was actually spiked with LSD. Before the concert, the Grateful Dead had acquired a large quantity of LSD. Owsley Stanley was well known for providing LSD, which he called community service. It is believed Stanley produced over

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a million doses of LSD in the late-1960s alone. In hindsight it seems clear that the Dead wanted their fans to use drugs at their concerts. The Grateful Dead were never formally accused or charged with anything and there is little evidence to implicate them in drugging their fans; however, with the group’s renowned drug use, it is not hard to believe. In the 1960s, the FBI and then-director J. Edgar Hoover were heavily investigating for information that would implicate the group in illegal drug use. Jerry Garcia and Brent Mydland, a former Dead keyboard player who died of an overdose in 1990, were known to mix both cocaine and heroin, in what they referred to as a “speedball.” Garcia was known to use many of his interviews to try and promote drug use. Dead concerts continued to be heavily infused with drugs in order to “enhance the live experience,” and drugs were very visible at concerts. Several songs, specifically “Space,” which is played at every concert, were created for people who are high on drugs. Many other songs contain lyrics and symbols pertaining to drug use. For example, the Dancing Bears often seen on Grateful Dead bumper stickers are also printed on LSD pills. On March 27, 1973, Jerry Garcia was pulled over for speeding. However, a simple speeding violation became more troublesome for Garcia when the police officer searched his car and found marijuana. The police officer noticed the marijuana when Garcia opened a bag to find his driver’s license. Garcia also had cocaine residue on him, but the officer did not notice the cocaine. Garcia was released on a $1,000 fine, and made it out of the situation with only a one-year probationary sentence. Instances such as this were nothing new to Garcia or the Dead, who had been caught many times

prior. In fact, the Dead even dedicated the song “Truckin,” to one of these particular instances. The Deadheads were as famous as the band early on, and also used hallucinogenic drugs while listening to the band. In April 1989, 55 Deadheads were arrested for drug possession and disturbing the peace. In December 1989, a Deadhead was high on LSD and died while in police custody for public intoxication at the L.A. Forum. The Deadheads and police officials also had many violent altercations; however, most resulted in law enforcement officers being cleared of any wrongdoing. Adam Stilgenbauer See also: Entertainers and Drug Use; Hallucinogens; LSD; Psychedelic Drugs

Further Reading Dolloff, M. 2013. “Did the Grateful Dead Serve LSD to Their Fans?” Music: Rock and Roll Diary Extra. http://wzlx.cbslocal .com/2013/05/30/did-the-grateful-dead -serve-lsd-to their-fans/. “The Grateful Dead Biography.” Rock and Roll Hall of Fame. http://rockhall.com/ inductees/the-grateful-dead/bio/. “The Grateful Dead: Biography.” Rolling Stone. http://www.rollingstone.com/music/ artists/the-grateful-dead/biography. Hartlaub, P. 2013. “Grateful Dead and the 710 Ashbury St. Drug Bust of 1967.” SFGate. h t t p : / / b l o g . s f g a t e . c o m / t h e b i g eve n t /2013/07/25/grateful-dead-and-the-710ashbury-st-drug-bust-of-1967/#14360101=0. Plunkett, C. 2004. “The Downside of Pop Culture / The Dead’s Free Ride on Drug Use.” SFGate. http://www.sfgate.com/opinion/ openforum/article/The-Downside-of-Pop -Culture-The-Dead-s-free-2815095.php. Swanson, D. 2013. “40 Years Ago: Jerry Garcia Arrested for Speeding and Drug Pos-

446   Green Rush session in New Jersey.” Ultimate Classic Rock. http://ultimateclassicrock.com/jerry -garcia-arrested-speeding-drug-possession -new-jersey/.

Green Rush Lines stretched around the corners at marijuana shops all over Colorado as the state became the first in the United States to legalize sales of recreational marijuana in 2013. Colorado voters had also legalized medical marijuana in 2000. For years, patients could get small amounts from “caregivers,” the term for growers and dispensers who could each supply only five patients. In 2007, a court lifted that limit and business boomed. Between 2000 and 2008, the state issued about 2,000 medical marijuana cards to patients. That number has grown to more than 60,000 in the last year. State senator Chris Romer, a Democrat whose south Denver district includes Broadsterdam, a medical marijuana dispensary, said the state receives more than 900 applications a day. One group watching with intense interest was investors. Because marijuana and related products could be a boom industry, it’s being called the “Green Rush,” where cannabis startups pitch to investors interested in putting seed money, as it were, into the industry. In Washington State, which has also legalized pot, the Medical Marijuana Business Conference had its second meeting in Seattle, where 30 exhibitors paid as much as $16,000 each to attend the event. One industry group says that the legal marijuana business will increase 64 percent this year and top $10 billion within five years. Investors were watching closely as lines stretched around the corner at mari-

juana dispensaries in Colorado. The shops range in size and shape. There are both health food stores and 1970s-style head shops. There are storefronts that pitch lowcost weed, and boutiques offering gourmet ganja. No stems and seeds here, just walnutsized buds freshly harvested in the cultivation room out back. Meanwhile, marijuana and related products have become hot investments, complete with gatherings where marijuana start-ups make pitches to people interested in putting serious money into the industry. Many people assume that marijuana was made illegal through some kind of process involving scientific, medical, and government hearings, and that it was to protect the citizens from what was determined a dangerous drug. The actual story shows a much different picture. Those who voted on the legal fate of this plant never had the facts, but were dependent on information supplied by those who had a specific agenda to deceive lawmakers. The history of marijuana’s criminalization is filled with racism; fear; protection of corporate profits; yellow journalism; ignorant, incompetent, and/or corrupt legislators; personal career advancement; and greed. These are the actual reasons why marijuana is illegal. For most of human history, marijuana has been completely legal. It’s not a recently discovered plant, nor is it a long-standing law. Marijuana has been illegal for less than 1 percent of the time that it’s been in use. Its known uses go back further than 7,000 bce and it was legal as recently as when Ronald Reagan was a boy. The marijuana (hemp) plant has an incredible number of uses. The earliest known woven fabric was apparently of hemp, and over the centuries the plant was used for food, incense, cloth, rope, and much more. This adds to some of the confusion over its introduction in the United

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States, as the plant was well known from the early 1600s but did not reach public awareness as a recreational drug until the early 1900s. America’s first marijuana law was enacted at Jamestown Colony, Virginia, in 1619. It was a law “ordering” all farmers to grow Indian hempseed. There were several other “must grow” laws over the next 200 years (you could be jailed for not growing hemp during times of shortage in Virginia between 1763 and 1767), and during most of that time, hemp was legal tender. (You could even pay your taxes with hemp—try that today!) Hemp was such a critical crop for a number of purposes (including essential war requirements—rope, etc.) that the government went out of its way to encourage growth. The U.S. Census of 1850 counted 8,327 hemp “plantations” (minimum 2,000acre farm) growing cannabis hemp for cloth, canvas, and even the cordage used for baling cotton. Cannabis sacrament or “pot churches” believe Cannabis sativa is a sacred plant that can be used for religious purposes to expand consciousness and draw people closer to God. While cannabis has been used in rituals throughout history by religious sects like Rastafari and Central Asian shamanism, modern pot churches are typically a strange blend of Rastafari, Gnostic Christianity, and New Age philosophy. Sacramental cannabis sects claim they should be exempt from current marijuana laws because they use cannabis for religious purposes. Cannabis sacrament church leaders believe marijuana makes the mind more spiritually aware, and therefore it is their right as ministers to provide marijuana to those who want it. Nancy E. Marion See also: Marijuana; Medical Marijuana

Further Reading “Cannabis Sacrament ‘Pot’ Churches.” http:// www.cannabisculture.com/content/2011 /03/21/DEA-Targets-Cannabis-Sacrament -Pot-Churches. “‘Green Rush’ as Investors Pour Money in Marijuana.” 2014. http://hereandnow.wbur .org/2014/01/03/marijuana-investors-rush. Guither, P. 2014. Why Is Marijuana Illegal? http://www.drugwarrant.com/articles/ why-is-marijuana-illegal/. “Medical Marijuana: Will Colorado’s ‘Green Rush’ Last?” http://www.cbsnews.com/ news/medical-marijuana-colorado-green -rush/. Spellman, J. 2009. “Colorado’s Green Rush: Medical Marijuana.” http://www.cnn .com/2009/US/12/14/colorado.medical. marijuana/.

Guadalajara Cartel Rafael Caro Quintero, Miguel Angel Felix Gallardo, and Ernesto Fonseca Carrillo created the Guadalajara Cartel in the 1970s. This group has worked with the Colombian cocaine cartels transporting cocaine and heroin into the United States. At its peak, the cartel was estimated to have been responsible for around 70 percent of cocaine that was trafficked into the United States. By the late 1970s, the cartel became one of Mexico’s preeminent drug exporters. This has brought the cartel fame and notoriety, and it is one of the five most famous drug cartels in history. The Coalition Against Drug Abuse lists the Guadalajara Cartel as one of, and possibly the most, dangerous and famous Mexican drug cartels. The cartel was responsible for trafficking marijuana and opiates into Mexico’s version of the Golden Triangle, which is found in a mountainous region near Sinaloa.

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The Guadalajara Cartel also became responsible for much of the cocaine-related activity in Mexico at the time. Despite its recent creation in the 1970s, and its peak to fame by the early 1980s, the cartel began crumbling in 1985 with the kidnapping and murder of Enrique “Kiki” Camarena, a Drug Enforcement Administration (DEA) agent. An investigation ensued that showed corruption among Mexican officials in the Guadalajara area. Suspicion about Camarena’s followed, and the disappearance was soon blamed on Caro Quintero, Gallardo, and Carrillo. In response to this, President Reagan ordered searches of every vehicle that crossed the Mexico–U.S. border. Eventually Quintero was arrested in Costa Rica, and Carillo was arrested in Puerto Vallarta. The men claimed to be innocent and claimed Gallardo to be the one who kidnapped the DEA agent, but it would take four more years to find and arrest Gallardo. In 2013, a Mexican appeals court ruled that Caro Quintero should be released because his trial should have been by a state court and not a federal court. Caro Quintero had served 28 years of his 40-year sentence. Later in the same year, the Mexican Supreme Court overruled the appeals court decision, instead ruling Caro Quintero be remanded to custody. He has yet to be remanded because since his release, his whereabouts are unknown. Quintero did send a letter to the Mexican president and attorney general, which claimed that Mexico was allowing the United States to seek revenge against him for a crime for which he had already been punished. There is $5 million reward from the DEA for information that would lead to the arrest of Caro Quintero. After the arrests of the major cartel leaders, in the 1990s the cartel began to fragment, and this resulted in the formation of many

other well-known cartels. After Gallardo was arrested in the late 1980s, the power shifted to a different region of Mexico, and the Sinaloa Cartel was created. The Juárez Cartel is also a direct result of the splintering of the Guadalajara Cartel. When Carillo died due to complications related to a plastic surgery, his nephews split off and formed the Juárez Cartel; however, because of actions by other cartels and Mexican and American enforcement, the Juárez Cartel is a mere shadow of what it once was. Fragmentation of the Guadalajara Cartel also resulted in the formation of the Tijuana Cartel, which was established by relatives of Felix Gallardo. Perhaps the greatest consequence of the fragmentation of the Guadalajara Cartel is conflict. Because these cartels splintered off from one another, cartel rivalry has led to violence in parts of Mexico. Nancy E. Marion See also: Camarena Salazar, Enrique; Mexican Cartels

Further Reading BBC News. 2013. “Mexico Supreme Court Overturns Drug Lord’s Release.” November 6. http://www.bbc.co.uk/news/world-latin -america-24846077. Bunck, J. M., and M. R. Fowler. 2012. Bribes, Bullets, and Intimidation: Drug Trafficking and the Law in Central America. State College, PA: Penn State University Press. Drug Enforcement Administration. 2013. “Drug Enforcement Administration: 1985– 1990.” http://www.justice.gov/dea/about/ history/1985–1990.pdf. Estevez, Dolia. 2013. “U.S. Treasury Tracks Secret Bank Accounts of Top Mexican Drugpin.” Forbes, December 5. http://www .forbes.com/sites/doliaestevez/2013/12/05/ mexican-fugitive-kingpin-caro-quintero-stashed-billions-in-secret-overseasaccounts-former-dea-agent-claims/.

Guillot-Lara, Jaime (ca. 1947– )  449 “The Five Most Famous Drug Cartels.” 2012. Coalition Against Drug Abuse. http:// drugabuse.com/the-five-most-famous -drug-cartels/. Matalon, Lorne. 2013. “Narco Killer Sought by U.S. Sends Letter to Mexican President.” Fronteras, December 6. http://www .fronterasdesk.org/content/9302/narcokiller-sought-us-sends-letter-mexican-president. Rohter, Larry. 1989. “Mexicans Arrest Top Drug Figure and 80 Policemen.” New York Times. April 11. http://www.nytimes .com/1989/04/11/world/mexicans-arresttop-drug-figure-and-80-policemen.html.

Guillot-Lara, Jaime (ca. 1947– ) One of the key drug smugglers in Havana is Jaime Guillot-Lara, a Colombian. The Drug Enforcement Administration became aware of Guillot-Lara in 1975, when they estimated that he was smuggling over 400,000 pounds of marijuana, 20 million methaqualone pills, and thousands of pounds of cocaine into the United States each year. Guillot-Lara met Cuban ambassador to Colombia Ravelo-Renedo in the spring of 1980. They allegedly had an agreement that GuillotLara would pay $200,000 in a “tax” for each marijuana shipment that weighed up to 10 tons. In return, Guillot-Lara received protection for his transit through Cuban waters. The tax was lower than that levied on other drug traffickers because Guillot-Lara also agreed to carry weapons to M-19 insurgents in Colombia. He allegedly met with the ambassador or his representatives in Bogotá, Panama, and Mexico to arrange the shipment of weapons to Colombia and drug transfers in Cuba. In March 1981, law enforcement seized a cache of weapons, and some of the guerrilla soldiers who were arrested implicated

the Cuban embassy as a recruitment center for the M-19 insurgent group. Colombian officials immediately halted all diplomatic relations with Cuba and chose to expel Ambassador Ravelo-Renedo from the country. However, this did not affect Guillot-Lara’s drug-trafficking and weapon-trafficking operations. In the following months, GuillotLara was able to deliver 200 tons of supplies and weapons to M-19 revolutionaries on Colombia’s Pacific Coast after the weapons were successfully transported on two of Guillot-Lara’s ships, the Karina and Monarca (later renamed the Zar). On November 7, law enforcement agents from Colombia watched from patrol boats as men unloaded weapons off of the Karina. The ship was sunk, killing most of those on board. When he heard about the boat, Guillot-Lara fled from Colombia, traveling first to Cuba and then to Nicaragua, where he reportedly met with the Cuban minister of armed forces, Raul Castro, Fidel’s brother. In that meeting, Raul Castro reportedly suggested that Guillot-Lara travel to Mexico City, where the Cuban embassy would pay him a half-million dollars in return for an earlier shipment of weapons. More money would later be delivered by Cuban couriers. But before Guillot-Lara could make the move, he was informed that he was being tracked by Mexican police. He called the Cuban embassy for help and was met by two Cuban military attachés who provided him with false identification. They then took him to the Nicaraguan embassy where he was provided with $700,000 to cover bribes and other expenses that would enable him to flee to France. On November 25, Guillot-Lara was arrested by Mexican authorities who charged him with possessing false documents. Cuban officials attempted to get Guillot-Lara released from custody to pre-

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vent him from giving away too many secrets. They approached Mexican officials multiple times, but had no success. Guillot-Lara told law enforcement about the arrangements he had with Cuban officials, and about his drug operations. From this, the U.S. intelligence agencies were able to put together the extent of Cuba’s involvement with the narcotics trade. He was released and fled to Spain, and eventually back to Cuba. In November 1986, a U.S. federal grand jury then indicted Guillot-Lara for being part of a drugs-for-arms operation alongside Colombian drug-trafficking organizations. The grand jury alleged that Guillot-Lara, along with four Cuban officials (members of the country’s ruling Communist Party), smuggled weapons and cash to Colombian M-19 leftist guerrillas. The publicity surrounding Guillot-Lara’s arrest led to charges that Cuban officials were involved in drug trafficking. As expected, Fidel Castro, the country’s leader, denied the allegations. The United States filed an extradition request for Guillot-Lara that was based on overwhelming evidence of his guilt, including his own admissions. However, U.S. officials are not optimistic that he will ever be returned to the United States to stand trial. Nancy E. Marion See also: Colombian Cartels; Drug Trade; Drug Trafficking; Mexican Drug Trade

Further Reading Carpenter, Ted Galen. 1985. “The U.S. Campaign Against International Narcotics Trafficking: A Cure Worse than the Disease.” The Cato Institute; Cato Policy Analysis No. 63. http://www.cato.org/pubs/pas/pa063 .html. Ehrenfeld, Rachel. 1994. Narcoterrorism. New York: Basic Books.

“U.S. Links Drug Trader in Miami to Raul Castro.” 1982. New York Times, January 25. http://www.nytimes.com/1982/01/25/us/ around-the-nation-us-links-drug-trader-in -miami-to-raul-castro.html. Volsky, George. 1982. “U.S. Drug Charges Cite 4 Cuban Aides.” New York Times, November 6. http://www.nytimes.com/1982 /11/06/us/us-drug-charges-cite-4-cuban -aides.html. Werner, Leslie Maitland. 1983. “U.S. Officials Link Castro and Drugs” New York Times, November 10. http://www.nytimes .com/1983/11/10/us/us-officials-linkcastro-and-drugs.html.

Gulf Cartel The Gulf Cartel is one of the largest and oldest surviving Mexican drug cartels. It is also one of the most violent of the Mexican cartels. It operates on the border with Texas, near Brownsville. Their main rival is the Sinaloa Cartel. The group was originally founded by Juan Nepomuceno Guerra who smuggled alcohol into the United States during Prohibition. But in the 1970s, the group started to traffic drugs, particularly cocaine, into the United States. Now the group mostly traffics in cocaine, distributing the drug throughout the United States as far north as Michigan and New York. The leader of the cartel after Juan Nepomuceno Guerro was Juan Garcia Abrego, who worked with members of the Cali Cartel to smuggle large quantities of cocaine into the United States. He built warehouses along the U.S.–Mexico border to hold tons of cocaine coming out of Colombia. By 1994, it was thought that the Gulf Cartel distributed about one-third of all cocaine shipments from the Cali Cartel into the United States, making it worth over $10 billion.

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Suspected member of the Gulf Cartel, Gregorio Sauceda Gamboa, is escorted in handcuffs after his arrest in Mexico City in 2009. Gamboa was a former state judicial police officer and an alleged member of the Gulf Cartel’s group called “Los Zetas.” (AP Photo/Marco Ugarte)

The FBI put Abrego on their Ten Most Wanted List in 1995. He was the first drug trafficker to be added to the list. He was arrested in January 1996, extradited to the United States, and put on trial. During the trial, a member of the cartel, Juan Antonio Ortiz, testified that he arranged for the transfer of 10 tons of cocaine to be smuggled over the Mexico–U.S. border over a period of several years. Ortiz also provided testimony that the organization had successfully bribed officials at all levels of the Mexican government. Abrego was convicted of 22 counts of money laundering, drug possession, and drug trafficking. As part of the trial, $350 million of his assets were seized. He was sentenced to serve 11 life terms in a maximum security prison in Colorado.

Oscar Malherbe de Leon Oscar Malherbe de Leon was the supposed heir to Juan Garcia Abrego. Malherbe alleg-

edly was a top lieutenant and money man for Abrego. Under Abrego, Malherbe was responsible for coordinating massive shipments of cocaine from Colombia via aircraft into Mexico and then into the United States. He was believed to be both the operations manager for the Gulf Cartel as well as the group’s primary hit man. In February 1997, Malherbe was arrested at a shopping center in Mexico City on charges of murder and drug trafficking. He was imprisoned at Federal Social Readaptation Center No. 1 in Mexico. The United States tried unsuccessfully to have him extradited to the United States to face criminal charges.

Osiel Cardenas Guillen In July 1999, Osiel Cardenas Guillen became the leader of the Gulf Cartel. He created the “Los Zetas” to be the armed members of the group, made up of military personnel who

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deserted from the armed forces. They serve as a private mercenary group for the cartel, who would protect Osiel Cardenas from other gangs and the Mexican Army. Together, the Zetas and the Gulf Cartel were known as La Compania, or the Company. Eventually the Zetas split from the Gulf Cartel. Osiel Cardenas Guillen was arrested in 2003 and was then extradited to the United States in 2007 to face drug trafficking charges, among other things. He was found guilty and sent to prison in Texas for money laundering, drug trafficking, and homicide charges. He agreed to collaborate with U.S. intelligence.

Antonio Cardenas Guillen/Jorge Eduardo Costillo Sanchez After Cardenas Guillen was arrested, his brother Antonio Cardenas Guillen and Jorge Eduardo Costillo Sanchez, a former police officer, became the cartel’s leaders. Antonio Cardenas died in November 2010 in an eight-hour shoot-out and Costillo Sanchez became the sole leader. Costillo was probably the stronger leader of the two. During this time, Los Zetas separated from the cartel and began a turf war between them, turning Mexico into a “war zone.” Costillo Sánchez was arrested in Mexico on September 12, 2010. Mario Ramirez Trevino Marion Ramirez Trevino oversaw the Gulf Cartel during a time of much infighting. He was given the orders to make the organization profitable again. He participated, and coordinated shipments of cocaine into the United States. The United States offered $5 million for his arrest but the Mexican government offered no reward. He was arrested by the Mexican Army on August 17, 2013, in Reynosa. He is currently being held in the Federal Social Readaptation Center No. 1 in Mexico.

Homero Cárdenas Guillén Homero Cárdenas Guillén is thought to be the next leader of the Gulf Cartel. Not everyone accepts him as the leader. In November 2013, a faction group of the cartel, the Los Metros, fought with the Gulf Cartel in an apparent attempt to take control of the territory. Metros and Rojos There are two factions within the Gulf Cartel, the Metros and the Rojos, who seem to be fighting for control over the organization, although it appears as if the Metros have the upper hand. Zetas This group began as the enforcer wing of the Gulf Cartel under Cardenas Guillen. When he was extradited, the Los Zetas split off. The two groups worked together for a few years, but the Zetas no longer take orders from the Gulf Cartel leaders. Activities While the Gulf Cartel is largely active in smuggling cocaine, they also are involved in other activities. These include: Protection racketeering: The Gulf Cartel extorts or blackmails businesses, demanding protection money from them, threatening to kill those who do not agree to pay the group. The cartel also places a “tax” on Mexican businesses that are operating within the United States and threatens them with property damage and murder if they do not comply. Kidnappings: The Gulf Cartel has been the drug cartel associated with the most kidnappings throughout Mexico. They sometimes kill the victims or other

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times hold the victim for money and other ransom. Human trafficking: It is not clear to law enforcement if the Gulf Cartel members control the human trafficking business or whether it simply taxes those who operate the business for use of their smuggling corridors. Either way, it plays a major role in the worldwide human trafficking trade. Bribery: Cartel members bribe many officials to build their drug empire and move millions of dollars in cash and drugs. They bribe law enforcement, elected officials, and even journalists so they do not mention violent acts in the media. Theft: The cartel steals oil products and sells them illegally in Mexico and in the U.S. black market. Money laundering: Some of the profits of the Gulf Cartel’s illegal activities are often laundered in foreign bank accounts, properties, vehicles, and gasoline stations. Bars and casinos are often the hubs for money laundering of the drug cartels. Arms trafficking: The illegal trafficking of weapons from the United States into Mexico is often carried out by individuals. There does not appear to be a criminal group in Mexico or an international organization that is solely dedicated to this activity. Prostitution network: These are used by the Gulf Cartel as a way to persuade journalists to favor the cartel in the media. Prostitutes are also used as informants and spies, using sexual favors to extract information from certain individuals. Counterfeiting: The Gulf Cartel launders money through counterfeiting. The illegal products sold can be fake clothing/

accessories, TVs, video games, music, computer programs, and movies. Police impersonation: Gunmen from the Gulf Cartel have been caught impersonating law enforcement officers. They wear military uniforms as a way to confuse rival drug gangs and to move freely through city streets. In Fall 2013, members of the Gulf Cartel created an Instagram account on which they posted three photos. The photos were pictures of weapons, other equipment, and the gunmen, some of which included the cartel’s logo. The cartel members also have other social media accounts, such as Facebook and Twitter. Through one account, the cartel posted a video of members who were helping to pass out food and water to victims of Hurricane Ingrid in the fall of 2013. Nancy E. Marion See also: Asset Forfeiture; Drug Trade; Extradition; Mexican Drug Trade

Further Reading Fausset, Richard. 2013. “Mexican Army Captures Leader of Gulf Cartel.” New York Times, August 17. http://articles .latimes.com/2013/aug/17/world/la-fg -mexico-cartel-leader-20130818. Fausset, Richard. 2013. “More Violence Plagues Mexico; Military Supplants Police Force.” Los Angeles Times, November 4. http://articles.latimes.com/2013/nov/04/ world/la-fg-wn-violence-mexico-military -police-20131104. “Gulf Cartel.” 2009. Borderland Beat. http:// www.borderlandbeat.com/2009/05/gulf -cartel.html. Roth, Mitchel, P. 2010. Global Organized Crime: A Reference Handbook. Santa Barbara, CA: ABC-CLIO.

454  Gutka

Gutka Gutka, or ghutka, is a chewable, smokeless tobacco, which is also known as betel quid. It is a sweet, chewable mixture combining tobacco with spicy and fruity ingredients. The spiciness comes from the Piper betel plant, which is native to India and neighboring states, with leaves that are chewed for their mild stimulatory properties and oral hygiene benefits. Ghutka also contains parts of the areca nut and other flavorings such as cardamom, turmeric, cloves, saffron, and mustard seed. Available in tins or sachets, it is consumed in the same way Americans use moist snuff. The individual places the substances between their teeth and gums or lip and sucks or chews the substance, and spits out the remaining pieces. Gutka has played a pivotal role in introducing many young people throughout the world to using tobacco products. An estimated 30 percent of Indian schoolchildren are addicted to gutka, and among schoolchildren worldwide, the use of gutka, bidis, and kreteks surpasses the use of U.S. cigarettes. Because of a tobacco-free version in Southeast Asia, many people wrongly believe that all versions of gutka are safe to use. This belief has been exploited by companies, and has become a widespread marketing technique directed at children. Like other forms of tobacco, gutka use can result in oral cancers and reproductive problems such as lower-birth-weight babies. One problem that appears to be caused by the areca nut in gutka preparations is oral submucous fibrosis, which is a stiffening of oral fibrous bands that prevents the user from opening his or her mouth. This problem is very serious because the condition is irreversible and may even impact the esophagus. Ghutka is not currently regulated in the United States, and globalization is making

gutka more accessible throughout the United States. Using betel quid and gutka may have both stimulant and relaxation effects. According to the World Health Organization (WHO), an estimated 600 million men and women use some variety of betel quid, and betel quid with or without tobacco is most commonly used in the countries making up the Indian subcontinent. However, it is also very accessible and widely used in Cambodia, China, Indonesia, Malaysia, Philippines, Taiwan, Thailand, and other parts of Asia. The following is a list of conditions, problems, and cancers that are related with gutka use.

Precancerous Conditions • Oral precancerous lesions, including erythroplakia (a reddened patch in the mouth) and leukoplakia, which is a white patch on the mucous membranes on the mouth. This condition cannot be wiped off. • Oral submucous fibrosis (OSF), which is a precancerous lesion that stiffens the soft pink tissue that lines the inside of the mouth (i.e., oral mucosa). OSF may extend into the esophageal tract. As previously mentioned, it is irreversible and a very serious condition that usually leads to the inability to open one’s mouth. The best treatment involves a painful procedure that cuts the fibrous bands in the mouth. Cancer • Oral cancers: mainly lip, mouth, tongue, and throat. Other Health Effects • Reproductive health problems such as the infant being below optimal birth weight. • Nicotine addiction.

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Gutka is a cocktail of tobacco, containing many dangerous additives including magnesium carbonate and phenyl ethyl alcohol, as well as harmful perfumery compounds including musk ketones and other injurious fragrance compounds. Gutka use is one of the major causes of oral cancer in India, and is one of the major social problems in India. The aforementioned is also applicable to Indian communities within the United States. Gutka is very convenient to purchase in Asia, and now even parts of England, because it is convenient to use, and is sweet, just like a piece of candy. The substances are very much like those of the traditional paan: a sloppy mix of lime paste, cardamom, fennel, honey, areca nut, and, usually flavored tobacco, and then all of this is wrapped tightly in a betel leaf. Additionally, gutka also has a high concentration of nicotine, which explains why gutka chewers often become addicted and suffer many negative effects related to nicotine usage. One of the key parts of gutka, the areca nut, is the fruit of Areca catechu. The areca is a palm tree with a tall, slender stem crowned by a tuft filled with large leaves. The fruit is orange-yellow when ripe, and grows in large bunches at the bottom of the leaves. The areca nut is also a stimulant and is dangerous when used in large doses. Further, the carcinogenic properties of areca nut are exacerbated when taken along with tobacco, the combination present in gutka. Areca nut chewing is an important ancient and traditional action in many parts of Asia and some islands in the Pacific. Specifically in India, chewing the areca nut is a 2,000-year-old practice, and is an important religious and cultural act. India has 75,000 to 80,000 new cases of oral cancer per year, which according to the WHO is the highest in the world. On top of that, 2,000 deaths per day in India

are related to tobacco use; those in healthrelated fields argue gutka and other forms of smokeless chewing tobacco are the cause. This increase in oral cancers was caused by the convenience of gutka. A 1997 survey of young adults in Mumbai by the Indian Dental Association found that 10 to 40 percent of school children and 70 percent of college students had used gutka, or practices related to the areca nut. Gutka is a serious problem because it is rooted in Indian culture and is believed by many to be a safe product to use. People from India have been one of the fastest growing American immigrant groups, specifically in New Jersey, and there are signs that gutka use is a problem there. First, the University of Medicine and Dentistry of New Jersey (UMDNJ) Asian Indian Health Disparities Coalition performed a survey that found chew tobacco was the most common method of ingesting tobacco among Indians in New Jersey. Many people in the UMDNJ Tobacco Dependence Program Clinic have entered the clinic and been treated because of gutka use. Currently, it is not exactly known how prevalent gutka is in the United States, but it is still a major problem that is growing in Asian immigrant communities. Kathryn H. Hollen See also: Addiction; Cigarettes; Nicotine; Tobacco

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Centers for Disease Control and Prevention. Betel Quid with Tabaco (Gutka). Smoking and Tobacco Use. http://www.cdc .gov/tobacco/data_statistics/fact_sheets/ smokeless/betel_quid/.

456  Gutka Centers for Disease Control and Prevention. 2006. “Use of Cigarettes and Other Tobacco Products Among Students Aged 13–15 Years—Worldwide, 1999–2005.” Morbidity and Mortality Weekly Report 55(20): 553–56. Gupta P. C., and C. S. Ray. 2003. “Smokeless Tobacco and Health in India and South Asia.” Respirology 8(4): 419–31. Nair, U., H. Bartsch, and J. Nair. 2004. “Alert for an Epidemic of Oral Cancer Due to Use of the Betel Quid Substitutes. Gutkha and Pan Masala: A Review of Agents and Causative Mechanisms.” Mutagenesi 19(9): 251–62. National Cancer Institute, Centers for Disease Control and Prevention, Stockholm Centre of Public Health. 2002. Smokeless Tobacco Fact Sheets, Third International Conference on Smokeless Tobacco, Stockholm. September 22–25.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2011. “Office on Smoking and Health: National Center for Chronic Disease Prevention and Health Promotion.” http:// healthfinder.gov/FindServices/Organiza tions/Organization.aspx?code=hr0049. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2014. “Smoking and Tobacco Use.” http://www.cdc.gov/TOBACCO/. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2004. The Health Consequences of Smoking: A Report of the Surgeon General.

National Cancer Institute, National Institutes of Health. “Smokeless Tobacco.” http:// www.cancer.gov/cancertopics/tobacco/ smokeless-tobacco.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Public Health Service, Center for Health Promotion and Education, Office on Smoking and Health. 1988. Nicotine Addiction: A Report of the Surgeon General.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2003. Targeting Tobacco Use: The Nation’s Leading Cause of Death.

Varughese, A. 2003. “Gutka–A Silent Killer.” The Nicotine Challenger. http://www .tobaccoprogram.org/pdf/tnc/spring03/ page7.pdf.

H hoped that the meeting would mark the beginning of a unified and global opium control regime. The United States set the agenda for the conference, asking participants to consider an international scheme that would strictly regulate the production, manufacture, and distribution of opiates, harmonize penal sanctions for drug law violations across the world, and grant reciprocal rights to search ships suspected of smuggling the drug. As they did at Shanghai, however, other nations balked at the costs such international regulations would have on their own commercial interests. Given the profitability of colonial opium manufactures and monopolies throughout Asia, many powers were unwilling to sacrifice such a significant source of revenue. Furthermore, countries feared that if they agreed to stop producing and shipping the drugs, others would step up their opiate operations so they could profit from the fact that other drug-producing nations were cutting back. The fact that two major players in the drug business—Turkey, which was a major producer of raw opium, and Switzerland, which was a principal manufacturer of morphine and heroin—were not at the conference made this fear all the more legitimate. There was also a rivalry between producing and manufacturing countries at the conference. Some participants argued that even if the opium-growing countries agreed to limit the amounts they sent to the Far East, states involved in the manufacture of opiate pharmaceuticals would take advantage and flood the Asian market with other drugs such as morphine and heroin. Thus

Hague Convention The second major international conference on opium control met at The Hague, in the Netherlands, in 1911. Though it took almost a decade for the agreements reached at The Hague to take effect, the conference was significant since it established the principles of international narcotics control that would shape drug policies across the globe until the 1960s. Thirteen countries had met at Shanghai in 1909 in the first meeting that aimed to create a global narcotics control regime. Despite the agreement on general principles for drug control, however, few tangible results came from the Shanghai meeting since most of the major powers were unwilling to put their national drug industries at risk. These few tangible results included to gradually suppress opium smoking, to limit the use of opium to medical purposes, and to control its export and harmful derivatives. Disappointed with the lack of decisive action at Shanghai, the United States began advocating for another international conference in the autumn of 1909. Though officials from many of the countries that participated in the Shanghai meeting were reluctant to participate in another conference, the United States, led by anti-opium reformer Hamilton Wright, continued to push for another conference, which eventually met at The Hague in December of 1911. Wright hoped to accomplish more with this conference than the vague and noncommittal agreements struck at Shanghai. Asking countries to take concrete steps and not just make promises, the United States 457

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in order to institute effective control over the transport of opiates, any international agreement would have to meet two key prerequisites. First, it would need to have the signatures not only of nations who drafted the agreement but also those of all countries involved in the opium trade. Otherwise, the opiate traffic would not be checked, but simply move to wherever it could operate without restriction. Secondly, such an agreement could not simply target raw opium, but would need to control the drug in its manufactured and synthetic forms as well. Given the potential drawbacks of such strict regulations, the participants at the conference were not eager to commit themselves to the narcotic control effort wholeheartedly. Commercial concerns aside, there were other major stumbling blocks that made the United States’ goal of instituting strict and internationally uniform controls untenable. Some nations (France, Germany, Holland) were reluctant to sign an agreement that would require them to alter their national legislation, regulate their drug manufacturing industries, or allow foreign agents to search their ships; others (Britain and China) still did not agree with the U.S. delegation on how to distinguish medical from recreational drug use, thus complicating the task of defining what sort of opium use was acceptable and what was not. The agreement that emerged out of the conference in January of 1912, therefore, did little to create an effective drug control regime, as representatives only agreed to sign a convention that was both vague and noncommittal. The convention of 1912 served as the groundwork for future international drug control regulations and came into full effect in 1915. The convention’s biggest weakness lay in its provisions concerning ratification. To ease concerns that drug control would be in-

effective unless all countries involved in the drug trade (and not just the ones present at the conference) were in agreement, the representatives at The Hague agreed that the protocols—indefinite though they were— would not take effect until the entire drugproducing world signed the convention. Thus in Article 22, the convention listed 34 countries that were not present at the conference but would need to sign the treaty in order for it to become operational. If all of the listed countries did not sign by the end of 1912, there was to be a second conference at The Hague to reconsider a new convention. This proved a major impediment to ratification. By the middle of 1913, 12 of the 34 countries had still not signed, among them a major opium producer (Turkey). At the follow-up meeting in July 1913, a handful of countries announced that they would not ratify the treaty at the present time because attempts at control without the participation of all producing and manufacturing countries would be useless. Thus another deadline for universal ratification was set, this time for December 31, 1913. Though three more countries signed the agreement by the end of the year, nine nations had yet to ratify it, many of them opium-growing states in Southeastern Europe that were too preoccupied fighting wars to consider the treaty. A third such conference then met at The Hague in June 1914 and called for all powers to sign by the end of the year. But before the ratification process could be completed, the beginning of World War I in August derailed it, and put the task of international drug control on the backburner until the end of the conflict. Despite its shortcomings and the fact that it did not take effect before the summer of 1914, the Hague Convention marked a broad step towards drug regulation by establishing a framework that would shape

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drug laws across the world. For one, it laid out scientific definitions of some of the major drugs that should be controlled—“raw opium” (coagulated juice obtained from the Papaver somniferum plant), “prepared” (i.e., smoking) opium (raw opium that is dissolved, boiled, roasted, and fermented), morphine (the alkaloid C17H19NO3), heroin (diacetyl-morphine, C21H23NO5), and cocaine (C17H21NO4). In addition, the convention also specified that medical preparations that had these drugs as ingredients should be regulated, recommending that any medicines with more than 0.2 percent morphine, 0.1 percent heroin, or 0.1 percent cocaine become subject to government restrictions. In so doing, it set an internationally stan­ dardized scientific definition of what substances were to be controlled, and at what levels. These standards would guide many countries as they began drafting their own drug control legislation over the next five years. Furthermore, in spite of its wishywashy language and complicated ratification procedure, the Hague Convention set out what the major goals of drug control were to be—the limitation of exports and imports, tight regulations that restricted access to the drugs for anyone other than doctors and pharmacists, the repression of opium smoking, the proper labeling of narcotics, and a crackdown on smuggling. In the United States, The Hague agreement helped give momentum to the move towards domestic drug control, which resulted in the Harrison Narcotics Act in 1914. In addition, the provisions of The Hague treaty would also have significant repercussions after World War I. Article 273 of the Treaty of Versailles, which ended the war, forced many countries that had yet to sign The Hague agreement to implement the provisions it laid out. The principles of the Hague Convention also helped set the agenda when the international com-

munity met to reconsider the drug problem at the League of Nations in the 1920s. In 1961 the Hague Convention was superseded by a Single Convention on Narcotic Drugs. The Single Convention consolidated all previous conventions into one regulation. In 1971 another convention created mechanisms to control the use of psychotropic substances. Member states in an attempt to combat the transfer of drugs adopted the 2000 UN Convention against Transnational Organized Crime, a vital tool in combating drug trafficking. Howard Padwa and Jacob A. Cunningham See also: Harrison Narcotics Act

Further Reading Bewley-Taylor, David R. 1999. The United States and International Drug Control, 1909–1997. London: Pinter. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Fedotov, Yury, Executive Director of United Nations Office on Drug and Crime. “Opening Remarks on the Event to Commemorate the 100th Anniversary of the Signing of the 1912 International Opium Convention.” http://www.unodc.org/unodc/en/speeches /1912-international-opium-convention .html. Lyons, F. S. L. 1963. Internationalism in Europe, 1815–1914. Leyden, Netherlands: A. W. Sythoff-Leyden. McAllister, William B. 2000. Drug Diplomacy in the Twentieth Century. London: Routledge. United Nations Office on Drug and Crime. http://www.unodc.org/unodc/en/frontpage/ the-1912-hague-international-opium-conv ention.html.

460  Haight-Ashbury

Haight-Ashbury Haight-Ashbury is a neighborhood located within San Francisco, California, located at the intersection of Haight and Ashbury streets, near Golden Gate Park. The area is the place where young people and hippies gathered during the mid-1960s and became known for drugs, free love, and psychedelic rock music, as well as other artistic ventures. In the 1960s, the area became renowned for being the center of the counterculture. As such, many of the residents were suspicious of the government. They rejected consumerism, and were opposed to the U.S. involvement in the Vietnam War. While some residents of Haight-Ashbury were interested in politics, most focused on art (music, painting, and poetry in particular) and were interested in community and sharing. The streets of Haight and Ashbury are named after two early leaders in the area, banker Henry Haight and Board of Supervisors member Munroe Ashbury. The name “Lower Haight” refers to an area that was populated by African Americans and Japanese during the early years of the city. Prior to the 1960s, the entire area had become run down, allowing for many cheap places to stay and vacant properties that were available to rent or buy. Because of the low prices, the area was a popular place for musicians to gather. Some of the most popular rock musicians of the time could be found there. Philosophers, artists (such as Alton Kelley), and poets also migrated to Haight-Ashbury. Some who came there were interested in religious or meditative movements. The area became the center of an illegal drug culture and a “rock and roll” lifestyle. One of the activist groups essential to the movement was the Diggers, a local “community anarchist” group of activists who were known for their street theater. They were

A young hippie walks past the intersection of Haight and Ashbury streets in San Francisco in 1970. The area became known as the center for the hippie subculture and drug use. (AP Photo)

often labeled by outsiders as “left-wing” because of their radical politics, but they claimed to support freedom while having community consciousness. The members of the Diggers worked to create a society free of money and capitalism. They provided free food (stew) to about 200 people each day in Golden Gate Park at 4:00. The meal always included whole wheat bread that was baked in coffee cans. In addition to providing free food, the Diggers also supported free stores that provided items to those who needed them. Others could drop off usable items if they had extra things they did not want or need. The Diggers also funded free parties, with music provided by the Grateful Dead, Janis Joplin, and Jefferson Airplane, among other bands. The Diggers worked with another organization called the Switchboard. This was a

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group of residents that helped young people find places to stay (“crash pads”), as most of them did not have jobs or money to support themselves. People with an open place to stay would call to let them know of any assistance they could provide. The head of the Switchboard, Al Rinker, sought to make the group a way to increase communication among the residents of Haight-Ashbury and San Francisco as a whole. The Switchboard also helped with children who had run away from their homes and appeared at Haight-Ashbury with nothing. The Switchboard would contact the parents to let the child talk to the parent, or simply tell the parent the child was OK. In some cases, the parent contacted the Switchboard to leave a message for the child. However, no parent would be told where the child was. While all of this was happening, national media coverage of the movement increased. The music popular to Haight-Ashbury was receiving more airplay on commercial stations nationwide. The Song “San Francisco (Be Sure to Wear Flowers in Your Hair),” written by John Phillips of the Mamas and the Papas became popular. The Monterey Pop Festival, held in June 1967, gave attention to the new style of music and to the Haight-Ashbury district. It included bands such as the Grateful Dead, Big Brother and the Holding Company, and Jefferson Airplane. This helped to elevate the bands that were popular in Haight-Ashbury to national recognition. Soon, the events in the neighborhood and the people living there received constant media attention. A 1967 story in Time magazine, called “The Hippies: Philosophy of a Subculture,” was followed by a CBS News report. These stories, along with many others, helped to show people, especially teens, about the counterculture movement. Thousands of young people flocked to the area,

along with reporters, law enforcement, and tourists. Alternative lifestyles abounded and were accepted. Because of the number of addicts in Haight-Ashbury, and the amount of drugs that were available, there were serious health concerns. Dr. David Smith saw this and founded the Haight-Ashbury Free Clinics in June of 1967. He was able to provide substance abuse treatment and other medical attention (including mental health services) to people who were in need, without any religious affiliation. The clinics still exist today, providing free health care to the residents of Northern California. The clinic became a model for free clinics around the nation. Today, the facilities provide medical help, substance abuse treatment, jail psychiatric services, and on-site medical services for public gatherings (i.e., concerts). The Summer of Love, 1967, was the peak of the Haight-Ashbury experience. It is estimated that around 100,000 traveled to the neighborhood to experience the sights and sounds that they had heard about in the media. The summer months were filled with music, drugs, and free love. Two of the participants, James Rado and Gerome Ragni, based their musical Hair on their experiences during this summer. The play opened off-Broadway in 1967. So many people traveled to the HaightAshbury neighborhood that it quickly deteriorated, with an influx of people who were homeless, hungry, and addicted to drugs. High crime became a serious problem. In the fall of 1967, some residents of HaightAshbury staged a mock funeral, calling it “The Death of the Hippie,” as a way to signify the end of the era. Many of the stores in the area handed out funeral notices, inviting mourners to a funeral service that began at sunrise on October 6. A funeral procession went down the street, carrying a casket.

462  Hallucinogens

After this, the district continued to decline because of the presence of drug addicts, severe overcrowding, and the attempts by the San Francisco police and government to regulate the area (they had promised to keep the hippies away). In the late 1970s, the area came back to life. In the 1980s, a comedy club called the Other Café opened, starring future comedians Robin Williams, Whoopi Goldberg, and Dana Carvey. Other new clubs and restaurants opened, bringing people back to the area. Today, the area still maintains an air of hippie presence. There are many stores (particularly head shops) and restaurants. The second Sunday of June the residents hold the Haight-Ashbury Street Fair as a way to preserve the cultural and historical significance of the district. Nancy E. Marion See also: Beatniks; Hippies

Further Reading Jacobs, M. W. 2010. San Fran 60s: Stories of San Francisco and Birth of the Hippies. CreateSpace Independent Publishing Platform. Jacobs, M. W. 2012. “From San Fran 60s— Haight-Ashbury Chicks” Huffington Post, November 29. http://www.huffingtonpost .com/mw-jacobs/haight-ashbury-1960s _b_2211569.html. Perry, Charles. 1984. The Haight-Ashbury: A History. New York: Vintage Books. Perry, Charles. 2005. The Haight-Ashbury. New York: Wenner.

Hallucinogens Hallucinogenic substances, drugs that produce unreal perceptions of sight, smell, taste, touch, or hearing that do not come

from external sources, have been used for centuries, especially by certain populations. Also known as psychedelics or club drugs because they are often used by people frequenting nightclubs to alter mood, they do not necessarily produce hallucinations unless they are ingested in high doses. Almost all hallucinogens contain nitrogen and are classified as alkaloids. Hallucinogens were originally derived from plants and fungi until the means were developed to manufacture synthetic hallucinogens in a laboratory. Historically hallucinogens were used for religious rituals. The American Indian Religious Freedom Act Amendment of 1994 (AIRFA), allowed Native American Church members to ingest peyote as a religious sacrament during all-night prayers. For a long time, hallucinogens’ mode of action had not been well understood, but researchers have learned relatively recently that hallucinogenic plants affect serotonin receptors in brain regions where mood, perception, and sensory signals are processed. Many hallucinogens have similar chemical structures compared with natural neurotransmitters. Since hallucinogens at high dosages are also neurotoxins—that is, poisonous to the neurons of the brain—the long-term devastation they can cause goes well beyond the immediate dangers they pose in terms of distorted perceptions. Common hallucinogens include dextromethorphan, Ecstasy, ketamine, lysergic acid diethylamide (LSD), peyote, mescaline, phencyclidine (PCP), psilocybin and other tryptamines, salvinorin A, flunitrazepam and gamma hydroxybutyric acid (GHB) (both technically depressants), lysergamides, indolealkylamines, alpha-methyltryptamine (AMT) and dimethyltryptamine (DMT). Hallucinogens have popular street names including Acid, Battery Acid, Blotter, Boom-

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ers, Golden Dragon, California Sunshine, Heavenly Blue, Microdot, Zen, and Window Class. Some hallucinogens that were originally developed as general anesthetics, such as PCP and ketamine, are known as dissociative hallucinogens because they cause the user to feel detached from his or her surroundings. Sometimes the cough suppressant dextromethorphan is included in this group. Some hallucinogens are regarded as stimulants because they elevate heart rate, blood pressure, and body temperature. It is not possible to predict how each individual will react to hallucinogens. Some experience pleasant distortions of time, space, and perceptions whereas others may have intensely disorienting and frightening experiences. Months after using hallucinogens, people may experience flashbacks, in which unpredictable bursts of visual or auditory memories or disorientation occur. In time, the intensity of these episodes may diminish. Psychotic-like reactions involving surreal sensations and bizarre behavior have been known to occur both during hallucinogen use and during flashbacks. Hallucinogens can cause dilated pupils, high temperature and blood pressure, loss of appetite, and sleeplessness. In the 1960s and 1970s, many people experimented with hallucinogens such as LSD, mescaline, and psilocybin. Hallucinogen abuse has declined somewhat, but addictions experts are concerned that a resurgence seemed to occur during the 1990s, and, by 1999, 1 out of every 6 college students reported using hallucinogens. An estimated 1 million Americans who are 12 years or older use them, according to the 2007 National Survey on Drug Use and Health. Experts attribute this upswing to the emergence of Ecstasy as a party drug among junior and senior high school students. Initially popu-

lar as a club drug at psychedelic raves and nightclubs, Ecstasy is also increasingly seen in adults in their 20s and 30s. A relative newcomer to the club scene is salvinorin A, also known as divinorin A, which is an extract of the mint-like herb known as salvia or sage and grown primarily in Mexico and South America. Although it has not yet been scheduled under provisions of the Controlled Substances Act (CSA), it is subject to international controls and many U.S. states have outlawed its use or distribution. Its effects are similar to those of LSD or ketamine, and it is used primarily by adolescents and young adults. Some hallucinogens can be addictive. In surveys, nearly half of the adolescents who used the drugs met diagnostic criteria for addiction, and more than half reported withdrawal symptoms and psychological distress when the drug was discontinued. In research studies with animals that, among other things, evaluate the addictive potential of various substances, the animals came to prefer Ecstasy to other naturally pleasurable stimuli; this response is viewed as a hallmark of addiction. A number of phenethylamine and tryptamine analogs (two classes of psychoactive chemical compounds that can act as neurotransmitters or neuromodulators with hallucinogenic properties) have entered the illegal drug market in recent years. In an effort to control their manufacture, distribution, and use, the Drug Enforcement Administration took emergency measures to place some of them on Schedule I under the CSA so that individuals trafficking in them can be prosecuted. To the concern of drug officials, more new drugs in this class continue to be synthesized. It has been said that licking the back of a cane toad or a Colorado River toad will result in a hallucinogenic “high” because their

464  Hangovers

skin contains psychoactive chemicals. However, these chemicals are highly poisonous, and ingesting them could lead to severe illness or death. Kathryn H. Hollen

National Institute on Drug Abuse. 2013. “Hallucinogens and Dissociative Drugs.” Research Report Series, September. http:// www.drugabuse.gov/publications/research -reports/hallucinogens-dissociative-drugs/ director.

See also: Controlled Substances Act; Drug Classes; Drug Typologies Flashbacks; Ketamine; Neurotransmitters; Phencyclidine

U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov.

Further Reading

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov.

Bayer, Linda N. 2000. Strange Visions: Hallucinogen-Related Disorders. Philadelphia: Chelsea House Publishers. Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Foundation for a Drug-Free World. http:// www.drugfreeworld.org/drugfacts/lsd/ street-names-for-lsd.html. Halpern, J. H., A. R. Sherwood, J. I. Hudson, D. Yurgelun-Todd, and H. G. Pope Jr. 2005. “Psychological and Cognitive Effects of Long-Term Peyote Use among Native Americans.” Biological Psychiatry 58(8): 624–31. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Langlitz, Nicholas. 2013. Neuropsychedelia: The Revival of Hallucinogen Research Since the Decade of the Brain. Berkeley: University of California Press.

U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Hangovers Withdrawal from drugs takes many forms depending on the drug or drugs. Hangovers are generally considered a relatively mild form of withdrawal from alcohol. Beginning within hours of consuming the last alcoholic beverage, hangovers produce symptoms ranging from a dry mouth, sleep disturbances, body aches, diarrhea, dizziness, fatigue, nausea, and mild headaches to trembling, anxiety, depression, and sensitivity to light and sound. Severe withdrawal from alcohol entails intense craving and psychological discomfort, nausea and diarrhea, mental confusion, hallucinations, even seizures. If these are accompanied by an elevated heart rate, rapid breathing, disorientation, blackouts, and delirium tremens, alcohol withdrawal can be a lifethreatening medical emergency. As a diuretic, alcohol increases the rate of urination, which drains essential fluids from the body, including water, and leads to dehydration, which produces many characteristic hangover symptoms. If the impurities and by-products produced during alcohol’s fermentation and distillation

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accumulate in the body, the symptoms may be more severe; this is particularly true if the individual drinks several different kinds of alcoholic products throughout the duration of the drinking event. Some degree of toxicity from acetaldehyde buildup in the body can be expected if the drinker consumes alcohol quickly or in quantities more than the liver can efficiently metabolize. The brain too is affected; since alcohol is a depressant that suppresses the excitatory neurotransmitter glutamate, the neurotransmitter must rebound to normal levels when the person stops drinking. The effect of rising glutamate levels interferes with sleep and produces the anxiety, tremors, and restlessness associated with hangovers. Some addictions experts refer to the effort on the part of the brain to normalize its chemical levels as rebound hyperexcitability. The severity of hangovers appears to be affected by a person’s age. Older users seem to have more and longer-lasting symptoms of a hangover than do younger users. Women also seem to have worse hangovers than men, maybe because the same number of drinks affects women more than men. Moreover, those who smoke cigarettes or use tobacco products suffer more serious hangover effects. Although people believe in hangover remedies like black coffee, raw eggs, chili peppers, steak sauce, vitamins, or fatty foods, there are no hangover cures—time and bed rest are the best remedies. However, drinking large quantities of water when consuming alcohol can help prevent the buildup of toxins in the body, or drinking fruit juice or sports drinks the next day to replace the body’s fluids can be helpful. Aspirin and similar compounds should be used carefully, because they can irritate an already inflamed gastrointestinal tract.

Hangovers can result in misery for the user, but they can also result in absenteeism, impaired job performance, and loss of productivity in school or work activities. Activities that are potentially dangerous such as driving a car may also be affected. The best way to prevent hangovers is to abstain from alcohol use, or use these substances only in moderation. Kathryn H. Hollen See also: Addiction; Alcohol Use; Alcoholism; Depressants

Further Reading “Hangovers.” CNN Health. http://www.cnn .com/HEALTH/library/hangovers/DS0 0649.html. “Hangovers.” Mayo Clinic. http://www.mayo clinic.com/health/hangovers/DS00649. “Recent Developments in Alcoholism: Alcohol Problems in Adolescents and Young Adults.” 2005. Guildford: Springer London. Sutton, Amy L. 2007. Alcoholism Sourcebook. Detroit: Omnigraphics. U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. 2011. “Beyond Hangovers: Understanding Alcohol’s Impact on Your Health.” Washington, DC. Vander Ven, Thomas. 2011. Getting Wasted: Why College Students Drink Too Much and Party So Hard. New York: New York University Press.

Hard Drugs vs. Soft Drugs “Hard” and “soft” are terms used to describe drugs based on addictive liability and potency. Some countries, such as the Netherlands, base drug-use legislative policies on sharp distinctions between the two groups.

466   Hard Drugs vs. Soft Drugs

In the United States, the distinction is not relevant in legal terms because the laws are specific to each class of drug, or schedule, as laid out in the Controlled Substances Act, but many Americans apply these terms in casual usage. The terms are very ambiguous and have little scientific criteria or basis on which to make the distinction. Soft drugs are usually regarded as the nonaddictive or mildly addictive drugs whose penalties for use, if any, are less severe. Some people use the distinction that these drugs are not injectable. Examples of soft drugs are hallucinogens such as LSD and mescaline. While some countries and legislative jurisdictions also regard marijuana as a soft drug, many do not. Others include alcohol and nicotine in this category because of its legal use by adults and social acceptability. In some research, the term “soft drug” is used interchangeably with the term “gateway drug.” Although many people categorize marijuana as a “soft” drug, as it is not considered to be highly addictive (although the federal government considers it to be), this is increasingly being reconsidered. There are several strains of marijuana, some of which are bred for higher levels of THC. Other types of marijuana, especially hashish and hash oil, can be very potent and cause longterm harm to the user. Hard drugs are highly addictive and injectable, and capable of causing serious harm to the user, even death. Users of these drugs are likely to commit more crimes simply to obtain more of it. They include opiates like heroin and morphine as well as cocaine, crack, and amphetamines (methamphetamine, crystal meth). Alcohol and nicotine are also considered hard drugs for their addictive liability and severe potential for damaging health.

Drugs that fall in the middle of these two extremes include caffeine and Ecstasy and, in some areas, marijuana. Although there has been some effort on the part of U.S. government and local drug officials to blur the distinction between soft and hard drugs to discourage the use of all drugs, most addictions experts believe the distinctions should be retained to give the public an accurate assessment of the relative risks the two groups pose to users. Categorizing different drugs into specific categories of “hard” and “soft” is not always easy. Some people determine the difference based on whether a drug can be injected. Those that are injectable are therefore “hard” drugs. However, heroin, crack, and meth are not “soft” drugs, but they are usually smoked. It is important to consider the purity of the drug, the frequency it is used, and the social context in which it is used to make this distinction. Further, hallucinogens, including magic mushrooms and LSD, and the designer drug ecstasy, are generally not considered by most users to be addictive, but some research indicates they are. Since these drugs have a lower rate of addiction among users, and because they are not injected into the body, they should be considered to be soft drugs. But because so many users have experienced bad “trips” and have experienced flashbacks, most would probably not agree that these are “soft” drugs. Prescription drugs and medications such as tranquilizers and painkillers pose another problem when it comes to categorizing drugs. They are not usually considered to be “hard drugs” as they are prescribed for a medical purpose. Even when they are abused, they are not given the label “hard drug.” However, some have the same chemical structure as hard drugs and are highly addictive.

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That being said, the distinction between a “hard” and a “soft” drug isn’t clear, and the distinction doesn’t help to provide any information about the drug. However, many people would argue that all drugs are dangerous and carry a risk of addiction, and therefore should be avoided. Kathryn H. Hollen See also: Caffeine; Controlled Substances Act; Drug Typologies; Ecstasy; Hallucinogens; LSD

Further Reading Benavie, Arthur. 2009. Drugs: America’s Holy War. New York: Routledge. “Hard and Soft Drugs: How Are They Different?” Drug and Alcohol Rehab Solutions for Addiction. http://www.drug-and -alcohol-rehab-info.com/addiction/index .php/hard-and-soft-drugs/. Levinthal, Charles E. 2012. Drugs, Behavior, and Modern Society. Boston: Allyn and Bacon.

Harm Reduction Programs The International Harm Reduction Association describes harm reduction programs as those policies, programs, and practices that are aimed primarily at reducing the adverse health, social, and economic consequences of the use of legal and illegal psychoactive drugs without necessarily reducing drug consumption. They are the approaches to drug use that are aimed at reducing the potential harms associated with drug use for those who are unable to abstain, or choose not to. These programs benefit those who use drugs, their family members, and the community because they lessen the potential dangers that drug addiction have on society.

The policy of harm reduction began became more popular after the threat of HIV began spreading quickly among drug users who inject substances. However, similar approaches have been used for those suffering from alcohol-related problems for long periods. The underlying philosophy of harm reduction is that there has never been, nor will there ever be, a drug-free society. Further, reducing the risk of drug addiction should be based on the person’s readiness to change. If an addict is not ready to stop using drugs, then the focus of their behavior should be the safe and managed use of drugs. But when the person is ready to change, there is no single, ultimate solution to treating individuals. Instead, there are many different interventions that may be successful. The treatment options should be based on science, public health, and common sense. Further, the success of a program should be measured in changes in the number of deaths, crime, and suffering. Harm reduction is not drug legalization. Instead, it can be thought of as managing a problem (drug addiction) so that the least harm is done not only to the person using the drug, but also the rest of society— family, co-workers, community members, and society as a whole. Because incarcerating users does not reduce the harms to society that come with drug use, harm reduction favors the treatment of addicts by trained health professionals rather than incarceration in the prison system. Treatment should be based on the potential harmfulness of a drug not only to the user, but also to society. So the treatment for marijuana abuse, a drug that is considered to be less harmful to the user than other drugs, will be significantly different than treatment for a more harmful drug. Another important part of harm reduction is to maximize any potential benefits from drugs. This is particularly relevant to

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marijuana, which some believe has medical benefits. The harm reduction strategy seeks to protect young people from the dangers of drugs by providing a factual, science-based drug education program, and eliminating the availability of drugs on the black market. The harm reduction philosophy also focuses on the harms caused by the fact that these drugs are illegal. For example, the purity of drugs is often in question because they are not regulated by any agency. Sometimes the drugs contain harmful adulterants that would not be present if the drugs were legal, or the production were overseen by an office. The availability of drugs to minors on the black market is a concern to those who support harm reduction because young people should not be using these drugs. Yet they are available to teens through the underground market. Another result of prohibition is crime that is committed that might not be if the drugs were legal. Harm reduction seeks to reduce the potential harm done by prohibition. Harm reduction policies are sometimes very controversial. Those who are opposed to the harm reduction approach argue that these policies actually further enable users to abuse drugs, and even entrench addictive behaviors by allowing users to continue to use the drugs instead of helping users abstain from further use. They argue that harm reduction gives drug users a reason to continue their drug use. Another argument against harm reduction policies is that these policies drain resources that could be used elsewhere. They point that the costs to implement these policies outweigh any possible benefit. The third argument against harm reduction policies is that they will only serve to increase disorder in communities and, in the long run, threaten the public’s safety.

Drug users will move to places where these policies are popular, thus compromising the safety of these communities. One common harm reduction policy is needle exchange programs. In these programs, sterile needles are provided to drug users in exchange for their used ones. This way, drug users will not be using needles to inject drugs into their bodies that are tainted with diseases. The reason behind this policy is that dirty needles are one of the primary ways in which HIV/AIDS and other deadly diseases are spread among users. It is hoped that by providing clean needles to users, they will be less likely to use a dirty needle that has been used by someone else. This program potentially reduces the harm to the drug user, and to society at large because it helps stop the spread of disease. Opponents of the needle exchange programs claim that it will only encourage drug use. Another example of a harm reduction program is providing a safe area for people to use drugs. Some cities provide private rooms for users to inject drugs. This way, criminals will not be able to prey on individuals who may not be able to defend themselves. Again, critics claim that providing private rooms for drug users is only making drug use easy and acceptable. A third harm reduction program is called “Dance Safe.” This is a program that tests Ecstasy pills at raves to check their purity. This reduces the harm to users because there is a lower chance that a user is taking a drug that is tainted with a harmful substance. It helps society by reducing the potential health care costs of the users and the chance that they may overdose. A fourth harm reduction program supported by some is the legalization of marijuana. The logic behind this is that many marijuana users are encouraged to use harder drugs by dealers who want to sell more drugs

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and make more money. If marijuana were sold legally, marijuana users would not be in contact with dealers who have an incentive to sell different drugs. Nancy E. Marion See also: Addiction; Drug Typologies; Electronic Dance Music; Needle Exchange Programs

Further Reading “About the Drug Policy Alliance.” http://www .drugpolicy.org/about-drug-policy-alliance. British Columbia Community Guide. http:// www.health.gov.bc.ca/library/publications/ year/2005/hrcommunityguide.pdf. Ferner, Matt. 2013. “People Should Not be Punished for Possessing Small Amounts of Any Drug.” Huffington Post, November 27. http://www.huffingtonpost.com/news/ drug-policy-alliance. Institute of Medicine of the National Academies. 2010. “Report Brief: Reducing Harm.” h t t p : / / w w w. i o m . e d u / R e p o r t s / 2 0 1 0 / Hepatitis-and-Liver-Cancer-A-National -Strategy-for-Prevention-and-Control-of -Hepatitis-B-and-C/Report-Brief-on -opportunities-for-harm-reduction.aspx. Marlatt, G. Alan, Mary E. Larimer, and Katie Witkiewitz. 2012. Harm Reduction: Pragmatic Strategies for Managing High-Risk Behaviors. New York: Guilford Press.

Harrison, Francis (1873–1957) Francis Burton Harrison was born on December 18, 1873, in New York City. His father, Burton Harrison, served as a lawyer and private secretary to Confederate president Jefferson Davis. His mother, Constance Cary Harrison, was a writer. Harrison graduated from Yale University in 1895. While a student there he joined the secret Skull and

Bones society for rising student leaders. Harrison then went to New York Law School, graduating in 1897. Harris then became an instructor at the New York Law School, and left to serve in the U.S. Army during the Spanish-American War. In 1900, Harrison married Mary Crocker, whose father was a railroad and mining magnate. Together they had two daughters, Virginia and Barbara. Mary was killed in an automobile accident in 1905, leaving Harrison to be a single father. After that, Harrison married Mabel Judson Cox, Elizabeth Wrentmore, Margaret Wrentmore, and Doria Lee, divorcing each one. His sixth wife, Maria Teresa Larrucea, outlived Harrison. In 1903, Harrison was elected to serve in the U.S. Congress as a member of the Democratic Party. In 1904, Harrison ran a campaign for lieutenant governor of New York but lost the election. He then returned to New York to practice law, but was reelected to Congress in the following election. In 1913, Harrison resigned from Congress to become governor-general of the Philippines. Before he left Congress, he proposed the Harrison Narcotics Act that would put limits on distribution of opium. That year, Harrison introduced two bills into Congress. The first was a proposal to prohibit the use and importation of opium, while the second was a proposal to regulate the manufacturing of smoking opium within the United States. He did so because at that time, opiates and cocaine use were mostly unregulated. The bill was introduced as revenue legislation, but there was no real intention of producing revenue. A few months after being introduced into Congress, the bills were passed and sent to the president for his approval. President Wilson signed the bills, and they went into effect on March 1, 1914. In the long term, the Harrison Act

470   Harrison Narcotics Act (1914)

created more drug use than it prevented. Soon after, a committee was formed and given the charge to investigate the increased drug use problem. The committee members found that the illicit use of narcotics had increased dramatically while the act had been in effect. While in the Philippines, Harrison became a candidate to be the Democratic nominee in the 1920 campaign for the presidency. He lost the nomination to Governor James M. Cox of Ohio. Harrison was governor-general of the Philippines from 1913 to 1921. He oversaw the transfer of authority to the Philippine people to prepare for their independence. His pro-Filipino positions made him popular with the Philippine people. However, many conservatives in the United States thought that he did not support American interests overseas. Harrison left the Philippines and moved to Scotland for a time, until returning in 1934. When Manuel Quezon became the first president of the Philippines, Harrison became his principal advisor. Eventually, Quezon arranged to have Harrison named a naturalized Filipino citizen. Later, he served as an advisor to the first four presidents of the Philippine Republic after it became independent. He then moved to Spain for six years, then returned to the United States where he died in New Jersey. He chose to be buried in the Philippines. Nancy E. Marion See also: Harrison Narcotics Act; Opium

Further Reading “Harrison, Francis Burton.” Biographical Directory of the United States Congress. http:// bioguide.congress.gov/scripts/biodisplay .pl?index=H000268. The Harrison Narcotic Tax Act. http://www .princeton.edu/˜ achaney/tmve/wiki100k/ docs/Harrison_Narcotics_Tax_Act.html.

Harrison Narcotics Act (1914) The Harrison Narcotics Act, which was passed in 1914 and took effect in 1915, marked the beginning of federal narcotics control in the United States, putting certain potentially addictive drugs into a separate legal category. Proponents and supporters of the bill argued that the law be passed in order for the United States to meet its international obligations (The Hague Convention of 1912). The act led to the creation of the Bureau of Narcotics and a variety of heroin clinics that were closed in 1920 due to changing public attitudes toward heroin use. Until the passage of the Comprehensive Drug Abuse Prevention and Control Act of 1970, it remained the overarching piece of federal drug policy legislation in the country. Before the Harrison Narcotics Act was passed, there was little federal regulation to oversee or govern the commerce or use of narcotics. One law was the 1906 Pure Food and Drug Act, which required preparations, including narcotics, to be properly labeled. Another federal law was the Smoking Opium Exclusion Act, passed in 1909, which prohibited the importation of opium prepared for smoking into the United States. There were a handful of state laws and other local regulations governing drugs like morphine, opium, and cocaine, but the federal government did not have any overarching laws limiting the domestic trade and exchange of these drugs. The move towards federal regulations covering narcotics began in the first decade of the 20th century. Many reformers considered the use of narcotics to be immoral, and also used racist scare tactics associating the use of certain drugs with minorities, claiming that opium was part of a Chinese effort to poison white Americans, or that cocaine made blacks particularly violent. Some lead-

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ers in Washington also wanted the United States to pass a law controlling domestic drug use to prove to other countries participating in the Shanghai and Hague conferences on international drug control that the United States was sincere in its efforts to create a global drug control regime. Hamilton Wright, a member of the U.S. delegation at these international conferences and leading proponent of stricter drug control, began working with members of Congress to draft a federal law controlling narcotics in 1909. Wright’s proposed law would have controlled the sale and purchase of drugs through taxation and obligated vendors to register with the government, record all of their drug transactions, and, most importantly, require them to have a special stamp issued by the federal government. By including provisions that would have punished anyone who was caught in possession of narcotics without a government stamp, Wright’s plan would have made it possible for the federal government to decide who could, and who could not, sell and possess these drugs. First, Wright tried to persuade Congressman James R. Mann of Illinois to introduce the bill, but Mann refused. Later, he convinced Congressman David Foster of Vermont to introduce another such bill that would have put new controls over opiates, cocaine, chloral, and cannabis, but the bill was eventually defeated in 1911 due to opposition from the pharmaceutical industry. Undeterred by these failures, Wright continued his efforts to get Congress to pass a federal drug control law. In 1912, when Wright returned from The Hague conference, he believed that the United States now had a moral and diplomatic obligation to conform to the guidelines laid out by the convention and pass stricter controls over the domestic trade in narcotics. He secured the agreement of New York Democrat Francis

Burton Harrison to help get his antinarcotics proposal approved by Congress. Harrison worked with Wright to assure his fellow representatives that the bill would not harm the interests of the medical or pharmaceutical professions, and consulted with these groups to gain their support. In 1913, a National Drug Trade Conference met in Washington to consider Wright’s proposed bill. The pharmaceutical industry representatives and pharmacist organizations opposed the bill because it would have created an overly complex procedure for selling narcotics, and would have been too cumbersome in its record-keeping requirements. Several suggestions put forth by the National Drug Trade Conference made their way into the bill that Harrison eventually proposed; chloral and cannabis were dropped from the list of drugs to be restricted (leaving just opium, cocaine, and their derivatives and salts), the amount of the proposed tax on sellers of the drugs was reduced, the recordkeeping requirements were simplified, and preparations containing small amounts of the controlled substances were exempted from the law. In June 1913, the chairman of the conference signed a draft of the bill, and Harrison, now with the support of the medical and pharmaceutical professions, presented the bill in Congress that summer. The bill Harrison proposed included many compromises with the professional interests that had opposed earlier versions of Wright’s narcotics control bills, but still imposed strict rules governing the transfer and sale of many dangerous drugs. The bill required anyone who purchased narcotics to keep records of their purchases for up to two years so that government agents could inspect them to assure that the drugs were obtained legally; copies of orders for narcotics now had to be kept on file at local revenue offices; pharmacists could only sell preparations con-

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taining opium, cocaine, or their derivatives to people who presented a prescription issued by a physician, dentist, or surgeon registered under the Act; patent medicines containing more than very small amounts of morphine, cocaine, opium, and heroin could no longer be sold by mail order or in general stores; retail dealers and physicians who dispensed the drugs needed to have a tax stamp in order to sell the drugs; and everyone who sold narcotics had to be registered with the government. Congress passed the bill in late June. In the Senate, the Finance Committee made one significant change to the bill, allowing physicians to provide narcotics to patients by mail, and after some prolonged debates over the right of physicians to prescribe narcotics and what amount of heroin should be permitted in medicinal preparations, the bill was finally passed in December 1914 and took effect in March 1915. The Treasury Department, which issued the stamps allowing people to possess narcotics, was put in charge of administrating the law. Violations of the act could be punished by a fine of up to $2,000 or up to five years in prison. Over five years after Wright’s first proposal, the Harrison Act finally instituted national controls over the domestic traffic in opiates and cocaine. Ultimately, the Harrison Act was an important first step, but not the ultimate end, of the legislative effort to institute a nationwide system of narcotics control in the United States. It restricted the freedom to sell narcotics by requiring revenue stamps, and benefited large pharmaceutical firms since it allowed for the prosecution of small, unregistered peddlers and patent-medicine salesmen. Yet it did not address the questions of addiction or recreational narcotics use. According to the act, a medical professional could give prescriptions for drugs or distribute them “in the course of his professional practice” and in “good faith.” While

meant to prohibit the distribution of drugs to recreational users and addicts, it was unclear if it was within the scope of a doctor’s “professional practice” to give drugs to an addict who needed them to avoid withdrawal symptoms. The ambiguities of the law would not be made clear until the Supreme Court set precedents in Jin Fuey Moy v. United States in 1916 and, in 1919, United States v. Doremus and Webb et al. v. United States. Building upon the legal edifice constructed by the Harrison Act, the United States would have a comprehensive narcotics control regime in place by the 1920s. It is argued that the Harrison Act created some of the modern problems that relate to drugs. First, it created a criminal class that did not exist before (addicts were now considered by the society as criminals). Second, it led to the formalization of the “addict subculture.” Howard Padwa and Jacob A. Cunningham See also: Pure Food and Drug Act; Smoking Opium Exclusion Act; United States v. Doremus and Webb et al. v. United States; United States v. Jin Fuey Moy

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Frydl, Kathleen J. 2013.The Drug Wars in America, 1940–1973. Cambridge: Cambridge University Press. “Harrison Narcotics Tax Act.” http://www .princeton.edu/~achaney/tmve/wiki100k/ docs/Harrison_Narcotics_Tax_Act.html. Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press.

Hashish (Hash)  473 Musto, David F., ed. 2002. Drugs in America: A Documentary History. New York: New York University Press. “Narcotics.” http://www.umsl.edu/~keelr/180/ narcotic.html. Schaffer Library of Drug Policy. http://www .druglibrary.org/schaffer/library/studies/cu/ cu8.html.

Hashish (Hash) Also called hash, hashish is a potent, resinous product of the cannabis plant that contains a high percentage of delta-9-tetrahydrocannabinol, or THC, the psychoactive component in marijuana. Although hashish oil comes from the same plant, it is not a product of hashish but is extracted from the cannabis plant by use of a solvent. Hash is one of the most widely used drugs in the world today. After flowering, female marijuana plants grow hairline projections called trichomes that are rich in resinous hashish. To separate the trichomes from the plant, the flowers are forced through a sieve in a process called sieving, either by hand or in motorized tumblers. This forms a powder, called kief, which is then heated and compressed into blocks of hashish. Another method to remove the trichomes is to submerge them in ice water. Sometimes, chemical methods are used to collect the resin. The unwanted parts of the plants are removed, and the solvent evaporated. The remaining substance is the resins, called honey oil or hash oil. Sometimes, small pieces of the leaves are left in the final product, either by accident or on purpose. Any leaf product will affect the purity of the drug, and thus the effects on the user. Once gathered, the hash can be crumbled and smoked in a pipe, hookah, or bong. The

hash can also be baked into certain foods such as brownies or cookies. Fresh hash is soft and pliable. Hash has the following effects on its users: euphoria, relaxed inhibitions, increased appetite, disoriented behavior, altered coordination of reflexes, and altered perception of time and distance. The effects of hash last between 2–4 hours. As hash ages, essential oils evaporate, making the hash hard and less potent. Many drugs that are smuggled into the United States are several years old before they find their way into the hands of the average user. By then, the drug is less potent and may not have the intended effect. Because of that, many secret growing laboratories have been established in the United States to cultivate

Pieces of hashish confiscated by law enforcement in Atlanta, Georgia, in 1973. Hash is a product of cannabis that contains high levels of THC. (Georgia Crime Laboratory, Atlanta, Georgia/Centers for Disease Control and Prevention)

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high-grade marijuana and hashish under tightly controlled conditions. The THC content of hash is about 5 percent, whereas the THC content of hash oil is upwards of 15 percent. The hash oil varies in color and odor depending on the type of solvent used to extract it from the cannabis plant. Some users place a drop of the oil on regular (tobacco) cigarettes as a way to smoke the THC in a similar way to smoking a marijuana joint. Although a great deal of marijuana is from North and South America, most of the hash imported into the United States comes from the Middle East, North Africa, Pakistan, Afghanistan, and Morocco. Hashish and hashish oil have been placed in Category I (Schedule I) of the Controlled Substances Act, meaning that the federal government has decided they have no medical value and are highly addictive and can be easily abused. Although hash and hash oil have no legally accepted medical uses, they are believed by some to be effective antiemetics (able to reduce nausea and vomiting) and are sometimes used illegally by cancer patients suffering from those symptoms as a result of chemotherapy. A patient who overdoses on hashish can experience excessive fatigue, hallucinations, paranoia, or other symptoms of psychosis. Hash has the following withdrawal symptoms: ionsomnia, hyperactivity, and decreased level of appetite. Hash was popular among users in the 1960s and 1970s because it was more potent than most strains of marijuana. However, the potency of marijuana has risen, making hash less popular. Hash has many street names, such as boom, chronic, and gangster. Kathryn H. Hollen See also: Cannabis; Controlled Substances Act; Marijuana

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Clark & Clark LLC. “Illegal Drugs: Information about Hashish.” http://www .newjerseydruglawyer.com/glossary-of -drugs/hashish-hash-hash-oil.html. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. South Carolina Department of Alcohol and Other Drug Abuse Services. “Hashish Oil Drug Profile.” http://www.daodas.state.sc .us/profile_hashish-oil.asp. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http:// www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Hazelden Foundation The Hazelden Foundation stands as one of the nation’s most renowned addiction treatment facilities. A nonprofit organization, the Hazelden Foundation utilizes a multidimensional approach to annually treating

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thousands of patients addicted to alcohol and other drugs in multiple locations across four states. Hazelden also serves as a major publisher of literature related to addiction and recovery, and the Hazelden Foundation includes research facilities and a graduate school in addiction studies. The first Hazelden treatment facility was launched in Center City, Minnesota, in 1948 as a small institution devoted to the care and rehabilitation of alcoholic priests and professionals. As such, much of the funding for the first Hazelden center came from local businesses and the local Catholic diocese, and in its early years, Hazelden stressed a simple approach to treating addicts. Residents at Hazelden were expected to make their beds, behave properly, talk with one another, and attend daily lectures on the Twelve Steps of Alcoholics Anonymous. Over time, however, the Hazelden approach took on other facets as it expanded. With the aid of greater financial contributions from donors and significant collaborations with other alcoholic treatment facilities in Minnesota, Hazelden began employing what would come to be called the “Minnesota Model.” This model emphasized understanding alcoholism as a progressive disease that necessitated lifelong abstinence, and it advocated a different approach to treating alcoholics. Instead of shunning drunks as societal failures, Hazelden’s Minnesota Model emphasized treating alcoholics with respect and put great importance on creating a mutually supportive environment for treating addicts. The Twelve Step approach continues to be a part of the Minnesota Model, but it has been supplemented by additional rehabilitation measures to form a multidimensional approach to addiction treatment. The result is a Hazelden more broadly developed than in its original form, and over the course of its history, more than 200,000

addicted individuals have been treated at Hazelden facilities. In its second decade, Hazelden began a process of physical expansion. It opened a halfway house for men in 1953 and a treatment facility for women in 1956, and Hazelden geographically branched out by opening treatment centers in Chicago; New York City; Newberg, Oregon; and multiple locations within Minnesota. Through these branches, Hazelden has also developed education and training programs. Hazelden’s programs include a certificate program for chemical dependency counselors and a Graduate School of Addiction Studies, which opened in 1999. In addition, Hazelden offers a Pastoral Training Program and Professional-in-Residence and Physicianin-Residence programs. The Butler Center for Research is also a part of the Hazelden Foundation, and it seeks to improve recovery from addiction by conducting clinical research, collaborating with other research centers, and disseminating scientific findings. Through these expansions as an institution, Hazelden generally moved from a focus on providing treatment services to an emphasis on providing patients with recovery services that cover a wider range of problems beyond alcoholism. Thus, at Hazelden’s Renewal Center, people suffering from depression, anxiety, posttraumatic stress disorder, gambling problems, and eating disorders are given recovery services. In September 2013, the Hazelden Center merged with the Betty Ford Center to form the nation’s largest nonprofit addiction treatment provider. The new organization will be known as the Hazelden Betty Ford Foundation. Finally, Hazelden has a long tradition of publishing within the field of addiction and recovery literature. This began with purchasing the rights to the recovery meditation book

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Twenty-Four Hours a Day, which it published to great success; it has sold over 8 million copies to date. It has also published important texts like Not-God: A History of Alcoholics Anonymous and Codependent No More. Hazelden claims to have sold 2,649,955 publications in 2007 alone, and over the course of its history, it has distributed over 50 million publications. Howard Padwa and Jacob A. Cunningham See also: Alcoholics Anonymous; LifeRing; Narcotics Anonymous

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Felci, Erica. 2013. “Betty Ford Center Merges with Hazelden Foundation.” USA Today, September 24. http://www.usatoday.com/ story/news/nation/2013/09/24/betty-ford -center-merges-with-hazelden-foundation /2865931/. Hazelden. “Hazelden: Changing Lives. Every Day.” http://www.hazelden.org/web/public/ about_hazelden.page.

Hemp Hemp, the fibrous product of Cannabis sativa whose name is sometimes used as a synonym for the marijuana-producing plant, is one of the world’s oldest sources of fiber and was widely used for paper and textiles until the Industrial Revolution. Hemp was also used for ropes because of its great strength, and resistance to rot and decay. Even as far back as 1000 BCE, the Chinese used hemp fibers for fabric, ropes, and fishing nets. The world’s oldest piece of paper dates to 500 BCE and was made of hemp fibers. Hemp

was brought to America with Christopher Columbus, and was used for its fibrous materials for many years, primarily to make ropes. The settlers in Jamestown grew hemp as a major commercial crop that they exported along with tobacco. It was so important that the colony of Virginia declared that all people were required to grow hemp and imposed penalties on those who chose not to produce it. Hemp is valued for its long stalks and strong fibers. The leaves of this plant have very little THC, the psychoactive element of marijuana. Because of that, it cannot be used as a drug. In World War II, U.S. farmers were temporarily encouraged to grow the plant to replace supplies no longer available through Japanese-controlled agricultural sources. Since then, because hemp is viewed as the “marijuana plant,” there are prohibitions against cultivating it in the United States even though it can be used for food or fuel and its seed oils are of value in the production of paints and other materials. Environmentalists are working to change U.S. law because hemp is easy to cultivate, grows quickly in all kinds of soils, requires no pesticides, and is fully biodegradable. It could replace other materials now used in industrial manufacturing that produce a high degree of waste and have significantly negative environmental impacts. Aware of its value, many European countries and Canada issue licenses to grow the hemp plant, exempting it from international drug laws in recognition that certain agricultural conditions and breeding practices can yield plants of high-quality fiber with little or no concentrations of THC. Currently, nine U.S. states allow growing of industrial hemp, and bills have been introduced into Congress to allow for industrial hemp farming. In 1988, a federal law

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Many more outlets are selling lotions, salves, and other products that are made with hemp since hemp was legalized in some states in the United States. However, these products remain illegal under federal law. (AP Photo/Ted S. Warren)

was passed to allow for growing hemp for a “test period.” This did not last. Currently, anyone wanting to grow commercial hemp is required to apply for a government-issued permit. Federal law prohibits hemp products from being imported, but hemp fibers, sterile seeds, and food products that contain no THC are permitted. Currently, around 1.9 million pounds of hemp are imported into the United States each year along with 450,000 pounds of hemp seeds and 331 pounds of hemp seed oil. Among the most notable features of hemp seed is its high nutritional value with high levels of fatty acids (linoleic acid-omega-6 and alpha-linolenic acid-omega-3), vitamin B, and dietary fiber. Hemp oil also contains gamma-linolenic acid (GLA), which is used to treat ailments such as neurodermatitis, arthritis, and premenstrual syndrome.

The hemp plant can also be used to make other products including biodegradable plastics and fuels. Hemp is used in many foods such as hemp energy bars, hemp salad dressing, hemp milk, and hemp protein shakes. Hemp is also found in cereal, frozen waffles, and ice cream. Health products on the market today using hemp are hemp oil gel caps and hemp protein powder. Hemp fibers have recently been combined with other materials such as fiberglass to make building materials and composite panels for automobiles. Many car manufacturers are beginning to experiment with using hemp in their cars, including Audi, BMW, Ford, Mercedes, Porsche, and Volvo. Kathryn H. Hollen See also: Cannabis; Marijuana

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Further Reading Arizona Industrial Hemp Council. http://www .azhemp.org/Archive/Package/History /history.html. Bourrie, Mark. 2003. Hemp: A Short History of the Most Misunderstood Plant and Its Uses and Abuses. Buffalo, NY: Firefly Books. Conrad, Chris. 1997. Hemp for Health: The Medicinal and Nutritional Uses of Cannabis Sativa. Rochester, VT: Healing Arts Press. Hemp Industries Association. http://www .thehia.org/. Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press.

In elementary school, Jimi would often carry a broom as a guitar, even though he did not own one. When he was 15, Jimi found a ukulele in the garbage and learned to play it by ear. He later purchased his first acoustic guitar for $5. With that guitar, he formed his first band called the Velvetones while in junior high school. That year, his father bought him an electric guitar. Jimi then joined a new band, called the Rocking Kings, which performed at many events. When someone stole his guitar, his father bought him another one. Jimi did not graduate from high school. When he was 16, police found him twice riding in stolen cars and gave him the choice

Ranalli, Paolo. 1999. Advances in Hemp Research. New York: Food Products Press. Robinson, Rowan. 1995. The Great Book of Hemp: The Complete Guide to the Environmental, Commercial, and Medicinal Uses of the World’s Most Extraordinary Plant. Rochester, VT: Park Street. Rothenberg, Erik. 2001. A Renewal of Common Sense, The Case of Hemp in the 21st Century. http://www.azhemp.org/Archive/ Package/renewal.pdf. Sanna, E.J. 2013. Marijuana; Mind-Altering Weed. Broomall, PA: Mason Crest.

Hendrix, Jimi (1942–1970) James Marshall “Jimi” Hendrix was a singer and songwriter who is thought to be one of the best electric guitarists in the history of rock and roll music. Born in Seattle in 1942, Jimi was the oldest of five children. Both of his parents struggled with alcoholism, and divorced when Jimi was nine. The court granted his father custody of the children. When he was older, Jimi claimed that he was sexually abused as a child.

Musician Jimi Hendrix, popular in the 1960s for his guitar playing, died in November 1970 at the age of 27 as the result of abusing barbiturates. Before his death, he was considered to be one of the most influential guitarists of the time. (AP Photo/dapd)

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to enroll in the army or go to prison. Jimi chose to enlist in the army, serving in the 101st Airborne as a paratrooper. While in the service, he formed a duo called the Casuals. Military life was not for Hendrix. He was often caught napping and failed to report for bed checks. His superiors claimed that he was not suitable for the army and that he should be discharged. He received an honorable discharge. When his band mates from the army were released, the men continued to play together. They formed a band called King Kasuals. Hendrix continued to play when he could and where he could. Hendrix won first prize in an Apollo Theater amateur contest, giving him a lot of attention. Throughout, Hendrix experimented with many illicit drugs. He often drank alcohol and took LSD. He also used hash, amphetamines, and cocaine. It was reported that Hendrix played his guitar all the time. He always had a guitar with him wherever he went. He was very shy, and the guitar was a way he could pass over those who wanted to talk to him. He was also very intensely self-conscious about his voice, and tried not to sing. In 1966, Hendrix formed a new band called the Blue Flame. He then decided to move to London where he worked with the former managers of the Animals, another popular group of the time. While in London, Hendrix stayed in Ringo Starr’s apartment. There, Hendrix and his manager created a band called the Jimi Hendrix Experience to showcase his skills. Hendrix signed with Track Records in London. They decided that, as a way to get attention, Hendrix would set his guitar on fire at the end of concerts. While in London, the Jimi Hendrix Experience had some top 10 hits, including “Hey Joe,” “Purple Haze,” and “The Wind Cries Mary.” In 1967, Hendrix played at the Monterey Pop Festival, which brought him great pub-

lic attention and fame. After that, Hendrix got many appearances. The following year, Jimi’s third and final studio album reached number one in the United States. It was entitled Electric Ladyland. This album turned out to be his first and only number one album. In 1969, Hendrix appeared at Woodstock where he played a now-famous rendition of the U.S. national anthem. Throughout all of his appearances, Jimi became known for his large hats with feathers and other outrageous patterned clothing. In addition to the many concerts, Hendrix also received a number of accolades from the music industry. He was named Artist of the Year by Billboard magazine, and Performer of the Year by Rolling Stone. He was even named the World Top Musician in 1969 by Disc and Music Echo, and Guitarist of the Year by Guitar Player. Even after his death, Jimi continues to receive awards. In 1992, the Jimi Hendrix Experience was inducted into the Rock and Roll Hall of Fame, and then to the UK Music Hall of Fame in 2005. On September 18, 1970, Hendrix died an accidental death related to drug use while in Kensington, London. He aspirated on his own vomit and died of asphyxia. He had taken nine sleeping pills earlier in the day. At the time of his death, he was only 27 years old. He was buried in Washington State next to his mother. A biopic movie was released in March 2014 that describes Hendrix’s life. Nancy E. Marion

Further Reading Cross, Charles R. 2005. Room Full of Mirrors: A Biography of Jimi Hendrix. New York: Hyperion. Edwards, Gavin. 2013. “Five Things PBS Could Teach You about Jimi Hendrix.” Rolling Stone, November 6. http://www

480  Heroin .rollingstone.com/music/news/five-things -pbs-could-teach-you-about-jimi-hendrix -20131106#ixzz2vQdwYjvZ. Hendrix, Jimi. 2013. Starting At Zero: His Own Story. London: Bloomsbury Publishing. Hendrix, Leon, and Adam Mitchell. 2012. Jimi Hendrix: A Brother’s Story. New York: St. Martin’s Press. “Jimi Hendrix Biography.” Biography.com. http://www.biography.com/people/jimi -hendrix-9334756. The Official Jimi Hendrix Site. http://www .jimihendrix.com/us.

Heroin Heroin is a powerful, highly addictive, and fast-acting opiate classified as a Schedule I drug in the United States under the Controlled Substances Act. The drug is synthesized from morphine, which is derived from the opium poppy, Papaver somniferum. Before being sold on the street, heroin is often cut with sugar, quinine, and other dangerous substances, although heroin of higher purity is becoming available in the United States. Historically, the leading source of P. somniferum was the “Golden Triangle” of Southeast Asia. Today, the majority of the world supply of opium poppies is cultivated in Afghanistan, but the primary source of heroin in the U.S. market is grown in South America. The laws regulating the cultivation of P. somniferum in the United States can cause confusion; growing the poppies for the production of heroin and other opiates is illegal, but they can be grown domestically for ornamental and culinary purposes. In the United States, east of the Mississippi, most heroin is sourced from Colombia, and is typically of a white to dark

brown variety. Since 2001, cultivation of P. somniferum and the production of heroin and other opiates in Colombia has steadily declined. However, west of the Mississippi the Mexican black tar variety of heroin is more common. Mexico has not seen a decline in production, and is now the leading supplier of heroin to the United States. The difference in color and texture of the heroin product depends on manufacturing processes and additives. Although heroin was initially used as a pain medication in the early 20th century and then developed to treat morphine addiction, it turned out to be somewhere between two to 10 times more addictive than the drug it was designed to replace. By 1914, heroin had become subject to legal controls and soon all use was pronounced illegal. Today, despite its powerful analgesic properties, it is considered to have no medical value even though other opium derivatives are widely used in medicine. Heroin has become a popular recreational drug, and use in the United States seems to be increasing. This may in part be the result of newer manufacturing procedures that result in a product that can be snorted or smoked. Those who may have rejected intravenous use due to the danger of spreading HIV, hepatitis, and other blood-borne diseases through the use of shared needles may be more open to the drug when these risks are removed. Although users of the Mexican variety must dissolve and inject the drug, those who purchase the powder tend to avoid IV use. Believing they are buying high-quality heroin when they purchase the drug on the street, users are often buying a product cut with sugar, starch, acetaminophen, or a number of other ingredients. Nevertheless, the purity of heroin sold today has increased; in the past, a “bag”—a specific unit of heroin—routinely contained 1

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A businessman injects heroin into his arm. Many people use heroin undetected. (Bialasiewicz/ Dreamstime.com)

to 10 percent pure heroin; today it is more likely to contain 10 to 70 percent. This level of purity has contributed to increased addiction, especially among young adults who mistakenly believe that smoking or snorting the drug is less addicting than IV injections and thus start using the drug less cautiously. As of 2012, heroin use in the United States has risen significantly, nearly doubling among young adults since 2007, and the number of persons dependent on heroin has doubled since 2002 to 467,000. The short-term effects of heroin use resemble those of other opiates, and include a sudden rush of euphoria and relaxation followed quickly by intermittent periods of dozing known as nodding off. Overdose may lead to respiratory depression, clammy skin, seizures, and, ultimately, coma and death. Long-term use of the drug can lead to heart or liver disease and a variety of pulmonary

disorders based in part on the overall physical debilitation that accompanies drug use. Intravenous users can experience collapsed veins, as well as serious infections. Tolerance to the drug can develop quickly, and withdrawal symptoms can follow within a few hours of the last dose. Withdrawal symptoms are notorious for the misery and discomfort they cause, including diarrhea and vomiting, muscle and bone pain, agitation, and intense craving. Sudden withdrawal from heroin can be dangerously traumatic to the body, even resulting in death in some cases. In April 2014, the FDA pushed through approval of the Naloxone auto-injecter Evzio, intended for the use of family, caregivers, and coworkers of persons with a history or risk of heroin or prescription opiate use. Naloxone works by blocking opiates from binding to receptors in the brain linked to respiratory function, thereby allowing time to transport

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a person experiencing overdose to a hospital for care. The drug had previously been available for decades for use by emergency and hospital personnel. In the past, kits containing the drug and given to caregivers were not FDA approved, and some required assembly of the needle using components from different manufacturers. The new, FDA-approved product is self-contained and provides voice instructions for administration when it is removed from its case. In 1997, recognizing that opiate addictions must be treated as a public health problem, the National Institutes of Health (NIH) convened a panel to address heroin addiction and treatment. In acknowledging the tremendous value of drugs like methadone or buprenorphine that block the effect of the heroin on the brain’s opiate receptors, the NIH panel stressed the importance of removing legal barriers to such treatments. It also recommended that supportive behavioral therapies be made broadly available since research has shown that cognitive behavioral therapy can be very useful in treating opiate addiction. As with many illegal substances, it can be difficult to establish the number of users, with rates of abuse being underreported, due in part to difficulty accessing at-risk populations. In 2012, a National Institute on Drug Abuse survey found the rate of persons having used heroin within their lifetime to be below 2 percent. When surveyed, few reported having used heroin within the past year, and only 0.3 percent had used the drug within the past month. Heroin users have the following physical symptoms: sedation, drowsiness, poor motor coordination, fresh puncture marks or tracks, slow or slurred speech, facial itching and scratching, dry mouth, deepening of voice, constricted pupils, impairment of night vision, and dizziness. Behaviorally, heroin users may show the following signs: mood changes, euphoria,

inability to concentrate, apathy, mental confusion, giddiness, fearfulness, and anxiety. Many entertainers have died of heroin overdoses, including Sid Vicious (born John Ritchie), who played bass guitar for the Sex Pistols. He died shortly after his release from prison. While Kurt Cobain died of a suicide, he was also addicted to heroin. River Phoenix was a young actor who died from a mixture of cocaine and heroin (called a “speedball”) in 1993. Also a victim of a speedball injection was John Belushi, a comic. Jim Morrison of the Doors died in his bathtub of a heart attack brought on by an overdose of heroin. Another singer of the time, Janis Joplin, also died of a heroin overdose, which was furthered by an addiction to alcohol. More recent deaths related to heroin overdose include the 2014 death of Philip Seymour Hoffman, a celebrated actor and director, and Cory Montieth, an actor from the hit television series Glee, who died in 2013. Street names for heroin include black tar (or negra), boy, brown, dope, H, henry horse, jones, junk, scag, and smack. Lindsay Powley See also: Addiction; Black Tar Heroin; Opiates

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Cope, Kevin, and Dan Drost. 2012. “Seed Poppy in the Garden.” Utah State University Cooperative Extension. http://extens ion.usu.edu/files/publications/publication /Horticulture_Vegetables_2012–03pr.pdf. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National

High-Intensity Drug-Trafficking Areas (HIDTAs)  483 Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Kroll, David. 2014. “FDA Rapidly Approves Naloxone Auto-Injector for Heroin and Prescription Opioid Overdose.” Forbes, April 3. http://www.forbes.com/ sites/davidkroll/2014/04/03/fda-rapidly -approvesnaloxone-auto-injector-for -heroin-and-prescription-opioid-overdose/. Office of National Drug Control Policy. “The International Heroin Market.” http://www .whitehouse.gov/ondcp/global-heroin -market. South Carolina Department of Alcohol and other Drug Abuse Services. http://www .daodas.state.sc.us/documents/heroinfs.pdf. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2005. Research Report Series: Heroin Abuse and Addiction. NIH Publication No. 05-4165. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. “Results from the 2012 National Survey on Drug Use and National Health: Summary of National Findings.” http://www.samhsa.gov/data/NSDUH/ 2012SummNatFindDetTables/Index.aspx. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

High-Intensity Drug-Trafficking Areas (HIDTAs) This program operates under the auspices of the Office of National Drug Control Policy (ONDCP), and is authorized under the Anti– Drug Abuse Act of 1988. Its purpose is to designate certain places within the United States as high-intensity drug-trafficking areas, or “HIDTAs.” Once an area is defined as a HIDTA, the label would be used to provide increased federal assistance to the area as a way to alleviate drug-related problems. Moreover, the program encourages cooperation between the federal, state, and local law enforcement communities in the battle against drug trafficking. Currently, the government has identified 28 communities as HIDTAs that encompass 60 percent of the U.S. population. These include New York City; Newark, New Jersey; Miami; Houston; Los Angeles; and the southwest border region with Mexico. Two new HIDTA initiatives have been approved for Puerto Rico and the Washington, D.C./Baltimore area as well. According to the ONDCP, 60 percent of Americans live in an area served by an ONDCP-funded HIDTA area. In fiscal year 1996, HIDTA partners (DEA law enforcement agencies) were empowered to coordinate their efforts by creating joint systems to work together and share resources. Typically, a HIDTA’s administrative personnel consists of an executive committee of 16 members, about equally divided among local, state, and federal officials, and a major task force consisting of 100 to 300 law enforcement employees. The various HIDTAs usually establish regional joint centers and information-sharing networks, which can sustain their law enforcement efforts. The 1996 budget for the HIDTA program was $102.9 million. In 2012 the HIDTA annual budget was $238 million, over a 100 percent

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increase. Currently there are 28 HIDTAs, which includes approximately 16 percent of counties in the United States and 60 percent of the U.S. population. The HIDTA examines the drug trafficking threat in that area and makes an assessment as to the most appropriate strategy to address it. The group must identify new targets and trends in drug use and abuse in their communities and then propose a budget necessary to carry out that strategy, which is covered by HIDTA funds. The committee must also prepare a report indicating the elements of, and success of, the strategy. Many of the HIDTA funds go toward drug prevention and treatment programs. These include drug courts, youth service organizations, and public awareness campaigns. Other funds are earmarked for specific antidrug programs including the Domestic Marijuana Investigation Project, the National Methamphetamine and Pharmaceuticals Initiative, and the Domestic Highway Enforcement Program. The HIDTA program has come under criticism as being inefficient and wasteful. Critics charge that states are receiving HIDTA money for purposes other than to stop drugs. They point to nonborder states such as Nebraska, West Virginia, and Wyoming that are receiving federal funds, diverting muchneeded money from states like California and Florida. One example of an anti–drug-trafficking program supported by HIDTA funds is found in Rhode Island, a state that would not be one that would typically would be considered to have much drug trafficking. Through an investigation labeled “Operation Hybrid,” the state police worked with other members of the task force (multiple local police agencies; agents from the federal Bureau of Alcohol, Tobacco, Firearms and Explosives; U.S. Immigration and Customs/Homeland Security

agents; Drug Enforcement Administration agents; and the National Guard) to arrest 12 drug traffickers. The investigation began in August 2012 and lasted 16 months as the task force identified the leaders and other members of the organization. Law enforcement had information that two men were leaders of a heroin distribution network in the city of Providence. They used several automobiles that had electronically operated hidden compartments to hide the drugs. Law enforcement agents received permission to “tap” the cell phones of the suspects, and for about a month listened to conversations. Through that, they were able to identify other conspirators in the drug-distribution network. They also conducted physical surveillance of the men. On December 11, 2013, agents from the task for arrested 12 people related to the drug-trafficking scheme. They also seized over 1 kilogram of heroin, two weapons, ammunition, drug-packaging paraphernalia, digital scales, nine automobiles, and over $11,000 in cash. The suspects were arrested on many charges, including conspiracy to possess with intent to deliver heroin, possession of heroin, delivery of heroin, possession of a firearm by criminals and fugitives, possession of a firearm while in possession with intent to deliver, conspiracy to deliver heroin, soliciting another to commit a crime, and others. Another example of an HIDTA-funded program is the Southwest Border HIDTA Arizona Partnership. This program, established in 1990, has as its mission “to facilitate federal, state and local multi-agency task forces and other partnerships to increase the safety of Arizona’s citizens, by substantially reducing drug trafficking and money laundering, thereby reducing drug-related crime and violence.” According to the annual report, the Southwest Border HIDTA Arizona Partnership is

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made up of seven counties in the state (Cochise, Maricopa, Mohave, Pima, Pinal, Santa Cruz, and Yuma) that, because of the large border regions, have a great amount of drugrelated activities. Additionally, they have three major ports, six international airports, and an established transportation system that is used by drug traffickers. Large amounts of drugs are smuggled through these counties and then distributed to other locations in the nation. There has also been violence directed toward law enforcement agents. The strategy of the Arizona partnership was to create a multiagency interdiction task force in each county that would target drugtrafficking organizations in that area. Specialized task forces would then target violent drug gangs, or money laundering. All of the individual task forces would provide information to the Arizona HIDTA Center based in Tucson. The partnership identified five priorities: (1) interdiction of drug smuggling from Mexico and South America; (2) the investigation, prosecution, and dismantlement of major drug smuggling, trafficking, and money laundering organizations in Arizona; (3) the immobilization of methamphetamine laboratories and the control of drug lab precursor chemicals in Arizona; (4) the control and reduction of violent crime associated with drug trafficking; and (5) the collection, analysis, and dissemination of drug-related intelligence to law enforcement agencies. As part of the strategy, the Arizona Investigative Support Center was established. A multiagency center, it helps facilitate information sharing among both state and federal agencies through sharing of resources. The strategy also includes the creation of the Arizona HIDTA Training Center to provide drug enforcement training to all law enforcement officers; a Drug-Free Workplace Agency to ensure that all businesses and

employees have the training and resources needed to ensure a drug-free and safe environment; a Border Anti-Narcotic Network to reduce drug trafficking and crimes; an Investigative Narcotic Technical Support Center to provide surveillance technology and support; a Joint Drug Intelligence Group; a Methamphetamine Task Force; the Phoenix Financial Task force to conduct financial investigations; the Southern Arizona Safe Trails Initiative to target violent criminal organizations; and many others. Nancy E. Marion See also: Drug Enforcement Administration; Federal Bureau of Investigation; Office of National Drug Control Policy

Further Reading HIDTA. http://www.usdoj.gov/deas/pubs/brie fing/3_11.htm. Rhode Island State Police. 2013. “Press Releases: RI State Police High Intensity Drug Trafficking Area Task Force and the RI Office of Attorney General Arrest 12 Subjects in ‘Operation Hybrid.’” http://www.risp.ri.gov. U.S. Drug Enforcement Administration. http:// www.justice.gov/dea/ops/hidta.shtml. U.S. Office of National Drug Control Policy. “High Intensity Drug Trafficking Areas: Southwest Border HIDTA Arizona Partnership.” https://www.ncjrs.gov/ondcppubs/ publications/enforce/hidta2001/ariz-fs.html. U.S. Office of National Drug Control Policy. “Southwest Border HIDTA.” https://www .ncjrs.gov/ondcppubs/publications/enforce/ hidta2001/sw-fs.html. U.S. Office of National Drug Control Policy. 2002. “Annual Report: High Intensity Drug Trafficking Area Program.” Washington, DC: Office of National Drug Control Policy. U.S. Office of National Drug Control Policy. 2003. “Design for a HIDTA/OCDETF Performance Monitoring and Management

486   Hip-Hop and Drugs System.” http://www.whitehouse.gov/ond cp/high-intensity-drug-trafficking-areas -program.

Hip-Hop and Drugs The opening lines to Dr. Dre’s 2010 single, “Kush,” are typical of the hip-hop and rap music of the late 20th and early 21st centuries in a musical way, the rhyme and rhythm, but also a thematic way as well. Hip-hop and rap music typically have themes revolving around loose women, violence, gang behavior, making money, and drug use. Drugs and drug use have always had a place very close to the heart of hip-hop music and culture, despite the problems that come along with it. One of the most influential and wellknown musicians in the world of hip-hop and rap is Calvin Cordozar Broadus, Jr. Although better known by his stage names, Snoop Doggy Dogg, Snoop Dogg, Snoop Lion, DJ Snoopadelic, or Snoopzilla, Broadus has had some legal issues relating to his drugs and drug use. In 1990, Broadus was convicted of felony possession of drugs and possession for sale. He was convicted for drug-related charges again in 2006 for possession of marijuana, cocaine, and a firearm. In 2012, Broadus was banned from entering the country of Norway after being stopped at the Norwegian border in possession of 8 grams of cannabis and $36,619 in Norwegian krone. He was charged a fine of $8,392.90 and was not allowed to enter the country again until 2014. He was also charged for misdemeanor marijuana possession on multiple occasions in 1998 in Los Angeles; 2001 in Cleveland, Ohio; and 2010 in Sierra Blanca, Texas. Another rapper that has had legal issues that include drug-related charges is Russell Tyrone Jones, better known by his stage

name, Ol’ Dirty Bastard (ODB) of the rap group the Wu-Tang Clan. Jones was arrested in 1999 for possession of 20 vials of crack cocaine and marijuana and driving without a license. He pled guilty to the crack cocaine charges in 2001 while the other charges were dropped. Sadly, Jones’s drug habits caused him more than legal issues. In 2004 the rapper collapsed in a recording studio in New York and died. The cause of his death was ruled to be an overdose of the opiate Tramadol, normally used to treat extreme pain. Another rapper that died due to drug-related overdose is Chad Lamont Butler, also known as Pimp-C of the rap group Underground Kingz (UGK) who died in December 2007. His death was caused by a combination of his recreational use of “syrup,” cough syrup laced with codeine, combined with his preexisting sleep apnea. More recently, rapper Chris “Mac Daddy” Kelly of rap group Kris

Snoop Dogg performs on stage in 2013. He is known for using drugs such as cocaine and marijuana, often facing legal battles related to drug use. (AP Photo/Invision/Paul A. Hebert )

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Kross died in May 2013 from an overdose of cocaine and heroin. Kelly had a history of drug use leading up to the end of his life. Another rapper who died due to his use of recreational drugs was Kenneth Doniell Moore, who performed under the name Big Moe. Moore died in October 2007 after being in a coma for a week after a heart attack. It has been speculated that Moore’s recreational use of syrup contributed a factor to his death. In his music, Moore discussed the topic of syrup quite often, calling his first two albums City of Syrup and Purple World respectively. In his song entitled “Purple Stuff” from the album Purple World he almost idolizes the drug, saying how he “loves that purple stuff” in reference to his work with DJ Screw who also had history using syrup recreationally and died of a heart attack. Although different rappers may not use syrup specifically, rapper Hakeem Seriki, also known as Chamillionaire, has openly spoken against the substance saying, “I know I’m running the risk of sounding ‘preachy’ . . . but I’m starting to hate everything that ‘syrup’ stands for.” Big Moe is not the only rapper that has spoken about drug use in music. In his 2003 hit, “In Da Club,” rapper Curtis Jackson, better known by his stage name 50 Cent, uses the line, “Look Miami I got the X if you into takin drugs.” This is in reference to the use of Ecstasy or MDMA, which is often used in dance clubs. Another song that is about the use of MDMA is “Dip” by Daniel Sewell, known by his stage name Danny Brown. In this song Sewell opens with the hook, “Dip I dip you dip, dip I dip you dip I dip.” These and others are lyrics that reference his experience with the powdered form of MDMA that he uses recreationally. Another song that discusses the use of drugs is “Ten Crack Commandments” by Christopher George

Latore Wallace, better known as The Notorious B.I.G. or Biggie Smalls. In this song, Wallace lists 10 rules for dealing drugs. This song gives instructions on how to deal drugs successfully, idolizes the act of dealing drugs, and makes it seem like some fantastic thing to do, almost encouraging people to do it regardless of the legal issues that may arise due to drug dealing. Drugs and drug use are something that sits very close to the center of hip-hop and rap music and culture, regardless of the consequences that go along with it. Many rappers have faced drug-related legal issues and some have even died due to their use of drugs. Although some members of the community may oppose the use of some drugs or the use of drugs altogether, it is unlikely that the community as a whole will ever give up the use of drugs. Just like the song “The Next Episode” says, they will continue to “smoke weed every day.” Jacob A. Marion See also: Entertainers and Drug Use

Further Reading Blankstein, Andrew. 2007. “Snoop Dogg Pleads No Contest to Felony Drug Charge, Gun Possession.” Los Angeles Times, April 12. http://articles.latimes.com/2007/apr/12/ local/me-snoop12. Bracamontes, Aaron. 2012. “Rapper Snoop Dogg Faces Drug Paraphernalia Charge after Stop.” El Paso Times.com, January 10. http://www.elpasotimes.com/newupdated/ ci_19704657. Jackson, Curtis. 2003. “In Da Club.” In Da Club. 50 Cent. Dr. Dre, Mike Elizondo, CD. Kaufman, Gil. 2006. “Snoop Arrested for Gun and Drug Possession After ‘Tonight Show’ Taping.” MTV, September 29. http://www .mtv.com/news/articles/1546734/snooparrested-gun-drug-possession.jhtml.

488  Hippies Lucas, Phillip, and Oscar W. Gabriel, II. 2013. “Overdose Suspected in Death of Kriss Kross Rapper.” The Big Story, May 2. http://bigstory.ap.org/article/chris -kelly-1990s-rap-duo-kris-kross-dies. Moore, Kenneth. 2002. “Purple Stuff.” Purple Stuff. Big Moe Feat. D-Gotti, CD. “ODB Pleads Guilty to Drugs Charge.” NME. com, April 23. http://www.nme.com/news/ ol-dirty-bastard/7484. Patel, Joseph. 2004. “Ol’ Dirty Bastard Died from Drug Overdose, Medical Examiner’s Office Says.” MTV, December 15. http:// www.mtv.com/news/articles/1494879/ ol-dirty-bastard-died-from-drug-overdose .jhtml. Peralta, Eyder. 2007. “Houston Rappers Remember Big Moe, Dead at 33.” Houston Chronicle, October 15. http://www.chron .com/entertainment/music/article/ Houston-rappers-remember-Big-Moe -dead-at-33–1797262.php. “Rapper Snoop Doggy Dogg Cited on Marijuana Charge.” 1998. Los Angeles Times, May 3. http://articles.latimes.com/1998/ may/03/local/me-45951. Rieken, Kristie. 2008. “Cough Syrup Found in Pimp C’s Hotel Had No Label.” Houston Chronicle, February 5. http://www.chron .com/entertainment/music/article/Cough -syrup-found-in-Pimp-C-s-hotel-had-no -label-1656505.php. Sewell, Daniel. 2013. “Dip.” Dip. Danny Brown. SKYWLKR, CD. “Snoop Dogg Is Banned from Norway.” 2012. BBC News, July 29. http://www.bbc.co.uk/ news/entertainment-arts-19036784. Wallace, Christopher. 1997. “Ten Crack Commandments.” Ten Crack Commandments. The Notorious B.I.G. DJ Premier, CD. Wiederhorn, Jon. 2002. “Snoop Dogg Fined for Marijuana Possession.” MTV, May 29. http:// www.mtv.com/news/articles/1454570/ snoop-fined-possession.jhtml.

Young, Andre. 2000. “The Next Episode.” The Next Episode. Dr. Dre Feat. Snoop Dogg, Kurupt, and Nate Dogg. Aftermath Entertainment / Interscope Records, CD. Young, Andre. 2010. “Kush.” Kush. Dr. Dre Feat. Snoop Dogg and Akon. DJ Khalil, CD.

Hippies The term “hippies” refers to youth in the 1960s and early 1970s who rejected the traditional customs and style of mainstream middle-class society and attempted to develop one of their own. The movement began in the United States and then spread to other countries, namely Canada and Great Britain. The hippy movement was born sometime around the fall of 1966 in the Haight-Ashbury District of San Francisco. It wasn’t long before the neighborhood surrounding Haight-Ashbury was internationally known. Young people flocked to San Francisco just to be part of the hippy movement. For the most party, Haight-Ashbury’s hippy community consisted largely of adolescents and teenagers who came from the suburbs as a way to rebel against their parents’ conservative backgrounds. According to scholars who have studied the hippy movement, its members were alienated and distrustful of social and political institutions and had strong beliefs about the appropriateness of aggressive personal behavior. The hippies adapted their own look that included unkempt long hair, bowler hats, colorful and loose clothing (lots of stripes, flowers, and patterns), and Victorian shawls. They wore flowers in their hair, painted their bodies like Easter eggs, and took drugs, especially LSD, calling themselves acid heads. Many sold marijuana joints and acid tabs (LSD). The Haight-Ashbury hippy scene deteriorated soon after it had reached international

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fame. To a certain extent the hippy message and lifestyle has become institutionalized and is now part of the system its proponents rebelled against. For example, the hippy image of rebellion has been used in advertising to entice consumers. Still, there has been an effort to keep the hippy ideal alive. Each year since 1971 an informal network of hippies and anarchists have used computers and word of mouth to organize the Rainbow Gathering, a modern-day counterculture gathering. Scholars who have studied the hippy community agree that drug use plays an important part in the hippy community. Hippies believe that drug use is not immoral as the larger society postulate it. Ron Chepesiuk See also: Beatniks; Ginsberg, Allen; HaightAshbury; Hashish; Leary, Timothy; LSD

Further Reading Chepesiuk, Ron. 1995. Sixties Radicals, Then and Now: Candid Conversations with Those Who Shaped an Era. Jefferson, NC: McFarland. Davis, F., and L. Munoz. 1968. “Heads and Freaks: Patterns and Meanings of Drug Use among Hippies.” Journal of Health and Social Behavior 156–64. Grode, Eric. 2010. Hair: The Story of the Show that Defined a Generation. Philadelphia: Running Press. Howard, John Robert. 1969. “The Flowering of the Hippie Movement.” Annals of the American Academy of Political Science 382: 43–55. Pivano, Fernanda. 2005. Beat and Pieces: A Complete Story of the Beat Generation. Milan: Photology. Sterne, Jane, and Michael Sterne. 1990. Sixties People. New York: Knopf.

HIV/AIDS and Drug Use HIV (Human immunodeficiency virus) severely damages a person’s immune system and causes acquired immune deficiency syndrome (AIDS), a condition that defeats the body’s ability to protect itself against disease. HIV is transmitted from person to person through contact with the blood or other body fluids of an infected person. It can be transmitted during unprotected sex or through sharing injecting drug-use equipment. AIDS is the final stage of HIV, which causes severe damage to the immune system and eventually death. Drug abuse and addiction have been linked with HIV/AIDS since the beginning of the epidemic. Drug use plays a big role in the spread of HIV. Injecting drugs into the body with needles is a leading cause of HIV transmission. It is well known that intravenous drug use and needle sharing can transmit HIV from one person to another. When syringes are shared by drug users, infected blood can be drawn up into a syringe and then get injected along with the drug by the next user. The infected blood goes directly into the user’s bloodstream. This is especially dangerous because HIV can survive in a used syringe for at least four weeks. In 2008, an estimated 4,444 Americans were infected with HIV by injecting drugs. Drug users who inject drugs represent about 12 percent of annual new HIV infections in the United States each year. Injection drug users compose about 19 percent of those already diagnosed and living with HIV in the United States. Among males, 9 percent of diagnosed HIV infections were attributed to injection drug use. Among females, 15 percent of diagnosed HIV infections were attributed to injection drug use. Once infected, a person can then pass on HIV to sexual partners. A person who is un-

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der the influence of certain drugs is more likely to engage in risky behaviors such as having unsafe sex with an infected partner. Indeed, the most common (but not only) way of contracting HIV is through unsafe sex. Users may be less likely to use condoms, or have multiple sexual partners. Drug addicts often participate in “transactional” sex— trading sex for drugs or money. For those addicted to drugs, the drug use can make the symptoms of HIV worse by causing greater neuronal injury and cognitive impairment, for example. HIV can also be transmitted from a pregnant woman to her child during pregnancy or childbirth. Continued drug use and addiction can worsen the symptoms of HIV for those who have contracted HIV, making the effects of the virus worse for those who have it. Continued drug use can cause greater neuronal injury and cognitive impairment. Some studies have shown that the use of methamphetamine can make the HIV reproduce more quickly inside the body, while other research indicates that those who are HIVpositive and use methamphetamines will suffer more damage to their brain cells, affecting their ability to think clearly. Drug use may also cause the antiretroviral medications to be less effective, or have unintended consequences because of drug interactions. Moreover, drug users are less likely to take all of their medications. People who miss doses of the drugs are more likely to have higher levels of HIV in their blood and to develop resistance to their medications. Drug abuse treatment can be an effective way to reduce the spread of HIV/AIDS. People in drug abuse treatment programs, which often includes HIV-risk-reduction counseling, often stop or reduce their drug abuse and related risk behaviors, including risky injection practices and unsafe sex.

Needle exchange programs have been developed around the country that provide free, clean syringes to users so they won’t need to share needles with others. While some people think that these programs promote drug use, research shows this is not the case. The International HIV/AIDS Alliance is one organization that has attempted to combat both drug use and the spread of HIV. The alliance works closely with those who use drugs and their families and households, encouraging them to make the changes needed to improve their health. This can include safe injecting practices and safe sex, building skills to protect and promote health, and improving access to health services. The alliance also provides harm reduction services to addicts that include opiate substitution treatment, clean needle and syringe programs, outreach to street drug users, information and education programs, and support programs for people who use drugs. Sexual and reproductive health services are available for those who inject drugs and their partners. Members of the alliance also seek to address the social norms and other social factors that influence the communities in which injecting drug users live. They seek to educate community members, health workers, police, and officials about responding to drug use in a humane fashion. They seek to overcome the stigma and discrimination that is associated with injecting drugs and living with HIV, primarily by campaigns and community education programs. They seek to mobilize community members to plan and act together to prevent further spread of HIV and care for people who have already contracted the disease. The alliance advocates for new or amended laws and policies geared to supporting the prevention of HIV, along with the treatment and care of those already infected. They also

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support new laws and policies that protect people who inject drugs from harassment and abuse. In 2011, the alliance established a new project to expand harm reduction services to over 180,000 injecting drug users, their partners, and children in the countries of China, India, Indonesia, Kenya, and Malaysia. Nancy E. Marion See also: Drug Abuse; Needle Exchange Programs

Further Reading AIDS.gov. “How Are Drug Use and AIDS Related?” http://www.aids.gov/hiv-aids -basics/prevention/reduce-your-risk/ substance-abuse-use/. Dutta, Arin. 2013. The Global HIV Epidemics Among People Who Inject Drugs. Washington, DC: World Bank.

Hoffman, Philip Seymour (1967–2014) Philip Seymour Hoffman was an award-winning film and stage actor and director who died of a drug overdose in 2014. Hoffman, who struggled with addiction early in his career, had been sober for 23 years before his death from acute mixed drug intoxication. The second of four children, Hoffman was born on July 23, 1967, in Rochester, New York. His father, who was employed by Xerox, and his mother, who became a lawyer, provided a middle-class upbringing. From a young age, Hoffman would go with his mother to see local theater productions. These early exposures to the theater would help develop Hoffman’s love of acting, and

International HIV/AIDs Alliance. “Drug Use and HIV.” http://www.aidsalliance.org/ TechnicalThemeDetails.aspx?Id=11. Malinowska-Sempruch, Kasia, and Sarah Gallagher. 2004. War on Drugs, HIV/AIDs, and Human Rights. New York: International Debate Education Association. MedLine Plus. “AIDS.” http://www.nlm.nih .gov/medlineplus/ency/article/000594.htm. National Institute on Drug Abuse. 2012. “Drug Facts: HIV/AIDS and Drug Abuse: Intertwined Epidemics.” http://www.drugabuse.gov/publications/drugfacts/hivaids -drug-abuse-intertwined-epidemics. Rhodes, Tim. 2001. Injecting Drug Use, Risk Behavior, and Qualitative Research in the Time of AIDS. Luxembourg: Office for Official Publications of the European Communities. Szalavitz, Maia. 2012. “How the Global War on Drugs Drives HIV and AIDS.” Time.com, June 28. http://healthland.time .com/2012/06/28/how-the-global-war-on -drugs-drives-hiv-and-aids/

American actor Philip Seymour Hoffman died in February 2014, after injecting heroin and swallowing prescription medications. He was found dead with the needle still in his arm. (Carrienelson1/Dreamstime.com)

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at the age of 12, he saw a play that he later explained had a profound effect on his life. “When I saw ‘All My Sons,’ I was changed— permanently changed—by that experience. It was like a miracle to me,” he said in an interview with the New York Times. As a teenager, however, Hoffman was first attracted to sports. A clean-cut jock, he was involved with both baseball and wrestling until he was sidelined by an injury. It was after this that he transitioned to the stage. His first foray into theater came courtesy of a high school crush. As he was walking down a hallway, he passed by a girl in whom he was interested. He asked her where she was going, and when she told him the auditions for the school play, he decided to follow her. When he was given a part in the play, he gained not only the opportunity to spend time with the girl, but also a new outlet for the competitiveness he had previously applied to sports. At the age of 17, Hoffman was accepted to the School of Theater of the New York State Summer School of the Arts, a summer intensive program that offers rigorous training in a student’s chosen discipline. He also spent time studying through the nonprofit Circle in the Square Theatre School, located along Broadway in New York City, which also counts among its alumni well-known and award-winning artists like Kevin Bacon, Lady Gaga, and Idina Menzel. Hoffman attended New York University’s Tisch School of the Arts, where in 1989 he earned a BFA in Drama. During his time at the university, he began abusing both drugs and alcohol. After his graduation, he entered a rehab program, later explaining in a 60 Minutes interview that he had things he wanted to accomplish, but his drug use had him worried for his life. After exiting rehab, he would remain sober for 23 years. Some of his first roles after college were bit parts in television series and films, in-

cluding an appearance on Law and Order. His first major film was 1992’s Scent of a Woman, directed by Martin Brest and starring Al Pacino and Chris O’Donnell, in which he played a supporting role as a prep school student. It was after this film that his career began to gain traction. Throughout the 1990s and early 2000s, he appeared in a variety of films, again as a supporting character, but these roles began to show his versatility as an actor, and his ability to imbue even small parts with life. He appeared in films alongside major names, including Nobody’s Fool with Paul Newman; Twister with Bill Paxton; Boogie Nights with Julianne Moore; The Big Lebowski directed by the Coen brothers; Cold Mountain with Jude Law, Nicole Kidman, and Renée Zellweger; and Todd Solondz’s Happiness. He also remained involved in the theater, winning Tony Awards for his appearances in Sam Shepard’s True West and Long Day’s Journey into Night. Hoffman’s breakthrough role came in 2005, when he played the title role in Bennett Miller’s Capote. The film chronicles author Truman Capote as he developed a complex relationship with prisoners accused in a grisly 1959 murder, collecting the material that would become his bestseller In Cold Blood. Hoffman was hesitant to accept the role due to the commitment it would require, but when he agreed, he threw himself into the project. A perfectionist, he spent hours studying Capote, reading about him, listening to interviews, and watching tapes. When the film was finished, he was relieved simply due to the effort required to play the part; however, the hard work would pay off when he was recognized the next year at the Oscars. Hoffman took home the award for Best Actor, and was lauded at numerous other ceremonies and by the critics. He would go on to appear in numerous critically

Hofmann, Albert (1906–2008) 

acclaimed and popularly successful films, including Doubt, Charlie Wilson’s War, Pirate Radio, The Invention of Lying, and Moneyball, again showing great range as an actor. In 2010, he made his directorial debut with the independent film Jack Goes Boating. Hoffman won his third Tony in 2012 for his final stage appearance in a revival of Arthur Miller’s Death of a Salesman. At the time of his death, he was reprising what would be his final role, a supporting character in the third installment of the popular Hunger Games trilogy, scheduled for release in 2015. He was also planning his second project as a director, a film titled Ezekial Moss, and had begun shooting a Showtime series, Happyish, in which he was slated to play the leading role. Hoffman did not often talk about his private life, preferring to keep a firm demarcation between himself and his family, and the roles he played on screen. In his dedication and quest for perfection, he wanted his audience to be able to get lost in his films, truly bringing his characters to life as he faded into the background. He therefore rarely spoke about his early struggles with addiction nor his drug use in the years leading up to his death. In 2012, he began abusing prescription medications, and then heroin. The following year, he entered rehab for a brief 10 days, and in December reportedly attended a Narcotics Anonymous meeting. However, those who saw him in public in the weeks leading up to his death claimed he had appeared disheveled. Several weeks before his death, he moved out of the apartment he shared with his long-term partner Mimi O’Donnell and their three children, and rented another apartment near their Greenwich Village neighborhood. It was there that, on February 2, 2014, he was found by concerned friends. When police investigated, they found packets of heroin, syringes, and prescription medications. The medical report

later stated that his cause of death was acute mixed drug intoxication, having found heroin, cocaine, benzodiazepines, and amphetamine in his system. It was unclear whether he had taken all of the drugs together, or if some were residual from earlier use. Hoffman’s 2014 death helped to bring attention to the growing use of heroin in the United States. Lindsay Powley See also: Entertainers and Drug Use; Heroin

Further Reading Biography.com. “Philip Seymour Hoffman.” http://www.biography.com/people/philip -seymour-hoffman-177232. Circle in the Square Theatre. “Notable Alumni.” http://www.circlesquare.org/alumni-notable .htm. Internet Movie Database. “Philip Seymour Hoffman.” http://www.imdb.com/name/nm 0000450/. Sacks, Ethan. 2014. “Philip Seymour Hoffman’s Showtime Series ‘Happyish’ Now in Limbo After Death.” New York Daily News, February 4. http://www.nydailynews.com/ entertainment/tv-movies/philip-seymour -hoffman-series-happyish-limbo-article -1.1601562. Schwirtz, Michael. 2014.“Hoffman Killed by Toxic Mix of Drugs, Official Concludes.” New York Times, February 28. http:// www.nytimes.com/2014/03/01/nyregion/ hoffman-killed-by-toxic-mix-of-drugs -official-concludes.html?ref=arts&_r=0.

Hofmann, Albert (1906–2008) Hofmann discovered the psychedelic compound lysergic acid diethylamide (LSD) and experienced its hallucinogenic effects in 1943. He later studied chemicals present in

493

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so-called magic mushrooms also responsible for hallucinogenic effects and synthesized the most important of these, psilocybin. Albert Hofmann was born in Baden, Switzerland, on January 11, 1906, to Adolf Hofmann, a toolmaker, and Elisabeth Schenk Hofmann. He attended Zürich University, from which he received his bachelor’s degree in chemistry in 1929 and his doctorate in the same subject in 1930. He then accepted an appointment as research chemist at Sandoz Pharmaceuticals, a company with which he remained for the rest of his professional career. The event in Hofmann’s life for which he is best known and that has now been recounted endlessly occurred on April 16, 1943. At the time, Hofmann was involved in a long-term study of some naturally occurring psychedelic plants, including the fungus ergot and the herb squill. He was working in particular with a chemical found in a number of these plants, known in German as Lysergsäurediethylamid, and in English as lysergic acid diethylamide (LSD). In particular, he was studying LSD-25, that is, the 25th preparation of the substance. During his research, Hofmann spilled a small amount of LSD-25 on his hands and, before long, began to feel mentally disoriented. After a period of time, he found he could no longer continue working and jumped on his bicycle to ride home. That bicycle ride, as Hofmann has recounted the event on a number of occasions, was such a bizarre experience that he thought for some time that he had perhaps lost his mind. After about six hours of “extremely stimulated imagination . . . a dreamlike state . . . and an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopic play of colors” (as he later described the experience), Hofmann returned to normal, but with a desire to learn more about the compound he had discovered.

Much of Hofmann’s career was devoted to further studies of LSD and other psychedelic compounds, research that was supported and encouraged by Sandoz because of its potential for application in the treatment of psychological disorders. In 1962, for example, Hofmann and his wife traveled to Mexico to collect the psychoactive herb Ska Maria Pastora (Salvia divinorum) for study and analysis. He also identified the most important active agent in another psychedelic plant, the Mexican morning glory (Rivea corymbosa), a close relative of LSD, lysergic acid amide. Hofmann retired from Sandoz in 1971 but continued a career of writing, public speaking, and participation in a variety of professional organizations. Perhaps his most popular book is his own account of his research on LSD and its psychedelic effects, LSD: My Problem Child (1980). Hofmann died on April 29, 2008, in the village of Burg im Leimental, near Basel, Switzerland, at the age of 102. David E. Newton See also: LSD

Further Reading Albert Hofmann Foundation. 2008. “Dr. Albert Hofmann—January 11 1906–April 29, 2008.” http://www.hofmann.org/. Bellis, Mary. “The Invention of LSD.” About.com. http://inventors.about.com/od/ lstartinventions/a/LSD.htm. Biello, David. 2008. “Albert Hofmann, Inventor of LSD, Embarks on Final Trip.” Scientific American. http://www.scientific american.com/article.cfm?id=inventor-of -lsd-embarks-on-final-trip Smith, Craig S. 2008. “Albert Hofmann, the Father of LSD, Dies at 102.” New York Times, April 30. http://www.nytimes .com/2008/04/30/world/europe/30hofmann .html.

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Hookah Also known as a waterpipe, a hookah is a Middle Eastern device used for smoking tobacco or fruity, tobacco-like substances whose smoke is filtered through water or other liquid held in the base. The smoking material is placed in a small bowl at the top, and, as it burns, smoke circulates through the liquid to pick up moisture and temper the harshness of the smoke. Smokers inhale from one or more of several small, flexible hoses projecting from the sides of the hookah. In some cultures, smoking a hookah with others is a social ritual that may occupy 30 to 45 minutes. In other cultures, some use hookahs for smoking marijuana or other psychoactive drugs. An increase in the Arab-American population in the United States has helped fuel the increasing popularity of smoking hookahs, a practice now spreading to other cultures in urban areas and university settings. Hookah bars and cafes are growing in number, creating concern among health professionals about the widening trend of younger people to be attracted to using fashionable hookahs to consume nicotine or other noxious substances. Given the variables involved in using a waterpipe—the nature of the material smoked, the liquid through which it is filtered, or the temperature at which it is burned, for example—the health effects of smoking tobacco through a hookah have not been definitively ascertained. Some suggest that the extended ritual delivers more toxins than an entire pack of cigarettes, while others claim that tobacco smoked through a hookah is filtered in a way that it cannot deliver the same level of carcinogens or produce as much carbon monoxide as cigarettes and cigars. Jurisdictions concerned about the adverse health effects of smoking hookahs have banned their use. Consequently, hookah

Teenage boys use a hookah pipe to ingest drugs. Hookahs are used in many cultures to ingest tobacco, or shisha, but they are sometimes used for taking illicit drugs. (ktaylorg/iStockphoto.com)

cafes, which are sometimes known as shisha bars for a popular type of sweetened tobacco frequently smoked in hookahs, are prohibited in many cities unless their managers have obtained special permits. In some areas, “shisha” is used as a synonym for “hookah.”

Harmful Effects Traditionally, a hookah pipe is used to smoke a tobacco mixture that is called shisha. Shisha contains tobacco and different flavorings such as fruit pulp, molasses, and honey. There are coals in the hookah pipe that heat the shisha mixture, and the smoke that is created from heating the shisha passes through

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the hookah tubes and water so it is cooled before it is inhaled by the user. According to the American Cancer Society, smoking a hookah pipe can cause several types of cancer as well as causing other health concerns. Passing the shisha smoke through water may remove some chemical compounds found in the tobacco, but research shows that many toxins remain in the water-filtered smoke. These toxins include nicotine, the highly addictive compound in tobacco smoke. Thus, hookah users experience the same effects of nicotine use by using a hookah as when they smoke tobacco cigarettes. This includes an increase in blood pressure and heart rate, and changes in dopamine production in the brain. Further, the American Cancer Society notes that when a person smokes shisha, they are not only inhaling tobacco smoke but also the smoke from the burning flavorings. Because hookah smoking is a relatively new activity in the United States, very limited research has been conducted on the health effects of inhaling smoke from the flavored substances. However, it is suspected that the smoke from the chemical flavorings can contain just as many toxins and be just as dangerous as tobacco smoke. Another issue that may be of concern to hookah users is that often the pipes of the hookah are shared with many other users. When any smoking instrument is shared, the user runs the risk of sharing germs, potentially leading to other diseases. Hookah is also known as narghile, argileh, shisha, hubble-bubble, and goza. Kathryn H. Hollen See also: Nicotine; Shisha; Tobacco

Further Reading Czoli, C. D., S. T. Leatherdale, and V. Rynard. 2013. “Bidi and Hookah Use Among

Canadian Youth: Findings From the 2010 Canadian Youth Smoking Survey.” Preventing Chronic Disease 10. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. “Smoking and Tobacco Use.” http://www.cdc.gov/tobacco.

Hoover, J. Edgar (1895–1972) J. Edgar Hoover was born on New Year’s Day in 1895 in Washington, D.C. He was the youngest of the three surviving children born to his parents, Dickerson Naylor Hoover and Annie Marie Scheitlin. Hoover studied law at George Washington University, joining the staff of the U.S. Department of Justice in 1917. Hoover first joined the Bureau of Investigation (as the FBI was once known), remaining employed by them when it was renamed the Federal Bureau of Investigation in 1932. It wasn’t long before he was named the head of the Bureau of Investigation within the Justice Department. When Hoover became the head of the agency, it had about 650 employees, comprising 441 special agents. Upon entering the office, he fired the agents he considered to be unqualified as a way to make the organization more professional. He also eliminated the seniority rule for promotion and chose to use regular performance appraisals. Hoover required that all new FBI agents had to be between 25 and 35 years old. He also established a formal training course for all new agents. As head of the FBI, Hoover directed much attention to fighting communists. He sought after and captured or killed high-profile gangsters including John Dillinger. Hoover was also allegedly using controversial tactics as head of the FBI. He maintained constant surveillance against Martin

Hoover, J. Edgar (1895–1972)  497

Luther King Jr. By using illegal wiretaps, Hoover sought to collect evidence against King to discredit him. There were also allegations that Hoover planted evidence and began false rumors. There are those who say that Hoover maintained secret files against his enemies as a way to blackmail them and keep his job. He also refused to initiate an investigation into the alleged crimes committed by organized crime members, including their alleged drug trafficking behaviors. Hoover knew that the bureau could fight crime more effectively if it had the public’s support. To do this, he became an expert at using the media to give the image of the FBI as a moral, hard-working, and dedicated group of agents. He wrote articles and books to mold the FBI’s image into one the public admired and respected. Hoover and Harry Anslinger, head of the Federal Bureau of Narcotics (FBN), were not always cooperative with each other. Anslinger also had ambitions to turn his agency into the premier federal law enforcement group. Anslinger had a different approach from Hoover when it came to investigating crimes. He allowed his agents to get their hands dirty, becoming more streetwise and working “in the trenches.” FBN agents were permitted to tap phones without court orders, interrogate suspected drug traffickers, and perform searches without warrants. FBN agents were more likely than FBI agents to come from urban areas and have an ethnic background. Anslinger allowed his agents to work undercover and sometimes even pose as criminals to get information. He often used paid informers, who were given immunity from prosecution. When Dwight Eisenhower was elected to be president in 1952, Hoover urged him to replace Anslinger with someone from the FBI. However, Anslinger had many Repub-

lican friends and was able to stay in office, despite Hoover’s attempt to remove him. Hoover served as the director of the FBI for 48 years. During that time, he was accused of abusing his power and exceeding the jurisdiction of the agency. Nonetheless, he received numerous medals and awards. Today’s FBI headquarters is named after him. Nancy E. Marion See also: Anslinger, Harry J.; Federal Bureau of Investigation

Further Reading Ackerman, Kenneth D. 2011. “Five Myths about J. Edgar Hoover.” http://articles. washingtonpost.com/2011–11–09/opinions /35281731_1_hoover-and-tolson. Biography.com. “J. Edgar Hoover Biography.” http://www.biography.com/print/profile /j-edgar-hoover-9343398. Charles, Douglas M. 2007. J. Edgar Hoover and the Anti-Interventionists: FBI Political Surveillance and the Rise of the Domestic Security State, 1939–1945. Columbus: Ohio State University Press. DeLoach, Cartha. 1995. Hoover’s FBI: The Inside Story by Hoover’s Trusted Lieutenant. Washington, DC: Regnery Publishers. Federal Bureau of Investigation. “J. Edgar Hoover Director.” http://www.fbi.gov/about -us/history/directors/hoover. Garrow, David J. 1983. The FBI and Martin Luther King, Jr. New York: Penguin Books. Johnson, David. 2007. Betrayal: The True Story of J. Edgar Hoover and the Nazi Saboteurs Captured During WWII. New York: Hippocrene Books. Theoharis, Athan G. 1995. J. Edgar Hoover, Sex, and Crime: An Historical Antidote. Chicago: Ivan R. Dee. Weiner, Tim. 2012. Enemies: A History of the FBI. New York: Random House.

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I potential uses continues. Patents have been issued in the United States and abroad for various indications. From 1988 to 1994, U.S. and Dutch researchers published results on ibogaine’s effect on opioid and cocaine addictions in animal trials. Studies have shown that ibogaine metabolism in the body produces another substance, noribogaine, which evidently blocks the brain receptors that control craving; it also tends to boost levels of serotonin and dopamine, which enhances a user’s overall sense of well-being and relieves withdrawal symptoms. The research suggests it can be effective in treating nicotine, alcohol, methamphetamine, and cocaine addictions, and perhaps even compulsive behaviors. The ibogaine is found in the bark of the root of the plant. The bark is scraped off the root and eaten directly, or dried and pounded into a powder. Users of the drug may experience different symptoms. In small doses, ibogaine can cause an increased sense of colors, with some experiencing spectrums, or rainbow-like effects to appear around objects. For some users, they are able to stay awake and alert for days after consuming the drug. With a higher dose, the user will experience slight nausea, dizziness, and a lack of muscular control. If one gram is consumed, the user may experience hallucinations that can last for days. Users can stay awake, sometimes for days, and stay alert. Despite significant excitement over the drug’s potential, many are dissuaded by its daunting side effects. Even at therapeutic doses, it can produce nausea, vomiting, uncoordinated movements, and exhausting

Ibogaine Ibogaine is a hallucinogenic drug derived from the African shrub Tabernanthe iboga, which grows primarily in the Congo Basin. The plant produces a yellowish or pinkish white flower that yields a small, oval, yelloworange fruit about the size of an olive. Used by indigenous groups as a stimulant in healing and initiation ceremonies, in high doses it is a powerful psychedelic. It is slowly gathering mainstream attention as an antiaddiction drug, a use widely recognized by traditional healers in the plant’s natural range. In Western medicine, the study and use of ibogaine dates back over a hundred years. During the early part of the 1900s, it was recommended as a treatment for asthenia, or weakness. By 1939, the drug was sold in France under the name Lambarène to treat fatigue and depression, and to aid in recovery from infectious disease. In 1955 at the U.S. Addiction Research Center, ibogaine was given to eight morphine addicts after detox. In the 1960s Howard Lotsof accidentally discovered the drug’s efficacy in reducing his own symptoms of withdrawal and craving associated with heroin use, and began advocating further research. There has since been intense interest in learning how the drug works in the brain. In 1967, along with other hallucinogens such as LSD, ibogaine was classified as a Schedule I controlled substance under the Controlled Substances Act in the United States. The World Health Organization considers ibogaine likely to cause dependence or harm. Despite this, interest in the drug’s 499

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psychedelic experiences that last for a day or more; at higher doses, it can be toxic and produce cardiac arrhythmias. Although the U.S. Food and Drug Administration approved trials of the drug in 1993, the National Institute on Drug Abuse (NIDA) elected not to fund it, partly because of these side effects. Additionally, long-term efficacy of the treatment has not been established—few studies have been conducted on relapse rates. Of 41 testimonials, presented by Lotsof to NIDA, 38 reported some opioid use following treatment. Nevertheless, many countries allow drug addiction clinics to conduct treatment using ibogaine as an experimental drug, and evidence is building that it can be effective with even a single dose, especially if the treatment is followed by counseling. Although not funding studies directly, NIDA supports ibogaine research with indirect grants. Canada recently approved a case study of people seeking ibogaine-based treatment for opiate addiction, as it has been used to cure people addicted to opiates, cocaine, alcohol, amphetamines, and nicotine. Kathryn H. Hollen See also: Hallucinogens; Heroin; LSD; Opiates; Treatment

Further Reading Ali, Syed F. 1998. The Neurochemistry of Drugs of Abuse: Cocaine, Ibogaine, and Substituted Amphetamines. New York: New York Academy of Sciences. Alper, K. R. 2001. “Ibogaine: A Review.” The Alkaloids: Chemistry and Biology 56: 1–36. Alper, Kenneth R., and Stanley Glick, eds. 2001. Ibogaine: Proceedings from the First International Congress. San Diego: Academic Press. Gahlinger, Paul M. 2004. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse. New York: Plume.

Hevesi, D. 2010. “Howard Lotsof Dies at 66; Saw Drug Cure in a Plant.” New York Times, February 17. http://www .nytimes.com/2010/02/17/us/17lotsof .html?_r=0. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2001. Research Report Series: Hallucinogens and Dissociative Drugs. NIH Publication No. 01-4209, March. Vastag, Brian. 2005. “Ibogaine Therapy: A ‘Vast, Uncontrolled Experiment.’” Science 308 (5720): 345–46. Vastag, Brian. 2008. “Addiction Alleviator? Hallucinogen’s Popularity Grows.” Science News 173 (1): 6.

Inhalants Over 1,000 substances fall into the category of inhalants, including many common household products. Unregulated under the Controlled Substances Act, they are abused primarily by children and adolescents. The 2010 National Survey on Drug Use and Health found that 68.4 percent of new users in the past year had been between the ages of 12 and 18. Because of the serious and often tragic consequences of acute and repeated abuse, most states have adopted stringent laws to discourage minors from the purchase or possession of these products, however, they are particularly insidious because they are legal, inexpensive, and readily available in every household. It is easy to hide their presence in plain sight and conceal their use since the products are everywhere and the symptoms of use are not always easy to recognize. Their ready availability deceives younger users into thinking they are safe when, in fact, they can be extraordinarily dangerous. Inhalants include:

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• Gases such as those found in aerosols and dispensers, lighters, and propane tanks; refrigerants; and ether, nitrous oxide, and chloroform that are used in medical settings. • Volatile solvents, which are regularor industrial-strength products that contain solvents, which include gasoline, glue, felt-tip markers, paint thinners, degreasers, and dry-cleaning fluids. • Aerosols, which are widely available in most households, including hair spray, vegetable sprays, spray paint, and similar products. • Nitrites, which fall into two categories: organic, such as butyl or amyl nitrites (poppers), and volatile, brown-bottle products such as leather cleaner, room odorizer, or liquid aroma.

A teenage boy inhales drugs (fumes) from a plastic bag. This practice is called “huffing” or “bagging.” (BananaStock/Getty Images)

There are several ways that these chemicals can be abused. Huffing involves holding a cloth soaked with the substance to the face so the user can inhale it, or the cloth is placed into an open container. Some users paint the chemicals onto their skin, clothing, or fingernails so they can inhale the fumes without detection. When bagging, users place objects like felt-tipped markers containing appropriate chemicals into paper or plastic bags, crush the bags, and then inhale the fumes. There is a seemingly endless variety of ways someone can abuse inhalants. Since the effect is short-lived, users often repeat the process, which deepens the intoxication, leads to disinhibition and loss of control, and can cause them to lose consciousness. Inhalants produce intoxicating effects similar to those of alcohol when they are sniffed, snorted, bagged, or huffed. Most frequently, the user will experience a rapid high, followed by drowsiness, disinhibition, lightheadedness, and agitation. Most inhalants will also have an anesthetizing effect and in sufficient amounts lead to unconsciousness. Although withdrawal from inhalants does not usually produce clinically significant symptoms, these substances are subject to compulsive and repeated use despite the associated negative consequences. Use of inhalants alters the pathways in the brain associated with reward and reinforcement, leading to addiction. They have a recognized effect on dopamine transmitters, and evidence suggests inhalants may also affect the transmission of glutamate and γ-Aminobutyric acid. The interactions of these systems are suggested to contribute to the addictiveness of inhalants. Long-term abuse especially can cause individuals to compulsively use inhalants, and can lead to mild withdrawal symptoms. Statistics show that the highest level of use is by 10- to 12-year-old children, with

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use declining as they get older. According to a national news report delivered in the spring of 2007, over half a million adolescents engaged in huffing in the previous year; in 2003, almost 23 million people ages 12 and older reported using an inhalant at least once in their lifetime. The 2012 Monitoring the Future survey, supported by the National Institute on Drug Abuse, found that 66 percent of eighth grade students believed trying these drugs was not dangerous, and 41 percent saw no danger in repeated use. Those using inhalants also report abusing other drugs at earlier ages and, in the long term, are more likely to develop substance abuse disorders than their peers. Inhalants share characteristics with other classes of drugs; they are depressants because they suppress the central nervous system and lower respiration and blood pressure; they resemble hallucinogens because they distort perceptions of time and space. They can induce slurred speech, nausea, and headaches; impair motor coordination; trigger excitable or unpredictable behavior; and produce physical evidence of use such as watery eyes or a rash around the mouth. Longer-term, more serious effects may include bone marrow, kidney, or liver damage from the chemicals contained in inhalants as well as memory and intellectual impairment. Some of the psychological and neurological damage caused by inhalants is extreme and tragic. An immediate and deadly consequence of use can be asphyxiation or heart failure, sometimes known as the sudden sniffing death syndrome seen in first-time users. Using a paper bag to concentrate the fumes is responsible for suffocation deaths due to displacement of oxygen in the lungs. A subset of nitrite-based inhalants commonly called poppers are abused primarily by older adolescents and adults. Individuals abusing nitrites generally seek to enhance

sexual pleasure, with the effects of the drugs generally lasting a few seconds to a few minutes. Poppers were first developed as a heart medication sold in small glass vials or bottles which users would break, or pop, to inhale the drug. They later became popular as recreational drugs, especially on the gay scene, transitioning to wider use in the 1970s. They are often sold as room deodorizer, video head cleaner, and leather cleaner; however, their production and sale is illegal in the United States. Some studies show that nitrite abuse can contribute to tumor growth and deplete the immune system’s ability to fight off infection. Reflecting the wide variety of products that can be abused as inhalants, many street names have emerged: Air Blast, Ames, Amys, Bang, Bolt, Boppers, Bullet, Bullet Bolt, Buzz Bomb, Discorama, Highball, Hippie Crack, Huff, Kick, Laughing Gas, Locker Room, Medusa, Moon Gas, Oz, Pearls, Poor Man’s Pot, Poppers, Quicksilver, Rush, Satan’s Secret, Shoot the Breeze, Snappers, Snotballs, Spray, Texas Shoe Shine, Thrust, Toilet Water, and Whippets. Kathryn H. Hollen See also: Depressants; Drug Classes; Hallucinogens

Further Reading Califano, Joseph A. Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Duncan, Jhodie Rubina, and Andrew John Lawrence. 2013. “Conventional Concepts and New Perspectives for Understanding the Addictive Properties of Inhalants.” Journal of Pharmacological Sciences 122. Hartney, Elizabeth. 2014. “What Are Poppers?” May 16. http://addictions.about.com/od/ designerdrugs/g/What-Is-Poppers.htm.

International Narcotics Control Act (1989)  503 Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth About Kids, Alcohol, and Other Drugs. New York: Ballantine Books. National Institute on Drug Abuse. 2012. Inhalant Abuse. July. http://www.drugabuse.gov/ publications/research-reports/inhalants. U.S. Department of Health and Human Services, National Institute on Drug Abuse (NIDA). http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2005. Research Report Series: Inhalant Abuse. NIH Publication No. 05-3818. March. U.S. Department of Health and Human Ser­ vices, Substance Abuse and Mental Health Services Administration (SAMHSA). www .samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration (DEA). http://www.usdoj .gov/dea.

International Narcotics Control Act (1989) The International Narcotics Control Act of 1989 was a bill signed into law by President George H. W. Bush on December 13, 1989, to authorize the appropriation of funds to combat the international drug trade with a focus on cocaine production in South America. The bill was originally introduced to the House as H.R. 3611 in early November

of that same year by Representative Dante Fascell and became Public Law 101-231. The law authorized fiscal year 1990 appropriations of $115 million for international narcotics control assistance and an additional $125 million for military and law enforcement assistance to Colombia, Peru, and Bolivia. The three Andean nations produced the majority of the world’s cocaine, a fact that remains largely unchanged today, although the number of hectares under cultivation has declined since 1990. The goal of the act was to reduce the flow of illegal drugs into the United States and to provide support to governments fighting against the production and trafficking of cocaine. Appropriations were earmarked primarily for the provision of military and law enforcement assistance to the governments of Bolivia, Colombia, and Peru. The funds were meant to enhance these countries’ ability to control the drug trade, strengthen ties between their governments and the United States, and increase respect for human rights and the rule of law among law enforcement agencies. Recipients of funding and assistance were required to be agencies or units organized by the governments of the three countries specifically for narcotics enforcement. Otherwise, funds were reserved for the deployment of Department of Defense mobile training units and the equipment of eligible Andean units. All assistance was conditional on the countries’ maintenance of democratic governments and their law enforcement agencies abstaining from violations of human rights. Other sections of the act largely focused on the need for concurrent support of programs that would help replace the coca industry and aid those affected by it. Congress promoted the involvement of major donor countries, including the United States, in funding programs in major coca-producing coun-

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tries. These would include crop substitution programs and the creation of alternative employment opportunities. Also suggested was multilateral support of programs focused on eradication of the coca crop, enforcement of narcotics laws, rehabilitation, treatment, and education. The act did not appropriate funds for these purposes; however, it urged the submission of a plan by the director of National Drug Control Policy to address these needs. Furthermore, it stipulated that the president make policies related to the international drug trade a major feature of the Andean Summit, scheduled for the following year. Additionally, the act authorized the president to forgive the Andean countries’ debts to the United States should they enter into bilateral or multilateral agreements to implement antinarcotics programs that measurably reduced the flow of cocaine into the United States. It also endorsed the creation of a multilateral narcotics strike force, through the United Nations or other existing multilateral organizations, and multilateral efforts to halt the transfer of weapons to traffickers in Latin America. Cooperation and partnership between the United States and the Andean countries was an important feature of the act. In a statement prepared for the signing of the bill, then president George H. W. Bush stressed the importance of international involvement in defeating the Andean drug trade and the special role of the United States in providing assistance. He also commended the efforts of then Colombian president Virgilio Barco Vargas to “wage a full scale war” and referred to the role of the Andean governments in determining the best use for funding and in assessing the effectiveness of programs. The law also made limited funds available for assistance to Mexico. An earlier law, the Foreign Assistance Act of 1961, required the full cooperation on antinarcotics activities of

countries receiving aid. While Mexico was the largest producer of marijuana and heroin entering the United States, thereby making it a major drug-producing country according to the act, various Mexican officials had allegedly been involved in the drug trade, leading Congress to limit support. This act was later reintroduced to Congress as the International Narcotics Control Act of 1992, and again signed into law, becoming Public Law 102-583. Nancy E. Marion

Further Reading Bush, George. 1989. “Statement on Signing the International Narcotics Control Act of 1989.” Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.uscb.edu/ws /?pid=17942. International Narcotics Control Act of 1989. Pub. L. 101-231. United Nations Office on Drugs and Crime. 2010. “The Global Cocaine Market.” World Drug Report 2010. http://www.unodc.org/ documents/wdr/WDR_2010/1.3_The_ globa_cocaine_market.pdf.

International Narcotics Research Conference (INRC) The INRC is an annual meeting designed to bring together drug abuse researchers from around the world to present their latest results on the basic mechanisms of narcotic drug effects and important advances in the molecular, cellular, and behavioral aspects of narcotic actions. The focus is on opioid drugs. Membership and attendance to the conference is open to all who are interested in furthering the purposes of the INRC, including scientists from all disciplines, clinicians, and researchers.

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The INRC grew out of the 1969 meeting of the International Union of Basic and Clinical Pharmacology (IUPHAR). During its early years the INRC met in satellite sessions of IUPHAR and other major pharmacological societies. Yearly meetings began in 1971, and in 1973 the INRC was formally given its name. An executive committee was formed and bylaws were first written in 1975. Today, membership of the INRC numbers in the hundreds. The executive committee, elected by the members, is made up of the group’s president, as well as past president and treasurer, and nine representatives. These representatives are drawn from three regions: North America, Europe, and the rest of the world. The principal office is located in Teaneck, New Jersey. Ron Chepesiuk See also: Opioids

Further Reading International Narcotics Research Conference. http://www.INRCworld.org.

Intervention An intervention is an attempt to encourage a drug-addicted person to seek help and be able to live a drug-free lifestyle. It generally takes the form of a face-to-face conversation conducted in a nonjudgmental atmosphere when the person is not under the influence and those conducting the intervention can maintain calm. Sometimes it is advisable to include a professional with experience in addiction and intervention to participate. Occasionally, a health care professional will conduct what is known as a brief intervention in a clinical setting, although this differs in several ways from what is generally thought of as an intervention. A success-

ful intervention occurs before the addicted person has hit bottom, interrupting their decline, and helps the person to realize the consequences of their addiction on their own life and the lives of those around them, and results in the addicted person making a commitment to treatment. Successful interventions are carefully planned and structured before the addicted person is approached. The Mayo Clinic breaks the process down into a series of seven steps, the majority of which occur before the intervention itself. Careful planning can be essential to successfully confronting the addicted person in a constructive manner. Generally, someone close to the addicted person initiates the process by forming a planning group composed of people familiar with the addiction. This group then takes part in information gathering to learn the extent, nature, and effects of the addiction as well as locating specific treatment options. At this point arrangements may be made for the addicted person to be enrolled in a treatment program. The planning group may then form an intervention team that includes those who will be present at the intervention itself. They will also plan a time and location. While this group may be the same as the planning group, it is preferable to only include those who will be able to stick to a clear, rehearsed message without becoming angry or upset. Those who may derail the intervention can still participate through clearly writing out their feelings and concerns to be read at the time of the intervention. Once the intervention team has been decided upon, the members will work together to develop a clear message and specific points that support their concerns. Each team member should write down specific examples of when the addiction negatively impacted the addicted person or those around them. They will also come up with specific consequences team

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members will impose should the addicted person not follow through on treatment, for example, asking the addicted person to move out or denying contact with children. Members should anticipate any objections the addicted person is likely to raise and be prepared to respond. On the day of the intervention, the addicted person will be asked to the prearranged location without being told the reason. When everyone has been gathered, the members of the intervention team will take turns expressing their concerns and feelings as well as the examples of specific events when the addiction negatively affected the addicted person or others. Each member will lay out what future consequences of not committing to treatment will be, and the addicted person will be presented with their treatment options. At this point, a program will likely have been prearranged so that the addicted person can begin treatment immediately. Allowing time to pass between the intervention and program can allow the addicted person time to lapse into denial or binge. The addict must therefore commit to a specific plan and follow through; a promise to stop or change behavior is not enough. After the intervention, team members should stay involved. They should be supportive of treatment, avoid enabling the addiction, and possibly personally participate in counseling, all the while being ready with a plan in case the addicted person relapses. This form of intervention is reliant on the personal connections of the addicted person, and so success requires team members to stay involved throughout and following the process, and to be supportive and nonjudgmental. Those involved in an intervention should be people who are well liked and respected by the addicted person. The group typically includes close family and friends, but can

also include clergy members, colleagues, teachers, and others who are close to and concerned for the addicted person. In any intervention, the inclusion of an interventionist or other professional with intervention experience can be helpful. A professional, typically a counselor, social worker, or interventionist, can be included throughout the process; in cases where the addicted person has a history of denial, violence, suicidal tendencies, or serious mental illness, inclusion of a professional is advisable. Intervention can be a very difficult, emotional, and painful process for everyone concerned. Most treatment centers and specialists recommend the inclusion of trained professional counselors to guide them through the process and help deal with the aftermath. There are three types of intervention. One is primary prevention intervention, which is geared toward a user who has had either no or little experience with illicit drug use. The goal is to prevent the user from using drugs at all. Usually these interventions are geared toward young people who are identified as “at risk” or who may have family members (parents, siblings) who are using drugs, and teach that it is OK to say “no,” to drugs, or how to say “no.” The second type of intervention is secondary prevention intervention, in which the target has had some drug use. The goal in these interventions is to limit the extent of the drug use, i.e., the number of times it is used or the amount. These strategies focus more on responsible use of drugs. Usually these interventions are for teenagers or young adults. The third type of intervention strategy is a tertiary prevention, geared toward the serious user/abuser. The goal is to get the user to agree to treatment in the hopes that he/she will refrain from further drug use. Another type of intervention that merits mention is the brief intervention. These are

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quick interventions conducted by health care or counseling professionals in a clinical setting. The professional will first perform a routine assessment of substance use. If an intervention is indicated, the professional will discuss the consequences of addiction and substance abuse, and may refer the addicted person to further treatment. The focus of brief interventions is on raising the addicted person’s awareness of substance abuse and motivating change. Brief interventions can also be included within the context of a treatment program; they offer specialized attention to those who need it. Brief interventions have been shown to be effective; a 2009 study published in the journal Drug and Alcohol Dependence showed a 68 percent reduction in the use of illicit drugs over a six-month period among those who received brief interventions. Kathryn H. Hollen See also: Addiction; Treatment

Further Reading Jay, Jeff, and Debra Jay. 2000. Love First: A New Approach to Intervention for Alcoholism & Drug Addiction. Center City, MN: Hazelden Foundation. Levinthal, Charles F. 2012. Drugs, Behavior and Modern Society. Boston: Allyn and Bacon. Mayo Clinic. 2013. “Intervention: Help a Loved One Overcome Addiction.” August 13. http:// www.mayoclinic.com/health/intervention/ MH00127. Monti, Peter M., Suzanne Colby, and Tracy O’Leary, eds. Adolescents, Alcohol, and Substance Abuse: Reaching Teens through Brief Interventions. New York: Guilford Press, 2001. Substance Abuse and Mental Health Services Administration. 1999. “TIP 34: Brief Interventions and Brief Therapies for Substance Abuse.” November.

Yates, Rowdy, and Margaret S. Malloch. 2010. Tackling Addiction. Philadelphia: Jessica Kingsley Publishers.

Intoxication A temporary state that is not itself evidence of addiction, intoxication refers to the direct effects that a psychoactive substance has on the central nervous system. It is the state of being when one is under the influence of alcohol or other drug so thinking, feeling, and behavior are altered. Although most would define intoxication in terms of how it makes them feel, in a literal context, intoxication means toxicity or poisoning. In a clinical setting, it is described as a transient condition that affects psychophysiological functions and responses and, when considered significant, is often referred to as acute intoxication. Common usage generally associates intoxication with alcohol consumption; however, it can refer to the effects of any psychoactive substance. Intoxication can result from smoking cigarettes (nicotine), drinking coffee (or caffeine), or taking an illicit drug. Some form of intoxication is part of everyday life. It is very closely integrated with social life in many cultures. Many smoke cigarettes in social situation. Others drink alcohol to make socializing “easier.” Others drink endless cups of coffee and tea every day, and some have a drink after work or before dinner as a way to relax. Others use marijuana to relax on weekends. Many others worldwide use drugs as part of a religious service. It has been argued that some form of intoxication, stimulation, or altered state is an innate need of all people. Dr. Andrew Weil is one who has speculated that the need of an individual to alter their consciousness periodically is a normal drive, similar to

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hunger. He points to children who spin in circles until they are dizzy as an early form of this need. People of all ages, races, economic statuses, and cultures have used some kind of drug to achieve intoxication. Many immigrants in working classes in America (Irish, German, Italians) drank heavily and often. Opium was the drug of choice for Asians. Queen Victoria used cocaine, and many poets and artists used laudanum. Symptoms of intoxication vary depending on the substance and how it affects the brain, but they frequently include perceptual difficulties, impaired coordination and reflexes, changes in personality, blurred vision, slurred speech, dizziness, and impaired judgment. These symptoms are generally temporary, but in cases where intoxication results in tissue damage or other complications, an individual may experience long-term effects. In extreme cases intoxication can lead to trauma, inhalation of vomitus, coma, delirium, and convulsions, dependent on the substance. Not all substances produce intoxication; one such drug is the psychoactive nicotine. Level of intoxication can depend on multiple factors, including the substance itself, the dose, social cues and an individual’s tolerance to that substance. An individual who has developed a higher level of tolerance through repeated exposure will display lower levels of intoxication for a constant dose of that substance. Some individuals with underlying metabolic conditions will show signs of intoxication at relatively small doses. Additionally, the types of symptoms may present differently in some individuals, for example, depressants may lead to agitation in some. Substances like cannabis have especially unpredictable results. Cultural and personal expectations of the effect of a substance will also influence symptoms of intoxication; an individual’s behavior after administration of a psychoactive

is in part influenced by his or her expectations of the results. Frequently, psychoactive substances are taken to achieve a desired level of intoxication with the expectation of specific psychophysiological effects. The role of cultural and personal expectations has been shown in studies on alcohol; even when a placebo is administered, people will often behave as though they have received the substance itself. For example, there is a common expectation that alcohol will lower social inhibitions and so, even after consuming only nonalcoholic beer, an individual will display the anticipated lowered inhibitions. Acute intoxication is associated with recent or continuing use of the psychoactive substance. In substance-induced psychotic intoxication, symptoms may appear during long-term withdrawal, days or weeks after use of the substance has stopped and the drug has been metabolized. Physiological intoxication represents the heart palpitations or other physical symptoms that drugs like caffeine might produce. Legally, what is considered intoxication varies by crime. Public drunkenness is subjectively determined, whereas in the case of DUI and OVI law, states set thresholds for intoxication based on blood alcohol level. For some crimes, intoxication is recognized as a defense, generally for specific-intent crimes. Involuntary intoxication is often treated similarly to insanity. Although intoxication is usually a manifestation of substance abuse, not addiction, it can be an early warning sign of addiction if even a few episodes of intoxication are seen in a young person between the ages of 15 to 25. Further, repeated episodes of intoxication in people of all ages are frequently associated with addiction. Kathryn H. Hollen See also: Addiction; Alcohol Use

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Further Reading Alcohol and Drug Information Clearinghouse. 2003. “A Parenting Perspective: Children of Alcoholics.” http://www.prevlink.org /getthefacts/facts/coa.html. Alcohol Policies Project, Center for Science in the Public Interest. 2000. “Alcohol Use.” 2006. New York Times. http://www.nytimes.com/health/guides/ specialtopic/alcohol-use/overview.html ?inline=nyt-classifier. American Legacy Foundation and the National Center on Addiction and Substance Abuse. 2003. “Reducing Teen Smoking Can Cut Marijuana Use Significantly.” September 16. http://www.teensarenotadisease.com/ CASA_smoking_pot_link.htm. American Psychological Association. “Understanding Alcohol Use Disorders and Their Treatment.” http://www.apa.org/. Bancroft, Angus. 2009. Drugs, Intoxication and Society. Cambridge: Polity. Centers for Disease Control and Prevention. 2013. “Fast Stats: Alcohol Use.” http:// www.cdc.gov/nchs/fastats/alcohol.htm. Harvard School of Public Health, College of Alcohol Studies Surveys. 1993–2001. http:// www.hsph.harvard.edu/cas/Documents/ trends/. Mayo Clinic, “Alcohol Use: If You Drink, Keep it Moderate.” http://www.mayoclinic .com/health/alcohol/SC00024. National Center for Biotechnology Information. 2012. “Alcohol Use and Safe Drinking.” http://www.ncbi.nlm.nih.gov/pubmedhealth/ PMH0002669/. National Institute of Health. 2011. “Alcohol Use and Safe Drinking.” http://www.nlm .nih.gov/medlineplus/ency/article/001944 .htm. National Institute on Alcohol Abuse and Alcoholism. “FAQs for the General Public.” http://www.niaaa.nih.gov/faqs/general.

National Institute on Drug Abuse. 2012. “Alcohol.” http://www.drugabuse.gov/ drugs -abuse/alcohol. Peterson, J. Vincent. 2003. A Nation Under the Influence: America’s Addiction to Alcohol. Boston: Allyn and Bacon. Schoenborn, Charlotte A. 2001. Alcohol Use Among Adults: United States, 1997–98. Hyattsville, MD: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Sutton, Amy L. 2007. Alcoholism Sourcebook: Basic Consumer Health Information About Alcohol Use, Abuse, and Dependence. Detroit: Omnigraphics. Weil, Andrew. 1983. The Natural Mind. Boston: Houghton Mifflin.

Investigational New Drug Program In 1972, the National Commission on Marijuana and Drug Abuse (a.k.a. the Shafer Commission) issued its report in which it indicated that marijuana may not be as dangerous as once thought. A few years later in 1975, Robert Randall was arrested for using marijuana, which he claimed to use to treat glaucoma. Randall used the “medical necessity” defense to argue that his marijuana use was a justification for breaking the law. A federal court agreed, and the criminal charges against Randall were dropped. In 1976, he became the first American to be granted legal access to marijuana for medical reasons. In order to supply Randall with the drug he needed, the federal government began to provide him with marijuana. It instituted a new program, the Investigational New Drug (IND) (or the Compassionate IND) program,

510   Investigational New Drug Program

which could explore the potential benefits of medical marijuana. Under the program, certain physicians identified by the government were given the ability to prescribe medical marijuana to some of their patients only on a trial basis. In the beginning, there was an extensive process for patients to enroll in the program, so there were only 12 patients accepted at first. Those accepted into the program had to follow strict protocols. All patients in the program received 300 low-potency marijuana cigarettes per month, or about 10.75 ounces (300 grams). The marijuana used in the program was grown at the University of Mississippi, which could provide patients with marijuana that was pesticide-free and of a standard potency. The Research Triangle Institute in North Carolina was allocated $62,000 a year from the federal government to roll and package the marijuana cigarettes and ship them to the patients’ doctors and pharmacists. All of the patients in the program were provided with a document from the FDA that granted them permission to use the marijuana. Today, the program is administered by the National Institute of Drug Abuse (NIDA). Between 1976 and 1988, there were only about six patients who qualified for the IND program. By 1989, largely because of the HIV/AIDS epidemic and patients seeking to relieve nausea, the FDA became overwhelmed with applications. President Bush was forced to close the program in 1992, claiming that it sent the wrong message and contradicted the position of the administra-

tion concerning illicit drug use. Efforts to reinstate the program under the Clinton administration failed in 1994. In a court brief, Clinton’s Justice Department acknowledged that the program’s use of medical marijuana “was bad public policy.” As of 2003, the program remained closed to new patients. While at one time the program had 30 patients, at this time, there are only four surviving patients who remain in the program. Nancy E. Marion See also: Commission on Marihuana and Drug Abuse; Randall, Robert

Further Reading Clark, Peter A. 2000. “The Ethics of Medical Marijuana: Government Restrictions vs. Medical Necessity.” Journal of Public Health Policy 21(1): 40–60. Gerber, Rudy. 2004. Legalizing Marijuana: Drug Policy Reform and Prohibition Politics. Westport, CT: Praeger. Kreit, Alex. 2003. “The Future of Medical Marijuana: Should the States Grow Their Own?” University of Pennsylvania Law Review 151 (5): 1787–826. Liccardo Pacula, Rosalie, Jamie F. Chriqui, Deborah A. Reichmann, and Yvonne M. Terry-McElrath. 2002. “State Medical Marijuana Laws: Understanding the Laws and Their Limitations.” Journal of Public Health Policy 23 (4): 413–39. Martinez, Martin. 2000. The New Prescription: Marijuana as Medicine. Oakland, CA: Quick American Archives.

J in 1972, including Got to Be There and Ben, producing successful singles such as “Got to Be There,” “Ben” and a remake of Bobby Day’s “Rockin’ Robin.” It was while playing the Scarecrow in the box office disaster The Wiz that Jackson connected with Quincy Jones. Jones, who had arranged the musical score for the film, agreed to produce Jackson’s album, Off the Wall. The 1979 solo album was the first ever to generate four top 10 hits. Jackson’s solo efforts charted at number three on the Billboard 200, and worldwide sales eventually topped 20 million copies. At the 1980 American Music Awards, Jackson took home three awards. That year, he also won Billboard Year-End for Top Black Artist and Top Black Album, and a Grammy Award for Best Male R&B Vocal Performance. Jackson again won at the American Music Awards in 1981. Despite its commercial success, Jackson felt Off the Wall fell far short of its potential. Two years later, the album that would forever change the face of the music industry was released. Debuting in late 1982, Thriller became the best-selling album of all time in the United States and worldwide. An estimated 65 million copies were sold, and the album topped the Billboard 200 chart for 37 weeks. On January 27, 1984, Michael and other members of the Jackson family were filming a Pepsi Cola commercial when the 25-yearold singer was seriously burned in an accident. In front of fans during a simulated concert, pyrotechnics caught Jackson’s hair on fire. He suffered second-degree burns to his scalp, and had to be treated to hide the

Jackson, Michael (1958–2009) Michael Jackson was born on August 29, 1958, in Gary, Indiana. He was the eighth of 10 children, who lived in a three-room house. His mother, Katherine Esther Scruse, was a devout Jehovah’s Witness, and his father, Joseph Walter “Joe” Jackson, was a steel mill worker who performed with an R&B band called The Falcons. In 1964, Michael and Marlon joined the Jackson Brothers as backup musicians playing congas and tambourine. By the age of eight, Jackson had moved from performing backup vocals and dancing to sharing the lead vocals with his older brother, Jermaine. The group, now renamed the Jackson 5, opened at nightclubs across the Midwest from 1966 to 1968 playing a mix of covers of contemporary Motown hits. The brothers frequently toured the “chitlin’ circuit,” a string of black nightclubs, often appearing onstage before stripteases and other adult acts. In 1966, the group began to attract attention when they won a major local talent show with renditions of Motown hits and James Brown’s “I Got You (I Feel Good),” led by Michael. The Jackson 5 went on to record several songs, including “Big Boy,” for the local record label Steeltown in 1967, before signing with Motown Records in 1968. The group’s first four singles, “I Want You Back,” “ABC,” “The Love You Save,” and “I’ll Be There,” set a record when they peaked at number one on the Billboard Hot 100. Jackson began releasing solo albums through Motown and the Jackson 5 franchise 511

512   Jackson, Michael (1958–2009)

Michael Jackson, most widely known for his music career, died as the result of an overdose of Propofol and other drugs in June 2009. (Imagecollect/Dreamstime.com)

scars. Jackson, who had previously undergone surgery to repair a broken nose, at this point had his third rhinoplasty. It is speculated that this was the time during which Jackson developed a dependency on pain relief medication, an addiction problem that would persist until his death. In 1993, after rumors of child sexual abuse had come to public attention, Jackson admitted to taking Valium, Xanax, and Ativan to deal with the stress of the allegations. He stated that the painkillers were originally prescribed to soothe excruciating pain that he was suffering after recent reconstructive surgery on his scalp and for pain stemming from oral surgery. In November of the same year, Jackson announced that he was addicted to painkillers. Claiming physical and emotional exhaustion caused by the allegations of child molestation and the pressure

of completing the Dangerous tour, Jackson said he would seek treatment. According to his lawyers, he was treated overseas for one and a half to two months. Michael’s health was on a serious decline. Arriving in London with friends Elizabeth Taylor and her husband, Jackson had to be physically supported as he made his way out of the airport. He was rushed to the home of Elton John’s manager and from there to a clinic. When searched on arrival, clinic staff found vials of medication in his suitcase. Michael was admitted to the hospital and was placed on intravenous Valium to wean him from painkillers. Stories circulated that Jackson was barely functioning intellectually. In 2004, Jackson was again treated for dependence on painkillers—morphine and Demerol—and was being treated for this dependency by herbalist Alfredo Bowman in Colorado. In 2009 Michael Jackson attempted a comeback for his waning career and threw himself wholeheartedly into physically grueling rehearsals for an upcoming series of concerts. Jackson was staying at a rented mansion in the Holmby Hills district of Los Angeles when he died in his bed. His physician, Conrad Murray, attempted to resuscitate Jackson, but was unsuccessful. Los Angeles Fire Department paramedics responded within minutes of receiving an emergency call, and again attempted to resuscitate the singer using CPR. Emergency personnel continued their efforts to revive Jackson en route to the Ronald Reagan UCLA Medical Center and for another hour after arrival. Following Jackson’s death, reports surfaced of his use of meperidine, a narcotic analgesic sold under the brand name Demerol. According to Cherilyn Lee, a nurse who provided nutritional counseling to Jackson, he

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asked her for unspecified sleep aids in April of 2009. Later that month, he told her that Propofol, widely used for anesthesia and sedation in intensive care units, was the only drug that helped him sleep. Lee refused, telling him, “Michael, the only problem with you taking this medication . . . is you’re going to take it and you’re not going to wake up.” Michael dismissed the warning, telling her he had been prescribed the drug in the past, by IV injection, and that his doctor told him it was safe. It was the last time they met. After his death, the Immortal World Tour, a production of Canadian company Cirque du Soleil in partnership with Jackson’s estate and featuring Jackson’s music, was created to keep Jackson’s legacy alive. Jackson’s estate has also been involved in a legal battle with the Internal Revenue Service on allegations of tax fraud, stemming from an undervaluation of Jackson’s worth at the time of his death. Nancy E. Marion

of a Billion-Dollar Empire. New York: Atria Books. James, Michael S., and Sarah Netter. 2009. “MJ’s Doc a Focus of Manslaughter Probe.” ABC News, July 23. http://abcnews .go.com/Entertainment/MichaelJackson/ story?id=8153815&page=1. Krohn, Katherine E. 2010. Michael Jack­ son: Ultimate Music Legend. Minneapolis: Lerner. “Michael Jackson Biography.” http://www .biography.com/people/michael-jackson -38211. “Michael Jackson Biography.” Encyclopedia of World Biography. http://www.notablebiographies.com/Ho-Jo/Jackson-Michael .html. “Michael Jackson Biography.” Rolling Stone Artists. http://www.rollingstone.com/music /artists/michael-jackson/biography. Smit, Christopher R. 2012. Michael Jackson: Grasping the Spectacle. Burlington, VT: Ashgate.

Further Reading

Taraborrelli, J. Randy. 2009. Michael Jackson: The Magic, the Madness, the Whole Story, 1958–2009. New York: Grand Central Pub.

“All Michael Jackson.” http://www.allmichael jackson.com/biography.html.

Tieck, Sarah. 2011. Michael Jackson. Minneapolis: ABDO Publishers.

Barnes, Brooks. 2009. “A Star Idolized and Haunted, Michael Jackson Dies at 50.” New York Times, June 26. http://www.nytimes .com/2009/06/26/arts/music/26jackson .html?pagewanted=all&_r=0.

Walter, Vic, and Richard Esposito. 2009. “Federal Drug Agents Asked to Join Michael Jackson Death Probe” ABC News, July 1. http:// abcnews.go.com/Blotter/MichaelJackson/ story?id=7982097&page=1.

Brown, Geoff. 2009. Michael Jackson: A Life in Music. London: Omnibus.

Whitfield, Bill, Javon Beard, and Tanner Colby. 2014. Remember the Time: Protecting Michael Jackson on His Final Days. New York: Weinstein Books.

See also: Entertainers and Drug Use

Ferran, Lee, and Eileen Murphy. 2009. “Jackson Attorney: FBI Files are ‘Almost Vindication.’” ABC News, December 23. http://abcnews.go.com/GMA/michael -jackson-attorney-fbi-files-vindication/ story?id=9407615. Greenburg, Zack O’Malley. 2014. Michael Jackson, Inc.: The Rise, Fall, and Rebirth

Jazz Culture Jazz music, which has its roots in Southern African music, became wildly popular in the

514   Jazz Culture

early 1900s. As is the case with many different music genres, drug use was widespread from the very beginnings among those involved. Ever since jazz arrived on the music scene, the link between marijuana, jazz, and creativity has been analyzed. In an interview with American drug policy expert David Musto, Harry Anslinger, the head of the Federal Bureau of Narcotics, claimed to have put “more jazz bands in jail than he could count.” The use of drugs may be just as much a part of this culture as jazz slang and the music itself. Many people involved in jazz culture have explained that drugs help to spur creative thought. The consumption of marijuana among musicians, particularly those playing in jazz bands, was thought to allow musicians to attain a certain gift or musical ability that they do not normally possess when sober. In the words of some, they become “hot.” Many artists explain that when they use marijuana, they are able to produce higher quality jazz by losing their inhibitions, generating better, more creative ideas. Others explain that marijuana allows a band to play in tune for longer periods of time. It is not just jazz musicians who see the connection between music and drugs. Members of the general public also perceive the link. The media has created an image of the classic jazz artist—a wild-looking hop-head. A study of jazz musicians in New York City, the jazz capital of the United States, sought to examine the number of jazz musicians who use narcotics, with what effects, and the trends in drug use. The study showed that there was difficulty in locating specific jazz musicians because of their constant travel schedules, a hesitancy of those who were directly questioned to answer truthfully, and the lack of adequate data on the basis of which a sample might be drawn. Consequently, it was decided that jazz of-

fices and organizations in New York City would be used as places to interview the artists. Every participant was asked to describe the drug use (or non-use) activities of band members. The members did not have to discuss their own personal drug use, although many chose to. Very few musicians admitted to using cocaine. Almost a third of participants observed that some musicians tried multiple drugs, just as others try various types of alcohol, to find the most satisfactory drug for them. While some artists used only one drug at a time, many jazz musicians admitted to using multiple types of drugs at the same time. Respondents pointed out that nearly every band member knew who the drug users in the band were. Some noted that cities like Billings, Montana, and Tacoma, Washington, were avoided by some jazz bookers, because the bookers knew that it was impossible to purchase any drugs in those areas, and because many artists would not want to be in a town performing that did not have a quality drug dealer. Dr. Geoffrey Wills, a U.K. psychologist, completed a study of famous jazz musicians that showed that 52 percent of subjects were addicted to heroin at one time or another, and heroin was thought to be involved in multiple drug-related deaths. Alcoholism also affected many, and 27.5 percent were also dependent on other drugs as well, such as heroin and cocaine. Only five alcoholdependent subjects were able to overcome their dependence. Miles Davis, Art Pepper, and Bill Evans each were dependent on cocaine, and in each case the artists began using cocaine after heroin abuse. There are numerous examples of jazz musicians who died at a young age, and at one time or another suffered from drug-related issues. For example, “Fats” Navarro, who died of tuberculosis at the age of 26, suffered

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from a heroin addiction. Charlie Parker, who played the alto saxophone, was also addicted to alcohol and heroin. These addictions led to health issues and eventually his death due to pneumonia at the age of 35. Nancy E. Marion See also: Entertainers and Drug Use; Heroin; Marijuana

Further Reading Fachner, J. 2003. “Jazz, Improvisation and a Social Pharmacology of Music.” Music Therapy Today 4(3): 1–26. http://music therapyworld.net. Frater, J. 2009. “Top 10 Jazz Artists Who Died Young.” Listverse. http://listverse.com/2009/07/08/top -10-jazz-artists-who-died-young/. Peretti, B. W. 1993. “The Jazz Studies Renaissance.” American Studies 34(1): 139–49. Wills, G. I. 2003. “Forty Lives in the Bebop Business: Mental Health in a Group of Eminent Jazz Musicians.” British Journal of Psychiatry 183: 255–59. Winnick, C. 1960. “The Use of Drugs by Jazz Musicians.” Social Problems 7(3): 240–53.

Jellinek, E. Morton (1890–1963) E. Morton Jellinek was perhaps the most influential proponent of the view that alcoholism was a disease. Jellinek made the case that there were five species, or types, of alcoholism. There was a continuum of “phases” that spanned from psychological to physical addiction. Jellinek made this claim a temporary hypothesis, and many of his ideas are well known by researchers who study alcoholism. Jellinek was one of the founders of the nation’s first outpatient clinics that treated victims of drug abuse.

Jellinek started his alcohol research in 1939 with the Research Council on Problems of Alcohol in New York. For the next 10 years, Jellinek continued his research at the Laboratory of Applied Psychology at Yale University. During his time at Yale, he became the first director of the Section of Studies on Alcohol, was a creator of the Summer School of Alcohol Studies, and eventually became an associate editor of the Quarterly Journal of Studies on Alcohol. Arguably he is most well-known for his studies towards popularizing, and giving scientific backing to, the notion of alcoholism being a disease that was treatable. Jellinek developed this notion at Yale. He published his work on drinking habits throughout society and “the Jellinek estimation formula.” This formula aimed to give an approximate amount of alcoholics in a particular population. Being an associate editor of the Quarterly Journal of Studies on Alcohol aided Jellinek in legitimizing studies of alcohol consumption by effectively connecting it to other areas of academic research, for example epidemiology. Jellinek also sought practical uses for his theories. This search for a practical use for his theoretical approaches led him to be instrumental in creating the Yale Plan Clinics, first American outpatient clinics for the treatment of alcoholics. The disease notion of alcoholism was not a completely new idea, with roots in earlier history. Swedish physician Magnus Huss in the 1800s is credited with creating the term alcoholism, as well as creating different classifications for the disease. During the late 1800s in the United States, Thomas Crothers argued that alcoholics should not be viewed as immoral. Instead, he argued that these people were similar to sick individuals afflicted with a disease.

516   Jellinek, E. Morton (1890–1963)

Jellinek took these ideas and ran with them. Through studies he was able to discover five varieties (or what he termed “species”) of alcoholism. First there were “alpha” and “beta” alcoholics, which do not fit the disease model but were psychologically dependent upon alcohol. “Epsilon” alcoholics also did not fit the disease model because their addiction was characterized by random binge drinking. Since binge drinking failed to show physiological dependence upon alcohol, epsilon alcoholics did not fit disease model of alcoholism. “Gamma” and “delta” alcoholics, however, had states of physical addiction and thus fit the disease model. In the disease model, gamma and delta alcoholism was characterized by a growing physiological adaptation to alcohol, changes at a cellular level, withdrawal from and cravings for alcohol, and a “loss of control” when drinking. The difference between gamma and delta alcoholics centered on how the experiences differed when not around alcohol. When not drinking, gamma alcoholics did not experience withdrawal. Delta alcoholics experienced withdrawal when going without drinking, consequently leading to seemingly nonstop consumption. Therefore, there was a progression of alcoholism “phases” leading from physiological to physical addiction. Jellinek conceded that his idea of alcoholism was merely a hypothesis, but his theories still became the foundational ideas of modern alcoholism studies. The disease model of alcoholism was entrenched in future research because of his powerful role as an editor of the Quarterly Journal of Studies on Alcohol and compiler of the Classified Abstract Archive of the Alcohol Literature. The Disease Concept of Alcoholism, published in 1960, helped cement his role as one of the greatest alcoholism researchers in history. He was one of the

first researchers to capture group values of both alcoholics and researchers. Jel­ linek’s legacy can also be felt today in Alcoholics Anonymous (AA) programs throughout the United States. Many of his ideas on the differing phases of alcoholism were hypothesized from data gathered from AA meetings. After leaving Yale in 1950, he continued researching alcoholism at many different places, including the Texas Addiction Research Foundation, the University of Toronto, and Stanford University. While working with the World Health Organization, he was instrumental in founding the World Health Organization Committee on Alcoholism, as well as the National Council on Alcoholism. Jellinek died at his desk on October 22, 1963, in Palo Alto, California. Howard Padwa and Jacob A. Cunningham See also: Alcoholics Anonymous; Disease Model of Addiction

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Edwards, Griffith. 2000. Alcohol: The Ambiguous Molecule. London: Penguin Books. Lender, Mark Edward. 1984. Dictionary of American Temperance Biography: From Temperance Reform to Alcohol Research, the 1600s to the 1980s. Westport, CT: Greenwood Press. Sournia, Jean-Charles. 1990. A History of Alcoholism. Trans. Nick Hindley and Gareth Stanton. Oxford: Basil Blackwell. White, William L. 1998. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chestnut Health Systems.

Johnson, Lyndon Baines (1908–1973)  517

Johnson, Lyndon Baines (1908–1973) Lyndon Baines Johnson was the U.S. president from 1964 to 1969, serving after Kennedy was assassinated in Dallas. Public concern about drugs was minimal during the 1950s and 1960s, yet during the Johnson’s administration, there was increased attention on the use of drugs and drug abuse problems in the United States. Because of the Prettyman Commission’s final report, issued to President Kennedy in November 1963, Congress created the Drug Abuse Control Amendments of 1965. These measures were designed to handle various problems associated with the diversion of depressant and stimulant drugs from legal channels into the illicit market. The Drug Abuse and Control Amendments of 1965 also required more complete record keeping and inspections for depressant and stimulant drugs, especially for barbiturates and amphetamines. On July 15, 1964, Johnson issued a statement on Narcotic and Drug Abuse. In that speech, Johnson said that “narcotic and other drug abuse [was] inflicting upon parts of the country enormous damage in human suffering, crime, and economic loss through thievery. The Federal Government, being responsible for the regulation of foreign and interstate commerce, bears a major responsibility in respect to the illegal traffic in drugs and the consequences of that traffic.” Johnson wanted “the full power of the Federal Government to be brought to bear upon three objectives: (1) the destruction of the illegal traffic in drugs, (2) the prevention of drug abuse, and (3) the cure and rehabilitation of victims of this traffic.” The program was further discussed in an advisory commission report on narcotics and drug abuse. Johnson concluded this brief speech by appointing White House staffer Lee White to act as a

U.S. president Lyndon Johnson at the White House in 1963. (Library of Congress)

liaison between the White House and agencies enforcing laws attempting to limit drug and narcotic use. One year later Johnson gave another speech regarding drug abuse, this time about the Drug Abuse Control Amendments Bill. Johnson praised the 1965 law saying that the Drug Abuse Control Act of 1965 would prevent the abuse and trafficking of medically important but potentially dangerous drugs, including sedatives and stimulants. Johnson believed that the law would increase the safety of localities, and that Americans had a responsibility to help remedy the inadequacies of the law. He said that the “values of our society and the security of our homes and communities can be protected by the law; and where the law is inadequate, or unjust, or obsolete, we have an obligation to cure what is wrong, and we can do it.” Johnson created the Bureau of Drug Abuse Control (BDAC), which was housed

518   Johnson, Lyndon Baines (1908–1973)

within the Food and Drug Administration (FDA), to enforce the provisions of the amendments. The FDA estimated that that at least 50 percent of the annual production of certain useful drugs was being diverted to illegal drug traffic. One year later, in 1966, Congress passed another major piece of legislation: the Narcotics Addict Rehabilitation Act. This new law focused on medical and rehabilitative measures instead of providing minor answers to illegal drugs, and fostered an increased emphasis on research and experimentation for drug abuse treatment ideas. Johnson thought the measure was another step forward in the American attack on criminal activity regarding drug abuse. In 1966, because of the increasing public concern over crime activity, specifically drug abuse, Johnson created the President’s Commission on Law Enforcement and Administration of Justice (the Katzenbach Commission) to “undertake a comprehensive study of the nation’s crime problem to provide recommendations to coordinate its eradication on all fronts” (President’s Commission on Organized Crime 1986, 220). By early 1968, President Johnson sent a reorganization plan to Congress that sought to restructure the federal drug enforcement effort. There were many key parts of the plan, a major one being the dissolution of the BDAC and the Federal Bureau of Narcotics, as well as establishing the Bureau of Narcotics and Dangerous Drugs under the Justice Department. Now, for the first time in its history, the Justice Department had a pivotal role in enforcing federal drug abuse laws. Despite all of the measures taken congressionally, and the enforcement of laws by different bureaucratic agencies, illegal drug use did not wane and consequently became one of the major issues of the 1968 presidential campaign.

During his 1968 State of the Union Address, Johnson again turned his focus to drug control, and argued that the “War on Crime” and controlling drug abuse would be at the forefront of the “war.” Johnson proposed creating a Drug Control Act, which would provide stricter penalties for LSD trafficking and selling other dangerous drugs to the American public. Secondly, Johnson wished for a more vigorous enforcement of all American drug enforcement laws and said that this could be accomplished by a 30 percent increase in the number of federal drug and narcotics control officials. In 1968, for his efforts against illegal drug use, the International Narcotics Enforcement Officers Association awarded Johnson and commended him for his action. During his acceptance speech Johnson emphasized all the actions of his administration had ordered different government agencies to take, and some of his own achievements during his presidency regarding drug use. By setting up a new Bureau of Narcotics in the Justice Department to strengthen the federal machinery. Under the Johnson presidency the federal government was taking new muchneeded measures to crack down on drugs. Johnson also requested a 30 percent increase in the number of federal agents to enforce American narcotics laws, as well as new legislation to make it a felony to manufacture and sell LSD and other dangerous drugs. Finally, Johnson pointed out the actions of his administration, which made a deep review of all federal narcotics laws to make them applicable to current American society. Being that he graduated from a teachers college, Johnson appreciated the role that education could play in the fight on drug abuse. Johnson believed that enforcement was only part of the solution in fighting drug abuse, and that where enforcement could not work, education could step in. Johnson

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firmly believed that education would help the American government fight drug abuse and help prevent young Americans from becoming drug abusers; education could stop the problem before it reached that stage. Along with enforcement and education, Johnson wanted to make sure that former drug abusers could be reintegrated into the community. Johnson wanted to make sure that American communities were willing to support and understood the importance of reintegration. This way, people who were previously addicted to drugs could become functioning members of the American public, giving the people a stake in society, lessening the likelihood of reverting back to drug abuse. Nancy E. Marion See also: Califano, Joseph A.; Drug Abuse Control Amendments; United States Bureau of Narcotics and Dangerous Drugs

Further Reading Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. Johnson, Lyndon B. 1964. “Statement by the President on Narcotic and Drug Abuse.” July 15. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=26374. Johnson, Lyndon B. 1965. “Remarks at the Signing of the Drug Abuse Control Amendments Bill.” July 15. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=27087. Johnson, Lyndon B. 1967. “State of the Union Address.” January 10. http://www2.hn.psu .edu/faculty/jmanis/poldocs/uspressu/ SUaddressLBJohnson.pdf. Johnson, Lyndon B. 1968. “Remarks Upon Accepting an Award From the International Narcotics Enforcement Officers Association,” April 29. Online by Gerhard Peters and John T. Woolley, American Presidency

Project. http://www.presidency.ucsb.edu/ ws/?pid=28824. Morgan, H. Wayne. 1981. Drugs in America: A Social History, 1800–1980. Syracuse, NY: Syracuse University. President’s Commission on Organized Crime. 1986. “America’s Habit: Drug Trafficking and Organized Crime.”

Jones, Marion (1975– ) Marion Jones was born on October 12, 1975, in Los Angeles. She attended the University of North Carolina at Chapel Hill, and played basketball as well as running track. In 2000, Jones competed as a sprinter at the Olympics, becoming the first female athlete to win five medals at a single Olympic Games, including three gold. She rocketed into the spotlight, quickly becoming athletics’ golden girl. She soon appeared on the cover of Vogue and became one of the sport’s first female millionaires. Jones also played for the WNBA Tulsa Shock, but was eventually cut. Despite accomplishing major feats in sports, what Jones is most remembered for is being found guilty of using performance enhancing drugs (PEDs) for two years prior to the 2000 Olympics in Sydney, Australia. By 2004, allegations of steroid use prompted the International Olympic Committee to open an investigation. Jones, by this time among the top female athletes in the world, had previously denied the use of steroids or other PEDs. The Washington Post later reported that, in a letter to family and friends, Jones had admitted to using steroids supplied by former coach Trevor Graham for two years beginning in 1999. In 2003, Jones initially lied when questioned by federal agents, wishing to protect herself and Graham. The PED Jones tested positive for was known as “the clear.” This particular PED

520   Jones, Marion (1975– )

Sprinter Marion Jones, the winner of three Olympic gold medals,  appears at a news conference during the opening day of the USA Track and Field Championships in 2001. She tested positive for a banned performance-enhancing drug at the event. She later admitted to using the drugs and was stripped of her gold medals. (AP Photo/Don Ryan)

was purchased from the Bay Area Laboratory Co-operative, which was run by Victor Conte. At the time the clear was a steroid that was administered through a syringe, and was then undetectable. The medals Jones had won were turned over to the U.S. Olympic Committee and U.S. Anti-Doping Agency Officials, eventually making their way back to the IOC. Soon after turning over her Olympic medals, Jones retired from the sport of track and field, but still received a two-year ban from the sport. Jones also had to vacate any results dating from September 1, 2000. Jones’s relay teammates also had to give back their medals. For lying to government officials about her drug use, Jones faced a possible five-

year sentence, but was ultimately sentenced to six months in prison. U.S. district judge Kenneth M. Karas’s decision was in acc­ ordance with the recommendations of the prosecution and sentencing guidelines. When she was released, Jones was also required to complete a total of 800 hours of community service. Today, Marion Jones speaks out against drug use, gives motivational talks on choices, is not afraid to comment on other athletes’ drug use, such as Lance Armstrong. In an Oprah interview Jones came across as very open about her drug use, stating that she had discussed it with two of her children, and said she wanted to try to be remembered in a positive light. Adam Stilgenbauer

Joplin, Janis (1943–1970)  521 See also: Steroids and Sports

Further Reading Biography.com. “Marion Jones Biography.” http://www.biography.com/people/marion -jones-9357466. ESPN. 2007. “Report: Jones Used Steroids for Two Years before 2000 Games.” http:// sports.espn.go.com/oly/trackandfield/news/ story?id=3049333. Holt, Sarah. 2008. “Marion Jones’s Fall from Grace.” BBC Sport. http://news.bbc.co.uk/ sport2/hi/athletics/7184067.stm. Schmidt, Michael S., and Duff Wilson. 2008. “Marion Jones Sentenced to Six Months in Prison.” New York Times. http://www.nytimes .com/2008/01/12/sports/othersports/11 cnd-jones.html?hp&_r=0. Shipley, Amy. 2007. “Marion Jones Admits to Steroid Use.” Washington Post. http://www .washingtonpost.com/wp-dyn/content/ article/2007/10/04/AR2007100401666 .html?sid=ST200710050209.

was teased and rumors about her were common: while some classmates called her a “pig,” others claimed she was sexually promiscuous. Joplin found refuge in a group of male friends who had similar interests in music. Musically, Joplin and her friends were drawn to blues and jazz, admiring artists such as Lead Belly. Legendary blues vocalists Ma Rainey, Odetta, and Bessie Smith also inspired Joplin. She and her friends patronized local blue-collar bars in nearby Vinton, Louisiana. By the start of her senior year of high school, Joplin had cultivated a reputation as a “ballsy, tough-talking” girl who liked to drink. After high school, Joplin enrolled at Lamar State College of Technology in Beaumont, Texas, where she dedicated much of her time not to her studies, but to hanging

Joplin, Janis (1943–1970) Janis Joplin was born on January 19, 1943, in Port Arthur, Texas. As a young child, Joplin developed a love of music and began singing in her church choir where she displayed some potential as a performer. Joplin’s childhood had been rather normal, but that changed just before entering high school when she began to suffer the negative effects of puberty. Joplin, who had been rather popular and a good student, gained weight and developed acne. Once she began attending Thomas Jefferson High School, Joplin’s rebellious side surfaced. She opted to wear tights or short skirts with men’s shirts rather than the fashions that were popular among teen girls in the late-1950s. By choosing not to conform to the norms of the era, Joplin

Janis Joplin, musician, performs at the New­ port Folk Festival in 1968. Joplin had a long history of drug use and died of a drug overdose in 1970 at the age of 27. (AP Photo)

522   Joplin, Janis (1943–1970)

out and drinking with friends. After one semester she left Lamar and spent some time at Port Arthur College. In the summer of 1961, she attempted to break away from Port Arthur by moving to Los Angeles; her stay there, however, was short-lived. Joplin fled to the University of Texas at Austin in the summer of 1962 to study art. In Austin, she began performing at informal musical gatherings (folksings) on campus and at a nearby bar, Threadgill’s. Joplin amazed audiences with her forceful, gutsy singing style that was a stark contrast to the gentler sounds of folk icons such as Joan Baez and Judy Collins. In early 1963, Joplin once again dropped out of school and migrated to San Francisco with her friend, Chet Helms, to check out the emerging music scene. This stint in California also proved to be unsuccessful. Even though Joplin was able to play some gigs in the Bay Area (including a performance on a side stage at 1963’s Monterey Folk Festival), she struggled to make it as a singer, and her career did not gain much traction. Joplin next tried her luck in New York City, but her aspirations were hampered by her drinking and use of drugs, namely, amphetamines. In 1965, in an effort to get herself together, Joplin returned to Port Arthur. She took a break from her music and her hard-partying lifestyle, dressed conservatively, wore her long hair in a bun, and did anything else so that she could to appear proper. Her attempt at conformity, however, was relatively brief. In May 1966, Joplin was asked to audition for Big Brother and the Holding Company, a new psychedelic rock band based in San Francisco. The group’s manager at the time was her friend, Chet Helms. The band, including members James Gurley, Dave Getz, Peter Albin, and Sam Andrew, was part of San Francisco’s burgeoning music scene

of the late 1960s, which also included the Grateful Dead. The band was blown away by Joplin’s audition and she was quickly offered a place in the band. Early on, Joplin sang only a few songs and was relegated to the background where she played the tambourine. As Big Brother’s following in the Bay Area grew, so too did Joplin’s role in the band. The group won acclaim for their performance of “Ball and Chain” at the 1967 Monterey Pop Festival. Joplin’s vocals in the song drew the most praise. Audiences were mesmerized by Joplin’s raw, gutsy sound and unrestrained sexuality which were fueled by a combination of heroin, amphetamines, and bourbon that she drank straight from the bottle during performances. This attention, however, created tension between Joplin and the rest of Big Brother’s members. Among the audience members at Monterey was Columbia Records’ president Clive Davis, who wanted to sign the band. Big Brother’s inaugural album with Columbia, Cheap Thrills, quickly became a certified gold record. The process of creating the album caused additional problems between Joplin and the rest of Big Brother’s members. Joplin’s performance on Cheap Thrills helped solidify her reputation as a “unique, dynamic, bluesy rock singer” (Biography. com). In spite of the band’s success, Joplin began to feel that the group was holding her back professionally. After struggling with her decision to leave Big Brother, Joplin decided to part ways with the group in late 1968. Her first solo album, I Got Dem Ol’ Kozmic Blues Again Mama!, was released in September 1969, a month after her historic performance at Woodstock. The reviews for the album, however, were mixed. At this time, Joplin’s dependence on alcohol and drugs—including heroin—soon took their

Juárez Cartel  523

toll. On October 4, 1970, Joplin died of an accidental overdose of heroin while staying at the Landmark Hotel in Hollywood. Joplin’s final album, Pearl, was released posthumously in 1971 and quickly rose to the top of the charts. The album included two songs written by Joplin, “Move Over” and “Mercedes Benz,” plus the hit “Me and Bobby McGee.” Janis Joplin’s songs continue to inspire performers and attract new fans. Over the years, several collections of her songs have been released. This includes 1971’s In Concert and 1999’s Box of Pearls. In 1995, in honor of Joplin’s significant accomplishments, she was posthumously inducted into the Rock and Roll Hall of Fame. In addition to being named the “first lady of rock’n’roll,” several books and documentaries have chronicled Joplin’s life. A book written by her sister, Laura Joplin, titled Love, Janis, has been adapted into a play. Stacy O’Hara Leiter See also: Entertainers and Drug Use; Heroin

Further Reading Biography.com. “Janis Joplin.” http://www .biograpy.com/people/janis-joplin-9357941 ?page=1.

Juárez Cartel The Juárez Cartel is one of four major cartels found in Mexico, the other four being the Gulf, Sinaloa, and Tijuana cartels. Amado Carrillo Fuentes, who took over its leadership in 1993, headed this cartel. The cartel operates primarily in the Juárez–El Paso areas, and stretches along the west Texas and New Mexico borders and into Arizona from Hermosillo, Mexico. Reportedly, the cartel has a close relationship with

the Amezcua Contrera organization. It is believed that the Juárez cartel was responsible for the approximately 650 pounds of methamphetamine that were seized in Las Cruces, New Mexico, in early 1995. The death of Carillo Fuentes in 1997 resulted in a vicious power struggle in the cartel as well as the territories controlled by the cartel. The current violence surrounding the cartel began in January 2008 after the drug-trafficking arrest in El Paso of a high-ranking Juárez member, Saulo Reyes Gamboa. Gamboa cooperated with U.S. law enforcement. Immediately following this arrest, a series of high-profile killings were carried out in Juárez. Locals familiar with the cartel believed these deaths were due to attempts by the Juárez Cartel to kill disloyal members and the internal power struggle that has taken place since 1997. The Sinaloa Cartel, the rival of the Juárez Cartel, was led by Chapo Guzman, and attempted to control the Juárez drug-trafficking market by exploiting the power struggle within Juárez. Since 2008 there have been very few days without violence, and these days were largely the result of a severe winter storm that forced gang members to stay inside. Even with Fuentes’s death, the Juárez Cartel is still around, and many local police officers will say that the cartel is trying to rebuild itself. The most powerful branch of the Juárez Cartel, La Linea, has diversified its activities from drug trafficking into multiple types of criminal enterprises. There have been members of the New Juárez Cartel (NJC) found throughout the territory, and many of their activities are threatening the ability of local law enforcement to keep the peace. One message from the NJC alleged that Julian Leyzaola, the Ciudad Juárez chief of police, was supporting rival cartels, and

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threatened that the cartel would kill one police officer every day until he stopped and police officers ceased arresting NJC members. More than 10 police officers were killed in January 2010, prompting many to question whether or not the message of the cartel should be heeded. Last year in Juárez alone, more than 1,300 people were murdered, including at least eight people killed during a prayer meeting at a rehabilitation center. Machine gun fire lasted 15 minutes and eyewitnesses reports say that nearby soldiers did nothing to remedy the situation. In October, four men were shot and killed at an amusement park, and in November, a headless body was hung from an overpass, one body was publicly burned, another was headless and handless and placed on a sidewalk in front of a police station. One day, 16 people were killed, including some who were executed beside a school soccer field. Despite the violence, very few people have been charged for being involved in these heinous acts. In 2008, when Mexican president Felipe Calderón sent 2,500 troops into northern Mexico to help maintain order and rid the area of corrupt police forces, the public primarily acted in two ways. First there was fear of a new group of armed men in the area. The other reaction was one of indifference. Many Mexican citizens in the area already associate the military with being unable, or unwilling, to stop the violence. Some people even theorize that the military is in Juárez to aid Guzman’s Sinaloa finally gain control of the Juárez Cartel. The violence taking place is often compared to the violence in the Middle East, and if Americans believe the violence does not impact them, they are wrong. Often, the violence in Juárez spills across the border to El Paso, Texas.

La Linea, the dominant branch of the Juárez Cartel, is believed to have committed some particularly violent acts. Some of these are the massacre of recovering drug addicts at a drug rehabilitation center in the Colonia Bella Vista and the killing of 15 teenagers who were mistaken for gang members. There have been multiple Juárez journalists killed, one being crime reporter Armando Rodriguez, who had been legendary for his investigative work. Three people associated with the U.S. consulate were assassinated. There were thousands of desecrated bodies left in the streets, some quartered, duct-taped, beheaded, burned sexually, or otherwise mutilated. A car bomb killed a Juárez policeman and a paramedic. La Linea is believed to be responsible for murdering 149 policemen in Juárez in 2010. That same year, 304 women were murdered. There have been numerous, large-scale murders in bars, homes, drug rehabilitation centers, private parties, shopping centers, restaurants, used car lots, junkyards, car repair shops, and other businesses. It is estimated that 20 percent of the murders associated with the Mexican drug war have occurred in Juárez, many of these attributed to La Linea. After the signing of the North American Free Trade Agreement, there has been great hope in the region that the violence would decrease, but that hope is gone. The Juárez Cartel and its rival, the Sinaloa Cartel, wage war in the streets, and Mexican security forces do little to solve the problem. Now it is believed that another drug cartel, the Zetas, has entered the region, and this will only add to the violence. The Sinaloa Cartel and the Zetas’ presence in the region has weakened, however, and this has led to the Juárez Cartel, particularly La Linea, gaining a newfound power in the region. Nancy E. Marion and Ron Chepesiuk

Jung, George (1942– )  525 See also: Drug Cartels; Gulf Cartel; Mexican Drug Trade

Further Reading Bauder, Julia. 2008. Drug Trafficking. Detroit: Greenhaven Press. Bewley-Taylor, David R. 2012. International Drug Control: Consensus Fractured. Cambridge: Cambridge University Press. Campbell, H. 2011. “No End in Sight: Violence in Ciudad Juárez.” NACLA Report on the Americas 44(3): 19. Hill, S. 2010. “The War for Drugs: How Juárez Became the World’s Most Dangerous City.” Boston Review 35(4): 19–23. “Mexican Drug Cartels: An Update.” 2010. Stratford Analysis, 4. “Mexico Security Memo: A New Juárez Cartel.” 2012. Stratford Analysis, 32. Nergon, S. 2009. “Baghdad, Mexico.” Texas Monthly 37(1): 60. Roth, Mitchel, P. 2010. Global Organized Crime: A Reference Handbook. Santa Barbara, CA: ABC-CLIO. “The Southwest Border Initiative 12 March 1997.” Remarks of Thomas A. Constantine, Director, DEA.

Jung, George (1942– ) George “Boston George” Jung was a drug trafficker in the United States through the 1970s and 1980s. He was raised in an upperclass family in Cape Cod, Massachusetts, graduating from high school in 1961. While attending the University of Southern Mississippi, he began using marijuana recreationally, being sure to sell a portion of what he bought as a way to break even. He dropped out of college and moved to California with friends, becoming enthralled with the drug scene there. He began to smuggle marijuana

from California to New England where the prices for the drug were higher. He then began smuggling drugs from Puerto Vallarta, Mexico, using airplanes stolen from private airports in Cape Cod. He was making hundreds of thousands of dollars each week. In 1974, Jung was arrested in Chicago while smuggling 660 pounds of marijuana and was sent to federal prison in Danbury, Connecticut. He was 32 years old at the time. While Jung was in prison, his cell mate was Carlos Lehder, who was serving four years for marijuana trafficking. Lehder was fascinated that Jung had been transporting tons of marijuana using private planes. While cocaine had been imported to the United States in small kilo lots, Lehder saw no reason it could not be smuggled in by the ton, like marijuana. The two men spent about a year fine-tuning their future smuggling operation. By 1976, the two men were released from prison. Lehder and Jung started smuggling cocaine in the United States from Colombia. The price for a kilo of cocaine in Colombia was $2,000, but in the United States it cost $55,000. They used the same methods previously used to smuggle marijuana to smuggle cocaine. At first, the smugglers convinced women to go to Antigua and pick up the drugs. The women would go on a paid vacation, carrying large suitcases. The suitcases had a fiberglass shell in which the drugs would be hidden. The women brought the cocaine-filled suitcases through Logan Airport (in Boston) easily. The plan was so successful, the women turned around and returned the following day for more. Later, the men arranged to have planes stolen from private airports as a way to smuggle more drugs more conveniently. Jung sold his first kilo to his contact in California, Richard Barile, a hair dresser in Hollywood who had previously purchased marijuana. The cocaine was wildly popular

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in California, and Jung made thousands. The men’s cocaine supplier turned out to be Pablo Escobar, a Colombian cocaine producer from Medellín. He supplied the pair with cocaine from his ranch. Pilots would fly on a Friday night from the Bahamas into Colombia and land on Escobar’s ranch, stay overnight, and return the next day to the Bahamas (Nassau). There would be 250 kilos of cocaine on board. The plane would be left at the airport, under police protection, for the night. On Sunday, the pilot would fly the plane to a remote air strip in the Carolinas. Jung would then fly or drive the drugs to California, sell them to his contact there, and return with a suitcase full of cash. It is estimated that Jung profited $15 million per run, making him the largest drug trafficker in the United States at that time. In order to hide his money, he kept the profits in the national bank of Panama City. At one point it had close to $100 million in it. The cash Jung brought back from California would be packed into door panels in Chevy Blazers that were being exported out of the United States and into Colombia. Lehder had a dealership there, and he purchased the Chevy Blazers. All of this was possible because at the time, drugs and drug smuggling were not the major social problem in the United States as they are today. That meant that it was easy to carry drugs in suitcases or through airports. The DEA was not fully aware of the extent of the drug trade in Colombia and the Bahamas. They did not have the manpower or equipment to stop it. As time went on, Jung used cocaine to stay awake, and soon became addicted to the drug. Lehder did not use the drug, and often told Jung to stop, which he would not do. When Jung finally introduced Lehder to his

drug contact in Los Angeles, Lehder knew he no longer needed Jung. So by the late 1970s, Lehder cut Jung out of the operation. Nonetheless, Jung continued to smuggle when he could, still making millions. In 1987, Jung was arrested at his home in Massachusetts. He decided to skip bail, and took his family to Mexico where he got involved in another deal. This time, an acquaintance betrayed him. Jung was arrested again in 1994 for smuggling 1,754 pounds of cocaine. This time, he pled guilty to three counts of conspiracy and received a 60-year prison sentence. He was incarcerated at Otisville Federal Prison in New York, and was later moved to the Federal Correctional Institution in Anthony, Texas. He chose to testify in the trial of former accomplice Carlos Lehder, and in exchange received a reduction in his sentence. He is now in the Federal Correctional Institution in Fort Dix, New Jersey, and may be released in November 2014. Jung’s drug trafficking story was made famous by the moive Blow, which starred Johnny Depp as Jung. Nancy E. Marion See also: Drug Cartels; Drug Trafficking; Medellín Cartel

Further Reading Gugliotta, Guy. 1990. Kings of Cocaine: An Astonishing True Story of Murder, Money and Corruption. New York: Harper and Row. PBS Frontline. “Interview with George Jung.” http://www.pbs.org/wgbh/pages/frontline/ shows/drugs/interviews/jung.html. Porter, Bruce. 1993. Blow: How a Small Town Boy Made $100 Million with the Medellin Cocaine Cartel and Lost It All. New York: St. Martin’s Griffin.

K During his 1962 State of the Union Address, Kennedy spoke out against illicit drug use and called for government action regarding it. Ideally, Kennedy wanted to increase food and medical standards, but he also wanted to crack down on illegal and dangerous addictive drugs. In September of 1962, Kennedy put together a White House Conference on Narcotic and Drug Abuse that was held in Washington, D.C., from September 27–28. This was a two-day meeting attended by 500 people who ranged from law enforcement to politicians and doctors. It became clear in the meeting that these politicians and other experts knew little about illicit narcotics—from the drug trade, to the effects on the body, or even why people

Kennedy, John F. (1917–1963) John F. Kennedy was the 35th president of the United States, with his presidency lasting less than one term, from 1961 until his assassination in 1963. The problem of illicit drug use was just becoming part of the national agenda during this time, so Kennedy gave the issue very little attention. During his campaign for the presidency, Kennedy promised to take action on the issue. By the time Kennedy became president in 1960, there was a small group of urban, middleclass youth who were openly using drugs, even more dangerous drugs like heroin. The public wanted him to do something about it.

U.S. president John F. Kennedy reports to the nation. (AP Photo) 527

528  Ketamine

seek to use them. The proceedings from the conference were released in March 1963. As a way to learn more and continue the work begun at the conference, Kennedy then appointed a President’s Advisory Commission on Narcotics and Drug Abuse. This happened on January 16, 1963, through Executive Order 11076. The commission members conducted an in-depth study into the entire world of illicit narcotics use, including any existing research (of which there was little), law enforcement, effects, addiction, and treatment options. The head of the commission was E. Barrett Prettyman, a retired chief judge of the U.S. Court of Appeals in Washington, D.C. Prettyman and the other members finished their report and presented it to President Kennedy in early November 1963. In late November, Kennedy was assassinated. The report had not yet been released to the public when that happened. Though Kennedy did not focus as much of his attention on drugs as other presidents, such as Ronald Reagan, Kennedy did have personal experience with drugs. President Kennedy suffered from autoimmune diseases that required him to take several different medications. From his childhood Kennedy had been called sickly, and suffered from constant bouts with nausea, diarrhea, joint pain, fatigue, and severe headaches, and was born with Schmidt’s Syndrome. JFK also suffered from adrenal degeneration, osteoporosis, anemia, and what is now called celiac disease. In 1955, Kennedy met Dr. Travell, who put Kennedy on a strict regimen of various medications. Kennedy was treated with methadone (Dolophine), meperdine (Demerol), and codeine, which are different types of opioids. Kennedy also had to take Tuinal, which is a type of sleeping medication. Along with sleeping aids and opioids, Travell also prescribed Kennedy different

stimulants, and orally taken hormones, as well as B-vitamins. Nancy E. Marion See also: President’s Advisory Commission on Narcotic and Drug Abuse; White House Conference on Narcotics and Drug Abuse

Further Reading Kennedy, John F. 1962a. “Annual Message to the Congress on the State of the Union.” January 11. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=9082. Kennedy, John F. 1962b. “Remarks to the White House Conference on Narcotic and Drug Abuse,” September 27. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=8905. Kennedy, John F. 1962c.“Statement by the President Announcing a forthcoming White House Conference on Narcotics.” May 29. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=8686. Kennedy, John F. 1963. “Letter to the Chairman in Response to the Interim Report of the President’s Advisory Commission on Narcotic and Drug Abuse,” April 4. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=9140. Tennant, F. 2012. “John F. Kennedy’s Pain Story: From Autoimmune Disease to Centralized Pain.” Practical Pain Management (September): 53–68. http://www.forestten nant.com/pdfs/905-Feature-JFK-Tennant .pdf.

Ketamine Ketamine is an anesthetic drug developed in 1963 that causes patients to feel detached

Ketamine  529

from pain or their environment. Ketamine is one of three powerful hallucinogens that are also known as date rape drugs. Originally an animal tranquilizer and anesthetic, ketamine has become popular at rave dance clubs, and has become associated with dubstep and other forms of electronic dance music (also known as house music). The drug acts quickly at low doses to cause dizziness and euphoria, but at higher doses causes the amnesia and coma that make users vulnerable to sexual predators. It can also cause delirium, high blood pressure, and depression. Ketamine has been known to cause hallucinations and vivid dream-like states. Some users have reported a pleasant floating sensation, or a feeling of being separated from their bodies. Some experiences involve a more unnerving or even terrifying feeling of sensory detachment, likened to a near-death experience. Dubbed the “K-hole,” these experiences are reportedly similar to a bad trip on LSD. Ketamine was originally developed as a battlefield anesthetic in the Vietnam War. Today it is produced in laboratories for legitimate veterinary use as a horse tranquilizer. But it is also increasingly diverted for illicit recreational use. Robberies of U.S. veterinary clinics have increased, and importation of the drug from Mexican pharmacies is on the rise. Criminal groups conspire with legitimate factories to produce ketamine in industrial quantities. It is then smuggled to the Far East, North America, and Europe, where there is high demand for the drug. Although it is manufactured as an injectable liquid, in illicit use ketamine is generally evaporated to form a white powder. By removing the liquid from the pharmaceutical product, users can orally consume the powder that remains or snort, inject, or sprinkle it on marijuana and smoke it. The method of administration determines how quickly

users experience its effects. Recently, Herd and coworkers studied the pharmacokinetic characteristics of ketamine in children undergoing painful procedures in an emergency department. Ketamine interacts with the inflammatory reaction in a specific way. After trauma or surgery, numerous reactions involving, among others, innate or specific immunity take place. This constitutes the inflammatory reaction. Ketamine is intended to restore homeostasis and promote wound healing. In September 2002, the World Health Organization Expert Committee on Drug Dependence completed a pre-review of ketamine, and, based on available info, a critical review was recommended. Around the same time, both the Netherlands and the European Union carried out their own risk assessment procedures to investigate the drug. Both concluded that there was no need to amend current control systems for the legitimate use of ketamine as a pharmaceutical product. According to the World Health Organization, ketamine can have numerous effects on the cardiovascular system, the respiratory system, and possibly mood. Small doses can give a burst of energy, similar to cocaine. Larger doses can cause temporary paralysis, anxiety, hyperventilation, black-outs, and psychosis. There do not appear to be any long-term adverse effects associated with short-term ketamine use on mood, personality, or cognition. Long-term, heavy use, however, may lead to persistent deficits in memory retention. It may also lead to the destruction of the lining of the bladder and urinary tract that is irreversible. Unlike most anesthetic agents, ketamine seems to have the effect of stimulating the cardiovascular system by producing changes in heart rate, cardiac output, and blood pressure. It is possible that this effect is caused by reuptake inhibition

530  Ketamine

of circulating catecholamines. However, in critically ill patients, cardio-depressant effects have been observed. This may be due to chronic catecholamine depletion preventing any sympathomimetic effects of ketamine and unmasking a negative inotropic effect, which is usually overshadowed by sympathetic stimulation. Typically, the cardiovascular effects of ketamine are not problematic, but it should not be administered to patients with significant ischemic heart disease and should be avoided in patients with a history of high blood pressure or cerebrovascular accidents. Illicit users examined on arrival at emergency departments commonly present with tachycardia. Ketamine also has the effect of acting as a mild respiratory depressant. It can shift the CO2 dose-response curve to the right in relation to the dosage and without changing the slope of the curve. Respiratory drive to CO2 may be depressed as much as 15 to 22 percent. This effect is closer to that observed with opioids rather than that of most anesthetics and hypnotics, suggesting opioid receptors may be at play. The effects have been observed only at high doses in clinical studies but regardless of the method of administration, whether the drug was delivered rapidly as an intravenous injection or as a routine intramuscular injection in a pediatric setting. At recreational doses respiratory depression is not likely to occur, but cannot wholly be excluded. Ketamine has a bronchodilator effect, and pharyngeal and laryncheal reflexes are maintained. Unlike other drugs, such as heroin or cocaine, ketamine does not seem to establish dependency in users. Only a very limited number of cases of ketamine dependence over the past 20 years have been described. A high tolerance to ketamine can develop quickly. In one case report, the subject described his use of the drug over the course

of a two-year period. He began by taking an occasional 50 mg dose, working his way up to 500 mg four to five times daily. He then transitioned to intramuscular injections, selfadministering between 300 and 750 mg five to six times per day, this higher tolerance developing in just a month. The tolerance dissipated on stopping the habit, but redeveloped at the same rate (within a month) after restarting intramuscular injections. In the course of its critical review, the WHO found that, of 74 countries surveyed, only three reported that they had brought the substance under control: Australia, Belgium, and the United States. In the United States ketamine is a Schedule III drug in the Controlled Substances Act, the same category as codeine or anabolic steroids. The Libyan Arab Jamahiriya also considered regulating the drug. Countries reported by the International Narcotics Control Board to have brought the substance under control are Malaysia, Myanmar, and the United Kingdom. Brunei Darussalam is reported to be considering its scheduling. Since 1997, France scheduled the raw material, but not the vials. Because ketamine manufacture is complex and time consuming, clandestine production is impractical. Rather, the drug is diverted from legitimate production facilities to the illicit market. Ketamine is commercially produced in a number of countries including Belgium, China, Colombia, Germany, Mexico, and the United States. A number of street names for ketamine can be found in the literature, including 1980 acid, cat valium, green, flatliners, jet, K, kaddy, Kate, ket, kéta k, Kit Kat, khole, liquid E, liquid G, mauve, purple, Special K, special LA coke, super K, super acid, super C, tac et tic, and vitamin K. The long-term medical consequences of ketamine use are just beginning to emerge. Kathryn H. Hollen

Khat  531 See also: Controlled Substances Act; Hallucinogens

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Drug Free.Org. 2012. “Drug Guide Information for Over 40 Commonly-Abused Drugs: Ketamine.” http://www.drugfree.org/drug -guide/ketamine. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology New York: Oxford University Press. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Lois, F., and M. D. Kock. 2008. “Something New about Ketamine for Pediatric Anesthesia?” Current Opinions in Anaesthesiology 21: 340–44. Nabben, T., and D. J. Korf. Ketamine. Amsterdam: Thela Thesis, 2000. Pagliaro, L. A., and A. M. Pagliaro. Pagliaros’ Comprehensive Guide to Drugs and Substances of Abuse. Washington, DC: American Pharmacists Association, 2004. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse.

2001. “Research Report Series: Hallucinogens and Dissociative Drugs.” NIH Publication No. 01-4209. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http:// www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea. World Health Organization. 2006. Critical Review of Ketamine.

Khat Pronounced “cot,” khat is a stimulant derived from the East African shrub Catha edulis and has been used socially for centuries by indigenous cultures to reduce fatigue and suppress appetite. The leaves and other parts of the plant are chewed like tobacco or dried to make a tea, paste, or flaky material that can be smoked. With excessive use, it is capable of producing manic behavior, hallucinations, grandiose delusions, increased heart rate, exhaustion, hyperactivity, insomnia, and gastric disorders. Reports on the effects of chewing khat leaves note an induced state of euphoria and elation, and a sense of increased alertness and arousal. While effects can last as long as 24 hours, they more often begin to subside after an hour and a half to three hours, with long-time users experiencing withdrawal-like symptoms including a depressed mood, irritability, trembling, loss of appetite, nightmares, and difficulty sleeping. Cathinone and cathine are the primary psychoactive substances in khat, with cathinone believed to be responsible for the majority of effects. These chemicals are similar in structure to amphetamine and produce a similar yet less potent stimulant effect in the brain

532  Khat

and body. Cathinone and cathine use leads to the release of norepinephrine, a stress hormone and neurotransmitter, and an increase in the amount of dopamine in brain circuits regulating pleasure and movement. However, there are many additional compounds in khat that are frequently overlooked by researchers—it would not be feasible to investigate the effects of each individual compound. Therefore, the effects of the drug may vary greatly among users, with a variety of possible impacts on both the central and peripheral nervous systems. Chronic khat use has also been consis­ tently but weakly associated with mental disorders in epidemiological studies. While khat itself may not be the cause of a mental illness, its use may exacerbate the symptoms of mental illness in users with preexisting psychiatric conditions. There is no consensus as to whether the use of khat leads to addiction, physical dependence, or tolerance. There are also a number of physiological effects that users may experience, similar to those typical of stimulants. This includes an increase in blood pressure and heart rate. Long-term, heavy use has been associated with a number of adverse effects, including tooth decay and periodontal disease; gastrointestinal disorders such as constipation, ulcers, and inflammation of the stomach; increased risk of upper gastrointestinal tumors; and cardiovascular disorders such as irregular heartbeat, decreased blood flow, increased blood pressure, and heart attack. One study found that heavy users may have as much as a 39-fold increase in risk of heart attack. Higher rates of stroke and hemorrhoids are also linked to khat’s cardiovascular effects. There is some association between khat use and the incidence of oral squamous cell carcinomas. In one study, it was found that abnormal cells were found in the loca-

tion on the buccal mucosa and lateral sides of the tongue where khat is typically held while chewing. Another survey of head and neck cancer patients found that 10 of 28 had used khat regularly over a period of 25 years or longer. Of these, eight presented with oral cancers, the malignant lesion appearing in the spot where khat was held in the mouth. These effects have been observed in additional surveys and studies, with one concluding that approximately 50 percent of khat chewers develop a precancerous lesion, oral mucosal keratosis. The effect appears to be correlated with the duration and frequency of use. Cathinone and cathine were also shown to cause rapid and synchronized cell death in human leukemia cell lines. There is evidence that khat use also exerts a negative effect on reproductive health. Chronic khat use among males can lead to spermatorrhea, decreased sexual functioning, and impotence. Malformations of the spermatozoa have been recorded, including defects to both the head or flagella, aflagellate heads, headless flagella, and multiple heads and or flagella on single spermatozoa. Decreases in sperm count and motility have also been noted among some users. In females, decreased blood flow to the uterine lining and placenta may have an effect on fetal development. Among pregnant women, khat users have a higher rate of low birth weights than nonusers. The chemical profile of khat varies with the environment and climate in which it is grown. Forty-four different varieties originating in different regions are grown in Yemen alone. The flavor of the leaves depends much on their tannic acid content and varies among varieties. Khat leaves have an astringent flavor and are aromatic, with young leaves being slightly sweet. In the United States, there is no accepted medical use of or treatments employing khat.

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Abuse of khat in the United States is most prevalent among immigrants from Somalia, Ethiopia, and Yemen, and is highest in cities with a substantial population of these immigrants. These cities include Boston; Columbus, Ohio; Dallas; Detroit; Kansas City, Missouri; Los Angeles; Minneapolis; Nashville; New York; and Washington, D.C. In 2004, the Kansas City Police Department reported a new form of khat within the Somali community had emerged. Graba is a dried form of khat that is similar to marijuana in appearance. This type of khat is produced in Ethiopia and is commonly dried before it is transported into the United States. While it is prohibited in the United States by federal law, khat is legal in much of Europe as well as on the Arabian Peninsula and East Africa, where it is grown and smuggled to the West. Cathinone and cathine are regulated in the United States under the Controlled Substances Act, under Schedule I and Schedule IV respectively. Despite this prohibition, khat has been widely available in the United States since 1995. According to recent federal drug seizure data, law enforcement seized 89,669 kilograms of khat in 2010. The National Forensic Laboratory Information System and the System to Retrieve Information from Drug Evidence indicate that 552 drug exhibits submitted to federal, state, and local forensic laboratories in 2011 were identified as khat, cathine, and/or cathinone, with the number rising to 718 exhibits in 2012. In the first quarter of 2013, there were 118 exhibits of the drug or its components identified. Its current use among particular migrant communities in the United States and in Europe has caused concern among policymakers and health care professionals. No reliable estimates of prevalence in the United States exist. It is estimated that as many as 10 million people worldwide chew khat. It is an

established part of cultural tradition in the southwestern part of the Arabian Peninsula and East Africa. The use of khat has been implicated in some countries as a contributing cause of social unrest due to its psychological effects, including, according to some, psychosis. In Somalia, civilian and military use of khat has been blamed for fueling civil war, draining the nation’s economy, and undermining international relief efforts. In one large study in Yemen, 82 percent of men and 43 percent of women reported at least one lifetime episode of khat use. Among khat’s street names are Abyssinian tea, African salad, catha, chat, kat, and oat. Kathryn H. Hollen See also: Controlled Substances Act; Stimulants

Further Reading Anderson, David, Susan Beckerleg, Degol Hailu, and Axel Klein. 2007. The Khat Controversy: Stimulating the Debate on Drugs. New York: Berg. Califano, Joseph A. 2007. Jr. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books.

534   Koop, C. Everett (1916–2013) U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http:// www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. 2008. http://www .usdoj.gov/dea; http://www.drugabuse.gov/ publications/drugfacts/khat. U.S. Department of Justice, Drug Enforcement Administration. 2013. http://www.deadiversion.usdoj.gov/drug_chem_info/khat.pdf. World Health Organization. 2006. “Assessment of Khat.” http://www.who.int/medicines /areas/quality_safety/4.4KhatCritReview .pdf.

Koop, C. Everett (1916–2013) After establishing a distinguished record as a pioneer in the field of pediatric surgery, C. Everett Koop was appointed by President Reagan in 1981 as deputy assistant secretary for health, with the understanding that he would be nominated to the position of surgeon general; he was officially sworn in to the top job in public health on January 21, 1982. Koop has been an outspoken advocate of public health issues. He especially went after the problem of tobacco use, aiming to rid the United States of smoking by the year 2000. While the dangers of tobacco have long been understood, with the Public Health Service calling attention to the health costs since the 1964 surgeon general’s report on smoking and health, anti-tobacco campaigns were relatively low-key before Koop’s era. No federal official before or since Koop has waged a more determined campaign against smoking. Tobacco use, especially smoking, is the leading cause of preventable death and dis-

ability in the United States. During his years as a pediatric surgeon attending medical conferences, Koop often witnessed the air at meetings filling with smoke, a sight he found dismaying. Up until the mid-1970s, this remained a common sight despite knowledge among the medical community of the potential dangers. However, Koop did not initially enter the office of surgeon general with a mission for smoking cessation. He himself had occasionally smoked pipe tobacco until giving up the habit in the early 1970s. However, when he began to dig further into the issue of smoking as a public health threat as preparation for the release of the annual, congressionally mandated report on smoking and health, Koop became aware of and appalled by the tactics of the tobacco lobby. Tobacco companies commonly employed deceptive advertising, and the industry’s efforts at lobbying lawmakers were aggressive. Over the course of his eight years in office, Koop devoted more time to the issue of smoking than any other, striving to alert the public, both smokers and nonsmokers, to the dangers of tobacco use. The year Koop was confirmed, 1981, nearly 400,000 Americans died from smoking-related diseases and complications, a higher toll than that of alcohol, drug abuse, and automobile accidents combined. In part because of Koop’s tireless campaign against tobacco use, the number of smokers among the American public fell from 33 percent of the population in 1981 to 26 percent in 1989. However, the work against tobacco was far from over; for example, the incidence of illness and death from smoking among women continued to rise during those same years. A report issued by Koop in 1982 highlighted the dangers of secondhand smoke, leading to restrictions on smoking in public buildings and facilities. It was the most authoritative statement to date on the connection between smoking and cancer of

Koop, C. Everett (1916–2013)  535

Former U.S. surgeon general C. Everett Koop meets with reporters at the National Press Club in 2001. As surgeon general, Koop advocated policies to stop drug use and addiction across the country. (AP Photo/Joe Marquette)

the lung, oral cavity, larynx, esophagus, stomach, bladder, pancreas, and kidneys. The report attributed 30 percent of all cancer deaths to smoking tobacco products. Subsequent reports issued during the 1980s showed that smoking caused even more deaths from heart disease than from cancer; that smoking was the major cause of illness and death from chronic obstructive lung disease; that smoking presented an even greater health hazard than exposure to workplace pollutants such as asbestos and coal dust, while at the same time increasing the lethality of such exposure; and that nicotine was an addictive substance. Despite public contestations of these reports by the tobacco industry, progress continued to be made in curbing their reach. By 1987, smoking had been banned on all domestic flights, with the ban being extended to all flights by 1990.

Koop embodied the efforts to curb smoking, and was an ideal proponent of policies against smoking, providing an air of authority and integrity alongside his devotion to health. The 1986 surgeon general’s report on the dangers of passive smoking provided another important milestone in the fight against tobacco. Despite having received support from tobacco producing states during his confirmation, Koop was not beholden to their interests and was prepared to work against the powerful tobacco industry and its congressional and administrative allies. At the time, the industry was spending $4,000 on advertising to every $1 spent by the U.S. Public Health Service spent on anti­ smoking messages. In 1982, Koop testified before Congress in support of changes to the warning labels on cigarette cartons. He advocated a series of rotating labels warn-

536   Koop, C. Everett (1916–2013)

ing against the specific dangers of smoking in place of the current single generic label, “Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Your Health.” Under pressure from the tobacco industry, the Reagan administration withdrew support from the measure, but Koop continued to push for changes to labeling. In 1986, he succeeded in having the surgeon general’s health warning placed on packages of smokeless tobacco, products that the tobacco industry had suggested were less harmful than cigarettes. Another of his efforts—to get rid of cigarette discounts for military personnel—failed. After the tobacco industry reached a major settlement with state governments, Koop appeared on the ABC television network show Nightline. While he said that he was open to some sort of deal, he noted that activists would want a public reckoning. He said that they would “want to see the culprit, the tobacco industry, flogged in public, and I understand how they feel. I feel that way myself. They are very guilty. But flogging a company in public, if it does not produce something for the health of the American public, is a futile gesture.” In testimony before a Senate committee, he asked lawmakers to “face the scourge of tobacco for what it is and legislate a tobacco policy that holds the industry accountable.” Extensive media coverage of the 1982 report showed Koop that the health causes he was working for could be better promoted through publicity and moral suasion when regulatory authority was incapable of doing so. Having no regulatory authority of his own, Koop competed against tobacco industry lobbyists to bring tobacco products under stricter control. When he launched the 1984 campaign to eliminate smoking in the United States by the year 2000, he did not rely on legislation, but in-

stead turned to moral suasion. Koop chose to launch his new program on the 20th anniversary of U.S. surgeon general Luther L. Terry’s “Report on Smoking and Health.” The landmark report warned the nation that men who smoked had a higher mortality rate from coronary heart disease, chronic lung disease, and cancer than men who did not smoke. This report managed to change Americans’ beliefs about what they had previously believed to be a glamorous and sophisticated recreational activity. Terry’s report had been the impetus for Congress to pass the original legislation mandating health warning labels on cigarette packages and, in 1970, to outlaw television advertisements for tobacco products. Koop called for smokers to voluntarily quit smoking, and for nonsmokers to insist on their right not to be exposed to secondhand smoke. Smokers ought to be respectful of that right, and not feel an entitlement to smoke in the presence of nonsmokers without first asking for their permission. Koop believed that through education, especially of children at every grade level, the cigarette industry could be extinguished by the year 2000, the year the first class to receive the antismoking messaging was set to graduate. In 1986, Koop issued a report that would bolster these efforts, titled “The Health Consequences of Involuntary Smoking,” which described secondhand exposure to cigarette smoke as not only a nuisance, but a danger, especially for children. Koop became the first public health official to emphasize the risk not only to smokers but also to bystanders from tobacco smoke, proudly creating what he called a “militant army” of nonsmokers intent to demand their right to smoke-free air. He thereby created the most successful antismoking movement in the world, with a broad base of scientific evidence and a moral drive that have allowed it to secure a legal ban on smoking in

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federal buildings and on public conveyances nationwide as well as in offices, restaurants, and other work sites in a growing number of states. While the United States was not smoke free by 2000, rates of smoking among both teens and adults have continued their decline. Richard E. Isralowitz See also: Elders, Joycelyn; Nicotine; Reagan, Ronald, and Nancy Reagan; Terry, Luther; Tobacco

Further Reading Bianchi, Anne. 1992. C. Everett Koop: The Health of the Nation. Brookfield, CT: Millbrook Press. CDC Office on Smoking and Health. “Trends in Current Cigarette Smoking.” http://www .cdc.gov/tobacco/data_statistics/tables/ trends/cig_smoking/index.htm.

Easterbrook, Gregg. 1991. Surgeon Koop. Knoxville, TN: Whittle Direct Books. Koop, C. Everett. 1992. Koop: The Memoirs of America’s Family Doctor. Grand Rapids, MI: Zondervan Publishing House. Koop, C. Everett. 2003. “Drug Addiction in America: Challenges and Opportunities.” Military Medicine 168: viii–xvii. National Library of Medicine, Profiles in Science. “The C. Everett Koop Papers: Biographical Information.” http://profiles.nlm .nih.gov/ps/retrieve/Narrative/QQ/p-nid/84. Simpson, Susanne, and Paula S. Apsell. 1989. “The Controversial Dr. Koop.” Nova. Boston: WGBH; Northbrook, IL: Coronet Film and Video. Williams, Brian. 2013. “C. Everett Koop, Former Surgeon General, Dies at 96.” NBC News, February 25. New York: NBC Universal Media, LLC.

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L who were using marijuana and found out as much as they could about the user’s drug supplier, the means of distribution, and the effects marijuana had on those who used it. The second phase of the study provided a more clinical perspective of marijuana use. The purpose of this part of the study was to determine the effects of marijuana on those who used it. There were two separate parts of this phase. The first was a general medical study, and the second was a psychological study of users. The subjects for the study were chosen from the inmates at a nearby prison, the penitentiary on Riker’s Island, with the approval of New York’s commissioner of correction. The inmates were sent to the prison mostly for minor criminal offenses, and were serving sentences that ranged from three months to three years. All of the inmates had been informed about the purpose and procedure of the study, and 77 volunteered to be part of it. There was a physician in charge of collecting the needed information, who was helped by an assistant physician, three psychologists, and a secretary. The inmates were under the constant supervision of the medical staff throughout the entire study period. In order to collect data on the effects of marijuana on users, the inmates were provided with the drug. Some inmates were given an extract that was taken orally, while others were provided with smokeable marijuana joints. Those inmates who smoked the drug had immediate effects, which lasted from one to four hours. The inmates who used the extract form of the drug had effects that came on more gradually and lasted for a

The La Guardia Report A report entitled “The Marijuana Problem in the City of New York: Sociological Medical, Psychological and Pharmacological Studies, by the Mayor’s Committee on Marijuana,” also known as “The La Guardia Report,” was released in 1944, and was the culmination of the study of the extent of marijuana use and its physiological and psychological effects. The study was undertaken at the request of New York City mayor Fiorello La Guardia and conducted by the New York Academy of Medicine. At the time, New York City was seen as something of an epicenter of illegal drug use. The report’s findings contradicted many of the claims about marijuana use that underlay public and political support for the Marihuana Tax Act and related state policies. The report, however, did not receive much publicity in the media. The commissioner of the Federal Bureau of Narcotics, Harry J. Anslinger, attacked the report’s methods and findings. In the first phase of the study, the Academy of Medicine examined the prevalence of marijuana use in New York City. Specifically, Academy members sought information on marijuana use among school children, its relation to criminal activity, and effects of the drug on users. To collect this information, the commissioner of police assigned six police officers (four male and two female) to serve as plainclothes investigators to go undercover. They circulated in those districts identified as having high rates of marijuana use, such as Harlem neighborhoods. The officers associated with those 539

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longer period of time, in some instances for 24 hours. As an individual’s dose increased, the effects were more severe and lasted longer, but the effect of any given dose varied in each individual. The physicians reported that some of the inmates became restless and talkative after taking the drug. They reported a sense of well-being, relaxation, and unawareness of their surroundings. After this, the inmates had feelings of drowsiness, especially in those inmates who were left alone. In general, the inmates had difficulty in focusing and sustaining their mental attention on a particular subject. They physician reported that nine of the inmates suffered what was termed a “psychotic episode.” Six of these lasted only a short time, from about three to 10 hours. These inmates suffered from periods of mental confusion and excitement mixed in with periods of laughter and anxiety. Reportedly, the effects experienced by the inmate subjects were similar to the effects that were often reported in the literature on marijuana use. One of the inmates who suffered from a psychotic episode attributed his reaction to epilepsy, while the other two inmates who experienced feelings of a psychotic episode were later diagnosed with types of psychosis. The medical team also examined the effects of marijuana use on the functions of different organs of the body. The team found that there was an increase in the inmates’ pulse rate and blood pressure as well as an increase in blood sugar and metabolic rate. There were no discernable differences in the inmates’ circulation rate and vital capacity. Further medical tests completed on renal and liver functions also showed no changes, and there were no changes found in blood counts and hemoglobin, blood nitrogen, calcium, and phosphorous concentrations. An electrocardiogram that was run on the inmates in-

dicated no abnormalities, and the marijuana appeared to have no effect on gastric motility and secretion. Some inmates had feelings of nausea and vomiting. Many of the inmates had more frequent urination and felt hungry. The inmates were also subjected to a psychological study, which was preplanned and implemented by trained psychologists. The analysis was geared toward determining the effects of marijuana use on psychomotor responses, intellectual functioning, emotional reactions, and personality structure. Overall, the study results indicated that marijuana was not an addictive drug similar to morphine, and that if a user acquired a tolerance for the drug, it was very limited. Moreover, those users who had been using the drug for an extended period showed no mental or physical deterioration that could be attributed to the use of the drug. The researchers completing the study also expressed interest in the possible therapeutic or medical uses for the drug. This pertained to the lessening of inhibitions, the euphoric state, the feeling of adequacy, the freer expression of thoughts and ideas, and the increase in appetite for food that was brought about after marijuana was used. They also noted that marijuana use could have beneficial effects on addicts who were undergoing withdrawal symptoms from morphine addiction. Of course, the researchers noted that it was necessary to conduct more controlled studies before definite conclusions could be drawn, especially regarding the therapeutic use of the drug. In the end, because the report received very little attention by the media and was opposed by many, it had little influence on public policy. Instead, new laws that established even stricter sanctions against marijuana manufacture and use were passed in the next decade. Nancy E. Marion

Labeling and the Criminalization Process  541 See also: Anslinger, Harry J.; Federal Bureau of Narcotics; Marijuana; Marihuana Tax act

Further Reading Mayor’s Committee on Marihuana. 1944. The La Guardia Committee Report: The Marihuana Problem in the City of New York. New York: New York Academy of Medicine, City of New York.

Labeling and the Criminalization Process Howard Becker took the career model and the study of occupations first described by sociologist Everett Hughes and applied it to drug users. This idea formed the basis for what came to be known as a new sociological theory of drug use, which was called “labeling theory.” When labeling theory was first applied to the field of addiction, it provided a new approach that permitted an analysis of individual drug users, of public policy, and the legal framework within which these activities take place. Becker’s concepts helped to restructure the way those who study drug use and users began to collect and analyze data. The new theory was described in Becker’s 1953 book, Becoming a Marijuana User. Labelling theory, stated very simply, is that society creates deviant behavior such as drug use by labeling those who are either part of the criminal justice system, or exhibit certain behaviors, or who are just different from others in some way. Once a person is labelled, they become that label. Labeling a person has consequences for their selfimage, but also for the public’s perception of them. After being given a label, a person is regarded to be how their label defines them. In other words, people are given labels that, in the long run, define that person’s

behavior. When it comes to drug users, if a person is labelled to be a drug deviant, they will continue to live that lifestyle. Once labeled, it is very difficult to break away from that classification. According to Becker, a person’s fate is determined to a large extent by the labeling process. For some people, being labelled as a “criminal” or a “drug user” only serves to reinforce problem behavior rather than reduce it. Essentially, labeling theory is more concerned with how a person becomes a criminal (the criminalization process) rather than solving the problem behavior of that person. It helps to explore how a community finds drug users, stigmatizes them, and then assigns them a negative status. The following assumptions are made by labeling theorists. One is that no act is intrinsically criminal. Instead, an act becomes illegal through the political action of law making. In other words, laws make crimes. Thus, criminal acts are defined by organized groups that have sufficient political power to influence the legislative process. A second assumption is that crimes are enforced as a way to support powerful groups such as the police, courts, correctional institutions, and other administrative bodies. While the law may provide detailed guidelines pertaining to a crime’s substantive definitions and rules of procedure, the way the law is implemented or carried out may be determined at least in part by the decisions of local officials. Third, an individual person does not become a criminal simply by violating the law. Instead, he or she is designated to be a criminal through the reactions of authorities. Fourth, typically only a few people are caught for their actions and are singled out for specialized treatment. Fifth, criminal sanctions vary based on certain characteristics of the offender. Most people labeled

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as criminal tend to be young, male, unemployed, poorly educated, lower class, minority, and residents of urban areas. Sixth, the criminal justice system is based on a stereotyped idea that the offender (e.g., drug user) is a willful criminal who is morally bad and deserving of punishment. Last, once an offender is given the label of being bad or evil, it is often difficult for that offender (and for society) to maintain a favorable image of himself or herself. According to Baker, when it comes to drug use, there is a series of events that take place that involves a feedback cycle that begins with labeling a person as a drug user. There are then more deviations (drug use), more penalties, more labeling (or relabeling) and then more deviations that justify greater penalties and more labeling. All the while, opportunities for the drug user to change his or her label are restricted. Often, the drug offender will accept his or her status and develop a career of violating the law. Thus, the labeling/criminalization process often serves as a self-fulfilling prophecy. The roots of the labeling and criminalization process tend to go right to the heart of a major controversy regarding the drug scene—that is, the belief that the judicial and law enforcement decision-making process underlying the drug problem is racially based. This is because in many situations, those who are identified (and labeled) as drug addicts are those who are racial minorities, or from lower economic status. They are labeled a criminal or drug addict based on their characteristics rather than the acts in which they are engaging. A perfect example is the disparity between the sentencing policies for those who use crack cocaine versus those who use powder cocaine. While cocaine is the primary ingredient in both drugs, the two substances are manufactured

and ingested differently. Crack cocaine is cheaper and provides a more intense feeling of being “high.” It is preferred by minorities, younger users, and those who do not have much money. On the other hand, powder cocaine is used more by wealthy classes. While this disparity was lessened in the Fair Sentencing Act signed by President Obama in 2010, there are many other examples of how minorities are more quickly labeled as “criminal” than others. Once a person has been labeled as “criminal” by those in the criminal justice system (or even in the education system), the person is stigmatized and seen as a deviant. That label, then, affects their self-concept and their future actions and behaviors. Those people labeled as a “pothead” or “junkie” will choose behaviors that reinforce the labels. A cycle then begins: the label causes the behavior, which in turns solidifies the label, leading to more deviant behavior, and so on. Eventually, this can lead to a “career criminal” in which the person immerses themselves in criminal behavior. Richard E. Isralowitz See also: Alcohol Use; Drug Abuse

Further Reading Becker, Howard S. 1953. Becoming a Marihuana User. Indianapolis: Bobbs-Merrill. Faupel, Charles E., Greg S. Weaver, and Jay Corzine. 2014. The Sociology of American Drug Use. New York: Oxford University Press. Library of Congress, Congressional Research Service. 1994. Criminal Theory: Selected References, 1991–1994. Washington, DC. Morrison, Wayne. 1995. Theoretical Criminology: From Modernity to Post-Modernism. London: Cavendish. Tierney, John J. 2006. Criminology: Theory and Context. Harlow, UK: Longman.

Latinos and Drug Use  543 Tierney, John J. 2009. Key Perspectives in Criminology. Maidenhead, UK: Open University Press. Wilson, William. 2002. Central Issues in Criminal Theory. Oxford: Hart.

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Latinos and Drug Use Across the United States, Latinos represent the largest and fastest-growing minority group. According to the U.S. Department of Health, the Hispanic population (as Latinos are officially known in U.S. government statistics) in the United States increased by 43 percent between the years 2000 and 2010. This accounts for over half of the total growth in the U.S. population in the last decade. In 2010, approximately 50.5 million persons in the United States were of Hispanic or Latino origin (about 16 percent of the U.S. population). Because of this growth, it is important to address the particular health and health care disparities experienced by Latinos. The Substance Abuse and Mental Health Services Administration (SAMHSA) is one organization that tracks these trends and is committed to reducing the disparities in access to and quality of behavioral health care for ethnic minorities, including the Hispanic population. According to SAMHSA: • In 2011, among persons aged 12 or older, the rate of current illicit drug use among Hispanics was 8.4 percent. This rate was lower than the rates among whites (8.7 percent) and blacks (10.0 percent). • There were no statistically significant differences in the rates of current illicit drug use between 2010 and 2011 or between 2002 and 2011 for any of the racial/ethnic groups, except for

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Hispanics. The current illicit drug use rate for Hispanics increased between 2002 and 2011 (from 7.2 to 8.4 percent). The rate of binge alcohol use among Hispanics was 23.4 percent. This rate was higher than the rate among blacks (19.4 percent), but lower than the rate among whites (23.9 percent). Among youths aged 12 to 17 in 2011, 12.6 percent of Hispanics currently use alcohol. Once again this rate is higher than among blacks (10.5 percent) and lower than among whites (14.6 percent). Among persons aged 12 to 20, the past-month alcohol use rate in 2011 among Hispanics was 22.5 percent, which maintains the pattern of alcohol use compared with blacks and whites (18.1 percent and 28.2 percent, respectively). In 2011, the prevalence of current use of a tobacco product among persons aged 12 or older was 20.4 percent for Hispanics. There were no statistically significant changes in past-month use of a tobacco product between 2010 and 2011 for this group. Among Hispanics, the rate of current cigarette smoking decreased from 7.9 percent in 2010 to 6.1 percent in 2011 for youths aged 12 to 17. Rates of current cigarette smoking were 28.4 percent for young adults aged 18 to 25 and 18.4 percent among those aged 26 or older. Among Hispanics in these two adult age groups, rates of current cigarette use in 2011 were not significantly different from corresponding rates in 2010. Data from 2003 to 2011 show that Hispanics aged 12 or older were more

544   Leary,Timothy (1920–1996)

likely than non-Hispanics to have needed substance use treatment in the past year (9.9 vs. 9.2 percent). • Hispanics who needed substance use treatment were less likely than nonHispanics to have received treatment at a specialty facility in the past year (9.0 vs. 10.5 percent). The overall health and well-being of the nation is improved by the extent to which our population has access to substance use treatment if it is needed. Better understanding of whether Hispanics with substance abuse problems seek and receive specialty treatment may help improve treatment and outreach programs for this population. Nancy E. Marion

Further Reading Cubbins, Lisa, and Daniel Klepinger. 2007. “Childhood Family, Ethnicity, and Drug Use Over the Life Course.” Journal of Marriage and Family 69(3): 810–30. Fisher, Gary L. 2013. Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. Boston: Pearson. Substance Abuse and Mental health Services Administration, Center for Behavioral Health Statistics and Quality. 2012. “Need for and Receipt of Substance Use Treatment among Hispanics.” National Survey on Drug Use and Health, October 25. U.S. Department of Health and Human Services. Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings. Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Behavioral Health Statistics and Quality. HHS Publication No. SMA 12-4713, 2012. http://www.samhsa. gov/data/nsduh/2k11results/nsduhresults2011.htm.

Leary,Timothy (1920–1996) Timothy Leary was a major figure in the 1960s counterculture who advocated the use of psychoactive drugs, LSD in particular. Once a professor at Harvard University, Leary ran afoul of the law, but he continued to advocate drug use even after his views cost him his job and his freedom. He remained a proponent of psychoactive drug use until his death in 1996. Timothy Francis Leary was born on October 22, 1920, in Springfield, Massachusetts. He attended Holy Cross College, West Point, and the University of Alabama, having disciplinary problems at each of them. His problems following rules, however, did not stifle his academic career, and he received his doctorate in psychology from the University of California, Berkeley, in 1950. Though a student of the discipline, Leary believed that conventional psychotherapy was ineffective, and during his time at Berkeley he began experimenting with group therapy and transactional analysis theory, which later became more popular in psychological practice. He taught at Berkeley where he served as the director of psychological research at the Kaiser Foundation Hospital in Oakland from 1955 until 1958, and in 1959 he joined the faculty at Harvard. In spite of his professional success, Leary went through a difficult emotional time at this point in his life, as his wife had committed suicide and he was left to raise his son and daughter on his own. Leary’s path to academic achievement was put off-track in 1960, when on a trip to Mexico he consumed psychedelic drugs— in this case, psilocybin—for the first time. Leary found the psilocybin experience to be a transcendental one, and when he returned to Harvard, he began introducing his fellow researchers to the drug, which at the time was legally available for psychiatric research. Beyond his colleagues, Leary also

Leary,Timothy (1920–1996) 

Dr. Timothy Leary, a supporter of psychedelic drugs, particularly LSD and psilocybin, often gave speeches about the drugs. He coined the phrase “turn on, tune in, drop out.” He was described by President Richard Nixon as the most dangerous man in America. (AP Photo/Eddie Adams)

administered the drug to prison inmates and divinity students. In 1962, he proposed using LSD in experiments, and when revelations came out that he had shared the drug with undergraduate students, he was fired in 1963. Undeterred, Leary continued to be an outspoken proponent of LSD, and he moved to a country estate in Millbrook, New York, which was supposed to be a center for drug research. In reality, the Millbrook estate turned out to be more of a hippie commune, a center where guests took psychoactive drugs and meditated. Leary’s legal troubles continued when he was arrested and convicted on marijuana charges in Texas, and his house in Millbrook was raided by law enforcement. Despite these problems, the counterculture of the 1960s provided a ready audience for Leary’s message, most famously summed up

by his call for people to “turn on, tune in, drop out”—to tune in and turn on to the magical world of the psychedelic, and drop out of mainstream society. In the 1960s, he experimented with psilocybin with leading countercultural figures such as Allen Ginsberg, Jack Kerouac, and William S. Burroughs. He also wrote several books, such as High Priest and Politics of Ecstasy, where he encouraged readers to explore psychedelic drugs. During U.S. Senate hearings in 1966, Leary and Ginsberg were invited to testify about their experiences with drugs. In his testimony, Leary described how he took LSD or psilocybin 311 times over a six-year period. He told the Senate that there is nothing to fear from LSD. The reason senators were afraid of the drug is because they were old fogeys who associated the word “drug”

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with dope fiend, dope addict, or criminal. To him it meant growth, opening up of the mind, beauty, and revelation. He suggested that Congress legalize LSD for responsible adults who would use the drugs for serious purposes such as spiritual growth, pursuit of knowledge, or personal development. In 1967, he founded the League of Spiritual Discovery, a quasi-religious group that used LSD as its sacrament, arguing that the hallucinations produced by the drug expanded consciousness in a way that was so profound it was transcendent. Leary also toured the country with a traveling lightand-sound show that he used to expound the virtues of psychedelic drugs, and by the end of the decade, he was a celebrity—adored by the counterculture and those who wanted to undertake psychedelic journeys with LSD, and reviled by law enforcement and others who were horrified by his message, fearful that it would inspire youths across the country to try psychoactive drugs. Though he had disavowed politics in the 1960s, Leary announced that he was going to run for governor of California in 1970. His campaign was stymied, though, when he was convicted on a marijuana charge and sentenced to 10 years in prison, which he served in San Luis Obispo, California. Leary escaped from prison by climbing up a rooftop and telephone pole and crossing over the prison’s barbed wire before dropping onto a nearby highway. From there, he fled first to Algeria and then to Afghanistan, where he was again arrested and deported back to the United States in 1973. In all, however, Leary served just 42 months in prison, as California governor Edmund G. Brown Jr. ordered his release in 1976. Leary spent the next two decades of his life living in Beverly Hills and giving lectures on college campuses across the country. While he continued to advocate experimentation with drugs, Leary also be-

came the leader of the futurist movement, which looked at trends in the future and technology. He also dabbled in virtual reality, designed computer games, and started a software company. Later in his life, he became fascinated by death, and in 1995, when he learned that he had an inoperable cancer, he responded by saying he was thrilled with the prospect of dying. In 1996, he passed away due to prostate cancer at the age of 75. Howard Padwa and Jacob A. Cunningham See also: Alpert, Richard; The Counterculture and Drugs; Hippies; LSD

Further Reading Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Jonnes, Jill. 1996. Hep-Cats, Narcs and Pipe Dreams: A History of America’s Romance with Illegal Drugs. Baltimore: Johns Hopkins University Press. Lattin, Don. 2010. The Harvard Psychedelic Club: How Timothy Leary, Ram Dass, Huston Smith and Andrew Weil Killed the Fifties and Ushered in a New Age for America. New York: HarperOne. Leary, Timothy. 1990. Flashbacks: A Personal and Cultural History of an Era: An Autobiography. New York: St. Martin’s. Mansnerus, Laura. 1996. “Timothy Leary, Pied Piper of Psychedelic 60’s, Dies at 75.” New York Times, June 1, 1 and 12.

Legalization The War on Drugs has no more controversial issue than legalization. Proponents of

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Libertarian presidential nominee Gary Johnson, left, speaks with a marijuana shop owner in Colorado in 2012. Colorado legalized recreational marijuana for its residents in November 2012. (AP Photo/Stephen Mitchell)

drug legalization, which now include a diverse group of scientists, social workers, economists, health professionals, and other leaders in society, see the underground economy arising from illicit drug use as the main source of drug-related crime and contend that legalizing drugs like heroin and cocaine will make it easier for drug abusers to receive the treatment they need for addiction. Opponents, on the other hand, contend that drug legalization would promote a lifestyle and culture that would be disastrous for society. Proponents of legalizing drugs argue many points, including: • Legalization of drugs would make the problems associated with illegal drugs more manageable and easier to control. • They argue that the use of drugs is a civil liberties issue and that it involves

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the right of adults to decide whether they want to use drugs. Many drugs have legitimate medical value, such as marijuana, which has been used for centuries to treat a variety of ailments and symptoms. Drugs could be taxed, bringing in thousands, if not millions of dollars to financially strapped state and local governments. Some drugs may lead to more creativity on the part of artists or religious thinkers. The sentencing for drug offenders is often racially, ethnically, or economically biased. Moreover, mandatory sentencing for drug-related offenses is causing great overcrowding in our prisons, increasing problems within the institutions and increasing costs to taxpayers.

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• Legalizing drugs would ensure that the drugs available to users would be free from impurities that can sometimes be very harmful. The government could regulate doses, strengths, and purity of the drugs. • Making drugs legal would reduce the violent crime associated with the underground drug trade worldwide. This includes drug trafficking, but also street-level crimes such as burglaries that are committed by users to get money for more drugs. • Governments could save millions of dollars now spent for drug prevention and law enforcement related to implementing antidrug laws. • Gang violence may decrease since most of their money is earned through drug trafficking. Opponents of legalizing drugs counter that legalization would open up a Pandora’s box of headaches for society that would exacerbate the drug problem and not alleviate it. Their arguments include: • The legalization of drugs would make them easily accessible to children. • Drug-related accidents already account for thousands of fatalities each year from accidents and other violence. This would only increase if drugs were legalized. • The black market for drugs would not disappear if legalized. • Drugs are harmful to the body and cause many long-term health issues, and the government should not be encouraging their use. • Legalized drugs would lead to more use and increased levels of addiction. With that, there would be increased crime and violence.

• Drug use is immoral and should not be supported by the U.S. government. Both sides have plentiful statistics to bolster their positions. The controversial Netherlands drug policy is a case in point. The coffeehouses of Amsterdam are nationally controlled drug distribution centers, which, in effect, make for a legalized drug program. To the Dutch and their supporters, criticism of that policy is unjustifiable because the policy’s success is demonstrated and supported by its results. For example, they say that the number of addicts in the Netherlands is low when compared to other countries. According to their statistics, about 1.6 percent of the people in the Netherlands are addicted to hard drugs, mostly heroin. These figures compare with 2.5 percent of the population in France, 1.5 percent in Germany, and 3 percent in Italy. “About fifty people a year die of drug-related causes in the Netherlands: the lowest rate in the Western World,” said Bob Keijzer, a senior drug policy advisor in the Netherlands Ministry of Health (Gross 1997). But statistics from Joseph Califano, director of the Center on Alcohol and Drug Abuse at Columbia University, present a different picture. “Anyone over the age of 17 can drop into a marijuana ‘coffee shop,’ and pick types of marijuana like one might chose flavors of ice cream,” he wrote in USA Today. “Adolescent pot use jumped nearly 200 percent while it was dropping by 66 percent in the U.S.” According to Califano, “Dutch persistence in selling pot has angered European neighbors because its wide-open attitude toward marijuana is believed to be spreading pot and other drugs beyond the Netherlands’ borders” (Califano 1997). The critics and supporters of Dutch policy disagree sharply over the reason why the number of coffee shops where marijuana is

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sold legally has been cut back. To Califano, the cutback was in response to complaints from Dutch citizens about “the decline in their quality of life.” Supporters, on the other hand, say it’s because the economic and monetary unification of Europe has forced the Netherlands to conform to the laws and mores of its neighbors. The differences over legalization have also affected the medical marijuana issue. Opponents charge that medical marijuana is an “insidious” way to legalize drugs. “Knowing that most Americans won’t countenance outright legalization, many promoters deceitfully profess their goal is to help the seriously ill,” charged Steve Forbes (Forbes 1997). Many states have, in fact, legalized medical marijuana, and some have even legalized recreational marijuana. These states have stressed the usefulness in treating many symptoms of various diseases, including glaucoma, seizures, cancer, multiple sclerosis, and AIDS. There have been efforts to legalize it on the national level, but the federal government has maintained the ruling that marijuana has no medical benefits but yet a high potential for abuse, justifying its Schedule I status. Despite the rhetoric on both sides, no one knows for sure what the health costs or social and economic implications would be if drugs were legalized. Many questions are unanswered. For example, which drugs should be legalized? All? Some? How would legalization be implemented? Who would be responsible for overseeing legalization? Where would the drugs be sold? Would legalization, if accompanied by adequate regulations, lead to a safer product? What potency levels should be permitted? What age limits? Despite the controversy and uncertainties surrounding the legalization issue, one coun-

try has boldly tackled the issue dead on. In November 1998 Switzerland took one of its most ambitious proposals to a referendum: the legalization of the use and sale of such drugs as marijuana, cocaine, and heroin. Critics said that, if the referendum passed, it would go the way of the country’s previous radical experimentation with drug legalization in 1995. That’s when police allowed drugs to be sold in open-air drug markets in Zurich and Bern, and the laissez-faire policy led to problems, as the markets attracted drug users and dealers from across Europe. Supporters hoped that legalization would put an end to the black market for drugs by putting the state in control of the supply of both hard and soft drugs. The state would issue a type of smart card, they said, that would prevent drug binging, as well as keep foreigners and children from taking part. The Swiss overwhelmingly rejected the proposed constitutional amendment to legalize drugs by a margin of 74 to 26 percent. Ron Chepesiuk See also: Bennett, William; Califano, Joseph Jr.; Clinton, Bill; Decriminalization; Harm Reduction Programs; Heroin; Marijuana; National Organization for the Reform of Marijuana Laws

Further Reading Califano, Joseph. 1997. “Legalization of Narcotics: Myths and Realities.” USA Today 125, no. 2622 (March): 46. Concar, David, and Laura Spinney. 1994. “The Highs and Lows of Prohibition.” New Scientist, October 1. “Drugs in Switzerland.” 1998. The Economist, November 28. “Equity and Addiction.” 1995. Nature, March 30. Forbes, Steve. 1997. “Deadly Deceit.” Forbes, September 8.

550   Legalized Marijuana Gross, Richard C. 1997. “Dutch Claim Drug Policy Works, but Agree to Stricter Enforcement.” Insight on the News, March 17. Husak, Douglas N. 2002. Legalize This! The Case for Decriminalizing Drugs. New York: Verso. Trebach, Arnold S., and James A. Inciardi. 1993. Legalize It? Debating American Drug Policy. Lanham, MD: University Press of America.

Legalized Marijuana Residents of Colorado and Washington (and even visitors to those states) can purchase and use marijuana recreationally under new laws approved by the voters. The Colorado law became effective in January 2014. Shops can sell marijuana over the counter to anyone over the age of 21. They do not need to have a physician’s recommendation. At this time, Colorado has laws allowing for medical marijuana. These laws, passed in 2000 and effective in 2001, require patients to have a prescription from their physicians in order to get this drug. A patient can possess up to two ounces of usable marijuana, and up to six plants (three mature and three immature). Those who suffer from particular ailments must register with the state, and then get their marijuana through dispensaries. The state tightly regulates dispensaries, requiring high levels of security, and all marijuana sales are strictly tracked. Medical marijuana became legal in Washington State in November 1998 when the voters passed Initiative 692, the Washington State Medical Use of Marijuana Act. The law removes penalties for use of marijuana by patients who have documentation from their physician. Patients in this state can possess a 60-day supply of the drug without facing legal sanctions.

Many of the plants grown for legalized marijuana sales are grown indoors. However, under the new law, citizens will be allowed to grow up to six plants—with only three flowering at a given time—in their home for personal use. Growers are required to obtain a license from the state in order to grow marijuana. One of the biggest concerns revolves around the federal legality of legalized marijuana. Although the voters of these states approved the concept, and state law will now allow for such use, the manufacture, distribution, possession, and sale of this drug remains illegal under the Controlled Substances Act, passed by the federal government in 1970. Marijuana is classified as a Schedule I drug, and sellers and users technically are violating federal law if they commit these acts. This also means they can be arrested and prosecuted for these behaviors. In August 2013, federal officials from the U.S. Department of Justice claimed that they will not interfere with the new laws in Colorado and Washington if they meet certain standards. They made it clear that they would not get involved if the new laws in these states prevent the use of marijuana by minors, prevent marijuana being taken to other states, prevent the presence of organized crime, prevent state-authorized activity as a cover for illegal activity, and prevent drugged driving and other negative effects on public health. Officials in both states have spent a great amount of time devising policies that will fit into these standards set by federal officials. If they have done so is still an unanswered question. Because there are so many unanswered questions, many attorneys refuse to get involved in anything having to do with legalized marijuana, including representing businesses and owners/operators of the new businesses related to the industry. Lawyers

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who help these businesses could be prosecuted for either aiding a client to break federal law or conspiring to break a federal law. They could then be disbarred from the profession. The Colorado state supreme court is considering a policy whereby lawyers won’t be found to be violating the profession’s ethical guidelines if they follow the new state law. However, lawyers are unsure about these new policies. Critics of the new law are concerned that more people will use the drug now that it is legal, and that young people will be more likely to use it. As it becomes more readily available, it will be readily available to those under 18. Moreover, legalized marijuana is sending the message that the drug is safe and fine to use. The marijuana sales will be taxed, and the money used for education programs and to regulate the industry. In July 2013, Colorado officials announced the rules by which recreational marijuana will be sold. It will be regulated by the state’s Revenue Department. More­ over, the marijuana must be labeled to include the product’s potency, the amount of THC in the product; instructions on how to properly use the product; a complete list of nonorganic pesticides, fungicides, and herbicides used during cultivation of the product; and more. According to the rules, all marijuana products sold under the new law must contain these warning statements: • “There may be health risks associated with the consumption of this product.” • “This product is intended for use by adults 21 years and older. Keep out of the reach of children.” • “This product is unlawful outside the State of Colorado.”

• “This product is infused with Retail Marijuana.” • “This product was produced without regulatory oversight for health, safety, or efficacy.” • “The intoxicating effects of this product may be delayed by two or more hours.” Anyone who seeks to purchase these products must show a government-issued photo ID to show that they are at least 21 years old. They will be limited to purchase up to an ounce of marijuana at a time. Shops selling the marijuana can also sell paraphernalia including pipes. Adults will be able to possess up to an ounce of marijuana legally. Visitors to Colorado can go on a “weed tour” with many activities and lots of marijuana use. Adult tourists are limited to purchasing only a quarter of an ounce at a time. While some people argue that the legalization of the drug will bring an end to the black market, or underground, illegal sales of marijuana, others argue this will not happen. In fact, they argue, it will only change the nature of the black market sales of marijuana and other illicit drugs. It has changed the black market. Old gang rivalries have stepped up. There is more competition. Gangs that previously relied on marijuana as income have to look to other markets, for example to crack cocaine. There was a collapse in need for cheap Mexican marijuana now that high-quality homegrown Colorado cannabis is available. Many other states are considering similar legislation. Nancy E. Marion See also: Controlled Substances Act; Drug Classes; Legalization; Marijuana; Medical Marijuana

552   Leonhart, Michele M.

Further Reading Coffman, Keith. 2013. “Colorado Governor Signs Recreational Marijuana Regulations Into Law.” Reuters, May 28. http:// www.reuters.com/article/2013/05/29/ us-usa-colorado-marijuana-idUSBRE 94S03Q20130529. Ferner, Matt. 2013. “Rules for Legal Recreational Marijuana Sales Announced in Colorado.” Huffington Post, July 1. http://www .huffingtonpost.com/2013/07/01/marijuana -legalization_n_3529986.html. Knickerbocker, Brad. 2013. “Colorado Marijuana Law: Obama Administration Backs Off.” Christian Science Monitor, August 29. http://www.csmonitor.com/USA/ Justice/2013/0829/Colorado-marijuana -law-Obama-administration-backs-off -video. Paulson, Amanda. 2013. “Legal Pot Is Imminent in Colorado and Washington. Are They Ready?” Christian Science Monitor, December 22. http://www.csmonitor. com/USA/Society/2013/1222/Legal-pot-is -imminent-in-Colorado-and-Washington .-Are-they-ready. Steinmetz, Katy. 2013. “Why Some Lawyers Won’t Work for Colorado Marijuana Businesses.” Time, December 23. http://nation .time.com/2013/12/23/why-some-lawyers -wont-work-for-colorado-marijuana businesses/#ixzz2oP9qMoKA.

Leonhart, Michele M. The current (as of April 2014) director of the Drug Enforcement Administration (DEA) is Michele M. Leonhart. She was recommended by President Obama and confirmed by the U.S. Senate on December 22, 2010. Mrs. Leonhart has served as a DEA special agent for her entire career, entering the agency in 1980.

Mrs. Leonhart was born and raised in Minnesota, and after finishing high school she enrolled in a Minnesota college in the mid-1970s, majoring in criminal justice. She received her BS degree in criminal justice in 1978. She then moved east to become a police officer with the Baltimore City Police Department, a position she held for three years before joining the DEA in 1980. Throughout the 1980s, Mrs. Leonhart worked a variety of field assignments for the DEA, as well as serving in various positions such as DEA special agent recruiter. She first began moving into the supervisory ranks in the mid-1990s, holding such positions as Career Board executive secretary, staff coordinator in the Operations Division, as well as a position in the supervision of the San Diego Field Division where she supervised agents working in the field. In 1997, she was the first female to be promoted to the coveted position of special agent in charge (SAC), at the San Francisco Field Division. After that assignment, Mrs. Leonhart began moving into additional supervisory ranks, climbing the DEA ladder. She served as the SAC for the Los Angeles Field Division from 1998 to 2003, then was promoted to DEA deputy administrator in 2004, and then in 2007, she was appointed the acting DEA administrator. Serving in the acting position for three years, she was finally confirmed to lead the DEA as the director in 2010. Mrs. Leonhart has received numerous awards for her service and she attended Boston University’s Leadership Institute while working for the DEA. She is married and has two sons. Nancy E. Marion See also: Drug Enforcement Administration

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Michele Leonhart, acting administrator of the U.S. Drug Enforcement Administration, delivers a speech during the opening ceremony of the International Drug Enforcement Conference in Cancun, Mexico, in 2011. Officials were meeting in Cancun to discuss issues pertaining to drug control. (AP Photo/Israel Leal)

Further Reading Bumgarner, Jeffrey B. 2006. Federal Agents: The Growth of Federal Law Enforcement in America. Westport, CT: Praeger. Drug Enforcement Administration. 2003. “Drug Enforcement Administration History.” http:// www.justice.gov/dea/pubs/history/. Drug Enforcement Administration. 2014. “DEA Leadership.” http://www.justice.gov/ dea/about/leadership.shtml.

LifeRing LifeRing, which is also sometimes referred to as LifeRing Secular Recovery, is a nonprofit, mutual aid organization that offers a nonspiritual alternative to Alcoholics

Anonymous (AA) and other 12-step abstinence programs. Unlike AA, which involves members admitting a powerlessness over alcohol and submitting to a personally defined “higher power” as important steps on the road to their recovery, LifeRing strives, in a secular manner, to empower individuals to take the lead in their fights against addiction. LifeRing, which split from Secular Organizations for Sobriety (SOS) in 1997 and officially incorporated itself in 1999, has meetings in the United States, Canada, and Europe. LifeRing’s history can be traced back to another nonspiritual addiction recovery group, SOS, which began when James Christopher, an alcoholic looking for help, became uncomfortable with AA’s invoca-

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tion of spirituality and a higher power as central components of overcoming addiction and maintaining sobriety. After publishing a well-received article, “Sobriety Without Superstition,” Christopher decided to form a secular self-help organization for recovering alcoholics. SOS’s first meeting took place in November 1986 in North Hollywood, California. SOS remains an active secular recovery organization with meetings in every state across the country, but in 1997, a number of SOS members split off and formed a separate faction, which officially incorporated itself as LifeRing in 1999. Since its founding, LifeRing has, like SOS, provided its members with a secular program for addiction recovery. LifeRing’s approach is typified by its belief that within each member is an addict self and sober self that struggle with one another for dominance within the recovering person. LifeRing’s central tenet is the “Three-S” philosophy. The first “S” in this philosophy refers to sobriety, which LifeRing defines as the complete abstention from alcohol or addictive drugs at all times. The second “S” refers to secularity, as LifeRing eschews the spiritual elements, such as the submission to a higher power, that famously characterize AA and numerous other 12-step programs. Secularity does not, however, mean that all LifeRing members are atheists; instead, LifeRing’s notion of secularity revolves around the inclusion of addicts of all faiths with the understanding that an individual’s recovery, regardless of his or her religious background, can be achieved through human, rather than divine, intervention. The third “S” in LifeRing’s philosophy is selfhelp, which foregrounds another difference between it and 12-step programs. Whereas the AA and Narcotics Anonymous (NA) programs are predicated on alcoholics and

addicts admitting their powerlessness over addictive substances, LifeRing focuses on individual motivation and effort as the keys to its members overcoming their addictions and achieving sobriety. LifeRing meetings are consequently run in a different fashion than those of AA or NA. As a secular group, LifeRing meetings do not, of course, begin with any prayers, but LifeRing meetings are also distinctive from AA’s in their lack of formal sponsorship. Members of LifeRing are encouraged to empower themselves, and this empowerment can take on a variety of forms, as LifeRing believes that individual members should be free to incorporate any ideas and approaches they find useful to their recovery. This can include adopting elements of the AA approach to sobriety. A survey LifeRing undertook of its own members affirms the prevalence of this approach; the survey indicated that 55 percent of LifeRing members reported continued participation in 12-step groups. Of those LifeRing members participating in multiple mutual aid recovery groups, 44 percent considered LifeRing the most important group for their recovery, while 30 percent reported that they held LifeRing and 12-step programs to be of equal importance. The fact that LifeRing meetings often take place on the same treatment premises that 12-step groups use further highlights the openness of LifeRing’s approach to promoting individualized recovery. The LifeRing survey also provided information about the organization’s demographic makeup. The average member is 48 years old, and 81 percent of members describe themselves as white. Eighty-one percent of LifeRing members have some level of college experience, and 58 percent of the organization’s members are men. Religiously, LifeRing members run the gamut of affiliations, with 31 percent reporting a

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background in Protestantism, 25 percent from Catholicism, and 4 percent from Judaism. Sixteen percent of members described themselves as something “other,” and 24 percent claimed to have no religious background. Despite coming from a variety of religious backgrounds, 82 percent of Life­ Ring members reported having little or no religious participation within the last year. About 75 percent of the organization’s members, however, did report having prior contact with a 12-step program before joining LifeRing. LifeRing puts out a number of publications, including How Was Your Week?, the organization’s main handbook, and Recovery By Choice, a workbook featuring exercises and worksheets intended to assist members in crafting a personalized recovery program. These books, as well as additional information about LifeRing meetings, can be found at the organization’s Web site, http://www .unhooked.com. Howard Padwa and Jacob A. Cunningham See also: Alcoholics Anonymous; Narcotics Anonymous; Recovery Circles; Ribbon Reform Clubs

Further Reading LifeRing. “About LifeRing.” http://www.unhooked.com/lifering.org/index.htm. Save Our Selves. “An Overview of SOS: A Self-Empowerment Approach to Recovery.” http://www.sossobriety.org/overview.htm. Save Our Selves. “The SOS Story.” http:// www.sossobriety.org/james%20christopher .htm. Walker, Ida. 2013. Addiction in America: Society, Psychology and Heredity. Broomall, PA: Mason Crest. White, William L., and Martin Nicolaus. 2005. “Styles of Secular Recovery.” Counselor (August): 58–60.

Yates, Rowdy, and Margaret S. Malloch. 2010. Tackling Addiction: Pathways to Recovery. Philadelphia: Jessica Kingsley Publishers.

Lincoln, Abraham (1809–1865) As a young, 33-year-old member of the Illinois legislature, Abraham Lincoln, later the 16th president of the United States, was a total abstainer of alcohol his entire life and active supporter of the temperance movement. In support of the movement, he became a member of the Sons of Temperance in the Sangamon Division of Springfield, Illinois. On February 22, 1842, he gave a speech in which he expressed his views in support of the temperance movement in the country. Called the Temperance Address, Lincoln spoke about the issues of alcohol and alcohol abuse to the Springfield Washington Temperance Society on what would have been George Washington’s 110th birthday. Although the meeting was held in the Second Presbyterian Church, the crowd attending that day was not there for a religious service. Although Lincoln did not support the abuse of alcohol, he made it clear that he did not support some of the extreme tactics of some members of the temperance movement. Lincoln began his speech by highlighting some successes resulting from the temperance movement, but then went on to criticize the tactics used by the early temperance reformers. Instead, he commended the approach taken by the more recent temperance reformers (the Washingtonians). Lincoln stated that those who did not drink should be involved in the temperance movement because it promotes greater political freedom. In his speech, Lincoln describes how the life of someone who abuses alcohol will

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change once they stop, and what effect that will have on his family. He said: And again, it is so common and so easy to ascribe motives to men of these classes, other than those they profess to act upon. The preacher, it is said, advocates temperance because he is a fanatic, and desires a union of the Church and State; the lawyer, from his pride and vanity of hearing himself speak; and the hired agent, for his salary. But when one, who has long been known as a victim of intemperance bursts the fetters that have bound him, and appears before his neighbors “clothed, and in his right mind,” a redeemed specimen of long-lost humanity, and stands up with tears of joy trembling in his eyes, to tell of the miseries once endured, now to be endured no more forever; of his once naked and starving children, now clad and fed comfortably; of a wife long weighed down with woe, weeping, and a broken heart, now restored to health, happiness, and a renewed affection; and how easily it is all done, once it is resolved to be done; how simple his language, there is a logic, and an eloquence in it, that few, with human feelings, can resist. They cannot say that he desires a union of church and state, for he is not a church member; they cannot say he is vain of hearing himself speak, for his whole demeanor shows he would gladly avoid speaking at all; they cannot say he speaks for pay for he receives none, and asks for none. Nor can his sincerity in any way be doubted; or his sympathy for those he would persuade to imitate his example be denied. Later, Lincoln explains why people make the choice to drink alcohol. He argued that people, when making the decision to use alcohol, look to the behavior of others around them. In other words, they make reference

to others’ behaviors when they decide how to act. He likened the choice to use alcohol to fashion—a person’s choice about what to wear is influenced by what others are wearing. He also expresses his views that people can change their behaviors when it came to alcohol use. Nondrinkers can help those who drink change their behavior by using “peer pressure”: But it is said by some, that men will think and act for themselves; that none will disuse spirits or anything else, merely because his neighbors do; and that moral influence is not that powerful engine contended for. Let us examine this. Let me ask the man who could maintain this position most stiffly, what compensation he will accept to go to church some Sunday and sit during the sermon with his wife’s bonnet upon his head? Not a trifle, I’ll venture. And why not? There would be nothing irreligious in it; nothing immoral, nothing uncomfortable. Then why not? Is it not because there would be something egregiously unfashionable in it? Then it is the influence of fashion; and what is the influence of fashion, but the influence that other people’s actions have on our own actions, the strong inclinations each of us feels to do as we see all our neighbors do? Nor is the influence of fashion confined to any particular thing or class of things. It is just as strong on one subject as another. Let us make it as unfashionable to withhold our names from the temperance cause as for husbands to wear their wives’ bonnets to church, and instances will be just as rare in the one case as the other. There is some evidence that Lincoln said the following about the temperance movement in a speech on December 18, 1840, to the Illinois House of Representatives. However, there is

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great debate as to whether this is an accurate record of what was actually said that day. Prohibition will work great injury to the cause of temperance. It is a species of intemperance within itself, for it goes beyond the bounds of reason in that it attempts to control a man’s appetite by legislation, and makes a crime out of things that are not crimes. A Prohibition law strikes a blow at the very principles upon which our government was founded. Nancy E. Marion See also: Alcohol Use; Temperance Movement

Further Reading Kleiman, Mark A.R., Jonathan P. Caulkins, and Angela Hawken. 2011. Drugs and Drug Policy. New York: Oxford University Press. Lincoln, Abraham. 1842. “Temperance Address.” Abraham Lincoln Online. http:// www.abrahamlincolnonline.org/lincoln/ speeches/temperance.htm. Morel, Lucas E. 1999. “Lincoln Among the Reformers: Tempering the Temperance Movement.” Journal of the Abraham Lincoln Association 20, no. 1 (Winter). http://quod.lib .umich.edu/j/jala/2629860.0020.103/—lin coln-among-the-reformers-tempering-the-te mperance?rgn=main;view=fulltext. Thompson, David DeCamp. 1901. Abraham Lincoln and Temperance. Chicago: Jennings and Pye. Wilson, Samuel. 2009. Abraham Lincoln: An Apostle of Temperance and Prohibition. Washington, DC: Library of Congress.

Linder v. United States (1925) Dr. Charles Linder was a prominent physician in Spokane, Washington, who, in 1922,

gave one tablet of morphine and three tablets of cocaine to an addict, Ida Casey, and was charged with breaking the law. Although the Harrison Act, passed in 1914, put limits on the distribution of morphine and cocaine, there was a clause that allowed doctors to prescribe the drug under certain circumstances. This 1925 U.S. Supreme Court decision (No. 83, U.S. Supreme Court 268; U.S. submitted March 9, 1925, decided April 11, 1925) reversed an earlier decision in United States v. Behrman of the same year. The Behrman decision declared that a narcotic prescription for a drug addict was unlawful, even if the drugs were prescribed as part of a cure program. In Linder v. United States, the U.S. Supreme Court overturned Linder’s conviction and ruled that narcotics agents had no legal right to interfere in the medical prescription of narcotics—even if the prescription is solely intended to maintain a narcotics addict on her drug of choice. In other words, the Supreme Court upheld the prescribing of a narcotic to a bona fide patient in reasonable amounts as a way to ease the patient’s withdrawal symptoms. The court’s decision was a major setback to those who supported antinarcotics laws and who wanted to stop the practice of allowing narcotics maintenance as a moral issue. In response to the decision, narcotics agents the following years indicted 15,000 people (by their own records) but the agents did not bring any of them to trial since they knew the charges would not hold up in a courtroom. The indictments, however, were sufficient to instill fear into those who prescribed drugs for maintenance reasons, and to permanently stop all medical attempts at narcotics maintenance in the United States. Ron Chepesiuk

558   Lindesmith,  Alfred R. (1905–1991) See also: Addiction; Cocaine and Crack; Harrison Narcotics Act; Morphine

Further Reading Isralowitz, Richard E., and Peter L. Meyers. 2011. Illicit Drugs. Westport, CT: Greenwood. Linder v. U.S., 268 U.S. 5 (1925). Findlaw, http://caselaw.lp.findlaw.com/cgi-bin/ getcase.pl?court=us&vol=268&invol=5.

Lindesmith,  Alfred R. (1905–1991) Alfred R. Lindesmith was a professor of sociology at Indiana University who was one of the first academics to study opiate addiction from a sociological perspective. His work led him to become an outspoken critic of federal drug policies in the middle of the 20th century, as he advocated for addicts to be treated more like individuals suffering from a disease, rather than criminals. Alfred Ray Lindesmith was born in Clinton Falls, Minnesota, on August 3, 1905. He graduated from Carleton College in Minnesota in 1927, getting a bachelor’s degree in education, and he earned a master’s degree in English from Columbia University Teacher’s College in 1929. After working at Central State Teacher’s College in Wisconsin, he went on to earn his doctorate in sociology at the University of Chicago in 1937, and he then took a position as a professor at the University of Indiana. It was during his time at Chicago that Lindesmith took an interest in addiction and drug policy, as he made connections with Ben Reitman, a doctor who specialized in the treatment of drug addiction. Through Reitman, Lindesmith made contacts with a Chicago thief, con artist, and drug addict named Broadway Jones, who provided him with an entrée into the drug

scene and social world of Chicago’s opiate addicts. In his dissertation, “The Nature of Opiate Addiction,” Lindesmith interviewed more than 60 addicts, and he also conferred with fellow graduate student Bingham Dai, who was writing his dissertation on the sociology of addiction as well. In his dissertation, Lindesmith found that withdrawal from opiate use was agonizing, that addicts continued to use opiates in order to avoid withdrawal symptoms (and not for pleasure), that they developed a self-concept based on their drug use, that they were of normal intelligence, that they were not violent or sexually deviant, that they were spread evenly among races and classes, that addiction was a mental phenomenon, and perhaps most importantly, that most addicts did not feel that tight drug control laws could stop illicit drug dealing. When Lindesmith published his findings in a series of journal articles in the 1940s, the Federal Bureau of Narcotics (FBN) was displeased, since his conclusions directly contradicted the assumptions that lay behind federal drug control policy. Possibly in hopes of discrediting him, FBN agents worked to sabotage Lindesmith’s career at Indiana University before he could get tenure. Undeterred, Lindesmith continued his studies, and in 1947 he published them in his first book, Opiate Addiction. He soon became a public critic of the FBN and its policies, and the FBN responded by convincing conservative judges and intellectuals to write articles that dismissed Lindesmith’s work in hopes of silencing him and his criticism of the federal approach to drug control. The federal authorities even went so far as to consider planting narcotics in Lindesmith’s home so they could “prove” he was a drug addict and debunk his theories, even though he never used drugs illegally or advocated their use. Few of Lindesmith’s fellow professors or intellectuals supported him either, and many criticized

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and dismissed his work. By the mid-1950s, Lindesmith ceased publishing in scholarly journals, and concentrated on advocating for changes in the nation’s narcotics laws in more public forums. He published articles in such popular publications as The Nation, the Saturday Review, and the New York Times, and he also expressed his views in testimonies before Congress. After the passage of the Boggs Act and the Narcotic Control Act of 1956 stiffened federal penalties against drug users and dealers, powerful organizations such as the American Bar Association and the American Medical Association began to echo Lindesmith’s criticisms of the federal government’s approach to the drug problem. This led to the publication of Lindesmith’s final and most important book, The Addict and the Law, in 1965. In The Addict and the Law, Lindesmith argued that the Harrison Narcotics Act, which was the basis of federal antidrug legislation at the time, was not intended to serve as a basis for prohibitive policies against drug use, and that the FBN purposefully misinterpreted it in order to make political and budgetary gains. The Boggs Act and the Narcotic Control Act, he argued, were continuations of the flawed logic of drug prohibition. Continuing to wage battle against drug use by stiffening penalties and tightening enforcement was useless, he maintained, since previous efforts to control opiates had not succeeded in reducing rates of addiction, but instead had the opposite effect of enticing people to become involved in drug trafficking due to the increased prices of illegal drugs caused by tight enforcement. Instead of trying to crack down on drug supplies by using the police and the criminal justice system, Lindesmith argued that the government should adopt a drug policy like Britain’s, which allowed for the provision of small amounts of drugs to addicts living in the community. Anticipating future devel-

opments that would take place in the 1980s, Lindesmith warned that if the government continued with its policies of repression against drug dealers and users, the prison population would explode in the United States. Though The Addict and the Law did not have a substantial effect on public policy, it was groundbreaking in that it helped plant an intellectual seed that would spur debates over drug policy for decades to come. Lindesmith retired from Indiana University in 1975, though he remained active in his calls for drug policy reform, speaking to civic organizations, community groups, and charitable foundations. He died in February of 1991, though his legacy was carried on in 1994 when an advocacy organization dedicated to drug law reform—the Lindesmith Center—was named for him. Howard Padwa and Jacob A. Cunningham See also: Dai, Bingham; Drug Policy Alliance Network; Federal Bureau of Narcotics

Further Reading Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Keys, David Patrick, and John F. Galliher. 2000. Confronting the Drug Control Establishment: Alfred Lindesmith as a Public Intellectual. Albany: State University of New York Press. Lindesmith, Alfred R. 1947. Opiate Addiction. Bloomington, IN: Principia Press. Lindesmith, Alfred R. 1965. The Addict and the Law. Bloomington, IN: Indiana University Press.

Long-Term Potentiation First recognized and identified in 1966, long-term potentiation describes the

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strengthening of synapses in the brain’s ventral tegmental area in response to specific stimuli. Addictive drugs, despite differences in their molecular structure, appear to share a capacity for inducing long-term potentiation; nonaddictive drugs do not. Scientists believe that long-term potentiation and its opposite, long-term depression, or a weakening of synaptic strength, are fundamental to behavioral sensitization and the formation of memories. The variability of its effect on cells and the length of time it continues to exert that effect—sometimes for years—depends in part on where it is taking place in the brain and the specificity of the neurotransmitters and receptors involved. In the ventral tegmental area, addictive drugs stimulate neurons to release glutamate that in turn causes dopamine-producing cells to increase their output into the reward pathway. The strengthened synaptic activity, known as potentiation, primes the cell so that it remembers its level of response. When the brain becomes primed to respond to drug cues, the likelihood of eventual relapse increases. Each time an individual consumes drugs, the intensity and duration of his or her response tend to increase and, as the dopaminergic effect lingers in the synapses for a longer period of time, the cells become sensitized. They are said to display synaptic plasticity, the characteristic neuroadaptation associated with addiction that may be part of the basis for craving. Researchers have found that stress triggers long-term potentiation the same way that addictive drugs do, perhaps because it reawakens the memory of strengthened synaptic connections and cells. Why is not yet clear, but it may help explain why stress can so powerfully threaten years of abstinence. Kathryn H. Hollen See also: Addiction; Neurotransmitters

Further Reading Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton. Kalivas, P. W., and Nora Volkow. 2005. “The Neural Basis of Addiction: A Pathology of Motivation and Choice.” American Journal of Psychiatry 162(8): 1403–13. Kauer, Julie A. 2003. “Addictive Drugs and Stress Trigger a Common Change at VTA Synapses.” Neuron 37(4): 549–50. Nestler, Eric J., and Robert Malenka, Robert. 2007. “The Addicted Brain.” Scientific American. http://www.sciam.com/article.cf m?chanID=sa006&colID=1&articleID=00 01E632-978A-1019-978A83414B7F0101. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2007. The Science of Addiction: Drugs, Brains, and Behavior. NIH Publication No. 07–5605.

LSD (Lysergic Acid Diethylamide) LSD is one of the most potent hallucinogens used by humans. The drug was first synthesized in 1938 by Swiss scientists who were attempting to discover the medical potential of particular fungi. After accidentally ingesting one of the compounds, one of the scientists experienced the first known LSD trip, which encompassed frightening hallucinations, feelings of dissociation from time and place, and distorted perceptions. Because of the structural similarity of LSD to brain chemicals, it was thought in the 1950s that the drug could was used to study mental illness. It was quickly discovered that it could be used for psychotherapy, allowing patients to recall repressed memories quite easily. LSD was not only used for psychotherapy purposes, but doctors realized it

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could be used for terminally ill patients. It helped to relieve the pain that cancer patients suffered, and also allowed them to sleep better. It was though that LSD did not just act as a painkiller, but also altered the usual perception of pain. The use of LSD became popular in the 1960s as a recreational drug. Use of the drug was popularized and even encouraged by popular members of the counterculture like Timothy Leary (1920–1996). Even though early research indicated that LSD could be a promising drug as a psychotherapeutic tool, or that it might have some other medical value, it was banned for any purpose (including for medical research) largely because of its popularity in the 1960s drug culture. Only in recent years was this original research ban lifted, and one group of scientists has received permission to conduct experiments with the drug. Results of some early studies show that LSD may have therapeutic value in the treatment of alcoholism. LSD is typically produced in a crystalline form in laboratories. It is crushed into a powder and then formed into tablets or thin squares of gelatin, then dissolved and diluted before being applied to colorfully printed paper or pressed into sugar cubes. “Blotter acid” refers to a small, single-dose squares of paper that has been permeated with the drug. Today’s doses are around 20 to 100 micrograms. Once ingested, the effects of the drug are felt by the user within 30 to 90 minutes. The effects peak within one to two hours, and typically last 12 hours or more. Author Ken Kesey wrote a great portion of One Flew Over the Cuckoo’s Nest while under the effects of LSD. The book was inspired by his experiences with the drug. In the book, he explores the questions of authority and sanity, particularly, what is normal? Kesey believed that the drug and its ability to alter the user’s perceptions made

LSD a valuable way to explore human consciousness and creativity. Hallucinogenic drugs like LSD produce a psychoactive effect by targeting specific serotonin receptors in the brain, specifically the cerebral cortex, where a person’s mood and perception are processed. The drug also affects the locus ceruleus, which serves to detect sensory signals from external stimuli and other parts of the body. The effects experienced by someone who has taken LSD are referred to as a “trip.” The exact effects of LSD can be very difficult to predict, and the effect LSD will have on each user is unpredictable. Some people may have different experiences each time they take the drug, depending on their mood, the surroundings, or the drug. Generally, some of the initial effects a user may experience includes elevated body temperature, increased heart rate and blood pressure, and insomnia. Some users may experience “crossover sensations,” which means that they can “see” sounds and “hear” colors or lights. Some patients report that they experience time differently so that a few seconds may feel like an hour. Other users have experienced feelings of despair and fear of insanity as they experience overwhelming hallucinations and feelings of panic. Some of the possible effects of LSD use can be very dangerous. While it is difficult to overdose on LSD, it can lead to bizarre and dangerous behaviors that can injure the self or others. Some users have believed that they can fly, and proceed to jump off a roof or other tall structure. Or they may think they are being attacked by their friends, and cause them harm as they “fight off” their attackers. This is more likely to happen if the user ingests a higher dose. Personal injury is also possible after using LSD, especially during flashbacks. Some users may even develop psychoses or severe depression. A negative

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experience or “bad trip” that occurs while a user is under the influence of LSD can haunt them for days or even months, causing some people to forego the drug forever. The popularity of LSD as a recreational drug has varied over the years. LSD remains a popular drug of abuse in nightclubs, concert venues, and raves, but its use has decreased in recent years. Although LSD is not addictive and most people can stop using it without any (or maybe only slight) symptoms of withdrawal, it does produce a tolerance in the user, even if a person has used the drug only once. Many LSD users may find themselves ingesting more to achieve the same effect, a practice that can lead to the death of brain cells and permanent neurological damage. People who have built up a tolerance to LSD also have an increased tolerance for other drugs such as psilocybin and mescaline, a phenomenon known as cross-tolerance. A new trend is to mix LSD with other drugs such as marijuana. This often occurs in parties where many drugs are passed around. This is more dangerous since the effects of LSD can be unpredictable, and may be heightened with the use of another drug. The chemicals may combine with each other to create a stronger drug, or one that produces a very different effect. Sometimes legally prescribed drugs can interact with LSD. If a user combines certain antidepressants with LSD, they may experience seizures or may even die. LSD mixed with caffeine increases the likelihood of a bad experience. Sometimes, a person who used LSD may experience a flashback. There have been reports that a user can experience a hallucinogenic experience many years after using LSD only once or twice, but most people who experience flashbacks have been heavy users of the drug. A flashback will involve

visual hallucinations, halos of color, or sparkling lights. While most law enforcement officials and health organizations support keeping LSD illegal, there are others who support legalizing the drug. One of those people, Albert Hofmann, who “discovered” the drug, wrote that LSD has potential for aiding in meditation. Others also believe that adults should be permitted to use LSD (and other drugs) for personal (artistic, spiritual) reasons. LSD goes by numerous street names, including Acid, Blotter, Blotter Acid, Dots, Mellow Yellow, Microdot, Pane, Paper Acid, Sugar, Sugar Cubes, Trip, Window Glass, Window Pane, and Zen. Kathryn H. Hollen See also: Controlled Substances Act; Flashbacks; Hofmann, Albert Drug Tolerance

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Nelson, Sheila. 2013. Hallucinogens: Unreal Visions. Broomall, PA: Mason Crest. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov.

Lucas, Frank (1930– )  563 U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2001. Research Report Series: Hallucinogens and Dissociative Drugs. NIH Publication No. 01-4209. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www .samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Lucas, Frank (1930– ) Frank Lucas was born on September 9, 1930, in LaGrange, North Carolina. After moving to Harlem in 1946, Lucas began a life of crime which, by the 1960s, had grown to include an international drug empire. He

maintained control of this empire through methods such as killings, extortion, and bribery. By the time he was arrested (1975), Lucas had amassed millions in cash and properties in multiple cities. Lucas’s family, like most African American families in Depression-era rural North Carolina, was extremely poor. At first, Lucas’s criminal activities were limited to stealing food. He did this because, as the oldest boy in the family, he was supposed to help the family survive, but the Depression made it difficult to find a job. Over time Lucas turned to mugging, preying on intoxicated tavern customers. In his late teens, Lucas assaulted his boss after being caught in bed with the boss’s daughter. After hitting the man over the head with a pipe, Lucas stole $400 and set the business ablaze. His mother, fearing that he would be arrested

Frank Lucas, a heroin dealer from Harlem in the late 1960s and early 1970s, was portrayed by actor Denzel Washington in the movie American Gangster. (AP Photo/Jim Cooper)

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and sentenced to prison for the remainder of his adult life, begged him to flee to New York. Once in New York, Lucas, rather than heeding the advice of others to get a decent job (e.g., elevator operator or doorman), embarked on a life of crime. In his opinion, illegal gambling and dealing drugs were the means of earning “real money” (“Frank Lucas Biography” 2007). The more experience he gained, the more ruthless and daring he became: armed robbery, stealing a tray of diamonds and breaking the jaw of a security guard, and robbing the players in a highstake craps game. His most brazen act occurred in the summer of 1966 when he shot a man on a crowded sidewalk for reneging on a drug deal. This was the act that caught the attention of Harlem gangster, Ellsworth “Bumpy” Johnson. There are conflicting stories regarding the nature of Johnson and Lucas’s relationship. Some claim that Johnson never trusted Lucas, regarding him as a lackey. Lucas, on the other hand, claims he was Johnson’s “right-hand-man” (“Frank Lucas Biography” 2007). The influence Johnson had on Lucas is not disputed: taking what Johnson taught him and creating one of the 20th century’s most lucrative criminal organizations. Upon Johnson’s death in 1968, Lucas seized the opportunity to gain as much control of Harlem as he could. Lucas had one major goal in life: to be rich. In his mind, the way to achieve his goal was by making it big in the drug world. The first step was to take over Johnson’s operation. This required breaking the Italian Mafia’s heroin monopoly by procuring the drug directly from Southeast Asia. His connection in Bangkok was a fellow North Carolinian named Leslie “Ike” Atkinson who managed a bar that was a popular gathering spot for

African American soldiers who were serving in the Vietnam War. After agreeing to supply Lucas with heroin, Atkinson took him on a two-week trek through the jungles of Thailand to the poppy fields of the Golden Triangle. Lucas returned to Harlem with 132 kilos of high-grade heroin at a cost of $42,000 per kilo. The Italian Mafia’s price was $50,000 per kilo. To transport the drugs, Lucas and Atkinson recruited members of the U.S. Army. Aside from draftees and enlisted personnel, the pair also needed high-ranking officers from both the American and South Vietnamese armies. Lucas used bribery and charm to create an “army inside the Army” (“Frank Lucas Biography” 2007). To supervise the operation, Lucas stationed himself in Southeast Asia, often posing as an officer in the U.S. Army. The drugs were then smuggled onto military planes headed to East Coast military bases. Once the product arrived in the states, it was distributed to associates who prepared it for sale. In New York, Lucas staffed his organization with people he could trust, namely, family members or his closest friends from North Carolina. Among those recruited were his five younger brothers who would become known as the “Country Boys” (“Frank Lucas Biography” 2007). Lucas employed this hiring tactic on the belief that those closest to him would have less incentive to steal. To keep the women who cut the heroin from stealing, Lucas enforced a strict dress code: plastic gloves were the only articles the women were allowed to wear. Lucas achieved his goal of getting rich. His heroin operation was incredibly profitable, and he claimed to have made $1 million per day. Unable to hide all his cash, Lucas laundered the money through a Bronx bank where it would be counted and exchanged for clean bills. That money would then be

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funneled into various legitimate businesses that Lucas owned. He also invested heavily in real estate in Detroit, Los Angeles, Miami, Puerto Rico, and North Carolina. Lucas became a fixture in the New York nightclub scene. He would hang out with boxing great Muhammad Ali and singers like James Brown and Diana Ross. Lucas and his wife, Julie, spent lavish amounts of money on items such as his and hers bracelets from Van Cleef ($140,000); he often sported the $50,000 chinchilla coat and matching hat ($10,000) that Julie had bought. Despite this occasional flashiness, Lucas spent much of his time dressed in more low-key attire in an effort to look as inconspicuous as possible. In Southeast Asia, Lucas relied upon his network of corrupt military personnel; in New York he had the help of equally corrupt police officers. The 1960s and 1970s were a dark period for the New York City Police Department, especially the Special Investigations Unit (SIU). The SIU was powerful—the unit’s jurisdiction encompassed the entire city and its nearly limitless authority allowed it to act with near impunity—and rife with corruption. The unit was often guilty of breaking into the homes and businesses of suspected drug dealers to conduct warrantless searches, illegally tapping phones, accepting bribes from drug dealers, and stealing heroin seized in raids. The head of the SIU, Bob Leuci, had even caught Lucas with large amounts of heroin and cocaine secreted in the trunk of his car. To secure his release, he offered Leuci $30,000 and two kilos of heroin. As the levels of corruption in the SIU were making national headlines, officials on the other side of the Hudson River created their own narcotics unit, the Special Narcotics Task Force (SNTF). The SNTF was headed by the Richard “Richie” Roberts, the assistant prosecutor of Essex County, New

Jersey. Roberts provided a strong contrast to the members of the SIU, namely, he was able to get the job done in a completely ethical manner. Lucas’s vast criminal empire came crashing down on January 28, 1975. Based on evidence gathered by the SNTF, a DEA strike force mounted a raid on Lucas’s home in a wealthy neighborhood in Teaneck, New Jersey. Panicking, Julie Lucas threw numerous cash-filled suitcases out a window. The amount of money seized in the raid totaled $584,000, representing but a fraction of Lucas’s cash assets. Other seized items included safe-deposit box keys from banks in the Cayman Islands, deeds to Lucas’s many properties, and a ticket to a ball at the United Nations. Ten arrests were made that day, but Lucas remained free because none of the evidence directly linked him to any drug operation. The prosecution caught a break during the interrogation of Lucas’s nephew. The nephew gave investigators names of members in the operation, revealed the locations where buys took place, and indicated which pay phones were used to make drug deals. On the basis of this evidence, Roberts was able to charge 43 members of Lucas’s organization with drug trafficking. Roberts was then able to gain the cooperation of the co-defendants, many of whom were members of Lucas’s immediate family, to cobble together enough evidence to bring Lucas to trial. The trial was marked by the testimony of several people who told of the deleterious effects of Lucas’s “Blue Magic” heroin (“Frank Lucas Biography” 2007). This particular brand was considerably more potent than the other brands of heroin and was blamed for many overdose deaths. To illustrate to the jury how devastating Blue Magic had been, Roberts declared that Lucas had “killed more black people than the KKK

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with the sale of Blue Magic” (Frank Lucas Biography 2007). The jury handed down a guilty verdict. Shortly after starting his 70year sentence, Lucas became an informant. He identified his accomplices in the Mafia, the SIU, and Southeast Asia, namely Atkinson. As a result, 75 percent of the New York City Drug Enforcement Agency and 30 members of the Lucas family were tried on assorted charges. In light of Lucas’s cooperation his original 70-year sentence was reduced to 15. Three years after his 1981 release, Lucas was once again arrested on drug charges. This time he had attempted to exchange one ounce of heroin and $13,000 cash for a kilogram of cocaine. By 1984 Roberts had become a criminal defense attorney and defended Lucas on these new charges. Despite another drug conviction he was sentenced to only 7 years. Upon his second release from prison in 1991, Lucas received more assistance from Roberts; this time Roberts would help Lucas straighten out his life. The former opponents developed a deep bond that culminated in Lucas naming Roberts as godfather to his new son. Lucas’s return to Harlem served as a wake-up call for the former drug kingpin. The poverty and decay that now plagued the area had been in part caused by Lucas’s drug operation. He admitted that “I did some terrible things. . . . I’m awfully sorry. . . . I really am” (“Frank Lucas Biography” 2007). In an effort to rectify his mistakes, Lucas

began working with the nonprofit organization Yellow Brick Roads, which is run by his daughter. Yellow Brick Roads gives children of incarcerated parents a safe refuge. Lucas’s life was brought to the big screen in the 2007 movie American Gangster starring Denzel Washington as Frank Lucas and Russell Crowe as Richie Roberts. Roberts once again defended Lucas after he was charged with defrauding the U.S. government. Prosecutors claim that Lucas cashed a federal assistance check in the amount of $17,345 before reporting it missing. He later attempted to cash the replacement check. Lucas accepted a plea deal in May 2012 which spared the then 81-year-old from a possible prison sentence of five years. By pleading guilty to third-degree theft by deception, Lucas received probation and was ordered to pay restitution. Stacy O’Hara Leiter See also: Drug Trafficking; Heroin

Further Reading “Frank Lucas Biography.” 2007. Biography .com. http://www.biography.com/people/ frank-lucas-253710. Friedman, Alexi. 2012. “Newark’s ‘American Gangster” Frank Lucas Gets Probation for Stealing Over $17K from Federal Government.” NJ.com, July 28. http://www .nj.com/news/index.ssf/2012/07/frank_ lucas_sentenced_in_newar.html.

M cope with stress. When the client completes the treatment, an aftercare plan is developed. In preparing an aftercare plan, counselors must consider issues relating to the client’s ongoing treatment, overall health, any necessary accommodations, and employment status. Aftercare caseworkers are needed to provide support and follow up with the client after they return to the community. It is generally accepted that an addict will require four weeks away from both the drug and the environment before they are able to be drug-free. Experts do not agree about the effectiveness of mandatory treatment programs. According to the National Institute on Drug Abuse, “most studies suggest that outcomes for those who are legally pressured to enter treatment are as good as or better than outcomes for those who entered treatment without legal pressure. Individuals under legal pressure also tend to have higher attendance rates and remain in treatment for longer periods, which can also have a positive impact on treatment outcomes” (National Institute on Drug Abuse 2012). However, those who are forced into treatment or rehabilitation may resist attempts to help them. Some researchers find that a person forced into treatment who does not want to change will not do so. But many addicts who attend treatment will improve their chances of staying clean later on. Nancy E. Marion

Mandatory Treatment Mandatory Treatment is an involuntary, harm reduction treatment strategy designed to get help to some of the most chronic abusers of alcohol, especially those who are known to be a risk to themselves or others. In some cases, they may be forced to go as a result of a pending criminal charge. If they attend treatment for drug and/or alcohol abuse, criminal charges may be dropped as long as the offender does not reoffend or commit more crimes. Or they may have to attend treatment as part of their sentence or as a condition for pretrial release, probation, or parole. Other addicts are forced into treatment for other reasons, such as the end of a marriage or failure in a career. Mandatory drug treatment is necessary because the people using the drugs are often not aware of the harm it is doing to their own bodies and how it is affecting others. Those on drugs may also be forced to commit crimes as a result of their drug use. Because they are not thinking clearly, and probably would not choose to go to treatment, it must be mandatory, and imposed by someone else. In most treatment programs, clients are offered a wide range of treatment options that may involve learning life skills and work readiness programs. Each client in the program has an individualized treatment plan to suit their needs. Options for these plans include things like participation in community treatment programs, cognitive based therapy, motivational enhancement, and development of alternative skills to

See also: Drug Courts; Harm Reduction Programs 567

568   Marihuana Tax Act (1937)

Further Reading Fitzgerald, Beth. 2012. “Christie Courts Mandatory Treatment for Drug Offenders.” New Jersey Spotlight, March 23. http://www .njspotlight.com/stories/12/0322/2124/. National Institute on Drug Abuse. 2012. “Is Legally Mandated Treatment Effec­tive?” http:// www.drugabuse.gov/publications/principles-drug-abuse-treatment-criminal-justice -populations/legally-mandated-treatment -effective. Tuccille, Jerome. 2010. “Just Say ‘No’ to Mandatory Drug Treatment.” Civil Liberties Examiner, March 10. http://www .examiner.com/article/just-say-no-to -mandatory-drug-treatment.

Marihuana Tax Act (1937) The Marihuana Tax Act was a piece of 1937 legislation that effectively outlawed the recreational use of marijuana in the United States. Like the Harrison Narcotics Act did for opiates and cocaine, the Marihuana Tax Act did not directly ban the use of cannabis, but increased the regulations around it so tightly that its use was effectively made illegal. Until 1937, cannabis was regulated by the 1906 Pure Food and Drug Act, which required that cannabis and preparations containing the drug be labeled as such when sold to the public. In the years leading up to the passage of the Harrison Act, many reformers wanted to include cannabis on the list of controlled substances, along with opiates and cocaine, but given that the drug was used mainly in plasters, veterinary medicine, and medical preparations that were not intoxicating, it was left off the list of drugs controlled by the act. In addition, it was not universally accepted that cannabis was a habit-forming drug at the time, and many witnesses be-

fore the House Ways and Means Committee charged with considering the Harrison Act denied that it had addictive qualities. In the following decades, however, attitudes towards the drug began to change. Popular association of the drug with Mexicans in the 1910s and 1920s made the substance seem foreign and menacing to many in the United States. This trend became more prevalent in the 1930s, as Mexicans competed for jobs with whites in the western United States during the Great Depression, fueling jingoism against Mexicans and their cultural practices. In 1925, the League of Nations added cannabis to the list of substances controlled by international narcotics control agreements, thus increasing the pressure to regulate it domestically. Furthermore, rumors abounded that those who used marijuana were likely to go on murderous rampages and commit horrible crimes. These rumors led many to believe that the drug was just as dangerous, or even more dangerous, than other, more tightly regulated drugs. Thus, when the Public Health Service narcotic hospitals were established in 1929, there were provisions made so that institutions could treat those individuals who were addicted to cannabis—a sign that increasing numbers of lawmakers in Washington, D.C., believed the drug was dangerous and habit forming. What is more, some states, such as Louisiana, New Mexico, and Colorado, passed state laws against marijuana in the 1920s. In spite of these changes, federal drug enforcement officials were reluctant to add another substance to the list of drugs it was charged with controlling, since they already had their hands full trying to control the smuggling and use of opiates and cocaine. Nonetheless, pressure continued to mount, especially after a presenter at the 1934 meeting of the American Psychiatric Association claimed that rates of cannabis

Marihuana Tax Act (1937) 

use in Southern states were as high as 25 percent, and that the drug had a tendency to cause homosexual behavior. As pressure to crack down on cannabis use began to mount in the early 1930s, the initial response of officials with the Federal Bureau of Narcotics (FBN) was to minimize the problem and encourage states to enact laws and enforce them if they wanted to address it. The FBN at first believed that marijuana was not nearly as menacing as heroin, doubted the constitutionality of proposed federal laws for marijuana control, and feared that marijuana laws would be difficult to enforce since cannabis plants—unlike opium poppies and coca leaves—could be grown so easily on U.S. soil. Eventually, however, the combination of pressure from local police forces in the southwestern parts of the country, coupled with appeals from governors and the secretary of the treasury, convinced FBN leader Harry J. Anslinger to lead the legislative charge against marijuana in the mid-1930s. To garner public support for antimarijuana legislation, Anslinger led a public relations onslaught against the drug, writing articles decrying its dangers such as “Marihuana: Assassin of Youth,” which appeared in American Magazine in July of 1937. In spite of opposition from some medical authorities who testified before Congress during the deliberations concerning the necessity of marijuana control, a new bill controlling the drug—the Marihuana Tax Act—became law in October 1937. Like the Harrison Act, the Marihuana Tax Act did not ban the use or sale of the drug. Instead, it regulated it, by requiring a stamp from the Treasury Department in order to sell the drug. Prices for the marijuana tax stamps varied, from $1 per year for producers of the drug and medical professionals, to $5 for individuals who were not medical professionals, and $24 for import-

ers and manufacturers of the drug. In addition, all marijuana transfers were taxed $1 per ounce. The act also had provisions that anyone who grew, transported, prescribed, or sold the drug needed to register with the federal government to pay the tax, but since the drug was illegal in most states, registration would have made individuals subject to prosecution for violating state laws. In addition, the federal government refused to give any of the tax stamps necessary to sell the drug legally, thus making commerce in the drug effectively impossible. Violators of the law—anyone who possessed marijuana without a tax stamp—were subject to a fine of up to $2,000 and up to five years in prison. Though the law allowed for the use of marijuana as a medicine, such exceptions were rarely made, and as a result of the act, medical preparations that included marijuana were pulled from the market by 1939. In the first five years the law was in place, it was enforced rigorously by federal officials, as they destroyed about 60,000 tons of marijuana and an average of about 1,000 individuals per year were arrested for violating the law. In 1950, the constitutionality of the act was challenged in United States v. Sanchez et al., when a district court ruled that the act was so severe that it imposed a penalty for the transfer of marijuana—not a tax—and that it was therefore unconstitutional. The Supreme Court, however, upheld the constitutionality of the act, concluding that it was legal even though it imposed severe regulations on the drug and discouraged and deterred the sale, possession, and use of cannabis. Like the Harrison Act, the Marihuana Tax Act was, while technically a revenue-raising measure, a piece of legislation that effectively outlawed the sale and possession of drugs. As a result of the act, marijuana came to be treated similarly to other controlled

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substances, such as opiates and cocaine. It was not until the 1960s and 1970s that attitudes and approaches towards marijuana would begin to change. Howard Padwa and Jacob A. Cunningham See also: Anslinger, Harry J.; Federal Bureau of Narcotics; Harrison Narcotics Act; Pure Food and Drug Act

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Earlywine, Mitch. 2002. Understanding Marijuana: A New Look at the Scientific Evidence. Oxford: Oxford University Press. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Marijuana The most commonly abused illicit drug in the United States, marijuana is sometimes categorized as a hallucinogen because delta-9-tetrahydrocannabinol (THC), its psychoactive ingredient, can produce altered sensations and perceptions at higher doses. It is also known for its ability to relax users, relieve pain or nausea, and aid sleep. Marijuana has a long history of use around the world. Documentation shows it was consumed in China in 2737 BCE, and there is evidence showing use by other cultures for centuries before that. In the United States in

the 1800s, it was a popular legal drug used for treating the pain of migraine headaches and for insomnia. One report states that until its use was prohibited in 1937, marijuana was one of the three most prescribed medicines in the United States, and when alcohol was prohibited in 1920, its use increased. Despite the lessons learned from the failures of Prohibition, the U.S. temperance movement and other groups succeeded in enacting laws prohibiting marijuana, and a 1936 propaganda movie, Reefer Madness, portraying marijuana as a drug that triggered psychotic behavior, supported that agenda. Early antimarijuana legislative measures included the Marijuana Tax Act of 1937 that levied taxes on its use. Decades later, the Comprehensive Drug Abuse Prevention and Control Act of 1970 classified marijuana as a Schedule I drug, and its importation, cultivation, possession, use, sale, and distribution illegal under federal law in the United States. Although criminalizing marijuana led to decreased consumption during the middle of the 1900s, use surged again during the Vietnam War when returning soldiers who began using the drug in Asia continued the practice in the United States. Its use has continued to expand. Despite eradicative efforts and increased enforcement of drug trafficking laws, marijuana production has grown dramatically on the domestic front, in Mexico, and especially in Canada where Asian groups are beginning to dominate high-potency marijuana wholesale distribution systems. The average content of THC in marijuana was less than 1 percent in 1974; today it is 4 to 6 percent, and can be as high as 25 percent. Because many factors affect potency, the strength of street marijuana varies considerably. Most of the drug available today is 15 to 20 times more potent than what was used 40 years ago. This is one reason addictions experts are concerned about marijuana

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The leaves of the marijuana plant are often dried and smoked by users to achieve a euphoric feeling. The effects are due to the chemical tetrahydrocannabinol (THC) in the plant. Use and possession of marijuana have been made legal in some states, but remains illegal by federal law. (Yakub88/Dreamstime.com)

use; it is a different drug from the one that was outlawed during the early part of the 20th century. Marijuana is usually harvested from the Cannabis sativa plant as a combination of dried leaves, stems, and seeds; a resinous product that can be scraped from the leaves is a more concentrated form called hashish; other extracts in the form of a sticky black liquid are known as hash oil. The dried marijuana is usually rolled in cigarette papers to form a joint, layered into a hollowed-out cigar and smoked as a blunt, or sprinkled into the bowl of a pipe or bong from which its smoke can be inhaled. It may also be brewed in a tea or baked into edibles like cookies or brownies, although its effects are not as great as those resulting from smoking the drug. It acts on the same dopamine reward pathway

as other drugs of abuse and, like some of them, seems to affect each individual differently based in part on genetic heritage. The use of marijuana, particularly for medical purposes, is the subject of ongoing and fierce debate. Many reputable medical authorities believe the drug has significant value in relieving pain and reducing the symptoms of certain diseases; they cite convincing evidence that a legal drug like alcohol has far more damaging effects than marijuana. They also suggest that much of the resistance against legalizing cannabis products comes from the manufacturing industry, which is fearful that increased use of hemp might prove too competitive for their plastics, petroleum, and textile products. Others argue that marijuana, especially in an able-to-be-smoked form, has dangerous

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health consequences and that legalizing the drug will only increase its use among adolescents whose developing brains should not be exposed to psychoactive drugs. They also fear that marijuana is a gateway drug to more dangerous substances. In spite of this controversy, the Drug Enforcement Administration has approved, and affirms that it will continue to approve, ongoing research into the medicinal value of THC. Depending on dosage, THC produces relaxation, hunger, enjoyment, dissociation from and relief of pain, heightened sensations, and altered perceptions. In higher doses, it can produce hallucinations and paranoia. Long-term smoking of the drug is often associated with respiratory problems. Other issues related to regular use over time include learning and memory impairments, infertility, depression, anxiety, and personality disturbances. Immediately after marijuana use, one study has shown a user’s risk of heart attack more than quadruples, and the high levels of hydrocarbons in marijuana smoke have convinced many researchers that it may be more harmful to the lungs than smoking tobacco. Some studies have indicated that marijuana smoking significantly increases the risk of cancer of the head or neck, in some cases doubling or tripling the risk. There is some debate about whether marijuana is truly addictive, but evidence shows that some people who use the drug—but by no means a majority—meet criteria that define addiction: they use the drug compulsively and they continue to do so despite negative consequences. Heavy users also exhibit signs of withdrawal including irritability, anxiety, and insomnia. According to some statistics, 10 percent of the 25 million Americans who use marijuana are addicted. Although there are currently no medications to treat marijuana addiction, researchers are

studying drugs that might block THC from binding to cannabinoid receptors in the brain, thus preventing marijuana from producing its psychoactive effect. Depending on its source, method of administration, or other factors, marijuana goes by a wide range of street names. Some include Aunt Mary, boom, bud, dope, gangster, ganja, grass, grifa, hemp, herb, hydro, joint, kif, Mary Jane, MJ, mota, pot, reefer, roach, sinsemilla, skunk, smoke, Thai sticks, weed, widow, and yerba. Kathryn H. Hollen See also: Cannabis; Drug Paraphernalia; Gateway Drugs; Gateway Hypothesis; Hemp; La Guardia Report

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. 2003. New York: Ballantine Books. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2001. Research Report Series: Hallucinogens and Dissociative Drugs. NIH Publication No. 01-4209.

Marijuana Businesses  573 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http:// www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Marijuana Businesses In recent years, states have passed laws allowing for medical marijuana use. To cater to these new rules, businesses have emerged to cater to patients or caregivers, or for dispensaries. This new industry is rapidly changing but expected to grow as more states pass similar laws. The demand for products related to medical cannabis has increased steadily. It has been estimated that the market for such products is worth about $5 billion yearly. Many companies have been developed to provide consulting, cannabinoid-based pharmaceuticals, specialty equipment, financing, and/or other industry-specific services to the medical cannabis community. Some of the biggest companies are: BG Medical Technologies, Cannabis Science, Cannavest Corp, GWPharmaceuticals, and Medical Marijuana Inc.

BG Medical Technologies Best known for BudGenius.com, this research laboratory serves the medical cannabis industry. This company analyzes cannabis crops to determine their potency and potential medical effects. This is important because every strain of Cannabis sativa has different genetic potential, and the cultivation of these plants can have an impact on whether the plant reaches this potential. Every crop is slightly different due to changes in the growing environment such as sunlight, rainfall amount, and soil. Moreover, when dispensa-

ries obtain cannabis from many independent growers, there is not a consistent inventory of strains that have a consistent effect for patients. BG Medical’s laboratory and research provides a rating of crops indicating the potency and potential medical effects. They have developed a scale that allows them to rate a plant’s effectiveness at relieving pain, mood modification, relief of anxiety, helping the patient sleep, relieving nausea, and stimulating the appetite. At the same time, BudGenius also tests for pathogens such as mold, pesticides, and insect problems.

Cannabis Science, Inc. This biotech company based in Colorado Springs, Colorado, is involved in research that develops prescription medicines that contain THC and cannabinoids. The company focuses on phytocannabinoid science, spotlighting the development and production of commercial phytocannabinoid-based pharmaceutical products. Currently, their attention is focused on developing medicines to treat skin cancer, posttraumatic stress disorder, and HIV. Their ultimate goal is to get cannabis-based medicines approved by the Food and Drug Administration. The company is aiming to develop two product groups: over-the-counter products for skin care and prescription products for serious illness, including over-the-counter skin products such as lip balm, sunscreen, lotions for eczema and psoriasis, and a moisturizing lotion. Cannavest Corp. Cannavest develops, produces, markets, and sells consumer products containing hemp-based compounds with a focus on cannabidol, a substance derived from hemp stalk and seed that can be used with foods and other nutritional supplements for health and wellness benefits, as well as in the pharmaceutical industry.

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GWPharmaceuticals Founded in 1998 in the United Kingdom, GWPharmaceuticals was able to obtain the only license in the UK that permitted them to cultivate marijuana from seeds and then to conduct scientific research on the potential medicinal uses of the cannabis plant. The company then joined with Hortapharm B.V., a cannabis research and development business based in the Netherlands that was growing medicinal strains of cannabis for the Dutch government. GWPharmaceuticals pursues the research, development, and commercialization of cannabinoid prescription medicines designed to meet the needs of patients who suffer from many different medical conditions. They are involved in all aspects of cannabinoid product development, from extraction technology to drug delivery. They conduct clinical trials of new drugs as they attempt to develop new prescription medicines. Their main product is Sativex, a cannabinoid mouth spray used by patients who suffer from multiple sclerosis to relieve symptoms of pain, spasticity, overactive bladder, and other problems. Medical Marijuana, Inc. The first publicly held company in the medical marijuana and industrial hemp industries, this company began by focusing on providing educational seminars about medical marijuana. Today the company conducts medical marijuana research studies and experiments. The company has been described as a “leading hemp innovator.” Medical Marijuana, Inc. currently has the following divisions and subsidiaries: The Hemp Network (“THN”) This company sells hemp products to thousands of distributors. The company has five proprietary products. THN also serves as a

platform from which other products from other companies can be launched.

HEMP Compounds (“HC”) HC focuses on the pharmaceutical market and nutraceutical raw materials market. It focuses on hemp strains that range from those with little or no tetrahydrocannabinol (THC) properties, to strains with high levels of cannabidiol (CBD). They are working with genetically altered varieties of hemp. In agricultural production facilities, HC materials can be added to existing products that are sold to or through THN, or directly to pharmaceutical and nutraceutical companies. MMI Technology MMI works to develop the most comprehensive information source focusing on hemp and cannabis strain usage, crop cost, crop cycles, history of genetics, origins of genetics, efficacy, strain stability, climate, and yields. MMI Biotechnology This company deals in biotechnology and equipment that are needed by those in the hemp agricultural and medicinal technology industry. This includes technology and equipment to assist with hemp extraction methods and processing techniques. Wellness Managed Services (“WMS”) WMS acquires management service contracts for medical clinics. Once a clinic is acquired, WMS will oversee its supply, technology, accounting, marketing, advertising, and purchasing power. WMS manages and develops health and wellness facilities throughout North America. CannaFuel This company underwrites hemp biofuel and alternative to coal burning biomass opportunities. The waste product of other

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businesses, such as hemp compounds or products developed for THN, is a highvalue biomass, which yields when converted to biofuel nearly three times as much per acre as conventional corn-based ethanol. This can be a useful alternative to the coalfired energy plants, allowing coal to be replaced with a renewable, sustainable energy source.

The Pet Hemp Emporium This company has developed everyday pet products, from hemp leashes to hemp beds. Featured companies of Medical Marijuana, Inc. include:   1. CanChew Biotechnologies has brought cannabinoid-based chewing gum to market that will be available on an over-the-counter basis and online in the United States. Each piece will contain approximately 7 mg of CBD. The product was launched in December of last year with a free product trial.   2. Canipa Holdings was created in 2012 to oversee the marketing, sales, and distribution of Medical Marijuana, Inc’s portfolio of products.  3. Hemp Meds was established as a way to develop online platforms for the marketing and sales of cannabis/ hemp based consumer products.   4. KannaLife Sciences helps to develop standardized packaging for cannabisbased products that are used as transport carriers.  5. PhytoSPHERE identifies the plants that contain the highest levels of cannabidiol, and then analyzes them for future development and production. The company is able to produce plants that have a high level of genetic purity. PhytoSPHERE produces

hemp oil products and distributes them in many international markets.  6. Dixie Elixirs and Edibles, Inc. has over 40 THC-infused products including medicated beverages and tonics, cannabis capsules, medicated lozenges and edibles as well as a full line of topicals and salves. The company provides medical marijuana patients with different methods to ingest medical marijuana. They manufacture medicated chocolate truffles, ice cream, crispy rice treats, fruit lozenges, capsules, and droplets. Their products are created for those patients who, for health or social reasons, would prefer to ingest marijuana by a method other than by smoking.   7. Red Dice Holdings was created when Medical Marijuana, Inc. and Dixie Elixirs formed a third company, a marketing and licensing company, designed to manage and license the assets of the Dixie Elixirs and Edibles brand and product. Red Dice Holdings owns the formulas, equipment, brands, and intellectual property of the Dixie brand of products, which includes Dixie, Dixie Botanicals, and Dixie Elixir’s Dixie Edibles.

Rapid Fire Marketing, Inc. Incorporated in July 1989, Rapid Fire Marketing is a holding company for several businesses, but the core business is the Vapro Inhaler, which is the technology found in CANNAcig that allows for vaporizing dried plant material. Hemp, Inc. This company supplies services, products, and information related to the medical marijuana industry. Its products include

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nutraceutical products that are designed to improve concentration and joint flexibility, increase awareness and energy, and improve overall patient wellness. It is not involved in growing, transporting, or marketing of medical marijuana, but instead creates an infrastructure to do this if the drug is legalized federally or in all states. Nancy E. Marion See also: Cannabis; Hemp

Further Reading “Can Cannabidiol (CBD) Fight Metastatic Cancer? According to the Latest Research the Answer Is Yes.” 2012. PRNewswire, September 21. http://www.prnewswire.com/ news-releases/can-cannabidiol-cbd-fight -metastatic-cancer-according-to-the-latest -research-the-answer-is-yes-170681736 .html. “Investor Q&A: Cannabis Market.” http://www .bgmedtech.com/articles/2- cannabis-market. “KannaLife Sciences Announces $1.5M Series A Financing from Medical Marijuana Inc. (OTC:MJNA) and CannaVest Corp. (OTC:FCLS); KannaLife Sciences, Inc.” 2012. PRNewswire, March 7. http://finance .yahoo.com/news/kannalife-sciences -announces-1–5m-140000539.html. “Medical Marijuana Inc. to Acquire Biotechnology Company PharmaSphere, LLC from Converted Organics: Executes Option Agreement to Acquire a 100% Stake in Company.” 2011. PRNewswire, November 18. http://www.prnewswire.com/news-rel eases/medical-marijuana-inc-to-acquire -biotechnology-company-pharmasphere-llc -from-converted-organics-134128383.html. “Medical Marijuana Inc. Announces Dixie X Compassionate Care Club.” 2012. PRNewswire, September 19. http://www .marketwatch.com/story/medical -marijuana-inc-announces-dixie-x-compass ionate-care-club-2012-09-19.

“Medical Marijuana Inc. (OTC: MJNA) Announces Its Wholly Owned Subsidiary Wellness Managed Services Signs an Additional Management Contract Increasing Annual Revenue by $1,700,000, Quarter Over Quarter Revenue Increase on Pace to Maintain 100% Compounded Quarterly.” 2012. PRNewswire, April 24. http://www .prnewswire.com/news-releases/medical -marijuana-inc-otc-mjna-announces-its -wholly-owned-subsidiary-wellness -managed-services-signs-an-additiona l-management-contract-increasing -annual-revenue-by-1700000-quarter -over-quarter-revenue-increase-on-pace-to -m-148683255.html. “Medical Marijuana Inc. Announces Wholesale Distribution Sales Program for Dixie X CBD Hemp Wellness Product Line.” 2012. MacReportMedia, October 12. http://www .macreportmedia.com/ViewSubmission.asp x?submissionRequest=17906. “Medical Marijuana, Inc. and CanChew Biotechnologies Have Officially Started Market Trial Sign-Ups for CBD Chewing Gum.” 2012. PRNewswire, October 16. http:// www.einpresswire.com/article/119215226/ medical-marijuana-inc-and-canchew -biotechnologies-have-officially-started -market-trial-sign-ups-for-cbd-chewing-gum. “Medical Marijuana Inc. (OTC: MJNA) Completes Financing Agreement with CannaBANK Inc for up to Four Million Dollars to Complete Several Key Acquisitions: Medical Marijuana Inc. (OTC: MJNA) Announces Wellness Managed Services Signs an Additional Management Contract, Increases Annual Revenue by $1,100,000.” 2012. PRNewswire, February 7. http:// www.prnewswire.com/news-releases/medi cal-marijuana-inc-otc-mjna-completes -financing-agreement-with-cannabank-inc -for-up-to-four-million-dollars-to-complete -several-key-acquisitions-140702663.html. “Medical Marijuana Inc., Corporate Update—Significant Revenue and Net Income

Master Settlement Agreement (MSA)  577 Growth 1st Quarter-Division and Corporate Holdings Update.” 2012. PRNewswire, April 4. http://markets.on.nytimes .com/research/stocks/news/press_release .asp?docTag=20130404. “Medical Marijuana, Inc. and Dixie Elixirs Strike Innovative Agreement to Extend Dixie Elixirs Brand to Other MMJ Legal States.” 2012. Business Wire, April 17. http://www.businesswire.com/news/ home/20120417005615/en/Medical -Marijuana-Dixie-Elixirs-Strike-Innovative -Agreement. “Medical Marijuana Inc. to Launch Revolutionary CBD Products into European Market with the Formation of Canipa Holdings.” 2012. PRNewswire, July 24. http://www.equities.com/news/headline -story?dt=2012-07-24&val=300985& cat=material. “Medical Marijuana, Inc. Portfolio Company CanChew BioTechnologies Inc. Updates and Expands Free Product Trial.” 2012. PRNewswire, November 20. http:// www.prnewswire.com/news-releases/ medical-marijuana-inc-portfolio-company -canchew-biotechnologies-inc-updates -and-expands-free-product-trial -180141391.html. “Medical Marijuana Inc. Red Dice Holdings Company Announces Dixie X Partnerships in New Mexico and Oregon.” 2012. PRNewsire, August 29. http://www.marketwatch .com/story/medical-marijuana-inc-red -dice-holdings-company-announces -dixie-x-partnerships-in-new-mexico-and -oregon-2012–08–29. “Medical Marijuana Inc. Portfolio Company Red Dice Holdings Achieves Soft Launch of Dixie X With Steady Success.” 2012. PRNewswire, September 13. http://www. prnewswire.com/news-releases/medicalmarijuana-inc-portfolio-company-red -dice-holdings-achieves-soft-launch-of -dixie-x-with-steady-success-169608476. html.

“Medical Marijuana Inc. Portfolio Company, Red Dice Holdings, Sees Continued Brand Recognition With CO-based Dixie Elixirs.” 2012. PRNewswire, June 1. http://www.bizjournals.com/prnewswire/ press_releases/2012/06/01/SF17529. “Medical Marijuana Inc., Update.” 2011. PRNewswire, December 23. http://www .prnewswire.com/news-releases/medicalma rijuana-inc-update-136136573.html. Parloff, Roger. 2013. “Yes, We Cannabis.” Fortune 167(5): 4150–59.

Master Settlement Agreement (MSA) Struck in response to a wave of state suits against big tobacco, the Master Settlement Agreement (MSA) was a 1998 deal between the attorneys general of 46 states and the tobacco industry. The MSA halted the states’ suits and prohibited most forms of future litigation against tobacco companies, who, in exchange, agreed to pay states billions of dollars towards the cost of caring for smoking-related illnesses and to fund antismoking programs. While the MSA has had the effect of reducing smoking levels, many feel the details of the MSA enabled the tobacco industry to get the better end of this landmark deal. The MSA took shape in the wake of the failure of a similar pact—the Global Settlement Agreement (GSA)—between big tobacco and a number of attorneys general. Announced on June 20, 1997, the GSA called for tobacco companies to pay $365.5 billion over the following 25 years in order to cover the states’ medical costs for smokingrelated illnesses and fund smoking cessation programs. Under the terms of the GSA, the tobacco industry also agreed to accept stronger warning labels on its products and

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assented to new and greater restrictions on the ways it advertised and promoted them. In exchange for these moves, the tobacco companies would be protected from the classaction lawsuits that had begun to seriously threaten the industry’s future viability. In addition, the states would prohibit punitive damage awards being granted on account of past industry misconduct. Though the GSA was announced, it would not be legally binding without the passage of a congressional act to authorize it. Debated vigorously by public health figures, attorneys, and industry lobbyists, as well as congressional figures on both sides of the aisle, the GSA proved to be a difficult sell. Despite the attempts of Senator John McCain (R-Arizona) to modify the GSA so as to gain more congressional backers for the bill, the GSA was not ratified, essentially leaving the attorneys general and the tobacco companies back where they began. Since the government proved unable to pass the GSA, when the tobacco companies and attorneys general retuned to the negotiating table, the tobacco industry presented a diminished version of the GSA that was called the MSA. Unlike its predecessor, the MSA went into effect immediately after being announced on November 16, 1998, because it dropped all elements of the GSA that would have required congressional approval. Consequently, Food and Drug Administration regulation of tobacco was not a part of the MSA, nor were new regulations regarding stronger label warnings and stricter public smoking bans. The MSA was also quickly accepted in large part because of the way the agreement was proffered. Only eight attorneys general were present at the negotiations that shaped the MSA, and they, in turn, offered all states the opportunity to sign on—but with only seven days to decide. Ultimately, 46 states de-

cided to accept the money guaranteed by the MSA rather than take the route of continued litigation and the financial uncertainty and legal risks that would come with it. Mississippi, Florida, Texas, and Minnesota were not part of the MSA, as they separately reached agreements with the tobacco companies. Under the regulations of the MSA, the four major tobacco companies—Philip Morris USA, R. J. Reynolds Tobacco Company, Brown & Williamson Tobacco Corporation, and Lorillard Tobacco Company—agreed to pay $206 billion to the remaining 46 states over a period of 25 years. (Forty smaller tobacco companies later joined the agreement.) The tobacco companies additionally consented to fund a national foundation dedicated to public health and reducing smoking. This foundation could not be like the industry-led Tobacco Institute Research Committee/Council for Tobacco Research or the Tobacco Institute, which had tried to obscure evidence that smoking was dangerous and were disbanded under the terms of the MSA. The tobacco companies also agreed to operate with greater transparency. This meant that industry records and research would be opened up to examination, and industry documents—many of which exposed decades of corporate fraud, prevarications, and full knowledge of the health threats that smoking posed—were to be posted on publicly accessible, userfriendly Web sites. More noticeable to the general public, the tobacco companies assented to drastic changes in the ways in which they could advertise and market their products. In general, they agreed to stop targeting youths. One component of this was a prohibition on the use of cartoon characters, such as Joe Camel, in their advertisements. Youth access to free samples was also prohibited, as was all outdoor advertising. The sale of merchandise

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bearing tobacco brand names was banned, and the MSA also restricted sponsorship by brand names. Proof-of-purchase gifts were prohibited, and the minimum size for a pack of cigarettes was set at 20. While these changes certainly altered the face and practices of the tobacco industry, many were unhappy with the MSA. Critics of the MSA argued that the advertising restrictions were not tight enough, as the agreement did not have any provision banning the use of human figures (such as the Marlboro Man) in tobacco advertising. Many officials and public health advocates believe that the $206 billion the tobacco companies agreed to pay is not enough to cover the true costs of caring for patients with tobacco-related illnesses. Moreover, under the MSA, though individual and classaction suits could still be brought against tobacco companies, states, who have to bear the biggest brunt of health care costs, forwent their right to future litigation. As such, many feel that in signing on to the MSA, the states, whose insurance programs will have to bear the monetary burden of dealing with smoking-related sicknesses, made a financially imprudent decision when considered in the long term. In the short term, too, the MSA has not proven to be as financially helpful in reducing smoking and its public health effects as many states had believed it would. In a number of cases, tobacco industry funds went towards balancing state budgets rather than directly into anti-tobacco programs. Though the Centers for Disease Control and Prevention recommended that a minimum of 20 percent of MSA funds should be funneled to such programs, only about 4 percent of these funds made it to their intended destination. And because the tobacco industry’s continued financial contributions to the MSA depended on the stability and profit-

ability of tobacco companies, cash-strapped state governments, who prior to the MSA had been opponents of the industry in many a courtroom, oddly became invested in the financial well-being of big tobacco. That the states and the tobacco industry had become strange bedfellows as a result of the MSA became apparent in Illinois, when a jury there returned a $10.1 billion verdict in a class-action lawsuit against Philip Morris, and in response, 30 attorneys general filed an amicus brief telling the court that if the tobacco giant went bankrupt, there would be dire financial consequences for the states that had become dependent on its financial contributions. These financial contributions, it turns out, have not been as sizeable as expected. Because of a tax within the MSA that caused cigarette prices to rise, the big tobacco companies lost some of their market share to cheaper, no-frills cigarette manufacturers. This triggered a provision within the MSA that permitted the tobacco companies, on account of lost revenues, to reduce their annual payments. The financial impact of this was far from trifling, as Philip Morris, for example, in 2006 said it expected to withhold $1.2 billion from its annual payments on account of its reduced market share. States were not the only ones who financially suffered on account of missing out on these payments, as institutions involved in anti­ smoking efforts quickly found themselves without vital funds. For example, payments to the Public Education fund ceased in 2003 as a result of market share changes, and the American Legacy Foundation, which runs the “Truth” antismoking campaign, also received its last payment from the tobacco industry that year. For all its shortcomings, the MSA did, however, significantly reduce smoking levels in the United States. Youth smoking lev-

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els, in particular, are at their lowest point in almost 30 years, and in general, tobacco sales fell by more than 20 percent, putting them to their lowest level since 1950. The MSA’s impact upon the tobacco industry and smoking in America has thus been mixed. Howard Padwa and Jacob A. Cunningham See also: Nicotine; Tobacco; Tobacco Institute

Further Reading Brandt, Allan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America. New York: Basic Books. Cordry, Harold V. 2001. Tobacco: A Reference Handbook. Santa Barbara, CA: ABC-CLIO. Goodman, Jordan, ed. 2005. Tobacco in History and Culture: An Encyclopedia. Detroit: Thomson Gale.

McCaffrey, Barry R. (1942– ) Barry McCaffrey, America’s fourth drug czar, served after Lee Brown and before John P. Walters. In this position, McCaffrey directed the nation’s antidrug policies. McCaffrey graduated from Phillips Academy, a boarding high school in Andover, Massachusetts, in 1960. He then attended the U.S. Military Academy at West Point. Following his graduation in 1964, he was commissioned into the infantry. He was assigned to the Dominican Republic with the Second Airborne Division, after which he served advisory duty with the Army of the Republic in Vietnam, returning with a shattered left arm that required multiple surgeries to repair. McCaffrey was the company command with the First Cavalry Division (1968–69). He served in both Operation Desert Storm and the First Gulf War. Because of his service, McCaffrey was honored with

the Distinguished Service Cross two times, three Purple Hearts for injuries sustained during Vietnam, and two Silver Stars for valor. McCaffrey then went on to earn an MA in civil government from the American University in Washington, D.C. He also attended the National Security Program and Business School Executive Education Program at Harvard University. As an adjunct professor at the U.S. Military Academy, he served as the Bradley Professor of International Security Studies, and the assistant commandant at the U.S. Army Infantry School. McCaffrey was appointed to serve as the deputy U.S. representative to the North Atlantic Treaty Organization (NATO), the assistant chairman for the Joint Chiefs of Staff and the director of strategic plans and policy for the Joint Chiefs of Staff. When he retired from the military in 1996, he was the youngest and most highly decorated four-star general, the highest peacetime rank in the Army. Because of his strong background in both national security and academia, President Bill Clinton nominated McCaffrey to serve as the nation’s drug czar in 1996. He was confirmed unanimously by the Senate on February 29, 1996. As drug czar, he was the head of the White House Office of National Drug Control Policy, a member of the president’s cabinet. During McCaffrey’s swearing-in, he described his plans to reorganize the office. He noted that the term “War on Drugs” was not an adequate way to describe the public health problem that had been caused by drug abuse in the United States. Rather, the drug problem is much more complex. He indicated that dealing with drug abuse should be thought of as dealing with cancer. Using his military background to describe his approach to fighting drugs, he said that fighting a war is straightforward:

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Barry McCaffrey, the White House drug czar, holds a copy of the 1996 National Drug Control Strategy at a luncheon in 1997.The strategy is a summary of the president’s policies to reduce drug use across the country. (AP Photo/Rene Macura)

a general is assigned to fight a particular enemy using certain resources. However, the fight against drug abuse is different because there is no “silver bullet,” or no quick and certain way to reduce drug use or its associated damage. Instead, a successful battle against drug use requires long-term commitment comprising treatment, education, enforcement, and interdiction. It is important to deal with the root causes of addiction, but treatment also should involve multiple people. McCaffrey viewed the national drug abuse crisis as a health issue with significant implications on productivity, work stability, the economy, families, and crime. He was also concerned that about 20 million Americans needed treatment but were not receiving it. Treatment for drug abuse must involve teachers, religious leaders, police officers, and treatment specialists. Moreover,

it was important that the country support drug education and prevention programs to protect youth and give them the information to understand the threat of drugs. Students must also understand that certain “gateway” behaviors such as smoking cigarettes can lead to long-term drug use. Because treatment has to be mixed with law enforcement, McCaffrey relied on his military background to help fight the war on drugs. He described the role of the armed forces as being the protection of the country’s borders, embracing air, sea, and land. Specifically, the role of the military would be in interdiction, or stopping the transportation of drugs into the country. He thought it was important to “play hardball” with countries that produce drugs. As the drug czar, McCaffrey supported more training and weapons for the Colombian Army as a way to reduce drug production and export into the United

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States. He gave support to a program beginning in 1999 that had the goal of eliminating coca farming in Colombia. A significant problem related to the drug war, according to McCaffrey, was the amount of violence committed by chronic drug addicts. One of the tasks assigned to McCaffrey was to write and publish the first “National Drug Control Strategy.” In the publication was an outline of the current trends in drug use in the country at the time, a description of general health risks of using illicit drugs, and a general cost of drug-related crime. The report also included the administration’s10-year plan to attack the drug use problem in the United States. General McCaffrey did not support the legalization of drugs. Once, the then-governor of New Mexico Gary Johnson attacked the national policy against drugs, saying that the national drug policy had failed. He tried to instigate a national debate of the nation’s drug policy to include the possible decriminalization or even legalization of some drugs. McCaffrey responded by saying that state governors play an important role in combatting drug use, and reminded Johnson that most Americans wanted illicit drugs to remain illegal. McCaffrey’s spokesperson called the legalization or decriminalization of drugs irresponsible, and that more kids would have access to the drugs if they were made legal. In 2010, at the National Marijuana Initiative and California Campaign Against Marijuana Planting Conference in California, McCaffrey raised many points as to why marijuana should remain illegal. He pointed out that the younger children are when they first use marijuana, the more likely they are to use cocaine and heroin, and become dependent on drugs as they grow into adulthood. Marijuana is detrimental to health, and the side effects include respiratory illnesses, problems with memory, increased heart rate,

and impaired coordination. Further, chronic marijuana use is associated with anxiety, depression, suicidal thoughts, and schizophrenia. Another health effect from marijuana use is cancer of the respiratory tract and lungs because it contains more carcinogenic hydrocarbons than tobacco smoke. McCaffrey continued by saying that marijuana is involved in 300,000 visits to the emergency room each year. Marijuana use also leads to criminal behavior and prison sentences. When state ballot initiatives passed in Arizona and California to allow for marijuana to be used for medical purposes, McCaffrey reminded people that the government has a process by which the Food and Drug Administration tests drugs to ensure they are safe and effective for users. Drugs should not be approved by popular referendums through which the safety of drugs is not ensured. He also expressed concern that the propositions would be a disaster for young people who may be more likely to have access to harmful drugs since these proposals were passed. He also noted that doctors who prescribe marijuana to their patients could be the focus of a federal investigation. They run the risk of losing their right to prescribe drugs. He advocated expanded treatment options for drug users such as drug courts. Of drug courts, McCaffrey said, “If you’re arrested at two in the morning and you’re dazed, drunk or drugged, you’re a male street prostitute or you’re breaking into a car when arrested, we would like to get you into the drug court system at the front end. . . . If you go into treatment and get a job, we’ll arrange the social services and medical care you need.” One of the controversial aspects of McCaffrey’s plan to reduce drug use, particularly by youth, was a plan to purchase antidrug advertising on television. Probably more controversial was his plan to pay producers to embed antidrug messages into

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the programs aired on television. A senior vice president for broadcasting acknowledged that the White House reviewed scripts for different shows and approved them. In return, the networks received almost $25 million from the federal government. Shows that took part in the program included ER, Beverly Hills 90210, The Drew Carey Show, 7th Heaven, and Chicago Hope. When asked about the program, McCaffrey explained that the White House did not regulate the content of the shows, but by including a negative message about drugs, tried to influence children into not taking drugs. After an investigation in 2000, the Federal Communications Commission ruled that the networks that accepted the money should have identified the ONDCP as a sponsor of the shows. Additionally, in 2005, the Government Accountability Office decided that the ONDCP had violated laws against domestic propaganda and publicity prohibitions by preparing prepackaged news stories on which there was no indication that they had been produced by the government. As expected, McCaffrey sought to take special action against methamphetamines (meth). He noted that meth is a dangerous drug that is used by many, for weight loss or for a burst of energy to stay awake. The drug, however, can impact the body, mind, and sense of social responsibility, according to the drug czar. It can cause users to be violent and irrational, and cause long-term harm to young people. But McCaffrey was encouraged by progress made by the nation, because meth use was down, and treatment professions were learning more about how to treat meth users. In order to address this threat, the ONDCP allocated $10 million from its budget, including $4 million provided to the Drug Enforcement Administration to create national precursor and clandestine lab databases; $4.2 million into the National Institute of Drug Abuse to study the physiological ef-

fects of methamphetamine; $1 million to the Environmental Protection Agency to establish clandestine-lab cleanup programs; and $700,000 into the Southwest Border Initiative to assist law enforcement officials coordinating antimethamphetamine activities along the border. He reiterated that drug abuse is a local problem and that local role models must take action to fight the meth problem. General McCaffrey resigned from the position of drug czar effective January 6, 2001, just a few weeks before President Clinton left office. Upon his resignation, McCaffrey said he was proud of the administration’s effect on reducing drug use by teens and reducing drug-related crime. After leaving the administration, McCaffrey served as a consultant and national security analyst for NBC and MSNBC. He also served on the boards of a number of organizations and corporations such as the Phoenix House drug treatment center. He is the president of his own consulting firm, BR McCaffrey Associates. Nancy E. Marion See also: Campaign against Marijuana Planting; Drug Czar; National Drug Control Strategy; Office of National Drug Control Policy

Further Reading Coleman, Michael. 1999. “Drug Czar Rebuts Johnsons’ Stance.” Albuquerque Journal, September 22. http://business.highbe am.com/2872/article-1G1-107079030/ drug-czar-rebuts-johnson-stance. “Former White House Drug Czar Barry McCaffrey Lays Out Case Against Legalizing Marijuana as California Prepared to Vote.” 2010. PR Newswire, May 10. http://www .prnewswire.com/news-releases/former -white-house-drug-czar-barry-mccaffrey -lays-out-case-against-legalizing -marijuana-as-california-prepares-to -vote-93313349.html.

584   McCoy, Bill (1877–1948) “Four-Star Gen. Barry McCaffrey, Former US Drug Czar, to Report ‘Drugs in the Workplace—Understated National Crisis’ at Labor Health & Benefits Expo Fri., Nov. 8, 10:30 AM at NYC Grand Hyatt.” 2013. PR Newswire, November 5. http://news.yahoo .com/four-star-gen-barry-mccaffrey -former-us-drug-203600503.html. McCaffrey, Barry. 1997a. “The National Methamphetamine Drug Conference: Closing Remarks.” Office of National Drug Control Policy. https://www.ncjrs.gov/ondcppubs/ publications/drugfact/methconf/close2.html. McCaffrey, Barry. 1997b. “The National Methamphetamine Drug Conference: Opening Remarks.” Office of National Drug Control Policy. https://www.ncjrs.gov/ondcppubs/ publications/drugfact/methconf/remark1 .html. National Drug Strategy Network. 1996. “General Barry R. McCaffrey Sworn In as New Drug Czar.” http://www.ndsn.org/march96/ drugczar.html. PBS. 1996a. “Battling Drug.” PBS NewsHour, March 12. http://www.pbs.org/newshour/ bb/health/jan-june96/drug_czar_3-12.html. PBS. 1996b. “Medical Marijuana: Good Medicine?” PBS NewsHour, December 30. http://www.pbs.org/newshour/bb/health/ july-dec96/mccaffrey_12–30.html. Right Web. 2008. “Barry McCaffrey.” http:// rightweb.irc-online.org/profile/McCaffrey _Barry. Rochelle, Carl. 1996. “Administration Moving to Stop Prescribed Marijuana.” CNN Interactive, December 29. http://www .cnn.com/US/9612/29/medical.pot/index .html?_s=PM:US.

McCoy, Bill (1877–1948) Bill McCoy was one of the nation’s most notorious liquor smugglers during national prohibi-

tion. Launching a famous smuggling operation that utilized a row of ships off the U.S. coastline, McCoy gained a reputation for importing high-quality, unadulterated liquor, which was referred to as “the real McCoy.” He was arrested for violating the Volstead Act, and upon his release, did not return to rum running. William McCoy was born in Syracuse, New York, in 1877 and served in the U.S. Navy. After his service, Bill, along with his brother, Ben, developed a successful business building yachts and speedboats in Florida, often for rich and powerful Americans like Andrew Carnegie, John Wannamaker, and members of the Vanderbilt family. The onset of the Great Depression, however, hurt McCoy’s financial standing and likely drew him into a new enterprise—smuggling. Smuggling also appealed to McCoy for reasons beyond the wealth that could be made by engaging in it during hard economic times. Though McCoy was not a drinker, he personally opposed national prohibition because of what he saw as its oppressive character. Likening the Eighteenth Amendment to the Stamp Act and the Fugitive Slave Law, McCoy claimed that prohibition ran counter to his notion of American freedoms. Similarly, McCoy cast himself in the mold of the nation’s founding fathers, who, he said, would patriotically defy the laws that they resented. In particular, McCoy modeled his role as a smuggler after John Hancock, who, in addition to being the first signer of the Declaration of Independence, proudly defied British embargoes by smuggling liquor (and other items) into the colonies and encouraged others to do the same. As a result, McCoy deemed that Hancock might stand as the patron saint of rumrunners. McCoy’s first smuggling efforts involved loading his ship in the Caribbean with cases of liquor and sneaking his cargo back to American docks. But what distinguished

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McCoy from other smugglers engaging in similar activities was his origination of “Rum Row,” which referred to the lining up of alcohol-carrying ships just beyond American waters. These boats were within the safety of international waters, but close enough to the American shore that other boats could sail out to meet them and purchase high-quality liquor. This novel setup was so successful that, after upgrading ships, McCoy’s boat was described as a high-end, floating liquor store. And consumer demand was particularly high because McCoy’s goods were noted for being undiluted and unadulterated, unlike much bootleg liquor in America, which could be downright dangerous to consume. As a result, the term “the real McCoy” was born to describe the quality of McCoy’s Rum Row liquor. Once purchasing their alcohol and returning to their own speed boats, McCoy’s patrons were generally successful in outracing Coast Guard patrols to the shore. In fact, the setup was so difficult for the Coast Guard to combat that Rum Rows sprang up across the Atlantic seaboard, with outposts along every state and nearly every city from Maine to Florida. Similar Rum Rows existed in the Gulf of Mexico and along the Pacific. McCoy’s signature business model, which brought him a great deal of wealth very quickly, was highly successful. But while other smugglers continued to operate under this setup, McCoy was actually captured by the government fairly early on. In 1923, he pleaded guilty to violating the Volstead Act and served less than one year of time in a low-security federal prison in Atlanta. Upon his release, McCoy did not return to the smuggling business and instead became a realtor. In the following years, Rum Rows devolved into more violent operations, and the Coast Guard more effectively policed the nation’s shores. Though he was

only a part of the business for a relatively short period of time, Bill McCoy was perhaps America’s most notorious smuggler. He died in 1948. Howard Padwa and Jacob A. Cunningham See also: Alcohol Bootlegging and Smuggling; Eighteenth Amendment; Prohibition; Prohibition Unit; Volstead Act

Further Reading Burns, Eric. 2004. The Spirits of America: A Social History of America. Philadelphia: Temple University Press. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press.

Medellín Cartel Named after the Colombian city of Medellín (population about 3 million), the capital of Antioquia province, the Medellín Cartel was the country’s most powerful drug-trafficking organization from the mid-1970s to the late 1980s, when it was crippled by the massive manhunt for its godfather, Pablo Escobar Gaviria. The cartel kept a high profile in its approach to drug trafficking and, in addition to Escobar, it included a number of godfathers or capos who became world famous in the 1980s: Jose Rodriguez Gacha, Carlos Lehder, and the Ochoa brothers (Fabio, Jorge Luis, and Juan David), among the most prominent. Historically, the area around Medellín had built a reputation as a center for smuggling liquor and cigarettes from the United States. Medellín began to play an important role in the international drug trade in 1973 when Chilean general Augusto Pinochet overthrew Marxist president Salvador Allende and either deported or put into jail numerous drug

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traffickers from Chile who had made Chile the central player in the emerging U.S. cocaine trade, although the market for cocaine at the time was small. The cocaine trade then moved to Colombia, where criminals like Pablo Escobar and Fabio Ochoa Sr. (the father of the Ochoa brothers) were able to expand the cocaine distribution network. Fabio Ochoa Sr., who got his start in the criminal world by smuggling whiskey and home electronic appliances, is credited with founding the Medellín Cartel around 1978, when Pablo Escobar convinced Fabio to use his well-established and connected smuggling routes for the more profitable drug business. The date of April 18, 1981, may be considered the key date for the Medellín Cartel’s establishment. Several drug traffickers, including Jorge Luis Ochoa, Fabio Ochoa Jr., Pablo Escobar, and Carlos Lehder met at the estate owned by the Ochoa clan to discuss ways to transport cocaine to the United States. By year’s end, the Medellín Cartel had supervised at least 38 shipments to the United States, containing about 19 tons of cocaine. As business picked up, other family members and relatives joined the cartel. The three Ochoa brothers, for example, took over from their father when he decided to retire. What the Medellín Cartel needed, though, to expand their operation and stay ahead of the competition was a fast, cheap transportation system. That was provided by Carlos Lehder, a flamboyant, unpredictable criminal of Colombian-German background who got his start in crime in the United States. Lehder revolutionized the way drugs were smuggled into the United States. He established a monopoly for the Medellín Cartel by retaining a fleet of small cargo planes and high-speed boats that were used to smuggle cocaine into the United States. This eliminated the middleman, or the “mule,” who

traditionally would be an unsuspecting person who would help the cartel smuggle cocaine into the United States. The cartel was able to establish air corridors or “paths” in South and Central America, with stops for refueling the planes on the islands of the Caribbean and Mexico. The transit sites included the Bahamas, the Turks and Caicos Islands, Jamaica, Mexico, and Nicaragua, which were protected by cartel employees or independent organizations, including those headed by local government officials. The planes blended in with the traffic over the Florida Keys, and upon reaching their destination, they either dropped their drug cargos to waiting boats or landed at clandestine air strips in Florida, Georgia, or Alabama. Lehder directed the transportation network from his command post at Norman’s Cay in the Bahamas. Once safely in the United States, cocaine shipments were taken to warehouses or stash houses and then distributed and sold to the cartel’s clients. For a big “service” fee based on weight of the shipment, independent dealers not affiliated with the Medellín Cartel could use the transportation system to get their drugs to the United States. Gilberto Rodriguez Orejuela, a founding member of the Cali Cartel, used his boyhood friendship with Jorge Luis Ochoa to ship an undetermined amount of cocaine through the system to Florida, where he would hire trucks to ship the cocaine to the Cali Cartel’s prime market, New York City. The Medellín Cartel was not afraid of violent confrontation with anyone, including the Colombian government, and it would not hesitate to eliminate any threats to its interests. During the 1980s, the Medellín Cartel used bombs and trained hit men known as sicarios to kill thousands of people, including some of the most prominent figures in Colombian politics: Rodrigo Lara Bonilla,

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Colombian justice minister, in 1984; Jaime Gomez Ramirez, head of Colombia’s National Police Anti-Narcotics Unit, in 1986; Guillermo Cano Isaza, the respected editor of El Espectador newspaper, in 1986; and Luis Carlos Galan, presidential candidate, in 1989; among others. The Cali Cartel, on the other hand, diligently cultivated an image as a kinder, gentler mafia that preferred to use the bribe rather than the bullet in doing business. As James Sutton, a Mexico City–based security consultant, explained, “The saying goes that the Medellín Cartel confronts; Cali corrupts” (Chepesiuk 1999, 144). Differences aside, the Medellín and Cali cartels helped to revolutionize cocaine trafficking, not just in the way the drug was transported to the United States, but also in how it was distributed within the United States. Both cartels established the drug trade on a business model with efficient, welloiled smuggling, marketing, and moneylaundering networks operating from coast to coast in the United States. By 1989 an estimated 300 Colombian trafficking groups and 20,000 Colombians were involved in the cocaine trade in the United States. At least 5,000 of the Colombians who worked for the cartels lived in the Miami area and another 6,000 in the Los Angeles area. “The Colombians have the momentum by benefit of their early involvement in the cocaine trade,” the President’s Commission on Organized Crime concluded in 1986. “They have evolved from small, disassociated groups into compartmentalized organizations that are sophisticated and systematized in their approach to the trafficking of cocaine in the U.S.” (President’s Commission on Organized Crime 1986, 78). According to law enforcement reports, the Medellín Cartel and other Colombian trafficking groups operate as self-centered cells of about five to 50 members with only a handful of the

“managers” knowing all the cell’s members. Top-level managers, both in Colombia and in the United States, are recruited on the basis of blood and marriage, which helps to minimize the potential for theft or disobedience because family members in Colombia are held accountable for drug deals gone bad. Middle managers are placed all over the United States and may include individuals who are not family members, but who are the friends of top-level capos or at least have roots in the same region the capos come from. The third level consists of thousands of workers, both inside and outside the United States—accountants, couriers, chemists, lawyers, stash house keepers, enforcers, bodyguards, launderers, pilots, and wholesale distributors—who perform specialized tasks and may work for different groups at different times. Although the cartels are predominantly Colombian in membership, they sometimes go outside their group to hire specialists, such as pilots or lawyers, and when need be, to cooperate with other criminal groups, including Mexican, Italian, Jamaican, and Nigerian criminal organizations. Despite its brilliance in organizing the cocaine trade, the Medellín Cartel’s emphasis on violence and narcoterrorism to fulfill its criminal objectives ultimately led to its decline and fall. From 1984 to 1993 the cartel engaged the Colombian state in a war of attrition. The terror and death toll was largely of Pablo Escobar’s making. “Every time there is a major assassination in Colombia, they (the Ochoas) send out word that they aren’t behind it,” revealed Maria Jimena Duzan, an investigative journalist and columnist with the Bogotá based El Espectador newspaper (Chepesiuk 1987). The Medellín Cartel, however, paid for its violent ways. On February 5, 1987, an elite Colombian police unit captured Carlos

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Lehder 20 miles outside of Medellín, the heart of Colombia’s cocaine industry, and quickly extradited him to the United States, where he was convicted of drug trafficking and given a life sentence plus 135 years in prison. Jose Gonzalo Rodriquez Gacha, who matched Escobar in ruthlessness, was killed in a shootout with police in December 1989, while all three Ochoa brothers, seeing the writing on the wall, turned themselves in and were sent to jail. Medellín’s dominance of the cocaine trade ended when Colombian police killed Pablo Escobar in 1993. That left the Cali Cartel to rule supreme over the Empire of Cocaine, until its organization too began to fall apart in the mid-1990s. In early 1998 the press began reporting about a revival of organized drug activity in the Medellín region by a number of loosely knit, small drug-trafficking groups that—unlike the original Medellín Cartel— shun a high-profile presence, are computer literate, and establish legitimate businesses to front for their illegal operations. Authorities, however, are not calling these organizations cartels. “They go around in taxis, meet in normal places,” said Colombian National police chief Rosso Jose Serrano. “You don’t see armed people, or those dressed the way they used to, with rings and big chains. They are very subtle.” Ron Chepesiuk See also: Cali Drug Cartel; Carter, Jimmy; Drug Trade; Drug Trafficking; Escobar, Pablo; Extradition; Noriega, Manuel Antonio

Further Reading Abadinsky, Howard. 2007. Organized Crime. Belmont, CA: Thomson/Wadsworth. Chepesiuk, Ron. 1987. “Kingpin’s Trial Small Win in Losing War on Drugs.” Orlando Sentinel, October 4.

Chepesiuk, Ron. 1999. Hard Target. Jefferson, NC: McFarland. Eddy, Paul, Hugh Sabogal, and Sarah Walden. 1988. The Cocaine Wars. New York: Newton. Gugliotta, Guy, and Jeff Leen. 1990. Kings of Cocaine. New York: Harper and Row. Strong, Simon. 1995. Whitewash: Pablo Escobar and the Cocaine Wars. London: Pan. U.S. President’s Commission on Organized Crime. 1986. Report to the President and the Attorney General. Washington, DC: U.S. Government Printing Office.

Medical Marijuana Marijuana has been part of the world’s cultures for many years and has been used for medication since ancient times. In every part of the world, marijuana has been used to treat many symptoms and diseases. In early Chinese culture, a medical text described the use of marijuana for hundreds of problems such as vomiting, parasitic infections, and hemorrhage. It may also have been used to treat diarrhea, dysentery, rheumatism, gout, malaria, and absent-mindedness. In Greece, medical marijuana was used to relieve inflammation, earaches, edema, and to stop nosebleeds. Egyptians used cannabis to treat gout, rheumatism, foot pain, eye problems, and hemorrhoids. In Africa, medical marijuana was used to treat snake bites, fever, blood poisoning, asthma, and dysentery. The major psychoactive chemical component in marijuana is delta-9-tetrahydrocannabinol, or THC. When the user smokes marijuana, THC passes from the lungs to cannabinoid receptors on the surfaces of nerve cells in the part of the brain that influences memory, concentration, and coordination. THC is believed to interact with parts

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An employee of the Oakland Cannabis Buyers Cooperative in California helps a customer choose a strain of marijuana to use for medicinal purposes in 2001. Although state law allows for such sales, they are illegal under federal law. (AP Photo/Ben Margot)

of the brain that play a role in pain sensation, memory, and sleep. The effect that marijuana has on these parts of the user’s brain is referred to as being “high.” Other chemical components in marijuana are responsible for the medical impacts that patients experience after smoking the drug. Cannabidiol (CBD) is thought to relieve convulsions, inflammation, high blood pressure, and nausea, or even inhibit cancer cell growth, among other things. CBD does not have psychoactive properties and therefore does not cause a feeling of being “high.” Different strains of marijuana have different amounts of THC or cannabidiol. The types of marijuana with high amounts of CBD are sometimes more useful for those

seeking relief from symptoms. Different patients seek different effects, and therefore desire different strains of the plant. In the U.S., medical marijuana was a common medicine through the 19th century. It was used as a pain reliever until the invention of aspirin. Some patent medicines during this time contained marijuana, but it was a small percentage compared to the ones that contained opium or cocaine. In the United States, federal laws such as the 1906 Pure Food and Drug Act limited some availability of the drug to the public, as did the Harrison Tax Act of 1914. The Marihuana Tax Act of 1937 mandated that anyone who bought, sold, or grew marijuana had to register with the federal government and

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purchase a stamp from the Treasury Department. It was now illegal to grow or possess marijuana without the stamp, but the Treasury Department did not issue any tax stamps for marijuana. Most physicians found it easier not to prescribe marijuana than to deal with the new law. About this time, many states were also passing laws to make marijuana illegal. Massachusetts became the first state to outlaw marijuana. Maine, Wyoming, and Indiana followed suit and passed laws in 1913. The following year, similar laws were passed in New York City, and in 1915, cannabis was outlawed in Utah and Vermont. Colorado and Nevada passed laws in 1917 to ban marijuana use. Through the 1970 Comprehensive Drug Abuse Prevention and Control Act, or the Controlled Substances Act, the federal government placed marijuana into the newly formed Schedule I. This meant that it has not recognized medical value along with a substantial potential for abuse. Also in Schedule I is LSD, heroin, hashish, and hallucinogens. For the time being, marijuana use for recreation or for medical reasons was banned. In recent years, the medical benefits are again being recognized. It is used for those suffering from AIDS (and especially the associated “wasting syndrome” that is characterized by extreme weight loss), alcohol withdrawal, Alzheimer’s disease, anorexia, cancer, Crohn’s disease, depression, diabetes, fibromyalgia, glaucoma, high blood pressure, insomnia, migraines, multiple sclerosis, nausea/vomiting, pain seizures, and many other symptoms. Some states have recognized these potential benefits and have opted to make medical marijuana legal in those areas. The state laws allowing for medical marijuana are each different. Some states require that every patient, before being allowed to

use medical marijuana, have written documentation from a licensed physician affirming that the person suffers from a debilitating condition and that they may benefit from the use of the drug. Other states require that a patient file for a “marijuana ID card” prior to receiving the drug. Other provisions may define the limits on the type of conditions for which medical marijuana can be used. State laws also vary in terms of the amount of marijuana that a person may possess, use, or grow. The states have different methods for dispensing the drug as well, with some having dispensaries and others allowing patients to grow their own plants. California was the first state to pass a bill to legalize medical marijuana in 1996, when voters passed Proposition 215, the Compassionate Use Act. This law allowed for the possession and cultivation of marijuana for medical purposes upon a doctor’s recommendation. Since then, 18 states and the District of Columbia have passed laws allowing for medical marijuana. Others are considering similar laws. The U.S. Congress had considered legislation to either legalize medical marijuana, or to reschedule into a Schedule II drug. That would open the possibility for more research into the drug and possible medical uses for it. Other proposals would eliminate drug categories established in the Controlled Substances Act and remove all penalties for its possession, sale, and cultivation of marijuana. Each state could then decide how to regulate it. None of these laws have passed. Many interest groups have been involved in the debate over medical marijuana. Groups like Americans for Safe Access, the National Organization for the Reform of Marijuana Laws, and the Marijuana Policy Project have worked for more research into the medical effects of marijuana. Many medical interest groups have also joined in the discussion.

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Examples of these include the American Medical Association, the American College of Physicians, and the American Academy of Family Physicians. Even though many state laws allow for medical marijuana use, it is still illegal under federal law. That means that anyone who uses the drug, dispenses it, or prescribes it to patients faces legal action by the federal law enforcement. Federal Drug Enforcement Administration agents continue to carry out raids on dispensaries and medical offices, even though they are legal by state law. In the United States, when state laws and the federal laws clash, the federal laws prevail. The international community has also played a role in the medical marijuana debate. The United Nations’ Single Convention on Narcotic Drugs classifies marijuana as a Schedule IV drug, meaning the member countries can choose whether to allow its use for medicine or research. Many countries have legalized medical marijuana and others have decriminalized it, including Israel, Belgium, Austria, Spain, Finland, and the Netherlands. In Canada, medical marijuana was made legal by Health Canada in 2000. It is allowed for those patients who have been diagnosed by a doctor with certain conditions, or as a way to provide compassionate end-of-life care. In Canada, the government provides marijuana to patients through the brand CannaMed. Illegal “compassion clubs” have popped up that make more strains of marijuana and other products available to patients. Patients can grow their own marijuana, if approved by Health Canada. In the United Kingdom, patients can legally use the cannabinoid-derived drug Sativex instead of marijuana. Many advocates have stressed the need for change in the federal medical marijuana

laws. They point to medical evidence that shows that marijuana has legitimate medical effects. They also argue that, traditionally in the United States, health and criminal activity are responsibilities of state government officials rather than federal. In 2013, public opinion polls indicated that 77 percent of respondents believed that marijuana has at least some legitimate medical uses in certain circumstances. The results showed that there were small differences between members of political parties: 82 percent of independents, 76 percent of Democrats, and 72 percent of Republics agree that marijuana has medical uses. In this survey, those most likely to be in favor of medical marijuana were those in the 18to 29-year-old category. Many companies have been established to help provide consulting, special equipment, financing, and/or other services to the medical marijuana community. The medical marijuana business is a growing industry, especially as more states choose to legalize it. Some of the larger companies are BG Medical Technologies, Cannabis Science, GWPharmaceuticals, and Medical Marijuana, Inc. Nancy E. Marion See also: Cannabis; Controlled Substances Act; Hemp; Marijuana

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcohol-

592   Meese, Edwin (1931– ) ism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. “Majority Now Supports Legalizing Marijuana.” 2013. Pew Research Center for the People and the Press, April 4. http://www .peopole-press.org2013/04/04/majority -now-supports-legalizing-marijuana. Marion, Nancy E. 2013. The Medical Marijuana Maze: Policy and Politics. Durham, NC: Carolina Academic Press. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov.

Meese also supported international cooperation to reduce the amount of drugs being imported into the United States. As such, he proposed a multinational narcotics police force to protect public officials in countries where drug cartels were using violence to intimidate law enforcement and others who sought to eliminate them. With the help of international organizations, law enforcement was able to carry out the “Pizza Connection” case in which worldwide heroin traffickers were put on trial. At one point, Meese said that illegal immigration and drug trafficking were interconnected. Thus, it was important for the federal government to end illegal immigration as a way to solve the nation’s drug prob-

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Meese, Edwin (1931– ) As a counselor to the president (1981– 1985) and as the 75th attorney general of the United States (1985–1988), Meese was one of President Ronald Reagan’s staunchest supporters and closest advisors. Meese played an important role in the early history of the War on Drugs as chairman of the Domestic Policy Council and, while serving as the attorney general of the United States, chaired the National Drug Policy Board. In that position, he helped to coordinate the national antidrug education campaign that included Nancy Reagan’s “Just Say No” program. Meese visited elementary schools where they taught children about the dangers of drugs as a way to support Reagan’s antidrug initiatives.

Attorney General Edwin Meese III appears before a congressional committee in 1987. As attorney general, Meese oversaw the enforcement of federal laws in the United States. (AP Photo/John Duricka)

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lems. He cited the flow of undocumented immigrants who crossed the U.S.–Mexican border as giving drug traffickers an opportunity to import drugs. Another policy that Meese advocated was seizing the assets of criminal activity, including expensive automobiles, yachts, businesses, and houses. He then advised Reagan to share the proceeds with international law enforcement agencies that cooperated with the United States, so they could enhance their own drug-fighting activities. Meese supported tough sentencing for drug traffickers, and sought to institute a policy of random drug testing for government employees, which the courts say would be fully consistent with constitutional rights. Currently, Meese holds the Ronald Reagan Chair of Public Policy at the Heritage Foundation, a public policy research and education institution, and is a distinguished fellow at the Hoover Institution, a think tank on the campus of Stanford University. Nancy E. Marion See also: National Drug Policy Board; Reagan Ronald, and Nancy Reagan; War on Drugs

Further Reading Brinkley, Joel. 1986. “Meese Supports DrugTesting for U.S. Employees.” New York Times, March 5. http://www.nytimes. com/1986/03/05/us/meese-supports-drugtesting-for-us-employees.html. “The Drug Thugs and Mr. Meese.” 1988. New York Times, April 10. http://www.nytimes .com/1988/04/10/opinion/the-drug-thugs -and-mr-meese.html. Gest, T., and G. Witkin. 1988. “The Days Dwindle Down for Edwin Meese.” U.S. News and World Report, April 11. Meese, Edwin III. 1992. With Reagan: The Inside Story. Washington, DC: Regnery Gateway.

Rohter, Larry. 1986. “Meese Observes a Drug Program in a City School.” New York Times, January 24. http://www.nytimes .com/1986/01/24/nyregion/meese-observes -a-drug-program-in-a-city-school.html. Scott, Janny. 1987. “Meese Links Illegal Aliens, Drug Problems.” Los Angeles Times, January 23. http://articles.latimes.com/1987-01-23/ local/me-663_1_illegal-immigration. “The Meese Record.” 1988. National Review, August 5.

Mescaline One of the oldest psychedelics known, mescaline (3, 4, 5-trimethoxyphenethylamine) is a powerful drug found in peyote and other varieties of small cacti. The drug was first identified in 1897 by German chemist Arthur Heffter, and first synthesized by Ernst Spath in 1919. Peyote buttons removed from the plant’s crown are dried and eaten, or soaked in water to produce a liquid that can be mixed with beverages or injected. Like LSD, mescaline is not addicting in the usual sense, but chronic or prolonged use can result in cognitive disruption and permanent mental disorders. Users may also develop a crosstolerance to other hallucinogens. If a user takes mescaline often, they will require more of it over time to achieve the desired result. Mescaline was used during the 1950s for psychoanalysis because it proved to be effective in recovering repressed memories. Some psychiatrists claimed that the drug allowed a patient to go beyond simply remembering an event, but could actually relive it. Moreover, most patients could tolerate the drug very well, and had no recurring psychoses or uncomfortable withdrawal symptoms. To prove the point, in 1955, Christopher Mayhew, a British politician and member of Parliament, took a dose of mescaline on the BBC tel-

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evision show Panorama. His experience was taped, although it was later deemed to be too controversial to be aired and was never shown. Mescaline (and peyote) have traditionally been featured in Native American religious and ceremonial rites. Members of the Native American Church have the legal right to use this drug in the United States. The drug became popular during the counterculture movement in the 1960s. Author Aldous Huxley, at the time a visiting professor of MIT, wrote two essays about his experiments with mescaline. They were “The Doors of Perception” (written in 1954) and “Heaven and Hell” (written in 1956). Hunter S. Thompson also wrote about his use of mescaline in “First Visit with Mescalito” in the book Songs of the Doomed. A Schedule I substance under the Controlled Substances Act, mescaline is not as potent as LSD, but the trips it produces can be positive or negative depending on dosage. The drug’s effects include a distorted sense of time and place, restlessness, flashbacks, vivid and sometimes terrifying hallucinations, disorganized thoughts, and potentially psychotic behaviors. Mescaline can be produced synthetically, with the result that a number of variations on the chemical formula of the natural substance have entered the market masquerading as Ecstasy. These include 4-methyl-2,5-dimethoxyamphetamine (DOM), 4-bromo-2,5-dimethoxyamphetamine(DOB), 4-bromo-2,5-dimethoxyphenethylamine (2C-B or Nexus), para-methoxyamphetamine (PMA), and para-methoxymethamphetamine (PMMA). PMA, which first appeared on the illicit market briefly in the early 1970s, is associated with a number of deaths in both the United States and Europe. Street names for mescaline and peyote include big chief, buttons, cactus, and mes. Kathryn H. Hollen

See also: Controlled Substances Act; Ecstasy; Flashbacks; Hallucinogens

Further Reading Califano, Joseph A., Jr. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books, 2007. Hoffman, John, and Susan Froemke, eds. Addiction: Why Can’t They Just Stop? New York: Rodale, 2007. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Nelson, Sheila. 2013. Hallucinogens: Unreal Visions. Broomall, PA: Mason Crest. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Meth Labs A meth lab is an illicit operation that has the apparatus and chemicals needed to produce the powerful stimulant methamphetamine. These small labs began showing up in California in the 1950s and spread throughout the Southwest in the 1960s. Today they appear in every state in the United States, especially Utah and Ohio. Meth labs are popular because the drug is easy to make and sell. A person can make $2.5 million worth of methamphetamine (crank or speed) in one night.

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Meth labs vary in size and output. Large labs, called super labs, can produce 10 pounds or more of the drug per cycle and are usually run by gangs or organized crime units. Small labs, called box labs, produce as little as an ounce or less of the substance and are small enough to fit into a box or backpack. Meth labs have become increasingly prevalent in the United States as more and more addicts and dealers learn how to make (or “cook”) it. They can be found virtually anywhere including secluded rural areas; residential, commercial and industrial districts; private homes; hotel rooms; and commercial properties. They have even been found in cars, boats, and luggage. The process for making meth is relatively easy and can be found on the Internet. One main ingredient is ephedrine or pseudoephedrine, which is found in over-thecounter cold and allergy medicine. The other ingredients are common household products including rubbing alcohol, drain cleaner, lye, and matches. Other materials needed to produce meth are salt, kerosene, and paint thinner. As a way to limit the availability of ephedrine, Congress passed the Comprehensive Methamphetamine Control Act in 1996. Now, many retail stores limit sales of all cold medications to three packages per customer, and place the packages behind the pharmacist counter where they cannot be stolen. The bill also limited the availability of iodine, red phosphorous, and hydrochloric gas. However, when the ingredients are not available legally, offenders will simply steal them or find ways to use other ingredients to make the drug. This, in turn, creates more crime in a community.

Signs of a Meth Lab There are many indicators that a meth lab is nearby. Some of the warning signs include

an unusual, chemical odor coming from the house that is similar to ether, ammonia, or acetone. The smell coming out of a meth lab has been likened to cat urine. It is more difficult to hide the smell when the lab is located in a highly populated area. But in a remote location, the odor is more difficult to detect. A meth lab may be surrounded by a significant amount of trash strewn about. Many times that can consist of chemical containers, duct tape rolls, coffee filters, or small pieces of cloth that are stained red. Since the owners seek to keep the meth lab a secret, the window curtains of the home will probably be closed, or the windows will be covered with aluminum foil or blackened in some way to help ensure privacy. If the meth lab is in a garage, shed, or other structure, it too will be closed up. Sometimes there will be evidence of chemical waste or dumping, especially in a remote area because the lab operators will get rid of the excess chemicals by taking them outside and dumping them on the ground. This, however, puts the chemicals into the environment, posing more dangers. In some meth houses, there will be many visitors who will be there to purchase the drug. Often they will show up at unusual times of the day. Some larger meth labs will set up extensive security measures like no trespassing or beware of dog signs, high fences, or large trees or shrubs. The occupants of the house may not be friendly or may be very secretive.

Risks of Meth Labs Living within proximity of or within a former meth lab carries many risks. Often, the people running the lab are inexperienced and do not fully understand the consequences of what they are doing. The operations are sloppy, with dangerous consequences. The

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leaders are usually addicts who can go without sleep for days at a time, and are often scared, violent, or even delusional. The chemicals that are used in the production of meth are extremely hazardous. Some of the chemicals used are highly volatile and may ignite or explode if mixed or stored improperly. These include highly flammable ether, acetone, red phosphorous, caustic sodium hydroxide, cancer-causing chloroform, and the extremely poisonous chemicals mercuric chloride, phosphane gas, hydrochloric acid, sulfuric acid, iodine gas, and cyanide gas. There is always a significant risk of a fire and explosion in the meth lab. This poses risks not only to the individuals who are producing the drug but also to anyone else in the house or in the surrounding area. This can be children, neighbors, and people simply passing by. Meth labs have been known to blow up, killing those inside. Those exposed to the toxic chemicals that are needed to produce the meth also risk multiple health risks, including intoxication, dizziness, nausea, disorientation, lack of coordination, pulmonary edema, serious respiratory problems, severe chemical burns, shortness of breath, cough, chest pain, and damage to internal organs. When a meth lab is found in a home, it can cost thousands of dollars to clean it, depending on the size of the lab and the extent of the damage. Despite efforts to eliminate the chemicals, they are extremely difficult, if not impossible, to remove completely. Currently, no federal rules require sellers or their agents to disclose a home’s meth history. Instead, any disclosure regulations are made by individual states and vary dramatically. Residing within a former meth house or meth lab location can pose serious risks to those who live there. The home’s surfaces, insulation, and carpeting may be steeped in poisonous sub-

stances. Home cooking meth spreads toxins to every inch of the room where the meth was cooked. Some contamination experts worry that even if a meth house is cleaned properly the toxins may not dissipate. Residing within a home with the presence of meth toxins may cause short-term health problems that range from migraines and respiratory difficulties to skin irritation and burns. Although the longterm health problems are not yet known, exposure to the chemicals used to produce methamphetamine may cause cancer in humans. Children are especially susceptible to all of these risks. Children of meth lab operators are especially at risk, because they inhale the toxic fumes in high amounts. These chemicals can damage the brain, liver, kidneys, lungs, and eyes. They can also cause learning disabilities, and emotional and behavioral problems in the children. Cleaning up a meth lab can be very complicated. Law enforcement personnel are usually present when a lab is dismantled, as they need to arrest any defendants who may be there when the lab is discovered. Law enforcement must also collect evidence and prepare it for a possible court hearing. In addition, fire department personnel must be present when a meth lab is dismantled in case of an explosion or fire. It is also important to have EMS personnel present in case someone gets hurt. The cleanup is made more complicated because federal funding for meth lab cleanup was cut in 2011. This means that states must pay for the majority of the costs. In some cases, the costs can be partly covered by seizing the assets of the offenders. This is uncommon, though, because most addicts have nothing to seize. They spend all of their money to buy drugs or for chemicals for the meth lab. Nancy E. Marion

Methadone  597 See also: Comprehensive Methamphetamine Control Act; Ephedrine and Pseudoephedrine; Methamphetamine

Further Reading Christie, Les. 2013. “How to Spot a Meth Lab.” CNN Money, February 12. http://money .cnn.com/2013/02/12/real_estate/meth-lab -house/index.html. Easter, Michael Glenn. 2010. “Are You Living in a Former Meth Lab?” Scientific American, April 29. http://www.scientificamerican .com/article.cfm?id=former-meth-lab. Gahlinger, Paul M. 2004. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse. New York: Plume. U.S. Department of Justice, National Drug Intelligence Center. 2004. “Methamphetamine Laboratory Identification and Hazards: Fast Facts.” NDIC Product No. 2004-L0559-001.

Methadone Methadone, a synthetic narcotic first developed to address a morphine shortage during World War II, has similar effects as morphine. Methadone has been shown to be an effective treatment for people addicted to opiates, particularly heroin, by binding to the brain’s opioid receptors. First introduced into the United States in 1947 as a pain reliever, methadone today is primarily associated with addictions treatment. It is a Schedule II drug in oral, tablet, or injectable formulations under the Controlled Substances Act. Methadone can produce a physical dependence, but since it does not provide the euphoric rush of other opiates, people treated with the drug do not engage in the uncontrolled and compulsive drug-seeking behaviors associated with opiate addiction.

When methadone is administered daily under carefully controlled conditions, it does not impair emotional, cognitive, or motor functioning, so addicts can engage in normal activities such as attending school, driving a car, or keeping a job. By suppressing cravings and eliminating withdrawal symptoms, more stabilized addicts are thus able to change their behavior and transform their lifestyle in ways that will sustain recovery. Methadone can be taken orally as a pill, or as a liquid. Users sometimes inject the drug into the bloodstream. The typical user takes 15 to 30 milligrams a day. For decades, federal regulations and state laws have governed the clinics and hospitals that manage methadone programs, which currently treat 150,000 to 200,000 estimated heroin addicts, but in 1999 proposals were made to give individual physicians greater latitude in prescribing methadone. This could help make the treatment more accessible to an estimated half a million additional heroin addicts, although the Drug Enforcement Administration would continue to oversee the drug’s distribution. Methadone is sometimes used to relieve severe and chronic pain in cancer patients. Like any other opiate, methadone can cause health problems if it is abused, but under medical supervision it is considered a safe drug, especially in view of the alternative. At proper dosages, it can produce minor symptoms like drowsiness, excessive sweating, and constipation, but these symptoms usually subside as the body adjusts to the drug. In terms of the cost, statistics show that methadone maintenance programs, at about $13 per addict per day, produce significant savings over incarceration or other control measures. Additional economies are realized by preventing the spread of diseases

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like HIV/AIDS, tuberculosis, and hepatitis through the use of infected needles. Kathryn H. Hollen See also: Controlled Substances Act; Drug Enforcement Administration; Heroin; Methadone Treatment Programs; Morphine; Treatment

Further Reading Califano, Joseph A., Jr. High Society: How Substance Abuse Ravages America and What to Do about It. 2007. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. U.S. Department of Health and Human Ser­ vices, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Methadone Treatment Programs Dr. Vincent P. Dole and Marie Nyswander together developed methadone maintenance treatment at Rockefeller University in the 1960s. These programs involve the substitution of the drug methadone, a synthetic

narcotic, for heroin. The addict must take the methadone once a day. After the drug is ingested, it is distributed in the body to the body tissues where it is stored and then released into the plasma. Because the drug is stored and released as needed, the user is comfortable and free from cravings or other symptoms, for a long period of time. While a person does not get the “high” associated with heroin use, they do not have the intense cravings. This makes it possible for addicts on methadone programs to be better able to tolerate withdrawal from their addiction to heroin. In the long run, it is hoped that the heroin addict will then eventually become free of heroin dependency. In most places, a person on a methadone maintenance program will be required to make daily visits to a clinic or office to receive the methadone. The addict is usually only given one dose at a time in order to prevent abuse of the drug. Some places also require a person on methadone maintenance to attend counseling at the same time. After a few months of daily clinic visits, a patient may receive permission to receive multiple doses of the drug, eliminating the requirement that they visit the clinic each day. This approach in drug treatment has been highly controversial from its start. There are many critics of methadone maintenance programs, for the following reasons: • A patient can develop psychological and physical dependency on methadone, meaning that a patient merely replaces one addiction with another. In this sense, methadone maintenance is just a drug replacement option. • Abusers will simply add methadone to their other addictions. • Abusers will sell the drug to make money to buy other drugs, making

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more drugs available on the black market. • Someone can be on methadone indefinitely, which could cost the government thousands of dollars each year. • There is a decreased rate of mortality by those in methadone treatment programs versus those on heroin. Supporters, on the other hand, say the opposite: that methadone maintenance programs are effective. They argue: • Methadone helps to stabilize the addict’s condition, allowing him or her to relieve the craving for heroin in a safe, legal environment where he or she can have access to rehabilitative services and even overcome the addiction. • Since most people on methadone maintenance take the drug orally, it may reduce sharing of needles and thus the transmission of AIDS or hepatitis. • The programs help addicts become able to live a normal life, maintain a job, and take care of their family and children. • Maintenance programs help to reduce crime because the users will not have the cravings to use heroin. Since the methadone is often injected by the user, clean needles are needed. If the user takes too much methadone, they can have trouble breathing, which can cause death. In May 2001, the U.S Department of Health and Human Services implemented new methods for regulating and monitoring methadone maintenance programs. Under the new regulations, the responsibility for oversight of the programs would be held in the Center for Substance Abuse Treatment,

found within the Substance Abuse and Mental Health Services Administration. Methadone programs will need to be accredited by independent organizations and states. Programs will still emphasize quality of care for their patients, but at the same time will emphasize community concerns about diversion of methadone. The goal of the reorganization is to improve patient care, increase the access to treatment programs, individualize treatment programs in terms of doses and length of treatment, and improving oversight of programs. Nancy E. Marion See also: Dole, Vincent; Heroin; Nyswander, Marie; Synthetic Drugs; Treatment

Further Reading Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. O’Brien, Robert, and Sidney Cohen. 1992. The Encyclopedia of Drug Abuse. New York: Facts on File. Yates, Rowdy, and Margaret S. Malloch. 2010. Tackling Addiction: Pathways to Recovery. Philadelphia: Jessica Kingsley Publishers.

Methamphetamine Methamphetamine belongs to the phenethylamine family, a class of stimulant and hallucinogenic chemicals. It is a powerfully addicting drug that has brought devastation and heartbreak to many U.S. communities and other areas of the world. Next to alcohol and marijuana, it is the most frequently abused drug in the western United States, but it is rapidly moving east as increasing numbers of drug trafficking organizations open up new smuggling routes. Synthesized in laboratories, methamphetamine was diverted from pharmaceu-

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A member of the Southwest Virginia Clan­ destine Lab Team gathers evidence at a methamphetamine lab in Virginia in 2004. Because the interaction of the chemicals used to make meth can be toxic, the official must wear a hazardous materials (hazmat) suit. (AP Photo/Rain Smith)

tical purposes in the 1960s and 1970s to make the rounds of college campuses as a recreational drug, which is any legal or illegal psychoactive drug that is used for recreational purposes. It was popular because it increased alertness, social extroversion, and concentration. However, its highly addictive qualities frightened off many users, and when the Drug Enforcement Administration placed it on Schedule II under the Controlled Substances Act, its use as a recreational drug dropped. It continued to be prescribed for certain conditions—such as the sleep disorder narcolepsy—and resurged again as a recreational drug in the 1980s as homegrown labs began manufacturing the drug

cheaply with easily obtained ingredients. In an effort to reduce the number of clandestine labs synthesizing the drug, federal legislation was enacted to restrict the accessibility and sale of the precursor chemicals that go into its production. These chemicals include ephedrine and pseudoephedrine, the active ingredient in many decongestants and cold medications. Tighter controls on access to these ingredients appear to have driven methamphetamine production into Mexico where larger organized groups of criminal drug traffickers are developing sophisticated manufacturing and smuggling operations. The Mexican drug trafficking groups produce meth on an industrial scale, preparing tons at a time in “super labs.” Unlike other stimulants such as cocaine, methamphetamine produces a long-lasting high that can last up to eight hours. After the immediate and profuse outpouring of dopamine that is produced by an initial dose of the illegal stimulant, the neurotransmitter remains active because methamphetamine also inhibits its reabsorption back into the neurons. This extended effect accounts for some of the popularity of the drug, but it is also one of the reasons it is so destructive. Extremely high levels of dopamine have been shown to damage the dopamine cells themselves and lead to symptoms similar to those seen in Parkinson’s disease. If the user is able to achieve long-term abstinence, some of these symptoms may be reversed, but in most cases they are permanent. The drug is available in several forms and can be injected, smoked, or snorted. “Crystal” or “ice” is a powerfully addicting form that can be diluted and injected, or rocks can be smoked to achieve a more intense rush. A Thai version of meth called “ya ba” (or “yaba”) is sold in a pill form that can be ingested or crushed and snorted. Taking the drug orally results in a less intense

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but more sustained reaction that lasts for several hours. In small amounts, meth produces wakefulness, gregariousness, heig­ htened physical activity, and sense of well-being, but the drug is so addicting that users quickly develop a chemical and psychological dependence and rapidly escalate use. As the high dissipates and the inevitable crash begins, users dose again and again to avoid the depression and anxiety associated with coming down off a high. This sets up a cycle of binge and crash that in some cases will continue for several days, during which the user does not eat or sleep. Such an episode is referred to as a “run” and may result in “tweaking,” a meth-induced psychosis that is characterized by auditory and visual hallucinations, extreme anxiety, irritability, paranoia, and a capacity for sudden violence. So severe are the symptoms that law enforcement personnel who must approach people they suspect of tweaking are advised to do so with extreme caution and with backup personnel. Over half of all meth users are said to tweak. Typically methamphetamine is made in a lab, where chemicals are mixed and cooked. A new method for making meth is referred to as “shake and bake.” This is also made from pseudoephedrine found in overthe-counter cold remedies, which is ground into a powder. It is then mixed with ingredients that are easily available in stores such as camping fuel, lithium, and lye (crystal drain opener). The ingredients are poured into an empty soda bottle and shaken by hand for a period of between one and five hours. The ingredients are converted to meth in a toxic chemical reaction that is highly explosive since lithium explodes when it comes into contact with water. As the mixture reacts, deadly ammonia gas builds up in the bottle and must be released. If not, the bottle will explode. In the last

stage of the process, the meth is separated from the liquid. Chronic long-term use of methamphetamine can be more ruinous than alcoholism or an addiction to opiates. Aside from hallucinations, paranoia, obsessive picking of the skin, bizarre or violent behavior, and potentially irreversible damage to the brain’s neurons that chronic methamphetamine use causes, its detrimental impact on others can be devastating. Methamphetamine addicts neglect their responsibilities, jobs, even their children, for days at a time, in effect abandoning them. They are likely to engage in risky sexual behavior, share dirty needles, and participate in other dangerous activities. The drug’s effects on cardiac rhythm and blood pressure can lead to heart attacks and stroke. A common symptom is “meth mouth” caused by the chemicals wearing away the enamel on the teeth. The drugs cause the user’s gums and salivary glands to dry up, causing the teeth to rot and decay. Although withdrawal from methamphetamines does not produce noticeable physical symptoms, the craving for the drug and the psychological crash are intense, and unseen but persistent changes in the brain are profound. Because of these lingering effects, many therapists believe that a standard inpatient four-week rehabilitation period might not be long enough. They suggest that it could take a good deal longer before meth addicts are psychologically prepared for outpatient treatment. There are, to date, no medications available to treat addiction to methamphetamines. Although it is particularly difficult to recover from a meth addiction, carefully tailored behavioral therapy, positive reinforcement, and drug testing to ensure and maintain compliance can be successful. The National Institute on Drug Abuse is actively pursuing

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research based on an immunization strategy for methamphetamine overdose. Statistics show that almost 5 percent of the population over 12 years old has tried methamphetamine at least once, and that most users are Caucasians in their 20s and 30s with a high school education or better. They are almost equally divided by gender with a broad variety of occupations. Fortunately, use among high school students has declined since 2001, but the World Health Organization estimates that there are 35 million methamphetamine users worldwide, compared to 15 million cocaine and 7 million heroin users. In the United States, meth addiction is at epidemic levels in many states, and drug enforcement officials, in virtual panic over its rapid spread into other areas of the country, say it is the number one drug problem. Some localities claim that 100 percent of the crime in their areas is directly related to methamphetamine. Methamphetamine addicts are very likely to relapse a few times because of the drug’s high addictive liability and the intense psychological craving users suffer during withdrawal. The matrix model, a cognitive behavioral technique using family therapy, positive reinforcement, and behavioral conditioning, has shown some promise in this area. In part, the therapy teaches recovering addicts to avoid drug cues and to learn to channel their habitual reaction to negative feelings like anger or disappointment in a more positive direction. In time, this builds new and healthier patterns of behavior. Rewards for clean urine tests in the form of tangible goods like cash seem helpful in keeping addicts abstinent. Because the dopamine system of a meth addict is depleted, treatment with the Parkinson’s disease medication levodopa (L-dopa) has also shown some benefit, although its effects diminish over time.

The enormous costs to society that meth addiction imposes are also environmental; every pound of methamphetamine that is manufactured produces about 6 pounds of toxic waste that is usually dumped into fields and streams across the United States and finds its way into the food and water supply. Street names for methamphetamine include bikers coffee, black beauties, chalk, chicken feed, crank, crystal, crystal (or krystal) meth, gak, glass, go-fast, ice, lith, methlies quick, poor man’s cocaine, shabu, speed, Stove Top, Tina, tweak, uppers, yaba, and yellow bam. Kathryn H. Hollen See also: Meth Labs; Over-the-Counter Drugs; Stimulants; Drug Typologies

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Sheff, David. Beautiful Boy: A Father’s Journey Through His Son’s Addiction. 2008. Boston: Houghton Mifflin. Sheff, Nicholas. Tweak: Growing Up on Amphetamines. 2007. New York: Atheneum Books. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006. Research Report Series: Metham-

Mexican Drug Trade  phetamine Abuse and Addiction. NIH Publication No. 06-4210. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Mexican Drug Trade Drug trafficking organizations have operated in Mexico for more than a century. Mexican drug trafficking organizations act like major wholesalers of illicit drugs throughout the United States. They are quickly gaining control of drug distribution throughout the United States through alliances with U.S. gangs and criminal organizations. The drug trafficking organizations often bribe officials and use violence (or threats thereof) to maintain their control and power over the industry. Violence is often used as a form of punishment to enforce rules, to enforce transactions, limit the entry of competitors, and force people to do what they want. Violence, alongside bribery and corruption, are used to neutralize government action (particularly law enforcement action) against the drug trafficking organizations, ensure impunity, and facilitate smooth operations. The proceeds of drug sales are either laundered or smuggled back to Mexico where the money is used to pay off border officials, law enforcement, security forces, and public officials to either ignore drug trafficking activities or to actively support and protect them. In the early 20th century, Mexico was the source of marijuana and heroin being smuggled into the United States, and by the 1940s, Mexican drug smugglers were well-known to law enforcement and users. The growth of Mexico’s drug trafficking organizations occurred when there was a one-party rule

in Mexico (the Institutional Revolutionary Party or PRI), which governed for a period of 71 years. According to most people, the PRI accommodated the smugglers. While there were drug arrests and crop eradication programs, the widespread corruption of government officials and police resulted in a quid-pro-quo relationship between Mexican authorities and the drug lords through the 1990s. The stable relationships began to change in the 1990s as the political power in Mexico became more decentralized and there was a push toward democratic pluralism. When the National Action Party (PAN) candidate Vicente Fox won the presidency in 2000, things really began to change. During the 1980s and 1990s, Colombian drug trafficking cartels, which once specialized in providing cocaine, were being broken up. The highly profitable cocaine trade was slowly taken over by Mexican smugglers. The traditional trafficking route that relied on stops in the Caribbean to refuel was shut down by the U.S. government. As Colombian drug trafficking organizations lost this route, they smuggled cocaine that was produced in the Andean region to the Mexican drug trafficking organizations, who they paid in cocaine rather than cash. The Mexican organizations slowly but completely took over the cocaine trafficking business from the Colombians, and they advanced from being drug couriers for the Colombians to being the wholesalers who provided the drug. Today the major Mexican drug trafficking organizations smuggle more than one type of drug. Some specialize in the production of the drug, while others focus more on the trafficking of products. Drug cartels in Mexico have become major producers and suppliers of heroin, methamphetamine, and marijuana to the U.S. market. They are also the principal transit country for cocaine sold in the United States. The west coast state of Sinaloa

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has a long coastline and difficult-to-access areas that are favorable for drug cultivation. This has become the crux of Mexico’s drug trade. Marijuana and poppy cultivation has flourished in this state for decades. According to the U.S State Department’s 2013 International Narcotics Control Strategy Report (2013 INCSR), more than 90 percent of the cocaine that is seized in the United States has come through the Central America/Mexico corridor. In 2011–2012, Mexico seized less than 2 percent of the cocaine that is estimated to traverse the country according to the 2013 INCSR. For 2012, the amount seized was roughly three metric tons. Cultivation of opium poppy (from which heroin is derived) and marijuana doubled in Mexico between 2006 and 2011. The U.S. government estimates that Mexico provides about 7 percent of the world’s supply of heroin, with most of its supply going to the United States although domestic consumption of heroin inside Mexico has increased. Production of methamphetamine is also believed to be climbing, as suggested by the high number of meth laboratories that are destroyed each year by Mexican forces. According to the 2013 INCSR, Mexican authorities seized 267 meth laboratories in 2012, up from 227 in 2011.

Mexico’s Major Drug Trafficking Organizations The drug trafficking organizations of Mexico have changed in recent years. In December, 2006, when President Calderón came into office, there were four dominant drug trafficking organizations: the Tijuana/Arellano Felix organization (AFO), the Sinaloa cartel, the Juárez/Vicente Carillo Fuentes organization (CFO), and the Gulf cartel. Since then, these four groups have split into many smaller organizations. For a time, according to the U.S. Drug Enforcement Administration (DEA), seven organizations were

dominant. Those included Sinaloa, Los Zetas, Tijuana/AFO, Juárez/CFO, Beltrán Leyva, Gulf, and La Familia Michoacana. However, many analysts suggest that those seven now seem to have fragmented to between 9 and as many as 20 major organizations. Today, two large “national” drug trafficking organizations—Sinaloa and Los Zetas—appear to be preeminent. But the diversification into other crime, the ephemeral prominence of some new gangs and DTOs, and shifting alliances make it difficult to portray the DTO landscape.

Violence of the Mexican Drug Trade As the drug trafficking organizations have split apart, they have fought each other for control of the trafficking routes. The amount of violence within groups and between groups has spiked. Sometimes, different cartels will fight each other to dominate trafficking routes. But violence within a group has also become more fierce as factions within the organization fight among themselves to replace a leader who has been killed or imprisoned. The groups have responded to law enforcement efforts to stop drug trafficking with violence. Gun battles between government forces and the criminal cartels happen regularly. The violence caused by drug trafficking in Mexico has been brutal and widespread. Since 2010 the violence has expanded considerably to new areas. The violence is concentrated along drug trafficking routes and in the northern border-states in Mexico. According to an analysis completed by the University of San Diego’s Trans-Border Institute, at the end of 2011, 84 percent of Mexico’s municipalities have been affected in some way by organized crime violence (with only 16 percent violence-free) and over time violence has spread to a larger number of municipalities. The Calderón government released data on homicides in Mexico linked to organized crime in January 2011 and

Mexican Drug Trade 

January 2012. In these two releases, the government reported that between December 2006 and September 2011 more than 47,500 killings were organized crime–related homicides. All reports released have shown the violence rising sharply since early 2007 and spreading to new parts of Mexico. Mexico’s brutal drug trafficking–related violence has been dramatic. There have been over 1,300 beheadings, public hanging of corpses, killing of innocent bystanders, car bombs, torture, and assassination of numerous journalists and government officials. The violence has spread deep into Mexico. Organized crime groups rely on extortion, kidnapping, auto theft, human smuggling, resource theft, and other illicit enterprises in addition to drug smuggling. In March 2012, the head of the U.S. Northern Command, General Charles Jacoby, testified to the Senate Armed Services Committee that Mexico had succeeded in capturing or killing 22 out of 37 of the Mexican government’s most wanted drug traffickers. General Jacoby noted that their removal had not had “any appreciable positive effect” in reducing the violence, which continued to climb in 2011.

Law Enforcement and the Mexican Drug Trade The U.S. Drug Enforcement Administration (DEA) has operated in Mexico since the mid-1970s. Currently, the DEA has offices in Mexico City, Guadalajara, Hermosillo, Ciudad Juárez, Matamoros, Mazatlán, Mérida, Monterrey, Nogales, Nuevo Laredo, and Tijuana. The DEA’s agents play an advisory role, but they also train law enforcement units. They also provide Mexican law enforcement agents with intelligence that will help bring down Mexican drug kingpins. In 2006, former Mexican president Felipe Calderón, with the help of the United

States, launched a massive crackdown against drug trafficking organizations. Since then, over 40,000 people have been killed in drug-related violence. The United States has supplied funding and personnel to increase Mexico’s ability to handle violence associated with drug trafficking. The focus of the U.S. involvement has been on cross-border policing and targeting of U.S. drug users. In order to improve intelligence sharing and increase U.S. support for Mexico’s fight against drug trafficking organizations, the United States in 2011 deployed unmanned aerial vehicles to gather intelligence on the activities of these organizations. They have also opened a compound, staffed by agents from the DEA, the CIA, and civilians from the Pentagon’s Northern Command, to gather intelligence in northern Mexico. Nancy E. Marion See also: Camarena Salazar, Enrique; Gulf Cartel; Juárez Cartel

Further Reading Bauder, Julia. 2008. Drug Trafficking. Detroit: Greenhaven Press. Beittel, June S. 2013. “Mexico’s Drug Trafficking Organizations: Source and Scope of the Violence.” Congressional Research Service, 1–50. Bewley-Taylor, David R. 2012. International Drug Control: Consensus Fractured. New York: Cambridge University Press. Leger, Donna Leinwand. 2013. “U.S. Cracks Down on Mexican Drug Trafficker’s Family.” USA Today, June 12. http://www.usato day.com/story/news/world/2013/06/12/ us-freeze-drug-kingpin-assets/2416191/. Steinberg, Michael K., Joseph J. Hobbs, and Kent Mathewson. 2004. Dangerous Harvest: Drug Plants and the Transformation of Indigenous Landscapes. New York: Oxford University Press.

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Military and Drug Use Members of the armed forces are not immune to the substance use problems that affect the rest of society. Although illicit drug use is lower among U.S. military personnel than among civilians, members of the military tend to abuse alcohol and tobacco frequently. In recent years, prescription drug abuse is increasing among military members. The abuse of drugs may be related to the stresses of deployment during wartime and the unique culture found in the military. Those with multiple deployments and combat exposure seem to be at a higher risk of using drugs and developing substance abuse problems. These personnel are more likely to participate in heavy binge drinking and participate in drug use. They are also more likely to begin smoking or using tobacco, or to relapse into such behaviors. The zero-tolerance policies adopted by military officials and the stigma associated with drug abuse pose difficulties in identifying those with substance abuse problems and providing them with treatment options. Many military personnel are deterred from seeking treatment when needed. According to the 2008 Department of Defense (DoD) Survey of Health Related Behaviors among Active Duty Military Personnel, about 2.3 percent of military personnel used illicit drugs in the month prior to the survey, compared with 12 percent of civilians. Among those age 18–25, the rate of use among military personnel was 3.9 percent, compared with 17.2 percent among civilians. These results could be influenced by the zero tolerance policy for drug use adopted by DoD personnel. Adopted in 1982, the policy is enforced by frequent random drug testing of military personnel. Those service members found to be using drugs face dishonorable discharge and even

criminal prosecution. This policy may also make personnel reluctant to self-report their drug use. However, prescription drug use is increasing and is even higher among service members than among civilians. In 2008, about 11 percent of service members reported abusing prescription drugs, a figure that was an increase of 2 percent from 2002, and an increase of 4 percent since 2005. Most of the prescription drugs misused by service members are opioid pain medications. The increased numbers may be because these drugs are more readily available than in the past. More prescriptions for these drugs written by doctors may be contributing to their misuse by service members. In fact, prescriptions for pain relievers quadrupled between 2001 and 2009. There are now about 3.8 million prescriptions written each year for pain relievers. This could be because of an increase in combat-related injuries and the strains from carrying heavy equipment during multiple deployments. Alcohol use is also higher among military personnel than among nonmilitary. Almost half of military service members (47 percent) reported that they participated in binge drinking in 2008, a figure that was up from 35 percent in 1998. That year, about 20 percent of military personnel reported binge drinking every week. When those who had combat exposure were asked that question, the rate was even higher—about 27 percent. Military members also tend to be heavy tobacco users. In 2008, around 30 percent of all service members used cigarettes regularly. For civilians, that percent was about the same (29 percent). The smoking rates for those who have been exposed to combat are significantly higher. A report was written in 2012 by the Institute of Medicine for the DoD that included

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recommendations to address the problems of substance use by military personnel. Some of these recommendations were to increase the use of evidence-based prevention and treatment programs and expand access to care. The report also recommended broadening insurance coverage to include more effective outpatient treatments and better equipping healthcare providers to recognize and screen for substance use problems. This way, they could refer patients to appropriate treatment. The report also included recommendations for preventative measures such as limiting access to alcohol on military bases. Another interesting point made in the report was a recommendation that the military increase the confidentiality policies for those who suffer from abuse, making it easier to seek help if needed. The report also suggested a change in the cultural climate found in the military in which drug problems are stigmatized. Some branches of the military have implemented new policies to address abuse of prescription drugs by military personnel members. The Army made changes that would limit the duration of prescriptions for opioid pain relievers to six months and have a pharmacist monitor a soldier’s medications when multiple prescriptions are being used. NIDA and other government agencies are currently funding research to better understand the causes of drug abuse and other mental health problems among military personnel, veterans, and their families and how best to prevent and treat them. Nancy E. Marion See also: Alcohol Use; Prescription Drugs

Further Reading DrugAbuse.gov. 2013. “Drug Facts: Substance Abuse in the Military.” http://www .drugabuse.gov/publications/drugfacts/ substance-abuse-in-military.

Minnesota Model Developed during the late 1940s and 1950s by therapists at a Minnesota state hospital, the Minnesota model is an addiction treatment method based on the principles of Alcoholics Anonymous (AA). It is a multidisciplinary approach that brings professionals and nonprofessionals into the treatment program to educate patients about the disease and offer intensive counseling, group therapy, and guidance in lifestyle and behavioral issues. In the 1950s, the model was adopted by the Hazelden Foundation, a prestigious addiction treatment facility, and it has since become a treatment standard worldwide. Originally structured as a 28-day inpatient treatment program that required follow-up membership in AA or other 12-step programs, the Minnesota model has evolved to meet the realities of a managed care economy; the length of inpatient stays has become more flexible and outpatient treatment is now frequently offered. Nevertheless, the core principles of the Minnesota model have remained unchanged. They reflect the firm belief that alcoholism and drug addiction are diseases that destroy the whole person— physically, mentally, and spiritually. Individualized treatment programs developed by professional and nonprofessional counselors help the addict address the different dimensions of his illness. Total abstinence, inclusion of the family in the treatment plan, and continued care after discharge are core elements of the model.

Principles of the Minnesota Model Several fundamental principles are the basis of the Minnesota model treatment approach. Although originally developed to treat alcoholism, they apply to all forms of chemical dependence.

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  1. Alcoholism is an involuntary, primary disease that is diagnosable.  2. Because it is a progressive, chronic disease, untreated alcoholism will worsen without treatment.   3. Although it cannot be cured, alcoholism can be arrested.   4. Treatment outcome cannot necessarily be predicted by the alcoholic’s motivations for seeking treatment.   5. Successful alcoholism treatment must address physical, psychological, social, and spiritual dimensions.  6. Alcoholics should be treated with respect and dignity in a supportive environment if treatment is to succeed.   7. Alcoholics and other addicts are vulnerable to the abuse of other drugs; treatment for these addictions can be addressed as chemical dependence.  8. Alcoholism and chemical depen­ dency are best treated with a multidisciplinary approach and individualized treatment plans.  9. A primary counselor, usually a recovering addict, is the best person to organize and implement an addict’s treatment plan. 10. Recommended treatment combines 12-step work such as that found in AA, lectures, and individualized counseling. 11. The best follow-up group support structure for recovering addicts is AA. The Minnesota model, which banished earlier methods of treatment such as punitive incarceration or commitment to insane asylums, represented a compassionate revolution in how society addressed addiction. Although it is still incorporated into many treatment programs today, cognitive behav-

ioral therapy and newer medications that treat the cravings and symptoms of addiction are supplementing this form of treatment or, in some cases, replacing it. Kathryn H. Hollen See also: Addiction; Alcoholics Anonymous; Twelve-Step Programs

Further Reading Spicer, Jerry. 1993. The Minnesota Model: The Evolution of the Multidisciplinary Approach to Addiction Recovery. Center City, MN: Hazelden Foundation. Yates, Rowdy, and Margaret S. Malloch. 2010. Tackling Addiction: Pathways to Recovery. Philadelphia: Jessica Kingsley Publishers.

Minorities and Drug Use Minority groups have been disproportionately affected by the drug control policies of the last 30 years. Although the rates of drug use and selling are comparable across all races, statistics show that people of color are far more likely to be stopped by police, searched, arrested, prosecuted, convicted, and incarcerated for drug law violations than are white Americans. African Americans and Latinos also have higher arrest and incarceration rates. Experts are quick to point out that these increased arrest rates do not necessarily reflect an increased prevalence of drug use or sales in these communities, but rather are due to discretionary law enforcement focus on urban areas, on lower-income communities, and on communities of color as well as inequitable treatment by the criminal justice system. The War on Drugs, started by the Reagan and Bush administrations, lead to vast increases of arrests and imprisonment of

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street-level drug dealers and harsher penalties for drug users and sellers. Policies toward drug offenders have disproportionately affected minority groups (Tonry 1994). “In the long term, disparities in jail and prison are mainly the result of differences in offending patterns. In the shorter term, the worsening disparities since 1980 are not primarily the result of differences in offending but were foreseeable effects of the War on Drugs and the movement toward increased use of incarceration” (Tonry 1994, 480). Up-todate evidence indicates that “African-Americans are no more likely to use or sell drugs than whites; thus, racial differences in the extent of drug offending cannot explain disparities” (Mitchell 2009, 49). Rather, “disparities in arrest and incarceration are better explained by the combination of policy to focus on low-level drug offenders, racial differences in the nature of drug offending, and the discretionary decisions of criminal justice officials, which appear to be affected by racial stereotypes” (Mitchell 2009, 49). Nancy E. Marion

Further Reading Drug Policy.org. “Race and the Drug War.” http://www.drugpolicy.org/race-and-drug -war. Mitchell, Ojmarrh. 2009. “Is the War on Drugs Racially Biased?” Journal of Crime and Justice 32(2): 49–75. Tonry, Michael. 1994. “Racial Politics, Racial Disparities, and the War on Crime.” Crime and Delinquency 40(4): 475–94.

Moncrieffe v. Holder (2013) In Moncrieffe v. Holder, the Supreme Court acted to ease immigration law as it related to

marijuana. Under the Immigration and Nationality Act (INA), a noncitizen convicted of aggravated felony is deportable. According to the INA, an aggravated felony includes the distribution or trafficking of illicit drugs. The Supreme Court ruled in Mon­ crieffe v. Holder that sharing of marijuana in small quantities by legal immigrants did not constitute an aggravated felony.

Background of the Case Since the 1980s, the U.S. government has repeatedly amended immigration laws. Some of the amendments have made it easier to facilitate the deportation of illegal residents of the United States who have been convicted of drug-related offences. One way Congress has done this was to expand the definition of an “aggravated felony” to include minor crimes that are either aggravated or a felony. On the other hand, the executive branch has pursued immigrants, both legal and illegal, for minor offenses such as the possession of small amounts of a controlled substance. The current Obama administration has annually set removal records of about 400,000 immigrants deported from the United States. This case involved Adrian Moncrieffe as the petitioner and Eric Holder, the U.S. attorney general, as the defendant. Moncrieffe, a Jamaican, arrived in the United States in 1984 when he was just three years of age with his parents. Since then, he has lived in Georgia and lived a normal, productive American life where he worked as a home care giver. He later got married and started a family of his own. He and his wife had two children. In 2007, Moncrieffe was stopped by the police for a traffic offense in Georgia, and was found with 1.3 grams of marijuana (equivalent to two to three cigarettes) in his car. He was charged and pleaded guilty as a first-time offender in a Georgia court to

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the possession of drugs and the intention to distribute the drug under Georgia’s criminal code. He was not sentenced to spend any time in jail, but was given five years of probation by the judge. Unfortunately for Moncrieffe, the U.S. Department of Homeland Security became involved in the case and brought proceedings for Moncrieff’s deportation, citing the INA. Under this law, Moncrieffe’s guilty plea and conviction in Georgia’s State Court for possession and intent to distribute marijuana was considered an aggravated felony under the Controlled Substance Act (CSA). Because Moncrieffe was guilty of an aggravated felony, he could thus be deported back to Jamaica. Moncrieffe appealed the deportation decision to the Board of Immigration Appeals and the United States Court of Appeals for the Fifth Circuit. Both courts denied his appeal. As a last resort, Moncrieffe filed a petition with the U.S. Supreme Court for writ of certiorari (a motion to ask the Supreme Court to review the case). The Supreme Court agreed to hear the case. The question in the case became: does conviction under a provision of state law for distribution of a small amount of marijuana constitute an aggravated felony, regardless of whether the conduct would constitute a federal felony? The Supreme Court favored Moncrieffe’s arguments. The justices argued that under federal law, the handling and social exchange of illicit drugs without any payment or exchange of money did not constitute an aggravated felony, but instead was a misdemeanor offense that did not require the defendant’s deportation. They cited the small amount of marijuana that Moncrieffe possessed (1.3 grams). The Supreme Court also rejected the government’s argument that this would make it easy for drug distributors to evade being deported. The Supreme Court noted that those

convicted with distributing larger amount of drugs are likely to face enhanced charges in the United States, and administrative bodies would always have the discretion to decide if deportation was the best choice of action. In short, the court concluded if a noncitizen’s conviction for a marijuana distribution offense fails to establish that the offense involved either remuneration or more than a small amount of marijuana, it is not an aggravated felony under the INA. It should be noted that the court explained that if a defendant was not charged with felony charges, it did not mean the person has automatically escaped deportation efforts. It only means that they have avoided mandatory deportation and retain the opportunity to appeal to the attorney general for leniency to remain in the United States. In answering this question, Justice Sonia Sotomayor wrote the majority conviction. She wrote that a conviction under a state law for the distribution of a small amount of marijuana does not necessarily constitute an aggravated felony. She continued the state law must be compared to the federal statute. In this case, the Controlled Substance Act (CSA) did not have provisions for conviction of the possession of marijuana as both a felony and a misdemeanor. Thus, it was easy to determine if the Georgia statute would be considered a felony or misdemeanor. This meant that it was difficult to tell if Moncrieffe’s case under the Georgia state statute would count as an aggravated felony. Because it was unclear, the Supreme Court ruled that if a foreigner is charged and convicted for possession of marijuana, and such conviction fails to determine the quantity or if remuneration is involved, then such cannot qualify as a case of aggravated felony. Justice Clarence Thomas wrote a dissenting opinion to Justice Sotomayor. He argued that because Moncrieffe was punished under

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the Georgia state statute as a felony, it should be considered by the Supreme Court as an aggravated felony. He also argued that the decision of the majority of the Court would allow for state felonies to be treated and seen as federal misdemeanors. Justice Samuel A. Alito Jr. also wrote a separate dissenting opinion in which he argued that the decision of the majority in the Moncrieffe case would allow for more freedom for convicted drug traffickers to remain in the United States. This ran against the interest of the government, the country, and existing precedent. Nancy E. Marion See also: Controlled Substances Act; Extradition; Marijuana

Further Reading “Case Study: Moncrieffe v. Holder.” 2013. Wash ULaw Blog, September 11. http://onlinelaw .wustl.edu/case-study -moncrieffe-v-holder/. “Moncrieffe v. Holder.” Cornell University Law School, Legal Information Institute. http:// www.law.cornell.edu/supct/cert/11–702. “Moncrieffe v. Holder.” SCOTUSblog. http:// www.scotusblog.com/case-files/cases/ moncrieffe-v-holder/. “Moncrieffe v. Holder: U.S. Supreme Court Ruling Could Have Big Immigration Impact.” Jakeman Law. http://jakemanlaw .com/moncrieffe-v-holder-u-s-supreme -court-ruling-could-have-big-immigration -impact-part-2/. Rosenbaum, Carrie L. 2013. “Supreme Court Decision in Moncrieffe Signifies a Return to Strict Application of the Categorical Approach.” ImmigrationProfBlog, Trident University, April 30. http://lawprofessors .typepad.com/immigration/2013/04/ supreme-court-decision-in-moncrieffe -signifies-a-return-to-strict-application-of -the-categorical-app.html.

Monitoring the Future Survey Monitoring the Future is a survey conducted each year of secondary school students, college students, and young adults that gathers information about the prevalence of drug use and the patterns of drug use. From the information collected, we know about the drugs that teenagers are using and how this is changing over time. Information is also collected about the lifestyles and opinions of these youth. The survey began in 1975. Changes were made in 1991 when students in eighth and 10th grade were added to the survey population. The survey asks about 50,000 students in about 400 public and private schools to complete a questionnaire. Follow-up surveys of these students are conducted to provide information about their continued drug use patterns. These follow-up surveys track respondents through the age of 55. The survey is conducted by the Institute for Social Research at the University of Michigan, in conjunction with the National Institute on Drug Abuse. The results of the survey can help policy makers respond effectively to drug use and abuse. In order to do that, however, policymakers need to have an accurate understanding of how teens are abusing drugs, what drugs they are using, and what new substances are being abused, if any. The Monitoring the Future Survey attempts to provide that information. Respondents to the survey are asked about the frequency with which they use the drugs. For example, the survey will ask “On how many occasions (if any) have you used marijuana: (a) in your lifetime? (b) during the past 12 months? (c) during the last 30 days?” Each of the three questions is answered on the same answer scale: 0, 1–2, 3–5, 6–9, 10– 19, 20–39, and 40 or more occasions.

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Respondents are then asked about the perceived risk of using a particular drug. For example, the survey asks, “How much do you think people risk harming themselves (physically or in other ways), if they . . . try marijuana once or twice?” The possible responses are “no risk,” “slight risk,” “moderate risk,” “great risk,” and “can’t say, drug unfamiliar.” The survey then seeks to investigate the attitudes of the young person related to drug use. Their disapproval of drug use is measured by questions such as, “Do you disapprove of people trying marijuana once or twice?” The possible answers are “don’t disapprove,” “disapprove,” and “strongly disapprove.” In the survey for the eighth and 10th grade students, a fourth category—“can’t say, drug unfamiliar”—is provided. More information is collected on the perceived availability of drugs is gathered. This is indicated by the question, “How difficult do you think it would be for you to get each of the following types of drugs, if you wanted some?” The possible answer categories are “probably impossible,” “very difficult,” “fairly difficult,” “fairly easy,” and “very easy.” For those respondents in the eighth and 10th grade, an additional answer—“can’t say, drug unfamiliar”—is available. The results of the 2013 Monitoring the Future survey showed that the use of any illicit drug increased by students in all three grade levels: by 1.5 percentage points in eighth grade, 1.6 percentage points in 10th grade, and 0.6 percentage points in 12th. When all three grades were combined, drug use increased by 1.3 percentage points. Most of this was due to increases in marijuana use. The use of marijuana was up by 1.1 percentage points by all three grades combined from last year. At the same time, the perceived risk of marijuana use declined sharply, as did disapproval of marijuana use.

The reported use of synthetic marijuana declined by 3.4 percentage points. The percentage of students using inhalants and the use of Vicodin for nonmedical purposes also decreased. The use of cocaine (both powder and crack cocaine), LSD, amphetamines, Ecstasy, methamphetamine, ketamine, steroids, and sedatives saw no major shifts either up or down. The use of any prescription drug taken without medical supervision remained largely the same. The percent of youth using tobacco (smoking cigarettes) fell after peaking in the midto late 1990s. This is partly due to increases in reported perceived risk and disapproval of cigarette use. Since 2000, there have been modest declines in the use of smokeless tobacco by teenagers, alongside increases in the perceived risks and disapproval of the use of these products. The drug most widely used by teenagers is alcohol. Seven of 10 students (68 percent) reported consuming alcohol by the end of high school and three of 10 have done so by eighth grade. About half (52 percent) of seniors and one eighth (12 percent) of eighth graders reported being drunk at least once. The results of the survey are limited. Those students who drop out of high school are not included in the sample used. Unfortunately, this is a population that typically has a high rate of drug use. Moreover, because the survey is self-administered, there can be issues with reporting distortions (i.e., students report more or less drug use than is accurate). This is of particular concern because the respondent’s name and address are listed on the cover sheet to enable the researchers to follow up with that respondent at a later time. Nancy E. Marion See also: Bath Salts and Synthetic Cannabis; National Household Survey on Drug Abuse;

Monroe, Marilyn (1926–1962)  613 National Institute on Drug Abuse; Public Opinion and Drug Use; Substance Abuse and Mental Health Services Administration

Further Reading Abadinsky, Howard. 2011. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Wadsworth Cengage. Johnston, Lloyd D., Patrick M. O’Malley, Richard A. Miech, Jerald G. Bachman, and John E. Schulenberg. 2013. “2013 Overview: Key Findings on Adolescent Drug Use.” Ann Arbor, MI: Institute for Social Research, University of Michigan . http://www.monitoringthefuture.org//pubs /monographs/mtf-overview2013.pdf. National Institutes of Health. 2013. “Sixty Percent of 12th Graders Do Not View Regular Marijuana Use as Harmful.” http://www .nih.gov/news/health/dec2013/nida-18.htm.

was married, Norma bounced between family members, foster homes, and orphanages. While in high school, Norma met a young man named James Dougherty, and they had a relationship. When it became clear that Norma, once again, would have to move to another home, she and James were married. Norma was only 16 at the time. During World War II, James enlisted in the Merchant Marines. While he was away, Norma Jeane worked on an assembly line at the Radioplane Munitions Factory. While they were making a film to boost the morale of the soldiers, a photographer noticed Norma Jeane and encouraged her to apply to be a model. She did and was immediately hired. She became very successful as a model and appeared on many magazine covers. In 1946,

Substance Abuse and Mental Health Services Administration, Data Archive. “Monitoring the Future Series.” http://www.icpsr.umich .edu/icpsrweb/SAMHDA/series/35.

Monroe, Marilyn (1926–1962) Norma Jeane Mortenson (later changed to Baker, then to Marilyn Monroe) was born on June 1, 1926, in the charity ward at Los Angeles County Hospital, the third child born to her mother, Gladys. There is some confusion as to the identity of her father, and her mother suffered from mental illness. Unable to support her children, they were placed in foster homes. There were times when Gladys attempted to get custody of Norma Jeane, but this was unsuccessful. As a young girl, Norma Jeane was placed with her mother’s best friend, Grace McKee. Grace instilled a love of movies into Norma. Grace allowed Norma to wear makeup, dress up in fancy clothes, and even pierce her ears. When Grace

Marilyn Monroe, an American actress, appears in a courtroom during a divorce proceeding in California, 1954. Monroe died of a barbiturate overdose in 1962 at the age of 36. She appeared in many films, including Bus Stop, Gentlemen Prefer Blondes, and The Seven Year Itch. (AP Photo)

614   Monroe, Marilyn (1926–1962)

she changed her name to Marilyn Monroe. Movie roles soon followed, first with nonspeaking roles but then speaking parts. She and James were divorced in 1946 after he made her choose between their marriage and her modeling career. Monroe continued to appear in low-budget, moderately successful films. She appeared nude in some pictures for a calendar in 1952, photos she explained were taken when she needed rent money. The photos were subsequently published in the first issue of Playboy in 1953. She began dating baseball great Joe DiMaggio, eventually marrying him in 1954. They divorced the same year. Monroe continued to have success in movies. She had roles in multiple films despite sometimes negative reviews of her acting abilities. Over time, she developed a reputation as being a “dumb blonde.” She was a popular actress. People loved her sex appeal and the characters she portrayed. Monroe eventually signed a movie contract with 20th Century Fox. Over the years, as Monroe became more successful, she also became more difficult to manage. She had angry outbursts and made demands of filmmakers. She married her third husband, Arthur Miller, in 1956. In the late 1950s, Monroe began seeing a psychiatrist. She complained that she had insomnia, and that she had seen many doctors who prescribed many different drugs, which Monroe mixed with alcohol. She separated from her husband, Arthur Miller, and began to abuse drugs again. She voluntarily admitted herself to the Payne Whitney Psychiatric Clinic, later transferring to the Columbia Presbyterian Medical Center, where she stayed for three weeks. She divorced her third husband in 1961. During the next year, Marilyn received treatment for her mental condition. She was diagnosed with a borderline personality dis-

order. She had also developed an addiction to barbiturates and alcohol. On May 19, 1962, Monroe performed at Madison Square Garden to celebrate President Kennedy’s birthday. She was released from her contract with 20th Century Fox, and was photographed nude by the photographer of Vogue magazine. She had many projects planned for the future. On August 5, 1962, Monroe was found dead in her home in Los Angeles at the age of 36. She was found only partially clothed, with a telephone in her hand. It was later reported that when she died, Monroe had 8 mg of chloral hydrate (the equivalent of 14–23 tablets) and 4.5 mg of Nembutal in her body, the equivalent of 40 or 50 capsules. The official cause of death was acute barbiturate poisoning, resulting from a probable suicide. These amounts would be enough to kill over 10 people. Monroe was interred in a crypt at the Corridor of Memories at the Westwood Village Memorial Park Cemetery in Los Angeles. There is great controversy over Monroe’s death. To this day, there are many who believe that Monroe was murdered instead of committing suicide. She had allegedly been involved with President John F. Kennedy and/or his brother Robert. Nancy E. Marion

Further Reading Barris, George. 1995. Marilyn: Her Life in Her Own Words: Marilyn Monroe’s Revealing Last Words and Photographs. New York: Citadel Press. Bell, Rachel. “Marilyn Monroe.” Crime Library. http://www.crimelibrary.com/notorio us_murders/celebrity/marilyn_monroe/6 .html. Leaming, Barbara. 1998. Marilyn Monroe. New York: Three Rivers Press.

Morality Policy  615 “Marilyn Monroe Biography.” Biography. com. http://www.biography.com/people/ marilyn-monroe-9412123. “Marilyn Monroe.” Official Marilyn Monroe Web Site. http://marilynmonroe.com/ history/. Monroe, Marilyn, and Ben Hecht. 2007. My Story. Lanham, MD: Taylor Trade. Nair, Vanita. 2013. “Marilyn Monroe Called Jackie Kennedy about JFK Affair, Book Claims.” CBS News. http://www.cbsnews .com/news/marilyn-monroe-called-jackie -kennedy-about-jfk-affair-book-claims/. Spoto, Donald. 2001. Marilyn Monroe: The Biography. New York: Cooper Square Press. Taraborelli, J. Randy. 2010. The Secret Life of Marilyn Monroe. New York: Grand Central Publishing.

Morality Policy A morality policy attempts to regulate personal morals or behaviors (Bowen 2012; Mooney 2000; Knill 2013). “Morality policies—such as those pertaining to abortion, capital punishment, gambling, gay rights, pornography, and sex education—generate conflict over core values” (Mooney 2000, 171). “Morality policies are neither tactical nor strategic. Rather, they are authoritative statements about what a polity holds to be fundamentally right and wrong” (Mooney 2000, 173). In general, morality policy changes are brought on by “moral panics,” or constructed social problems, where issues such as abortion or gambling provoke alarmist claims by politicians and the media. These moral panics, typically dealing with core value problems, heighten levels of public concern and place pressures on policymakers to implement corrective public policy (Omori 2013, 2–3; Hawdon 2001).

This core value conflict “leads to three important characteristics of morality policy. First, morality policy tends to be technically simple. Almost anyone can have an informed opinion on these issues because the question is about what is right and wrong, not about what will ‘work.’ Second, morality policy has the potential for high public salience. These issues threaten some people’s basic values; therefore, these people care deeply about them” (Mooney 2000, 174). The technical complication and “unclear instrumental impacts that take most public policy off the general public’s radar screen are less prominent in morality-policy debate” (Mooney 2000, 174). Third, these conflicts over core societal values can “generate an unusually high level of citizen participation” compared to that of non-morality-policy debates (Mooney 2000, 174). In addition to issues such as abortion, gambling, gay rights, and pornography, many sociologists and political scientists characterize drug policy as a type of morality policy (Omori 2013). Similar to other types of morality policy, drug policy seeks to “affirm, modify, or replace community values, moral practices, and norms of interpersonal conduct” (Tatalovich and Daynes 1998; Omori 2013). Drug policies, like other morality policies, are greatly affected by pressures placed on politicians by the general public and the media (Mooney 2000; Omori 2013). Community-wide methamphetamine and other drug abuse issues, for example, may act as moral panics that can yield morality policy remedies for reducing drug abuse (Omori 2013). Additionally, policies dealing with needle exchange programs, intended to reduce the spread of HIV in injection drug users, share many characteristics of other morality policies (Bowen 2012). Nancy E. Marion

616  Morphine See also: Drug Addiction and Public Policy

Further Reading Bowen, Elizabeth A. 2012. “Clean Needles and Bad Blood: Needle Exchange as Morality Policy.” Journal of Sociology and Social Welfare 39(2): 121–41. Hawdon, J. E. 2001. “The Role of Presidential Rhetoric in the Creation of Moral Panic: Reagan, Bush, and the War on Drugs.” Deviant Behavior 22: 419–45. Knill, Christoph. 2013. “The Study of Morality Policy: Analytical Implications from a Public Policy Perspective.” Journal of European Public Policy 20(3): 309–17. Mooney, Christopher Z. 2000. “The Decline of Federalism and the Rise of Morality-Policy Conflict in the United States.” Publius 30: 171–88. Omori, Marisa K. 2013. “Moral Panics and Morality Policy: The Impact of Media, Political Ideology, Drug Use, and Manufacturing on Methamphetamine Legislation in the United States.” Journal of Drug Issues 43(4): 517–34. Tatalovich, R., and B. W. Daynes. 1998. Moral Controversies in American Politics: Cases in Social Regulatory Policy. New York: M. E. Sharpe.

Morphine A derivative of opium, morphine is one of the most powerful natural pain relievers known and has become the standard against which other opiates, natural and synthetic, are judged. The drug was first extracted from opium in 1803 by Friedrich Wilhelm Adam Sertürner, who called it “morphine” after Morpheus, the Greek god of dreams. The drug quickly became a legal analgesic that most were able to use safely. It was only

after the later introduction of the hypodermic needle, which made intravenous injection possible, that morphine became commonly associated with abuse and addiction. When the drug is injected, it bypasses the gastrointestinal tract and speeds up the drug’s effect. During the Civil War, returning soldiers brought home morphine kits for alleviating the pain of battle injuries. Many of them developed dependencies, becoming so common that addiction to morphine was called “soldier’s disease.” Women also learned to inject the drug about this time. By the late 1800s, there were over 150,000 morphine addicts and roughly 400,000 users in the United States. Today, morphine is available in an oral form, suppositories, and injectable preparations. Because synthetic and semisynthetic morphine-like drugs are widely available both by prescription and through illicit channels, addiction to natural morphine is not as widespread as it once was even though opiate addiction in general continues to be a significant problem. Like other pain-relievers such as codeine and heroin, morphine powerfully engages the dopamine reward pathway. Synthetic derivatives such as hydromorphone that have been manufactured in the laboratory are even more potent than morphine and are extremely addicting. Not only do drug abusers pay the consequences but babies born to morphine-addicted women must endure the notoriously agonizing process of withdrawal as well. Morphine is a Schedule II drug under the Controlled Substances Act. On the street the names for morphine include M, sister morphine, Vitamin M, and morpho. It is the precursor needed to make heroin and codeine. Morphine addiction is very difficult to cure. The withdrawal process can kill the addict if not done slowly. It can lead to a stroke,

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heart attack, or even death. Withdrawal symptoms include diarrhea, runny nose, yawning, sweating, headaches, irritability, loss of appetite, body aches, severe abdominal pain, nausea, vomiting, and severe drug cravings. Sometimes, addiction can be treated with substances like naloxone and naltrexone that block its effect. Another popular treatment is methadone. Some addicts are successful when they go “cold turkey,” or stop using the drug all at once. While this can be dangerous if done by oneself at home, if done in a rehabilitation center with trained staff, it can be successful. Most often, a combination of drug therapy and counseling works the best. According to the International Narcotics Control Board, the organization that oversees the supply and demand of opiates, the supply of world opiates is in excess of what is needed to cover the production of legal drugs. They recommend more education about the need to assess the medical needs for opiates around the world. They point out that increasing the morphine production in the world is not likely to increase the medical consumption of the drug. Despite recommendations of the World Health Organization that morphine be used as a pain analgesic, there are many reasons why people may not use it. They may be concerned about drug addiction, there may be restrictive national laws, in sufficient local production, and deficiencies in national health-care delivery systems. Some countries may rely more on traditional herbal remedies for pain. In December 1997 comedian Chris Farley died as a result of an overdose of morphine mixed with cocaine. Kathryn H. Hollen See also: Addiction; Codeine; Controlled Substances Act; Methadone Treatment Programs; Opiates; Opium

Further Reading Califano, Joseph A., Jr. High Society: How Substance Abuse Ravages America and What to Do about It. 2007. New York: Perseus Books. Chouvy, Pierre-Arnaud. 2010. Opium: Uncovering the Politics of the Poppy. Cambridge, MA: Cambridge University Press. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Sanna, E. J. 2013. Heroin and Other Opioids: Poppies’ Perilous Children. Broomall, PA: Mason Crest. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Ser­vices, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Mothers Against Drunk Driving (MADD) Mothers Against Drunk Driving (MADD) is a nonprofit organization whose mission is to stop drunk driving, support the victims affected by it, and prevent underage drinking. To these ends, MADD has grown from a handful of mothers dedicated to fighting drunk driving into the nation’s most

618   Mothers Against Drunk Driving (MADD)

prominent grassroots anti–drunk driving organization. MADD was founded by Candy Lightner in May 1980 following her daughter’s death as a result of a hit-and-run incident involving a drunk driver. Thirteen-year-old Cari Lightner was walking on the sidewalk to a church carnival in Fair Oaks, California, when she was struck from behind by a repeat drunk driving offender. In fact, the driver, who had a blood alcohol content of 0.20 at the time of the incident, had a number of prior convictions from drunk driving, including one just two days before killing Cari Lightner. He was out on bail at the time of the fatal crash, for which he received a sentence of two years. Enraged by the leniency of the punishment, a resolute Candy Lightner incorporated MADD in September of that year in order to empower victims of drunk driving in their fight to prevent incidents such as the one that took the life of her daughter. Originally called Mothers Against Drunk Drivers, Lightner’s MADD initially attempted to prod the government to pass new, tougher driving while intoxicated (DWI) legislation. Though the death toll caused by drunk driving was significant in the late 1970s and early 1980s, public awareness of it was limited, and the punishments given to offenders were generally light. As a result, MADD’s early efforts failed to generate legislative change. But Lightner and other members of her small, though quickly growing, organization aroused enough media attention to bring about the creation of a California Governor’s Task Force on Drinking-Driving. MADD’s fight against drunk driving quickly went well beyond California, as Lightner joined forces with Cindy Lamb, a woman whose five-month-old daughter became the nation’s youngest paraplegic as a result of a drunk-driving crash, and who had launched a chapter of MADD in Maryland. Lightner and Lamb, the most

public faces of MADD, came together at a repercussive press conference on Capitol Hill on October 1, 1980, resoundingly placing MADD at the center of a new, national, grassroots movement to fight drunk driving. Candy Lightner’s passionate advocacy and tragic personal history helped distinguish MADD among other anti–drunk driving groups, such as RID (Remove Intoxicated Drivers) and SADD (Students Against Destructive Decisions; originally known as Students Against Driving Drunk). While these two organizations certainly played a role in heightening awareness of the serious consequences of drunk driving, it was Lightner and MADD who were most instrumental in giving a voice to drunk driving’s victims. In fact, by 1982, when MADD proclaimed itself the voice of the victim, it had grown into a national organization with 100 chapters. In the following year, Lightner helped put a face on drunk-driving victimhood when NBC produced and aired a made-fortelevision movie called MADD: The Candy Lightner Story. The film generated additional awareness of MADD and its efforts, as a national poll taken a month after the program’s airing showed that 84 percent of Americans knew of MADD. Building upon its newfound prominence in the public eye, MADD grew into a national organization composed of some 320 chapters in 1985. MADD parlayed this organizational growth into legislative change on the federal level in the early 1980s. For example, in 1982 the Presidential Commission on Drunk Driving was formed. In the same year, a bill giving states federal highway funds for anti–drunk driving efforts was enacted, and in 1984 the National Minimum Drinking Age Act was passed, effectively persuading states—by the federal government threatening to withhold federal highway funds—to set 21 as the minimum age for legally pur-

Mullen, Francis (1943– )  619

chasing and publicly possessing alcohol. Prior to 1984, only 12 states had 21 as the minimum drinking age. As MADD grew into the group of and for drunk-driving victims, it underwent a slight modification of the organization’s name— from Mothers Against Drunk Drivers to Mothers Against Drunk Driving. The name change was intended to reflect the group’s opposition to the crime of drunk driving, rather than towards the individuals who commit it. This stance is reflected in MADD’s advocacy for victim impact panels (VIPs), which allow victims of drunk driving incidents a forum for discussing their experiences with first- and second-time DWI offenders. In addition to mentally and emotionally helping victims, MADD believes these VIPs reduce the rate of recidivism among participating DWI offenders. In the 1990s, MADD changed its mission statement to accentuate its aim of preventing underage alcohol use. Reflecting this new organizational focus, in 1996 MADD began lobbying for a “Zero Tolerance” policy that would declare any measurable amount of alcohol in the system of a driver under the age of 21 to be illegal. Similarly, by declaring alcohol to be the nation’s top drug problem affecting youth, MADD has called upon the Office of National Drug Control Policy to set aside a portion of its drug education funds for alcohol education. MADD has also attempted to curb incidents of teenage drunk driving by raising arguments that are not always directly related to the issue of drinking and driving. For instance, MADD has sponsored a series of public service announcements that linked teenage alcohol consumption to sexually transmitted diseases, obesity, date rape, and a reduced life span. More conventionally, MADD has called upon the alcoholic beverage industry to cease any advertising campaigns, such as

those that employ cartoon characters, athletes, or celebrities, that may hold a particular appeal to young people. For drivers who are of legal drinking age, MADD has engaged in a variety of programs to help cultivate more responsible alcohol consumption. The “designated driver”—an individual who is selected in advance of a group’s drinking to remain sober and be responsible for the transportation of those who do consume alcohol—is a lasting concept that MADD has done much to popularize. MADD also promotes awareness of the perils of drunk driving through public service announcements in the run-up to holidays, when drinking and driving is more prevalent. Howard Padwa and Jacob A. Cunningham See also: Students Against Destructive Decisions

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Laurence, Michael D., John R. Snortum, and Franklin E. Zimring, eds. 1988. Social Control of the Drinking Driver. Chicago: University of Chicago Press. Ross, H. Laurence. 1992. Confronting Drunk Driving: A Social Policy for Saving Lives. New Haven, CT: Yale University Press.

Mullen, Francis (1943– ) In July 1981, Mullen was appointed to be the acting administrator of the Drug Enforcement Administration (DEA). President Reagan then announced in January 1982 that he was nominating Mullen to serve as the administrator of the agency to replace Pe-

620   Mullen, Francis (1943– )

ter Bensinger. Mullen had a difficult time in the confirmation process because of his handling of the Abscam investigation and the Federal Bureau of Investigation (FBI) background check of Raymond J. Donovan, who became U.S. secretary of labor. Nonetheless, he was confirmed by the Senate in September 1983, and served in that capacity until March 1985. During this time, there was substantial drug use in the United States, especially in southern Florida where the cocaine trade from Colombia was flourishing. As part of his War on Drugs, Reagan provided allocations to the DEA. The agency’s budget rose from $206.6 million in 1980 to $362.4 million in 1985. There was also an accompanying increase in the number of DEA agents, which rose from 1,941 in 1980 to 2,234 in 1985. Much of that money and the extra agents became part of the Southern Florida Task Force, a multiagency force aimed at attacking the growing drug trade and related violence in that state. As director, Mullen sought to cooperate with other drug and law enforcement communities. Mullen is credited with getting closer cooperation with the FBI on such matters as wiretaps and criminal investigations. This began in January 1982, when the attorney general, William French Smith, announced that the FBI was joining with the DEA for antidrug investigations as a way to increase the resources available to the agencies and coordinate activities. Under the reorganization, the DEA would be the principal drug enforcement agency, but Mullen answered to the FBI

director, who was William H. Webster at the time. At that point, the FBI had legal jurisdiction alongside the DEA over drug offenses. It was a positive effort as the combined efforts mixed the streetwise DEA agents with FBI investigative skills and knowledge, especially in the areas of money laundering and organized crime. Mullen served in the U.S. Air Force from 1953 to 1957 before returning to school and earning a bachelor of science degree in history and education from Central Connecticut State College. Mullen joined the FBI as a special agent in 1962, and by 1980 he had risen to executive assistant director of investigations, one of the FBI’s top three management positions. His responsibilities involved supervision over all of the FBI’s intelligence and criminal investigative operations. FBI director William Webster convinced Mullen to leave his position in the FBI to head the DEA and coordinate the government’s new plan to share responsibility between the two agencies in the drug enforcement area. Nancy E. Marion See also: Drug Enforcement Administration; Federal Bureau of Investigation; Reagan, Ronald, and Nancy Reagan

Further Reading Lardner, George. 1982. “FBI Withholds Files It Had on Donovan.” Washington Post, June 6. U.S. Drug Enforcement Administration. “A Tradition of Excellence: 1980–85.” http://www .justice.gov/dea/about/history/1980–1985 .pdf.

N policy] are like the gay-rights movement was in the early to mid-1990s, where the Civil Rights movement was in the 1960s. Nevertheless, there is a rising sense of frustration.” Nadelman also told Congress, “The federal government continues to waste tens of millions of dollars each year on D.A.R.E., the National Youth Anti-Drug Media Campaign, student drug testing and other scaredbased prevention programs repeatedly proven to be ineffective.” Nadelmann is the founder and executive director of Drug Policy Alliance, the leading organization in the United States promoting alternatives to the war on drugs. Ethan Nadelmann and the Drug Policy Alliance have played a major role in the drug policy reforms ballot initiative campaigns in the United States. The major ballot issues include medical marijuana and legalized marijuana use for prison reform purposes, drug treatment, and reforms of asset forfeiture laws for drug-related offenses. Nadelmann and the Drug Policy Alliance also played major roles in reforms dealing with drug sentences, access to sterilized syringes to reduce HIV/AIDS, access to drug treatment, prevention of overdose fatalities, and all aspects of marijuana policy. Nadelmann also plays a drug advisory role to George Soros and other philanthropists and offers his advisory services to legislators at both the federal and state level. Ron Chepesiuk

Nadelmann, Ethan (1957– ) A former professor of politics and public policy at Princeton University, Nadelmann is today a prominent and crusading advocate for harm reduction, the alternative approach to the War on Drugs that seeks to decrease the harm caused by drug abuse and drug trafficking. From 1984 to 1985, Nadelmann served as a narcotics policy consultant to the U.S. State Department, but in June 1987 he shocked a drug policy conference at Bolling Air Force base, near Washington, D.C., by comparing current U.S. drug policy to the prohibitionist policy toward alcohol in the 1920s. In 1996 he became an important consultant to the successful Arizona and California medical marijuana election initiatives. Nadelmann has become a visible spokesperson for legalization of drugs. He has argued that the government should make drugs that are now banned legally available to competent adults, while establishing and enforcing strong regulatory powers over all production and sale of the drugs. He also advocates for government-backed treatment programs. He believes that this would save the government billions of dollars each year. He says this because current drug policies have failed, and will continue to fail. They are highly costly and counterproductive. Nadelmann argues that new federal statutes make crimes of behaviors that previously were legal, and that this, in turn, expands the authority of law enforcement, especially the Drug Enforcement Administration. In 1997 Nadelmann told Rolling Stone magazine, “We [opponents of U.S. drug

See also: Drug Policy Alliance Network; Harm Reduction Programs; Medical Marijuana; Prohibition 621

622  Naltrexone

Further Reading Adler, Patricia A., Peter Adler, and Patrick K. O’Brien. 2012. Drugs and the American Dream: An Anthology. Malden, MA: Wiley-Blackwell. Dreyfuss, Robert. 1997. “Hawks and Doves: Who’s Who in the War on Drugs.” Rolling Stone, August 7. “Ethan Nadelmann, Executive Director.” Drug Policy Alliance. http://www .drugpolicy.org/staff-and-board/staff/ethan -nadelmann-executive-director. Kan, Paul Rexton, Robert MacCoun, Peter Reuter, Mathea Falco, and Ethan Nadelman. 2007. “To Legalize, or Not to Legalize” Foreign Policy 163: 4, 6, 8. Nadelmann, Ethan. 1988a. “The Case for Legalization.” Public Interest 92: 5–6, 30–31. Nadelmann, Ethan. 1988b. “U.S. Drug Policy: A Bad Export.” Foreign Policy 70: 92–93, 95–96, 106–7. Nadelmann, Ethan. 1993. Cops Across Borders: The Internationalization of U.S. Criminal Law Enforcement. University Park: Pennsylvania State University Press.

Naltrexone Naltrexone, which also goes under the trademarked name of Revia or Vivitrol, is an opioid antagonist that was developed in order to treat opiate addiction, but it has also been used to reduce the incidence of relapse among alcoholics. Taken orally, naltrexone was first synthesized in 1965 as a medication capable of reversing most effects of morphine-like drugs, and in the early 1990s it was discovered to possibly reduce an individual’s craving for alcohol. Recent studies suggest that naltrexone may also be effective in treating compulsive shopping disorder, eating disorders, and addiction to cigarettes.

Naltrexone’s origins can be traced back to the early 1960s and William Martin and Abraham Walker at the U.S. Addiction Research Center, where the two suggested that opioid antagonists might be effective in the treatment of opiate addicts. Since opioid antagonists would block the pleasurable effects of morphine-like drugs, they reasoned that opiate addicts would have little incentive to continue using if administered an opioid antagonist. The next step in developing such a drug occurred in 1965 when H. Blumberg and H. B. Dayton successfully synthesized naltrexone, and study of the drug’s efficacy took place as a result of the Special Action Office for Drug Abuse Prevention’s call for nonaddictive antagonist drugs to be used in the treatment of heroin addiction. Naltrexone is structurally similar to other opioid antagonists like oxymorphone and naloxone, but distinct from them in important ways that get at naltrexone’s particular abilities to treat opiate addiction and alcoholism. Unlike oxymorphone, which is a strong painkiller, naltrexone is not an analgesic. And unlike naloxone, which is typically used in emergency situations of opioid overdose, naltrexone is generally used for longer-term recovery from opiate addiction (though it, too, is capable of reversing the effects of an opioid overdose). Contributing to its particular usefulness in the long-term treatment of opiate addicts is the fact that naltrexone can be taken orally and lasts at least 24 hours, which is considerably longer than other opioid antagonists. As such, naltrexone can be effective in treating opiate addicts throughout the process of detoxification, and not just in overdose situations. In a number of studies, naltrexone has proven to be extremely effective in combating opiate addiction. Five-year success rates as high as 95 percent have been reported, signaling naltrexone’s tremendous efficacy when

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administered in particular situations and to particular subject groups. In general, it seems that recovering opiate addicts with fairly stable lives are more receptive to naltrexone programs—which require weekly doses of around 350 milligrams, with some patients taking 50 milligrams per day and others swallowing a 150-milligram pill every third day— than street addicts who typically altogether refuse to begin a naltrexone regimen or discontinue one shortly after starting. Naltrexone cannot be given to a patient who is still physically dependent on opiates, as ingesting it will cause withdrawal symptoms such as diarrhea, abdominal cramps, a runny nose, goose bumps, and muscle, joint, and bone pain. In order to avoid inducing withdrawal, naltrexone should be administered to patients only after seven to 10 days have been allotted for physical dependence to run its course. In addition to its ability to counteract the effects of opiates, researchers in the early 1990s discovered that naltrexone was also effective in diminishing the rate of relapse in alcoholics. It seems that naltrexone reduces alcoholics’ craving for alcohol, though it does not appear to induce greater numbers of alcoholics to become completely abstinent from drinking. The Food and Drug Administration approved naltrexone for use in treating alcoholism in 1995, making it an alternative to disulfiram for those looking for medicinal assistance in controlling their drinking. More recent research suggests that naltrexone may also be effective in helping individuals stop smoking, control overeating, and curb compulsive shopping. Naltrexone has the following side effects; confusion, hallucination, blurred vision, severe vomiting, and diarrhea. It can also cause loss of appetite and anxiety for its users. If taken in large doses naltrexone can cause liver damage. Naltrexone falls within the class of drugs called opiate antagonists, because they

help to reduce the craving of drug addicts for either alcohol, opiates, and other drugs. Naltrexone comes in the form of a tablet and can be taken at home or under supervision at a treatment center or clinic. Howard Padwa and Jacob A. Cunningham See also: Addiction; Food and Drug Administration; Opiates; Treatment

Further Reading Black, Donald W. 2007. “Compulsive Buying Disorder: A Review of the Evidence.” CNS Spectrum 12(2): 124–32. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. “Naltrexone.” U.S National Library of Medicine/National Institute of Health. http:// www.nlm.nih.gov/medlineplus/druginfo/ meds/a685041.html. O’Brien, Charles P., Laura A. Volpicelli, and Joseph R. Volpicelli. 1992. “Naltrexone in the Treatment of Alcoholism: A Clinical Review.” Alcohol 13(1): 35–39. O’Malley, Stephanie. 2002. “Naltrexone and Alcoholism Treatment.” Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. O’Malley, Stephanie S., Adam J. Jaffe, Grace Chang, Richard S. Schottenfeld, Roger E. Meyer, and Bruce Rounsaville. 1992. “Naltrexone and Coping Skills Therapy for Alcohol Dependence.” Archives of General Psychiatry 49: 881–87. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment. 2009. “The Facts About Naltrexone for Treatment of Opioid Addiction.” Washington, DC.

624   Narcotic Addict Rehabilitation Act (1966)

Narcotic Addict Rehabilitation Act (1966) The Narcotic Addict Rehabilitation Act was a piece of 1966 legislation that allowed for the civil commitment of addicts before they went to trial or faced sentencing. It was among the first pieces of federal legislation that provided a treatment alternative, instead of prison sentences and fines, for drug law offenders. As such, it represented a revolutionary step in the way that legal authorities in the United States handled addiction, as instead of just punishing it, the Narcotic Addict Rehabilitation Act also provided a means for curing addiction. From the 1930s through the 1950s, drug control policies in the United States had become increasingly stringent. Though there were Public Health Service narcotic hospitals that were designed in part to treat addicts, these hospitals had a largely punitive component, as residents stayed in cellblocks with barred windows that made the institutions resemble prisons more than hospitals. While the one treatment option available to most addicts was rather punitive, so was the approach that federal law enforcement officials took towards drug use and dealing. The Federal Bureau of Narcotics (FBN), under the leadership of hardliner Harry J. Anslinger, was merciless in its prosecution of not only dealers, but also addicts, when enforcing the Harrison Narcotics Act and the Narcotic Import and Export Act. New pieces of legislation in the 1950s—the 1951 Boggs Act and the 1956 Narcotic Control Act— stiffened penalties for not only drug traffickers and dealers, but also for addicts, and instituted mandatory minimums for drug law violations while also stipulating that some violations of the nation’s narcotics control legislation could be punishable by death. Partially in response to the draconian pun-

ishments allowed under the Boggs Act and the Narcotic Control Act, many in the medical community, as well as lawyers and certain sectors of the mainstream media, began to protest against the government’s approach to the drug problem, arguing that in addition to punishing those who supplied drugs, it also had a responsibility to both treat and rehabilitate addicts. The fact that rates of drug abuse rose dramatically in the early 1960s in spite of the tougher law enforcement approach gave fodder to these criticisms, as long prison sentences alone did not seem to quash drug addiction, but counterintuitively, seemed to contribute to its spread. In 1962, President John F. Kennedy convened a White House Conference on Drug Abuse, and by 1963 it had evolved into a Presidential Commission on Narcotic and Drug Abuse. In its first report, issued in 1963, the commission recommended the relaxation of mandatory minimum sentences, increases in appropriations for research on drug addiction, and the redistribution of funds from the FBN to the departments of Justice, Education, and Welfare. Furthermore, it allowed for local governments to receive federal aid to establish treatment centers, meaning that addicts would now have places to go for treatment legally without having to enter a Public Health Service narcotic hospital. While states such as New York and California took advantage of these initiatives to create experimental programs for the outpatient treatment of addicts, the federal government still sought to create treatment alternatives for drug law offenders throughout the country. The result was the 1966 Narcotic Addict Rehabilitation Act (NARA). NARA stipulated that individuals charged with or convicted of breaking federal laws who were addicted, and likely to be rehabilitated through treatment, could be civilly committed to treatment so that they

Narcotic Addict Rehabilitation Act (1966) 

could restore their health and return to society as upstanding citizens. If individuals were convicted of an offense, NARA allowed them to submit to physical examinations to determine if they were addicted or not. If the exams showed that lawbreakers were addicts, NARA then allowed for them to be given mandatory treatment in an institution for up to three years instead of going to prison. If individuals were found guilty of committing a federal offense, the mandatory stay in treatment could be longer. In addition, NARA also made provisions for addicts who did not commit crimes—but still wanted to be cured—to volunteer for civil commitment and treatment so that they could be rehabilitated and resume normal lives. Significantly, NARA empowered the surgeon general to enter into contract agreements with any public or private agency to examine and treat addicts, so only a fraction of the individuals who entered treatment under the auspices of the act wound up receiving treatment in the Public Health Service narcotic hospitals. NARA not only allowed for local treatment centers to take on the task of rehabilitating addicts, but it also gave state and local governments financial assistance for their creation, maintenance, and functioning, providing them with $15 million—more than double the entire budget of the FBN. Federally funded treatment, therefore, was no longer limited to the Public Health Ser­ vice narcotic hospitals, but could be carried out at any number of treatment centers that began to pop up throughout the country. By 1971, NARA had funded the creation of 50 community-based drug treatment programs. In the first two years NARA was in operation, many of the addicts who came before judges were not found to be suitable for treatment, and instead given jail sentences. In addition, many NARA patients were noncompliant, and did not complete treatment suc-

cessfully. Studies in the early 1970s showed that the NARA program had mixed results, as high numbers of former NARA patients went back to using drugs upon completion of the program, though not as many of them wound up falling back into full-blown addiction. Even though studies showed that the program had mixed success, it was nonetheless significant for several reasons. First, it created an option for judges to put addicts who came before them in rehabilitative programs instead of prison, an option that would resurface in the 1990s with the emergence of drug courts. Secondly, by funding state and local treatment programs, NARA led to the drying up of the addict populations that had once filled the Public Health Service hospitals in Fort Worth, Texas, and Lexington, Kentucky, and not surprisingly, these institutions were closed within a decade of its enactment. Most importantly, however, NARA represented a landmark in the way that the federal government handled the drug problem. For the first time since the creation of the Public Health Service narcotic hospitals in the 1930s, NARA added a therapeutic and rehabilitative piece to federal drug policy, providing a much-needed counterbalance to the practices of the FBN, which had tried to solve the drug problem by simply arresting and incarcerating traffickers and dealers without taking much care for another major aspect of the drug problem—the fact that there were addicts who, by going uncured, provided a lucrative market for the dealers the FBN was tracking. By taking a major step to address the question of demand for drugs, and not just cracking down on supplies, NARA marked a turning point in the way that the federal government would address the drug problem from the mid-1960s onward. NARA was a buildup on the Porter Narcotic Farm Act of 1929. NARA was signed into law by President Lyndon Johnson as Public Law

625

626   Narcotic Clinics

89-793 (80 Stat. 1938). The act was meant to provide rehabilitation and treatment for addicts, which was a different approach to previous sentences and fines leveled on addicts by the court system. The act had four main sections: Subsection I allowed addicts charged with federal drug offense to choose civil commitment to treatment rather than prosecution. Subsection II allowed civil commitments to addicts after they are convicted. Subsection III allowed addicts to be committed to a local surgeon if the court is petitioned by the addict’s family or no further laws are broken by the addict. This allowed for local content development and establishment of treatment centers. Subsection IV provided federal funding for state and local governments to establish treatment centers for addicts. Howard Padwa and Jacob A. Cunningham See also: Boggs Act; Drug Courts; Federal Bureau of Narcotics; Narcotic Control Act

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Kleiman M. A. R, and J. E. Hawdon. Encyclopedia on Drug Policy. http://knowledge .sagepub.com/view/drugpolicy/n237.xml. Martin, William R., and Harris Isbell, eds. 1978. Drug Addiction and the U.S. Public Health Service. Rockville, MD: National Institute on Drug Abuse. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press. Musto, David F., ed. 2002. Drugs in America: A Documentary History. New York: New York University Press. White, William L. 1998. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Chestnut Health Systems.

Narcotic Clinics As the federal government began instituting narcotic control measures in the 1910s, many state and local governments responded by establishing maintenance clinics—places where addicts could continue receiving drugs to maintain their drug habits and avoid the pains of withdrawal. Most of these clinics, however, were short lived, as the Narcotic Division of the Prohibition Unit, led by Levi G. Nutt, deemed these clinics illegal, and ordered them to be shut down. By 1923, all of the narcotic clinics in the country were closed. The first narcotic clinic established by a government entity in the United States came before the federal government became involved in the question of narcotics control and addiction treatment. Dr. Charles E. Terry, the city health officer of Jacksonville, Florida, established a narcotic clinic so addicts could receive free narcotic prescriptions in 1912. The main reason Terry created the clinic was to institute tighter control over the flow of opiates, as many pharmacists complained that a good number of addicts who they served were too poor to go to a doctor for a prescription. In addition, the public clinics forced addicts to go to a government clinic, where they would receive help in their struggle against addiction, instead of to private physicians who could have prescribed drugs indefinitely, thus feeding, instead of curing, addiction. After the clinic opened in August of 1912, 646 addicts began receiving services there. The early success of his clinic made Terry a strong proponent of getting public health services, and not just police departments, involved in the addiction problem, since clinics provided a way to both treat and keep track of addicts and their drug-taking.

Narcotic Clinics  627

After the passage of the Harrison Narcotics Act, many local officials began to fear that the sudden lack of availability of opiates could cause a public health crisis if large numbers of addicts suddenly started having withdrawal symptoms. Some in the federal government also recognized the difficult situation that the Harrison Act put addicts in, and in July of 1915 it issued recommendations for the temporary supply of narcotics to addicts until they could kick the habit. The federal government also advised revenue officials to work with local authorities to assure that the abrupt withdrawal of drugs would not lead to a public health crisis. For a brief while, federal officials permitted certain physicians in some regions to continue prescribing maintenance doses, while in other places, the municipal government established narcotic clinics—between 80 and 90 of them operated throughout the country. In some cities, federal officials allowed health departments and police stations to continue providing maintenance treatments to addicts. Even after the 1919 Supreme Court rulings in the Webb and Doremus cases outlawed maintenance prescriptions by private practitioners, many of these public institutions dispensed narcotics, and many municipalities set up new narcotic dispensaries to provide legal supplies of opiates to addicts. The situation changed, however, in 1920, after Levi G. Nutt became the head of the Narcotic Division of the Prohibition Unit. To decide if maintenance treatment was medically necessary, the Revenue Bureau charged with enforcing the Harrison Act sent out questionnaires to leading physicians and scientists to solicit their opinions on the outpatient maintenance treatment of addicts. Most of the medical authorities surveyed opposed the maintenance treatments given in clinics, instead advocating for addicts to un-

dergo detoxification treatments in inpatient settings. In 1920, the American Medical Association introduced a resolution opposing the maintenance clinics. Further research by the Narcotic Division showed that the clinics were not effective in curing addiction, and that many dispensed narcotics with no intention of weaning addicts off of opiates until they were drug-free. Taking these factors into account, Nutt decided to close the narcotics clinics and oppose maintenance treatments in all cases except those involving the elderly or incurable patients. Believing that there was no valid medical treatment for addiction other than withdrawal of drugs, the Narcotic Division reasoned that there was no need for clinics to distribute narcotics to the addicted, and began ordering them to be shut down. By 1923, the last of the major narcotic clinics, located in Shreveport, Louisiana, was closed. The closure of the narcotic clinics, together with the Supreme Court decisions in the Doremus and Webb cases, left many addicts with little choice but to quit or to turn to the black market for supplies. Not surprisingly, increasing numbers of them wound up in the criminal justice system, and federal prisons were flooded with individuals convicted of narcotic-related offenses in the mid-1920s. By 1928, almost one-third of the inmates in federal penitentiaries were incarcerated for violating the Harrison Act, and there were more people behind bars for breaking drug laws than there were individuals incarcerated for violating the prohibition of liquor. Eventually, the high numbers of addicts in federal prisons led the federal government to create special institutions that were both prisons and hospitals—the Public Health Service narcotic hospitals—for addict offenders in the 1930s.

628   Narcotic Control Act (1956)

Narcotic clinics or narcotic treatment clinics (NTCs) are specialized clinics that treat addicts of heroin and other opiates. Patients are prescribed medically supervised maintenance and withdrawal drugs like methadone or buprenorphine. Federal laws protect the confidentiality of all addicts that visit narcotic clinics. NTCs also offer other services such as social and human services, mental health ser­ vices, educational and vocational services, family counseling, HIV/AIDS counseling and prevention, and risk reduction education. NTCs are inspected once a year to ensure that they comply with federal and state regulations that bind their operations. Howard Padwa and Jacob A. Cunningham See also: Harrison Narcotics Act; Nutt, Levi G.; Treatment; United States v. Doremus and Webb et al. v. United States

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Department of State Health Services, Texas. “Narcotic Treatment Clinics.” http://www .dshs.state.tx.us/hfp/ntc.shtm. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Narcotic Control Act (1956) The Narcotic Control Act was a piece of legislation that became law in 1956 and severely stiffened penalties for drug trafficking and dealing in the United States. The act

toughened the already harsh penalties that were established just five years earlier in the Boggs Act, and also introduced the ultimate penalty—death—for certain drug offenses. In addition, the act also had provisions to facilitate the surveillance and apprehension of drug users and traffickers. The Narcotic Control Act was an outgrowth of the Boggs Act, which created federal mandatory minimum sentences for drug-law offenders. The legal and medical professions were highly critical of the Boggs Act, and the Federal Bureau of Narcotics (FBN), in turn, vigorously defended the new law as an effective deterrent for would-be drug dealers and users. In spite of the FBN’s counteroffensive, Senator Price Daniel of Texas introduced a resolution for the Senate Judiciary Committee to review the nation’s drug laws and consider drafting new legislation. In hearings held in eight cities, the committee listened to testimonies concerning the nation’s drug laws and took suggestions for changes to narcotics control statutes. The committee was concerned by what it heard about drug trafficking, and concluded that rates of drug addiction had tripled in the decade after World War II ended. Propaganda, often coordinated by the FBN, linking the rise in drug addiction to organized crime and conspiracies out of communist China also heightened the sense of alarm in the mid-1950s. Thus even though Senator Daniel had been open to suggestions for new treatment options for addicts, the scope and scale of the problem led the committee to suggest more stringent measures to crack down on drug trafficking and cut down on drug supplies, rather than institute treatment measures to address the question of demand for narcotics. The legislation that emerged as a result of the Senate committee’s investigations—the Narcotic Control Act of 1956—toughened

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the amendments to the Narcotic Import and Export Act that had taken effect with the 1951 Boggs Act. The Narcotic Control Act increased both the minimum and maximum sentences for trafficking and illegal possession of opiates, cocaine, and cannabis. First offenses were now punishable by between five and 10 years’ imprisonment, while sentences for second offenses were increased to 10 to 20 years. Smuggling and dealing were targets of particularly harsh punishments, as the minimum for illicitly importing narcotics was raised to five years in prison, with a maximum of 20 years’ incarceration. The penalties for repeat offenders were also raised, to a minimum of 10 years and a maximum of 40 behind bars. The legislation also raised the maximum financial penalty for individuals found guilty of violations from $2,000 to $20,000. To help the FBN enforce the law, the act authorized narcotic agents to carry guns and arrest suspected violators of drug laws without a warrant. To facilitate the surveillance of likely drug smugglers, the act also had a provision requiring addicts, drug users, and those who had drug-related offenses on their criminal records to register and get a Treasury Department certificate before they left the country. In addition, it allowed for the FBN to share intelligence gathered on addicts with state and local governments, and also for the FBN to train state and local narcotics enforcement agents. The act targeted heroin in particular, as it allowed, at the discretion of juries, for adults caught selling heroin to minors to be sentenced to death. It also stipulated that all heroin—even that which was within the bounds of previous laws—had to be surrendered to the federal authorities, and banned its use for any reason. While officials in the FBN and other supporters of tougher treatment of drug traffickers supported the Narcotic Control Act, the

legislation also drew its share of criticism. The New York Times, for example, published an editorial stating that tougher enforcement alone could not solve the drug problem. Addiction experts, such as Lawrence Kolb, also criticized the new draconian measures. Thus even though it toughened the government’s stances on how addicts and dealers should be treated, the Narcotic Control Act also had the unintended consequence of creating resistance to the law-and-order approach to narcotics control. While it marked an apex in the development of the federal government’s tough approach to the drug problem, the act also spawned resistance that would ultimately lead to the demise of the law-andorder paradigm in the 1960s and 1970s. The Narcotic Control Act toughened the penalties outlined in the Boggs Act and made several amendments to the Internal Revenue Code of 1954 and the Narcotic Drug Import and Export Act of 1922. Among the notable features of the act was the increase in the sentence for first-time offenders and the inclusion of felony and sometimes the death penalty for second-time drug offenders. The act also places stricter penalties on trafficking and possessing opiates, cocaine, and marijuana. First-time offenders had a sentence period between five and 10 years. Second-time offenders had a sentence between 10 and 20 years. Penalties for smuggling and dealing in narcotics was as high as 20 and 40 years for first- and second-time drug offenders respectively. Furthermore, the act places a $20,000 fine on offenders of narcotic laws. Though the act placed tough punishments on drug offenders, the late 1960s and early 1970s experienced increases in drug use in the United States. Illegal drug use was prevalent among college students and Vietnam War veterans. Howard Padwa and Jacob A. Cunningham

630   Narcotic Drugs Import and Export Act (1922) See also: Boggs Act; Federal Bureau of Narcotics

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Kleiman M. R. A., and J. E. Hawdon. Encyclopedia on Drug Policy. http://knowledge .sagepub.com/view/drugpolicy/n238.xml. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Narcotic Drugs Import and Export Act (1922) The Narcotic Drugs Import and Export Act, sometimes referred to as the Jones-Miller Act, was a piece of 1922 legislation in the United States that governed the international commerce in controlled substances. Though it was originally created to address concerns about drug smuggling into China, the law also broadened the scale and scope of narcotics control in the United States. The Narcotic Drugs Import and Export Act was the result of a concerted effort to restrict narcotic exports out of the United States that began in the autumn of 1920, when Representative John Miller and Senator Homer Jones met with members of the China Club, a Seattle-based organization interested in improving trade with China. Earlier that year, China Club members had discovered that foreign morphine was being smuggled through the United States and Japan for use in China, and feared that the drug trafficking could endanger American eco-

nomic interests in China. To address these concerns, Miller and Jones drafted a piece of legislation. The original proposal would have amended the Harrison Narcotics Act to include a ban on all exports of narcotics out of the United States, and given the surgeon general the power to decide if crude opium or coca leaves could be imported. At hearings held on the bill in the winter of 1920–1921, witnesses revealed that the smuggling of opiates and cocaine out of the United States affected not only China, but Canada as well. They also testified that most of the illicit drugs in the United States were probably manufactured domestically, legally exported, and then smuggled back in to the United States illegally. Restricting narcotic exports, therefore, held the promise of not only helping other countries address their drug problems, but also of helping domestic narcotic law enforcement efforts by cutting off the cycle of exporting and importing that fed the illicit drug market within the United States. The fact that the legislation could help domestic control efforts was enough to convince drug manufacturers, who otherwise would have opposed the limitation of exports, to support it. In February of 1921, Representative Henry T. Rainey introduced a revised version of the bill that Jones and Miller had proposed. Rainey’s proposal was less ambitious, as it allowed for the export of narcotics, but only with the approval of the secretary of state, the secretary of the treasury, the secretary of commerce, and only if there was assurance that the nation receiving the exports would monitor the distribution and use of the drugs. Exporting drugs that were not believed to have any medicinal use, namely, opium that was prepared for smoking, was also prohibited. The law placed tight restrictions on the importation of narcotics, stipulating that they could not be brought into the United

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States unless deemed necessary for use in medicine. When it became law as the Narcotic Drugs Import and Export Act in May of 1922, it created a new organization—the Federal Narcotics Control Board—to determine if drug exports were legal and if drug imports were necessary under the provisions of the law. The administration of the law was left to the discretion of the Treasury Department’s Narcotic Division, which oversaw domestic narcotic control efforts as well. The penalties for breaking the Narcotic Drugs Import and Export Act were stiff, as violators could face fines of up to $5,000 and up to 10 years in prison. If foreigners were caught breaking the law, the act allowed for them to be deported. In comparison to the Harrison Act of 1914, the Narcotic Drugs Import and Export Act was particularly harsh, as it provided for double the prison time and more than double the fine for individuals caught up in drug smuggling. Together with the Supreme Court decisions in Webb et al. v. United States and United States v. Doremus, the Narcotic Drugs Import and Export Act contributed to the sharp rise in the number of individuals who were incarcerated for violating the nation’s drug laws. The Federal Narcotics Control Board was dissolved with the formation of the Federal Bureau of Narcotics in 1930. The Narcotic Drug Import and Export Act ensured that drug import and export to the United States and its territories was discouraged. The act placed a $5000 fine and incarceration for up to 10 years on all convicted of disobeying the act. The act allowed for the export of narcotics to other countries for legitimate purposes, so far as the country in question monitored and regulated the use of narcotics. Howard Padwa and Jacob A. Cunningham See also: Federal Bureau of Narcotics; Harrison, Francis; Harrison Narcotics Act; United

States v. Doremus and Webb et al. v. United States

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Kleiman M. R. A., and J. E. Hawdon. Encyclopedia on Drug Policy. http://knowledge .sagepub.com/view/drugpolicy/n240 .xml#n240. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Narcotics The Harrison Narcotics Act (1914) profoundly changed drug policy in the United States by statutorily controlling the production, sale, distribution, and prescribing of opium, cocaine, and their derivatives. In so doing, the act included both cocaine and opium in the definition of narcotic drugs. Then in 1956, Congress passed the Narcotics Act that imposed even stronger penalties on opium. Under this law, anyone over 18 years of age who sells heroin to a minor could be sentenced to the death penalty. From a pharmacological standpoint, only opium, its derivatives (morphine and codeine), and semisynthetic (heroin, hydromorphone [Dilaudid]) or synthetic (methadone, meperidine [Demerol]) substitutes that have a similar chemical structure and effect are technically narcotics. As a class, narcotics are characterized as having analgesic (i.e., pain-killing) and sedating effects, but they can also impair

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the user’s mental and physical capabilities. Cocaine (and its derivatives) has neither analgesic nor sedating properties when ingested, although it can be used as a topical anesthetic, and is classified as a central nervous system stimulant. The term narcotics refers to three categories. The first is opium and the three natural components that can be extracted from it: morphine, codeine, and thebaine. The second category is opium derivatives that are created when a slight change is made in the chemical composition of morphine. This includes heroin. The third category is synthetic opiates that are not chemically related to morphine or any derivatives, but produce effects in the body similar to opiates. Upon ingestion, narcotics can cause slowed reflexes and breathing, cold skin, restlessness, constipation, and vomiting. They relax the user, usually after a rush immediately after ingestion. Withdrawal symptoms include fever, increased blood pressure, runny nose, diarrhea, involuntary twitching, insomnia, and depression. Narcotics are typically used for treating pain, for treating dysentery, and the suppression of coughing. Since the 1990s, three prescription pain relievers have been diverted to the black market and used for nonmedical purposes. These are OxyContin, Vicodin, and Percocet. In recent years, the term narcotic is used to refer to all illegal drugs. In blurring this important distinction between two very different drug classes, the Harrison Act set precedent for subsequent legislation (e.g., the Controlled Substances Act of 1970) that continued to misuse the term narcotic as referring to virtually any drug deemed to be harmful, and thereby warranting restricted access. As a result, drugs such as marijuana, PCP, and amphetamines among others have been included in antinarcotics legislation

even though, like cocaine, none are pharmacologically narcotics. For those people who have become addicted to a form of narcotic, many treatment options are available. One is Narcotics Anonymous, which has adopted the 12-step program format made successful in Alcoholics Anonymous. This provides a support group to help addicts become drug-free. Nancy E. Marion See also: Cocaine and Crack; Harrison Narcotics Act; Heroin; Narcotics Anonymous; Opium

Further Reading Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press. Kumah-Abiwu, Felix. 2012. The Dynamics of U.S. Narcotics Policy Change. Saarbrucken, Germany: LAP Lambert Academic Publishing. Levinthal, Charles F. 2012. Drugs, Behavior and Modern Society. Boston: Allyn and Bacon. Sanna, E. J. 2013. Heroin and Other Opioids: Poppies’ Perilous Children. Broomall, PA: Mason Crest. Trujillo, Fraco L. and Tina R. Contreras. 2011. International Narcotics Control Hauppauge, NY: Nova Science Publishers. Yates, Rowdy, and Margaret S. Malloch. 2010. Tackling Addiction: Pathways to Recovery. Philadelphia: Jessica Kingsley Publishers.

Narcotics Anonymous (NA) Narcotics Anonymous (NA) is a 12-step program for narcotic addicts that is adapted from the Alcoholics Anonymous (AA) model. NA differs from AA in its stance that alcoholism is too narrow a term for what ails

Narcotics Anonymous (NA) 

its members; instead, NA targets addiction writ large, which it designates a disease. NA emerged from meetings held in Kentucky in 1947, developed in New York City, and officially started in Southern California in 1953. The creation of a World Service Office in Los Angeles in 1972 gave NA greater organizational coherence, and following the 1983 publication of its “Basic Text,” NA quickly expanded into an international organization with 43,000 weekly meetings across 127 countries. The origins of NA can be traced back to an AA member who, as part of AA’s Twelfth Step—which encourages carrying the organization’s message to others with drinking problems—brought into the AA fold an alcoholic who also used morphine as a means of combating his hangovers. The sponsor, who was referred to as “Houston” in a Saturday Evening Post article recounting NA’s early history, continued to work with the alcohol/ morphine abuser, whom Houston dubbed his “Pigeon,” and who was committed to the U.S. Public Health Service hospital in Lexington, Kentucky. In conversation with the hospital’s director, Dr. V. H. Vogel, Houston argued that AA’s Twelve Steps, which were useful in dealing with Pigeon’s alcoholism, could be adapted to combat the patient’s morphine addiction, which AA—which strictly focused on alcohol—did not address. Dr. Vogel agreed to allow Houston to start such a group for drug-addicted patients in the Lexington hospital, and the first meeting took place on February 16, 1947. A particularly enthusiastic member of the Lexington group, an addict referred to as “Dan,” became clean and started, in New York City in 1948, the first group outside of the Lexington hospital, which he called NA. Despite contacting everyone he knew from Lexington, Dan got only three people to attend these weekly meetings, which took

place at a local Salvation Army building. Although the meetings of the nascent NA owed much to AA, the protocol for adapting the Twelve Steps to deal with narcotics addiction was hardly well established. For example, early meetings were marked by debates over how best to work through drug withdrawals, with the group eventually determining that it would encourage members to do so within institutional care. NA spread slowly and somewhat erratically across the United States, with the first official meeting taking place in Southern California in July 1953. Local fellowships throughout the country held weekly meetings, but rising membership numbers were difficult to sustain in the early years of the loosely grouped organization, in part because of a lack of centralized leadership, and in part because the group was still hammering out its core principles and approaches to combating drug abuse. Thus, one of NA’s first publications, a self-titled pamphlet that appeared in 1962 and came to be known among members as the White Booklet, attempted to give greater coherence to the organization by defining itself as a nonprofit fellowship or society of people for whom drugs had become a major problem. Like AA, NA articulated a program of regular meetings to help members stay clean, but unlike AA, NA declared that it was unconcerned with what particular substance was being abused by the addict. As such, when NA adapted AA’s First Step, which involves members acknowledging their powerlessness over alcohol, the word “alcohol” was removed and, in its place, the term “addiction” was inserted. This seemingly small change actually represented a significant modification, for it announced that as indebted as NA was to the path laid out by AA, it held a different belief about the fundamental nature of addiction. By stressing that addiction—and

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not the particular substance, be it alcohol or heroin or any other drug, to which the user is addicted—is the problem, NA’s revision of AA’s First Step reflects the “disease concept” of addiction. Beyond this conceptual difference about the nature of addiction, NA generally resembles AA in how it operates and works to promote sobriety. As is the case with AA, the bedrock of NA is the meeting of local fellowships, at which addicts join together to provide mutual support in their quest to lead clean lives. These gatherings are open to addicts of all religious, social, racial, and ethnic backgrounds, and members often find therapeutic value in working closely with other addicts, discussing their struggles, and pledging assistance to one another’s quests to lead drug-free lives. Weekly meetings usually take place in buildings run by public, religious, or civic organizations, and they generally consist of individual members who function as meeting leaders guiding other members to take part by sharing their own trials and tribulations in recovering from drug addiction. NA meetings also resemble those of AA in that they are guided by the principles contained in the Twelve Steps and Twelve Traditions, which are a series of ideas and protocols borrowed from AA that aim to promote recovery from addiction. Among the most important steps are those that involve addicts admitting their problem, believing in a higher power capable of restoring normalcy in their lives, undergoing a searching self-examination, making amends to persons harmed as a result of their addiction, and trying to carry the message of NA to other addicts in need. The most contentious of these principles are those involving a belief in a God or higher power, as NA emphasizes the centrality of spirituality to recovery from addiction. NA maintains that it is, like AA, a

nonreligious organization, and members are encouraged to define this God/higher power in their own terms so as to better achieve the spiritual awakening deemed vital to recovery from addiction. The similarities between the two organizations are such that AA has an official policy of cooperation, though not affiliation, with NA. In fact, NA has no affiliations with treatment centers or correctional facilities of any kind. Similarly, NA employs no professional counselors or therapists in its quest to help narcotics addicts maintain abstinence from all drugs, including alcohol. Beyond the goings-on at local, weekly meetings, NA exists as a larger institution. Since 1972, with the founding of the World Service Organization that year, NA has had a central body, and this Los Angeles– based office has proven instrumental in retaining members and growing the fellowship as a whole. In addition to the headquarters and the local meetings, NA maintains a Web site, http://www.na.org, which contains information for prospective and active members, has online versions of its periodicals and newsletters, and features a store selling NA books and other literature. The 12-step program of Narcotics Anonymous is as follows:   1. We admitted that we were powerless over our addiction, that our lives had become unmanageable.  2. We came to believe that a Power greater than ourselves could restore us to sanity.   3. We made a decision to turn our will and our lives over to the care of God as we understood Him.  4. We made a searching and fearless moral inventory of ourselves.

Nation, Carrie (1846–1911)  635

  5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.   6. We were entirely ready to have God remove all these defects of character.   7. We humbly asked Him to remove our shortcomings.   8. We made a list of all persons we had harmed, and became willing to make amends to them all.   9. We made direct amends to such people wherever possible, except when to do so would injure them or others. 10. We continued to take personal inventory and when we were wrong promptly admitted it. 11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out. 12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs. (Narcotics Anonymous 1998)

Narcotics Anonymous. 1998. “Institutional Group Guide.” http://web.na.org/admin/incl ude/spaw2/uploads/pdf/handbooks/IGG .pdf.

Nation, Carrie (1846–1911) Carrie (or Carry) Amelia Moore (Nation) was born in Kentucky in 1846 to plantation owners, the eldest of four boys and two girls. As a child she was often sick. Her family was not well off, and she had little access to any kind of formal education, but read the Bible often. Her mother suffered from mental illness and believed that she was the lady-inwaiting to Queen Victoria, later believing that she was the queen herself. The family moved often, to Kansas, Kentucky, Texas, Arkansas,

NA has three major kinds of meetings it provides to addicts to help them live a drugfree life. First, the leadership meeting, second, the open discussion meeting, and third, the literature discussion meetings. Howard Padwa and Jacob A. Cunningham See also: Alcoholics Anonymous

Further Reading Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Narcotics Anonymous. 1991. White Booklet. Center City, MN: Hazelden Publishing and Educational Services.

Carrie Nation was an early activist who supported the temperance movement across America in the mid- to late 1800s. She was known to go into saloons with an axe and break up bottles of alcohol. (American Stock/ Hulton Archive/Getty Images)

636   Nation, Carrie (1846–1911)

and Missouri. During the Civil War, Carrie helped to take care of injured soldiers. In 1867, Carrie married Dr. Charles Gloyd, a physician from Ohio who was also an alcoholic and a tobacco smoker. Her parents allegedly knew of Gloyd’s drinking problems and tried to prevent the marriage, but to no avail. Together the couple had a daughter, Charlien, in 1868. Not long after, the two separated. Dr. Gloyd soon died, probably because of complications of his alcoholism. Their child, Charlien, was not a healthy child and suffered from multiple physical and mental disabilities, a condition for which Carrie blamed her husband’s alcoholism. She vowed to fight the “demon liquor” that caused her husband to leave her and harm her child. To support herself and her daughter, Carrie was forced to sell some land that was a gift from her father, and along with her husband’s estate, was able to build a small house in Missouri. She lived there with her daughter and mother-in-law while attending the Normal Institute. She received her teaching certificate in 1872 and became a teacher for four years, until being fired after a conflict with a member of the school board. In 1874, when she was 28, Carrie met and married an attorney, David A. Nation, who was 19 years older than she. In addition to being an attorney, Nation also served as a minister and newspaper journalist. David had a daughter from a previous relationship, giving Carrie a stepdaughter. From the start, David and Carrie fought often and did not seem to be happy. Nonetheless, they purchased a 1,700acre cotton plantation in Texas and moved there, along with Carrie’s first mother-in-law. The plantation was not successful. David continued to practice law while Carried operated a hotel. She lived at the hotel with her daughter, her first mother-in-law, and her stepdaughter, Lola. She and David then decided to move to

Richmond, Texas, where they could manage a hotel together. In 1889, David became part of the Jaybird-Woodpecker (Democratic Association) War, a disagreement between political factions in Texas about reconstruction in the post–Civil War era. When his life was threatened, he and Carrie moved to Kansas, where he became a minister at the Christian Church and she managed another hotel. Carrie also taught Sunday school and became a jail evangelist. She assumed that most people who had been arrested were in jail because of alcohol-related offenses. During this time, she became acutely aware of the needs of poor people. She often spoke about the evils of alcohol, but also opposed the use of tobacco and immodest dress by women. While in Kansas, Carrie organized a branch of the Woman’s Christian Temperance Union (WCTU). She had become convinced that alcohol was an evil that had to be rooted out of American society. In Kansas, the citizens had voted for a constitutional amendment establishing prohibition in 1880, but saloon keepers were ignoring the laws and liquor was readily available. The WCTU fought to enforce the state’s ban on liquor sales. They held protests and sang hymns in saloons. But the group’s efforts did not seem to be working, so Nation began to pray to ask God to give her some direction. Her religious beliefs had become more intense in recent months and her belief in God became even stronger when her boardinghouse was left standing after a fire swept through the town. After praying for guidance, Carrie claimed to have received a vision, telling her to go into saloons and smash things. With this “divine ordination” to demolish saloons, Carrie collected “smashers” (rocks and bricks), and entered a number of businesses and began to throw rocks at the liquor bottles in the bar. Not long after, a tornado

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came through Kansas, which Carrie took as a sign of approval from God that she was doing the right thing. Carrie continued to destroy saloons in Kansas with rocks. After one such raid, her husband joked that she could use a hatchet instead of rocks to cause more damage. Thus, in the 1900s, Carrie started a series of “hatchetations” where she would enter a saloon, either alone or with others, axes in hand, and break liquor bottles, windows, and furniture while singing religious hymns. She would also yell to the others, “Smash, ladies, smash!” A very imposing woman, Carrie stood almost six feet tall and weighed about 175 pounds. She described herself as a bulldog. She always wore black and white clothing, making her appearance even more stern. While holding an axe, Carrie was a frightening sight to owners and patrons alike. It is alleged that even prize-fighter John L. Sullivan ran and hid when Nation burst into his New York City saloon to carry out a hatchetation. Carrie and her followers could cause significant damage to the businesses they attacked. She was often assaulted by patrons, and arrested for her hatchetations, some say over 30 times. In order to pay for her fines and her bail, Carrie gave lectures and sold souvenir hatchets. Some weeks, she would make over $300. After a hatchetation in a luxury hotel in Kansas City, Carrie was arrested and appeared in court. The judge fined her $500, but suspended the fine if she never returned to the city. She was also arrested for destroying a nude painting in one saloon, and for vandalizing the saloon in the Kansas State Senate complex. Carrie quickly became famous for her hatchetations, which lasted about 10 years. Saloon owners and patrons used the slogan: “All Nations Welcome But Carrie.” Nonetheless, Carrie continued her temperance

activities. She published a newsletter, The Smasher’s Mail, and a newspaper called The Hatchet. She also wrote an autobiography, The Use and Need of the Life of Carry A. Nation, published in 1904. Carrie and her second husband divorced in 1901, he claiming that she deserted him. They did not have had any children. He died in 1903. Carrie gave many lectures about the dangers of alcohol, but also talked about the dangers of fraternal orders, tobacco use, foreign foods, and barroom art she considered to be pornographic. She also supported women’s rights and suffrage. She also appeared in vaudeville in the United States and in Britain where she lectured about the dangers of alcohol. Her lectures were not always well received. In Britain, she was hit by an egg thrown from the audience. After President McKinley was assassinated, Nation claimed that he got what he deserved, as she believed he drank alcohol in secret. Carrie moved to Arkansas and established a home in the Ozarks that she called Hatchet Hall which she intended to become a school of prohibition. In a speech in Eureka Springs, she collapsed and was taken to a hospital where she died on June 9, 1911. She was buried in an unmarked grave in the family plot in Missouri. Later, the WCTU added a headstone that was inscribed “Faithful to the Cause of Prohibition, She Hath Done What She Could.” The group also purchased her home in Kansas. In 1976 it was declared a national landmark. In her later years, and after her death, Carrie was ridiculed for her actions. The anti-temperance movement used her image, carrying a hatchet, as a way to belittle both the crusade against liquor and for women’s rights. Congress passed Prohibition nine years after Carrie died. While she did not get to

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experience it, Carrie played a significant role in the laws that banned alcohol across the nation. Nancy E. Marion See also: Eighteenth Amendment; Prohibition; Prohibition Party; Temperance Movement; Woman’s Christian Temperance Union

Further Reading Burns, Eric. 2004. The Spirits of America: A Social History of Alcohol. Philadelphia, PA: Temple University Press. “Carry A. Nation.” U.S. History.com. http:// www.u-s-history.com/pages/h1058.html. Grace, Fran. 2001. Carry A. Nation: Retelling the Life. Bloomington: Indiana University Press. Hill, Jeff. 2004. Prohibition. Detroit, MI: Omnigraphics. Lewis, Joan Johnson. “Carry Nation: Hatchet Wielding Saloon Smasher.” About.com Women’s History. http://womenshistory .about.com/od/temperance/a/Carrie -Nation.htm. Nation, Carry A. 2006. The Use and Need of the Life of Carry A. Nation, rev ed. Fairford, UK: Echo Library. PBS. “Carrie Nation.” American Experience. http://www.pbs.org/wgbh/amex/1900/ peopleevents/pande4.html.

National Association of State Alcohol and Drug Abuse Directors The National Association of State Alcohol and Drug Abuse Directors (NASADAD) is a private, not-for-profit organization that was established in 1971 as a forum to assist statelevel drug agency directors. In 1978, the agency expanded its membership to include state-level directors for agencies that deal

with alcoholism and related concerns. The primary goal of the current organization is to support the development and implementation of effective programs geared toward preventing and treating those with problems related to alcohol and drug abuse. To that end, it is an education, scientific, and informational organization that supports research endeavors that will help state officials establish, maintain, and improve their programs related to alcohol and drug abuse concerns. NASADAD works to develop, expand, and use relevant educational materials and scientific research. They coordinate the exchange of information between the states and federal government regarding drug and alcohol abuse, including funding or grant opportunities. The main office is located in Washington, D.C., and has divisions on Research and Program Applications, Prevention Services, and Public Policy. Together, the group evaluates alcohol and other drug-related issues and legislation that are of interest to many state and national organizations and federal agencies. They will often represent states on any issues that come before Congress or other federal agencies. NASADAD also provides information to citizens on health-related policies at both the federal and state level. According to the organization, the general objectives of NASADAD are:  1. To facilitate the translation of research and knowledge into practice and identifies problems and issues that merit further study and research;   2. To foster communication and collaboration with other orgs and national associations that interface with issues of substance abuse;   3. To promote training within the field of substance abuse prevention and treatment as well as cross-training in

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other systems to provide technical assistance to its membership;   4. To promote the establishment of national standards for quality assurance, outcomes, and performance;   5. To shape public policy positions that advance the provision of effective prevention and treatment services and increase funding for same; and   6. To maintain a stable base of funding to ensure continued long-term financial viability. In addition, NASADAD has also developed the National Treatment Network, an organization composed of state alcohol and drug agencies. In recent years, a network for women called Women’s Service Network has been created. This group focuses primarily on issues that affect female drug addicts, treatment, and their recovery. NASADAD has also created a network for all HIV/AIDS coordinators at the state level that gives them a way to share ideas and learn more about programs that service this population. In 2011, NASADAD received a $1.1 million grant from the Substance Abuse and Mental Health Services Administration to help states maximize the use of their available resources earmarked for substance abuse programs as a way to increase service delivery systems and care. In the end, the grant will help state-level substance abuse agencies to increase their service capacity to their clients who are in need of treatment. It will also help states respond more quickly and more efficiently to emerging issues as they arise. Nancy E. Marion

Further Reading National Association of State Alcohol and Drug Abuse Directors. “About Us.” http:// nasadad.org/about-us.

National Association of State Alcohol and Drug Abuse Directors. “Treatment.” http:// nasadad.org/treatment.

National Clearinghouse for Alcohol and Drug Information (U.S.) The National Clearinghouse for Alcohol and Drug Information (NCADI) is the information service of the Center for Substance Abuse Prevention, which is located in the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services. As the world’s largest resource of current information and materials concerning substance abuse and drugs, this federal agency is the focal point for information on drugs, tobacco, and other substance abuse. It provides information through publications (brochures, fact sheets, monographs, pamphlets, and posters) and a computerized information service that is tailored for use by parents, teachers, youth, communities, and prevention/treatment professionals, usually at no charge. NCADI has established a Prevention Materials Database that includes over 8,000 materials related to drug use prevention. The materials NCADI collects come from many different agencies. Some of those include the Center for Substance Abuse Prevention, the Center for Substance Abuse Treatment, the National Institute on Alcohol Abuse and Alcoholism, and the U.S. departments of Education and Labor. Every week, NCADI keeps track of the top 50 requested publications and lists those for readers. The top 10 requested publications have recently related to teenagers and drug use. Some other topics included addiction, treatment, HIV/AIDS, older adults, drug fact sheets, substance abuse disorders

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in the workplace, alcohol and pregnancy, family therapy, Spanish-language publications, problem gambling, and mental health issues. Many of the publications issued by NCADI are part of a series. For those who are interested, the agency can send them either individually or as a complete set. Some of the series publications include: • • • • • • • • • • • • • • • • • • • • • • • • •

Communities That Care CSAP Resource Guides CSAT Treatment Advisory Drug Abuse Warning Network Drug and Alcohol Services Information System Knowledge Application Program Keys Making the Link Fact Sheets Mind Over Matter Series Monitoring the Future Study Morbidity and Mortality Weekly Report National Survey of Substance Abuse Treatment Services National Survey on Drug Use and Health NIAAA Alcohol Alert NIAA Special Report to the U.S. Congress on Alcohol and Health Quick Guides SAMHSA Managed Care SAMHSA News SAMHSA Short Reports Technical Assistance Bulletins Technical Assistance Publications Tips for Teens Treatment Episode Data Set Treatment Improvement Protocols Uniform Facility Data Set What You Need to Know

Located in Rockville, Maryland, NCADI is staffed by both English- and Spanishspeaking personnel who are available to

make recommendations on a range of topics, from appropriate posters and videos to grant and funding information. They also make referrals to other organizations. Anyone interested in receiving periodic updates from NCADI via e-mail can arrange for that. Anyone interested in learning more or in requesting a free customized search can contact the clearinghouse to speak to a representative. Nancy E. Marion

Further Reading “National Clearinghouse for Alcohol and Drug Abuse Information.” Substance Abuse and Mental Health Services Administration. http://www.cocommunity.net/agency/ national-clearinghouse-alcohol-and-drug -information.html. NCADI. http://ncadi.samhsa.gov/. “SAMHSA: National Clearinghouse For Alcohol and Drug Information.” U.S. Department of Health and Human Services. http:// www.dhs.state.il.us/page.aspx?item=4843.

National Council on Alcoholism and Drug Dependence (NCADD) The National Council on Alcoholism and Drug Dependence (NCADD) is the largest public health advocacy group in the United States on alcoholism and drug-related problems. NCADD was born out of the desire to better educate Americans about alcohol and alcoholism, and it was founded, initially under the name of the National Committee for Education on Alcoholism (NCEA), in 1944 by Marty Mann, the first woman to recover from alcoholism through Alcoholics Anonymous (AA). Over the decades since its founding, NCADD established, among other things, the first research society dedicated to alcoholism and the first public education campaign promoting the disease concept of alcoholism.

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NCADD began as the NCEA in 1944 as a result of the work of Marty Mann, who envisioned a public health organization— along the lines of those already in exis­tence dedicated to the medical conditions of tuberculosis, cancer, and heart disease—geared towards changing America’s perception of alcoholism and alcohol. Mann’s initial efforts were supported by a number of prominent Americans, chief among them perhaps being E. Morton Jellinek, one of the nation’s most influential proponents of the disease conception of alcoholism. An associate editor of the Quarterly Journal of Studies on Alcohol and a creator of the Yale Plan Clinics—which were the first American outpatient clinics for the treatment of alcoholics—Jellinek saw Mann as a natural partner in promoting the idea of alcoholism as a disease, and he offered for Yale to sponsor the nascent organization. Starting with an annual budget of $13,000 and a small office in New York City staffed merely by a lone secretary and herself, Mann grew the NCEA out of its Yale beginnings and into a national organization with local branches across the country. Spurring this growth was the NCEA’s five-point program, which, firstly, aimed to educate local communities about alcoholism. Secondly, it worked to create alcohol information and referral centers in those communities. Thirdly, it pushed for the involvement of community hospitals, rather than jails, in the detoxification of alcoholics. Fourthly, it worked to create clinics for diagnosing and treating alcoholism, and, fifthly, it helped establish rest centers that offered long-term care for alcoholics. Volunteers were responsible for running the local NCEA chapters, and many of the unpaid staffers were recovered alcoholics and members of their families. In support of these local branches and their work on various alcohol-related fronts, the NCEA

also promulgated five ideas nationally. First, the NCEA argued that alcoholism is a disease. Consequently, its second point was that alcoholics are sick people. Their third idea was that alcoholics could be helped; the fourth, and related, notion was that alcoholics were worth helping. The fifth and final idea was that because alcohol is a public health issue, it was the public’s responsibility to address it. After a decade of NCEA advocacy, public health campaigns, and work on behalf of alcoholics, Americans proved receptive to the organization’s ideas and programs, and many began to view alcoholics not as criminals, but as diseased individuals. Ten years after its founding, the NCEA had grown to include 50 communities spread across 27 states. Helping spur this development were state governments, which began allocating tax dollars to develop alcoholism treatment programs rather than taking punitive measures against alcoholics. By 1953, some 3,000 hospitals offered care for acute cases of alcoholism; by contrast, fewer than 100 hospitals did so when Mann founded the NCEA. Similarly evidencing the sea change in Americans’ views on alcoholism, a 1957 Roper poll showed that 58 percent of the nation viewed alcoholism as a disease; a mere 6 percent felt that way in 1943, the year before the NCEA’s founding. Reflecting these remarkable developments, the NCEA itself underwent a transformation. It amicably separated from Yale and underwent an organizational name change, becoming the National Committee on Alcoholism (NCA). The organization’s development over many of those years had much to do with R. Brinkley Smithers, a recovering alcoholic and philanthropist who was elected to the organization’s board of directors in 1954. Under his stewardship, the NCA was able to add a dozen staff members, expand the board

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of directors to 60 volunteers, establish a direct service program for New York City, and found the earliest reference library of its kind on alcoholism. The NCA also did consulting work with companies worried about the impact of alcoholism on their business, and it entered into working relationships with a variety of labor, health, clergy, and women’s organizations. Brinkley’s philanthropy likewise enabled the NCA to appoint to its staff Dr. Ruth Fox, who would lead the organization into the medical and research field. The government took note of the NCA’s importance as a public health organization, and the secretary of health, education, and welfare dubbed it America’s agency for alcoholism. Federal funding for research projects followed, and in 1966, President Johnson appointed Marty Mann to the first national advisory commission on alcoholism. Now a fixture in Washington, D.C., the NCA successfully advocated for the passage of the 1970 Hughes Act, which established the National Institute on Alcohol Abuse and Alcoholism. In addition to its successes in Washington, D.C., the NCA also developed a number of prominent educational campaigns intended to destigmatize alcoholism. The organization’s messages were worked into the storylines of television sitcoms and dramas, and more overtly, the NCA arranged professional education and training events. For example, its prominent 1976 event, “Operation Understanding,” featured 52 famous Americans announcing their recovery from alcoholism. After Marty Mann’s death in 1980, the NCA entered a period of flux on multiple fronts. For one, Mann’s passing deprived the organization of its key figure, a woman who, even after stepping down as the head of the NCA in 1967, continued to be its biggest advocate through years of public speaking. Without the founder’s presence, the NCA also experienced significant financial dif-

ficulties that necessitated the philanthropic intervention of R. Brinkley Smithers’s foundation. The NCA’s name also underwent yet another change, with the organization that was initially called the NCEA becoming the National Council on Alcoholism and Drug Dependence (NCADD) in 1990. The name change reflected the increasing number of alcoholics who were addicted to more than one substance, and it was generated by the growing dissonance between the national organization and its affiliates, whose treatment programs for such patients became far larger than their public education and policy work. The strained relationship between NCADD and its affiliates led to the number of local affiliates dropping, in 2000, below 90 after a high of over 230 in the early 1980s. In recent years, NCADD has emphasized the importance of rebuilding its relationship with affiliates. NCADD has also renewed its commitment to leading public education campaigns, and as such, it has a leading role in promoting Alcohol Awareness Month and National Recovery Month. Likewise, NCADD and its messages continue to be a part of public consciousness through cable television programming, newsletters, and its Web site, http://www.ncaad.org. NCADD services covers two broad areas, alcohol and drug abuse. The drug section includes prescribed, nonprescribed, and hard drugs. NCADD offers its services to parents, youth, and addicts recovering from drug abuse. NCADD therefore provides preventive and treatment services. Howard Padwa and Jacob A. Cunningham See also: Alcoholics Anonymous; Jellinek, E. Morton; National Institute on Alcohol Abuse and Alcoholism

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance

National Drug Control Strategy  643 in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. National Council on Alcoholism and Drug Dependence. “NCADD History and Mission.” http://www.ncadd.org/history/index.html.

National Drug Control Strategy The National Drug Control Strategy is a yearly report that outlines a plan or framework to reduce illicit drug use and availability in the United States. It is created each year by the Office of National Drug Control Policy (ONDCP). Each year, the office develops goals to reduce drug use and policies to reach those goals. It also attempts to reduce the manufacture and distribution of illicit drugs and the crime and violence associated with it. Another goal is to reduce the health consequences that result from the use of illicit drugs. The yearly strategy usually has both domestic and international components. At the same time, many of the components are geared toward the local governments and allow communities to address their drug problems as they choose. The plan typically has components of drug treatment, prevention, and interdiction. There is also an attempt to create a workable balance between treatment for those addicted to drugs and criminal sanctions for drug activities. One essential component revolves around initiatives to prevent illicit drug use by young people and those identified as being in “high-risk” populations.

The law enforcement component of an antidrug strategy is essential. The strategy typically incorporates strong support for law enforcement’s role in fighting illicit drug trafficking, particularly the disrupting and dismantling of organizations involved in such behaviors. This can include investigations, arrests, prosecutions, and imprisonment of drug traffickers, and seizing of their assets. The Drug Control Strategy under President George W. Bush included additional federal funding for faith-based drug treatment programs. President Obama released his initial National Drug Control Strategy in 2010. In included efforts to reduce illicit drug use across the United States. His strategy is to focus on a balanced approach to substance abuse prevention, treatment, and recovery. According to Obama’s Drug Control Strategy, his approach is to: (1) Prevent drug use before it ever begins through education; (2) Expand access to treatment for Americans struggling with addiction; (3) Reform our criminal justice system to break the cycle of drug use, crime, and incarceration while protecting public safety; and (4) Support Americans in recovery by lifting the stigma associated with those suffering or in recovery from substance use disorders. According to the 2013 National Drug Control Policy, Obama has set goals that should be met by 2015. They are: Goal 1: Curtail illicit drug consumption in America. 1a. Decrease the 30-day prevalence of drug use among 12–17 year olds by 15 percent. 1b. Decrease the lifetime prevalence of 8th graders who have used drugs, alcohol, or tobacco by 15 percent. 1c. Decrease the 30-day prevalence of drug use among young adults aged 18–25 by 10 percent.

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1d. Reduce the number of chronic drug users by 15 percent. Goal 2: Improve the public health and public safety of the American people by reducing the consequences of drug abuse. 2a. Reduce drug-induced deaths by 15 percent. 2b. Reduce drug-related morbidity by 15 percent. 2c. Reduce the prevalence of drugged driving by 10 percent. The National Drug Control Strategy is composed of seven chapters. In the first one, called “Strengthen Efforts to Reduce Drug Use in Our Communities,” it is noted that prevention is a foundational pillar of the National Control Strategy and one of the administration’s highest priorities. A national prevention system must be grounded at the community level, and the federal government needs to collaborate with states to support the local communities to reduce drug use. The importance of communitybased prevention is noted. The National Youth Anti-Drug Media Campaign, along with “Above the Influence,” have helped to keep kids from using drugs, and these will continue under the National Drug Control Strategy. Other key elements include strengthening family relationships, disseminating information on drug and alcohol use on college campuses, and working with law enforcement to prevent drug use. Chapter 2 of the National Drug Strategy is called “Seek Early Intervention Opportunities in Health Care.” Because identifying substance disorders early is so critical, today’s health care providers will need to continue to adopt evidence-based approaches to address substance addictions. Through a program called SBIRT (Screening, Brief Intervention, and Referral to Treatment), physicians will ask their patients about their drug abuse

(screening), and then, if necessary, provide a brief intervention or referral for treatment. In Chapter 3, entitled “Integrate Treatment for Substance Use Disorders into Health Care and Expand Support for Recovery,” it is noted that investing in treatment for those who are addicted to drugs reduces health care costs and saves lives. However, only a small portion of those receiving treatment actually get it. To address this, all insurance plans will be required to cover mental health and substance use disorder services (drug treatment). Additionally, there will be an expansion of community-based recovery support programs. “Break the Cycle of Drug Use, Crime, Delinquency, and Incarceration” is the title of Chapter 4. Through alternatives to incarceration such as drug courts, the Obama administration seeks to decrease recidivism and reinvest the money into abuse treatment services. The administration is also reducing barriers to reentry and recovery for inmates, and supporting treatment and other ser­ vices for those who have been released from prison. They also seek to do more to prevent young people from entering into or moving further into the criminal justice system because of substance abuse. The need to “Disrupt Domestic Drug Trafficking and Production” is the focus of Chapter 5. The Drug Strategy notes that criminal groups, both international and in the United States, are responsible for smuggling and distributing drugs and are also responsible for much of the violence that occurs. Law enforcement at all levels play a role in reducing drug use by targeting these organizations. The federal government will support drug law enforcement. In Chapter 6, “Strengthen International Partnerships,” the administration’s plans to work with regional allies to address the drug threats that affect citizens are described. The Obama administration seeks to collaborate

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with international partners to disrupt the drug trade; support the drug control efforts of major drug source and transit countries; and attack key vulnerabilities of drug trafficking organizations. And finally, Chapter 7, “Improve Information Systems for Analysis, Assessment, and Local Management,” indicates that the policies and programs found in the National Drug Control Strategy are evidenced-based and grounded in scientifically rigorous studies that have been published by government sources or in peer-reviewed literature. Because of this, existing sources of data should be maintained and enhanced. It is important that new data systems and analytical methods to address existing gaps in the existing data should be developed and implemented. Moreover, measures of drug use and related problems must be useful at the state and community level. The Drug Control Strategy also contains two examples of a “Policy Focus.” The first one is on how to reduce drugged driving, and the second is on preventing prescription drug abuse. In an effort to raise awareness about drugged driving, President Obama declared December as National Impaired Driving Prevention Month. Additionally, the ONDCP will work with national partners such as Mothers Against Drunk Driving and RADD: The Entertainment Industry’s Voice for Road Safety to produce educational programming for youth. The administration will continue to work to educate states about “zero tolerance” laws and the importance of drugged driving legislation. The office is also equipping the nation’s law enforcement officers with training as an integral part of reducing drugged driving crashes. To prevent prescription drug abuse, the administration has plans for education (of physicians), monitoring (drug monitoring programs between states), disposal programs for un-

needed prescription drugs, and enforcement to address doctor shopping and pill mills. Nancy E. Marion See also: Bennett, William; Bush, George W.; Clinton, Bill; High-Intensity Drug Trafficking Areas; Office of National Drug Control Policy

Further Reading Office of National Drug Control Policy. http:// www.whitehouse.drug.policy.gov/. Office of National Drug Control Policy. “The 2013 National Drug Control Strategy.” http://www.whitehouse.gov/ondcp/ 2013-national-drug-control-strategy. Office of National Drug Control Policy. “The 2013 National Drug Control Strategy— Full Strategy.” http://www.whitehouse .gov//sites/default/files/ondcp/policy-and -research/ndcs_2013.pdf.

National Drug Policy Board The National Drug Policy Board was created on March 26, 1987, through Executive Order 12590, signed by President Ronald Reagan. The board was established as a way to develop and coordinate the National Drug Policy geared toward reducing the supply and use of illegal drugs. The board’s strategy was to include international approaches to reducing the availability of drugs, law enforcement strategies, and components of prevention, education, treatment, and rehabilitation. The board was also to devise a plan to collect information regard illegal drug use and support additional research. Part of the board’s responsibilities was also to advise the president and Congress on programs and policies that should be implemented to reduce illicit drug use and abuse. The board was also given the responsibility to coordinate all groups and agencies that

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had a role in fighting illicit drug use. To do this, the board was to establish a Drug Enforcement Coordinating Group and a Drug Abuse Prevention and Health Coordinating Group, the members of which were to be designated by the chairman of the board. According to Reagan’s executive order, the board comprises the following members: (1) the attorney general, (who served as chairman); (2) the secretary of health and human services, who shall serve as vice chairman; (3) the secretary of state; (4) the secretary of the treasury; (5) the secretary of defense; (6) the secretary of the interior; (7) the secretary of agriculture; (8) the secretary of labor; (9) the secretary of housing and urban development; (10) the secretary of transportation; (11) the secretary of energy; (12) the secretary of education; (13) the director of the Office of Management and Budget; (14) the assistant to the president for national security affairs; (15) the director of central intelligence; (16) the chief of staff to the vice president; (17) the director of the White House Drug Abuse Policy Office; and (18) such other members as the president may, from time to time, designate. On June 30, 1988, the board presented a report to President Reagan. In a statement given about the report, Reagan said, “we cannot tolerate drug users who provide the illegal market for the drugs or who benefit from the taxpayers’ generosity through Federal grants, contracts, or loans. We must hold people responsible for their drug use through

accountable treatment programs and through our parole and probations systems. This problem touches all of us at home, at school, at work, whether in government or in the private sector.” He then went on to describe the six goals of the report. The first was a drug-free work force, both in the government and in the private sector that would be ensured by random drug testing and treatment programs. Second was to ensure drug-free schools that would be made a condition for receiving federal aid. The third goal was to expand drug treatment and the accountability of the treatment to ensure that those programs eliminate drug use. Fourth, the report recommended expanding international cooperation through interdiction, joint detection, apprehension, and eradication programs. The fifth goal was increased law enforcement and sentencing, such as the federal death penalty for drugrelated murders. The final goal was to expand the public’s awareness of the dangers of drug use. Nancy E. Marion

Further Reading Reagan, Ronald. 1987. “Executive Order 12590—National Drug Policy Board.” March 26. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ws /?pid=34026. Reagan, Ronald. 1988a. “Remarks to the National Drug Policy Board.” October 3. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=34956. Reagan, Ronald. 1988b. “Statement on the Recommendations of the National Drug Policy Board.” June 30. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=36063.

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National Household Survey on Drug Abuse The National Household Survey on Drug Abuse is also known as the National Household Survey on Drug Use and Health (NSDUH). The survey, first conducted in 1971, samples household members 12 years and older in which respondents are randomly selected and then interviewed about their current and past use of a wide sample of legal and illegal drugs, including alcohol. From 1972–1990, the survey was conducted every two or three years. Since then, the survey is taken annually. Participants record their responses on answer sheets that are self-administered. The sample is around 70,000 people. The survey results provide data on national and state use of tobacco, alcohol, and illicit drugs (including nonmedical use of prescription drugs) and mental health in the United States. The NSDUH is sponsored by Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Department of Health and Human Services. The surveys and projects of the NSDUH are supervised by SAMHSA’s Center of Behavioral Health Statistics and Quality. The NSDUH is authorized by Section 505 of Public Health Service Act, which requires surveys to collect data on the level and patterns of substance abuse in the United States. Data collected by the NSDUH must achieve the following goals: • provide accurate data on the level and patterns of alcohol, tobacco, and illegal substance use and abuse; • track trends in the use of alcohol, tobacco, and various types of drugs; • assess the consequences of substance use and abuse; and

• identify those groups at high risk for substance use and abuse. Many government agencies, private organizations, and individuals use NSDUH data, for example, the White House Office of National Drug Control, the U.S. Department of Justice, and state health agencies to estimate the number of treatment facilities needed. The selection process of respondents follows a scientific random sample of households across the United States. Once a household is chosen, it cannot be replaced; this is to ensure the data is representative of the larger U.S. population. An interviewer visits the household to do an in-person interview, and after the interview the respondent is given $30. The survey maintains the confidentiality of respondents, which is required by the Confidentiality Information Protection and Statistical Efficiency Act of 2002. When completed, the results show the incidence, prevalence, and trends in drug use for the United States. Statistics from the survey are used by the federal government to plan future policy and establish funding priorities related to substance abuse. The survey’s primary purpose is to estimate the prevalence of illegal drug use (the number of people using illegal drugs) in the United States. The name of the survey was recently changed to the National Survey on Drug Use and Health to reflect changes in the focus of the information collected. According to the 2008 survey, an estimated 20.1 million Americans aged 12 or older were current users of illicit drugs, meaning they had used an illicit drug during the month prior to the survey. This figure represents 8.0 percent of the population aged 12 years old or older.

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The illicit drugs used included marijuana/ hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescriptiontype psychotherapeutics used nonmedically. The rate of illicit drug use was 8.0 percent, the same as in 2007. The most commonly used illicit drug was marijuana. Further statistics showed that in 2008, there were 1.9 million cocaine users, composing 0.7 percent of the population. Hallucinogens were used in the past month by 1.1 million people (0.4 percent) aged 12 or older in 2008, including 0.2 percent who had used Ecstasy. The number of methamphetamine users decreased by over half between 2006 and 2008. Regarding alcohol use, the survey found that a little more than half of Americans aged 12 or older reported drinking alcohol (51.6 percent). This means that about 129.0 million people use alcohol. Over one-fifth of the respondents (23.3 percent, or 58.1 million people) participated in binge drinking. Heavy drinking was reported by 6.9 percent of the respondents. Among young adults aged 18 to 25, the rate of binge drinking was 41.0 percent, and the rate of heavy drinking was 14.5 percent. Some results of the survey show that in 2008, there were about 9.8 million adults who were dealing with serious mental illness (SMI), which accounts for about 4.4 percent of adults in the country. The rates of those with SMI were highest for adults between the ages of 18 and 25 (7.4 percent) and lowest for those adults who were over the age of 50 (2.3 percent). Women had more SMI (5.6 percent) than did men (3.0 percent). Those adults who were unemployed had a higher rate of SMI (8.0 percent) than those who had employment either full time (3.5 percent) or part time (4.8 percent). The results of the survey are limited because some populations are not included in the process. For example, those who are

homeless or live in dormitories, prisons, or hospitals are not included in the survey. Because the questionnaire is voluntary and participants self-report their behaviors, the results may be biased and may underestimate the extent of drug use. Some respondents may not want to report their drug behavior for fear of repercussions or punishments, or may not understand the language used in the questionnaire. These issues may affect the results and accuracy of the survey results. Nancy E. Marion See also: Alcohol Use; Cocaine and Crack; Monitoring the Future Survey; Substance Abuse and Mental Health Services Administration

Further Reading Abadinsky, Howard. 2011. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Wadsworth Cengage. Substance Abuse and Mental Health Services Administration. “National Survey on Drug Use and Health.” http://www.oas.samhsa .gov/nhsda.htm. Travis, Jeremy. 1998. “National Institute of Justice: Research in Brief.” NarcOfficer (March/April). U.S. National Survey on Drug Use and Health. 2008. “Results from the National Survey on Drug Use and Health: National Findings.” Rockville, MD: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. U.S. National Survey on Drug Use and Health. 2009. “Results from the National Survey on Drug Use and Health: National Findings.” Rockville, MD: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Wright, Douglas A. 2003. “State Estimates of Substance Use from the 2001 National

National Institute on Alcohol Abuse and Alcoholism (NIAAA)  649 Household Survey on Drug Abuse.” Rockville, MD; Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

National Institute on Alcohol Abuse and Alcoholism (NIAAA) The National Institute on Alcohol Abuse and Alcoholism (NIAAA) was formed in 1970 when President Richard Nixon signed the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act. The agency serves as the nation’s primary institute and source of funding for alcohol-related research. It is the first U.S. federal agency dedicated exclusively to alcohol since the Prohibition Bureau, and it is guided by the idea that alcoholics deserve medical treatment as opposed to social rejection or moral censure. It is the primary agency that is responsible for conducting scientific research on the effects of alcohol. The agency has conducted and funded a multitude of research, and disseminated the research findings to the public in its attempt to improve public health. The origins of the NIAAA are located in the history of efforts to reframe alcoholism as a medical condition instead of a moral failing. With the founding of Alcoholics Anonymous (AA) in 1935, the nation became more appreciative of an approach to alcoholism based on the idea of aiding alcoholics in their recoveries instead of simply judging them as morally suspect. Similarly, the research and publications coming from the Yale Center on Alcohol Studies beginning in the mid-1930s helped shift the nation’s focus onto alcoholism as a disease that warranted scientific research along the lines of other sicknesses. In the

following decades, the disease conception of alcohol was further institutionalized with the founding of the National Committee for Education on Alcoholism, which was later renamed the National Council on Alcoholism and Drug Dependence, and the American Medical Association’s 1955 statement that alcoholism was a treatable disease. In the 1960s, the American Psychiatric Association and the American Public Health Association also declared alcoholism an illness. With growing momentum behind the idea of alcoholism as a treatable illness, in 1970, President Richard Nixon signed the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act, generally known as the Hughes Act. The law took the name of Senator Harold E. Hughes of Iowa, the first admitted recovering alcoholic to serve in Congress. The Hughes Act recognized alcohol abuse and alcoholism as major public health issues. Consequently, the bill created the NIAAA to deal with these problems. The Hughes Act defined the NIAAA’s mission as one of researching, developing, and conducting programs aimed at preventing and treating alcoholism and helping rehabilitate alcoholics. Additionally, the Hughes Act, among other things, required that alcoholism programs be made available to federal civilian employees, prohibited discrimination with regard to the hiring and firing of recovered alcoholics in nonsecurity jobs, and authorized the distribution of federal funds to states and researchers for a variety of alcohol-related projects across the country. In particular, the NIAAA funded projects geared towards developing prevention and treatment programs for specific groups, such as Native Americans, drunk drivers, women, employed individuals, the poor, the homeless, and young people.

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In 1981, the NIAAA was overhauled under the Reagan administration. These changes came in the wake of criticisms over the NIAAA’s lobbying efforts, the way the group distributed its funds, and its advocacy of responsible drinking, which was seen by some as an indirect endorsement of alcohol consumption. The new NIAAA was decentralized and ultimately moved within the National Institutes of Health, along with sister organizations like the Alcohol, Drug Abuse, and Mental Health Administration and the National Institute on Drug Abuse. These moves also forced the NIAAA into a near-exclusive focus on science and research with a biomedical orientation. One of the NIAAA’s most important research endeavors has been Project MATCH, an eight-year, nationwide clinical study geared towards determining the efficacy of various treatment approaches through patient responses. Launched in 1989 and monitoring 1,726 patients in over 30 alcohol-related institutions and agencies, the study compared the approaches and results of three major alcohol-abuse treatments. Project MATCH studied the 12-step facilitation therapy connected to AA, the cognitive-behavioral therapy approach to alcohol treatment that focuses on coping skills to prevent relapses, and motivational enhancement therapies that were designed to increase drinkers’ commitments to behavioral change. Interestingly, this large clinical trial concluded that there were no significant differences in levels of success from the three therapies. The NIAAA has also, in recent years, focused on research involving the genetics of alcoholism and the efficacy of intervention methods of treating alcohol abuse. With regard to the latter, the NIAAA has aided trials surrounding the pharmacological treatment of alcohol dependence, particularly the use of naltrexone, an opioid-receptor antagonist,

and acamprosate, a drug that scientists believe may restore the chemical balance in the brain that is disturbed by alcoholism. In addition, the NIAAA has widely supported research involving underage drinking. Especially in the 1990s, the NIAAA focused its efforts on the issue of college drinking by developing the Task Force on College Drinking. Similarly, the NIAAA has involved itself in studying interventions for reducing drinking and driving and the accidents associated with it. Information on these research endeavors and many other projects undertaken by the NIAAA are available at the group’s Web site, http://www.NIAAA.nih.gov. A great deal of this material can be easily downloaded, but much of the NIAAA’s findings are also published as part of a congressional mandate to summarize the state of the nation’s alcoholrelated problems and researchers’ efforts to deal with them. This publication is the Alcohol and Health Report, and the NIAAA also produces the journal, Alcohol Research and Health, which has appeared since 1973. The NIAAA is one of the 27 institutes and centers that constitute the National Institute of Health. The NIAAA has the following major research projects: Medications Development, Underage and College Drinking Program, Fetal Alcohol Spectrum Disorders Program, and the Collaborative Study on the Genetics of Alcoholism Studies. Howard Padwa and Jacob A. Cunningham See also: Alcoholics Anonymous; National Council on Alcoholism and Drug Dependence; National Institute on Drug Abuse

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO.

National Institute on Drug Abuse (NIDA)  651 Mendelson, Jack H., and Nancy K. Mello. 1985. Alcohol: Use and Abuse in America. Boston: Little, Brown and Company. National Institute on Alcohol Abuse and Alcoholism. “About NIAA.” http://www.niaaa .nih.gov/AboutNIAAA/. National Institute on Alcohol Abuse and Alcoholism. “Research.” http://www.niaaa.nih .gov/research. Nixon, Richard. 1974. “Remarks on Signing Two Bills Providing for Drug and Alcohol Abuse Prevention.” May 14. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=4207. Warren, Kenneth R., and Brenda G. Hewitt, “NIAAA: Advancing Alcohol Research for 40 Years.” National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa .nih.gov/publications/arh40/5–17.htm.

National Institute on Drug Abuse (NIDA) The National Institute on Drug Abuse (NIDA) is the federal agency that serves as the government’s center for research on drug abuse and addiction. NIDA’s mission is to advance scientific research on addiction, and the organization addresses the most fundamental and essential questions about drug abuse. It focuses on understanding how drugs work in the brain and body, developing and testing new treatment and prevention approaches, and detecting and responding to emerging drug abuse trends. Before the 1970s, the center of government research into addiction was located at the Addiction Research Center at the U.S. Public Health Service Narcotic Hospital in Lexington, Kentucky. The structure of the federal government’s antiaddiction efforts underwent an overhaul in the early 1970s, however, with

the closure of the narcotic hospitals as community treatment for addiction became more prevalent. Further changes were made with the dismantling of the Federal Bureau of Narcotics, the creation of the Drug Enforcement Administration, and the passage of the 1970 Comprehensive Drug Abuse Prevention and Control Act. In 1972, the Drug Abuse Office and Treatment Act was part of these broader changes, as Congress sought to strike a balance between taking a punitive, enforcementcentered approach, and the recognition that drug abuse was also a social and public health problem. The Drug Abuse Office and Treatment Act had several provisions designed to address the health concerns associated with addiction. It created a Special Action Office for Drug Abuse Prevention within the White House, provided guidelines for giving grants to states so they could develop and evaluate prevention services, and authorized the creation of NIDA as part of the National Institute on Mental Health. NIDA’s charge under the law was to develop and conduct comprehensive health, education, training, research, and planning programs for drug abuse prevention and treatment, and also to oversee programs for the rehabilitation of drug users. Its first director was Robert L. DuPont, who served in the post until 1978. When it began operating in 1974, the Addiction Research Center at Lexington became the center of NIDA’s research program. Soon after its formation, NIDA began two of its most enduring programs—the Monitoring the Future Survey, and the Research Monograph Series—in 1975. The Monitoring the Future Survey is a survey of high school seniors that measures levels of nonmedical drug use and attitudes towards it. While useful as a research tool, the Monitoring the Future Survey has sometimes been used for political ends as well, as was the case in the 1980s when politicians support-

652   National Institute on Drug Abuse (NIDA)

ing the harsh provisions of the Anti–Drug Abuse Acts used it to scare the public about trends in cocaine and crack abuse among youths. In 1991, NIDA expanded the Monitoring the Future Survey to include eighth graders and 10th graders as well. The Research Monograph Series is the set of publications NIDA uses to disseminate scientific information concerning addiction, with scientific papers that cover subjects concerning drug abuse treatment and prevention. In 1976, NIDA began the Community Epidemiology Work Group, which allowed for local and state representatives to meet with NIDA staff to discuss drug abuse trends in their communities and identify populations at risk for developing addiction problems. In 1979, NIDA moved its clinical research program from Lexington to Baltimore. When Congress and the Reagan administration recognized the connection between intravenous drug use and the HIV/AIDS epidemic, NIDA saw its budget quadruple so it could conduct further research into both diseases. In the 1980s, NIDA also began its monthly newsletter, NIDA Notes, and set up its Drug Abuse Information and Treatment Referral hotline. NIDA has also achieved some major breakthroughs in the study of addiction and its treatment, as it received FDA approval for medications for the treatment of opioid dependence, and NIDA researchers successfully cloned the dopamine transporter, which plays a key role in many psychoactive drugs’ actions in the brain. Recent years have also seen NIDA expand the gamut of its research and prevention efforts beyond illicit substances, as in 1999 it created the Transdisciplinary Tobacco Use Research Centers to study tobacco addiction and find new ways to combat it, and it has since expanded its research efforts to study behavioral addictions as well. NIDA has also continued to expand

its public education and prevention efforts, launching the “NIDA Goes to School” initiative to provide middle school students with information on how drugs affect the brain, as well as programs designed to provide drug education to elementary school students. In 1992, NIDA was transferred to the National Institutes of Health. Today, NIDA has 11 main divisions and offices. The Office of the Director leads the institute by setting research and programmatic priorities. The Division of Epidemiology, Services, and Prevention Research plans, develops, and supports research on the nature and consequences of drug use, gathers data to better support prevention and early intervention services, conducts addiction prevention research, studies the consequences of drug abuse, and researches treatment programs. The Division of Basic Neuroscience and Behavioral Research supports outside research in the biomedical and behavioral sciences that look at addiction as a public health problem, while the Division of Clinical Neuroscience and Behavioral Research focuses on the study of addiction as it relates to brain functioning and individual behavior. The Center for the Clinical Trials Network supports a network of 16 regional training centers and over 200 community treatment programs in hopes of bridging the gap between the latest science on addiction treatment and its practice in real-world settings. The Division of Pharmacotherapies and Medical Consequences of Drug Abuse plans and directs studies in order to identify, develop, and obtain FDA approval for medications that can assist in the treatment of addiction. The Intramural Research Program, based in Baltimore, conducts research on the biological and behavioral mechanisms that cause drug abuse and addiction. The Office of Science Policy and Communications co-

National Minimum Drinking Age Act (1984)  653

ordinates NIDA’s research programs, and develops policy options based on the institute’s latest research. The Office of Extramural Affairs provides scientific analyses of NIDA’s external research activities, while the Office of Planning and Resources Management provides administrative and management support services for the organization. NIDA’s current director is Nora D. Volkow, a doctor who pioneered the use of brain imaging techniques to investigate the toxic and addictive properties of psychoactive drugs. She has served as the director of NIDA since 2003. Howard Padwa and Jacob A. Cunningham See also: Anti–Drug Abuse Acts; Cocaine and Crack

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. National Institute of Health. “The NIH Almanac.” http://www.nih.gov/about/almanac/ organization/NIDA.htm. National Institute on Drug Abuse. “Important Events in NIDA History.” http://www.nih .gov/about/almanac/archive/1999/organizat ion/nida/history.html.

National Minimum Drinking Age Act (1984) The 1984 National Minimum Drinking Age Act is the piece of federal legislation that effectively made the age at which one can legally drink in the United States 21 years old. The law does not directly outlaw underage purchase and possession nationally. In-

stead, the law mandates that states pass such laws if they are to receive federal funding for highway construction. The minimum drinking age remains a state decision. According to studies, the act has accomplished its main goal—to decrease fatalities caused by drunk driving. To meet the requirement set under the federal law, many states chose to pass a ban on drinking by anyone under the age of 18 for any reason. Some of those states include Idaho, North Carolina, and Pennsylvania. Many other states allow underage consumption (under the age of 18) in special situations. For example, in some states, underage people can drink alcohol if a parent or adult is present or during religious ceremonies and occasions. In some states, there is no restriction on private consumption. The punishments for violating the statutes depends on the states. At the beginning of the 20th century, several laws prohibiting the sale of alcohol to minors were implemented as part of the broader trend towards temperance, which culminated with the passage of the Volstead Act in 1919. When alcohol prohibition was repealed in 1933, each state implemented a legal minimum drinking age for the purchase and consumption of alcohol, and most set that age at 21. In the following decades, the question of the drinking age received little public attention, though states began to lower their drinking ages in the mid-1970s after the voting age was dropped from 21 to 18. Between 1970 and 1975, 29 states lowered their drinking ages to either 18 or 19, and around the same time, studies began to show that there were increased rates of teenagers being involved in car accidents. In response, some states—beginning with Maine in 1977—began to raise their drinking ages back up. Research showed that in states that had raised their drinking age, there were declines in the number of car accidents involving young drivers. Soon,

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advocacy groups, led by Mothers Against Drunk Driving, began pushing states to raise their drinking ages, and between 1976 and 1983, many did. Some states resisted, however, since they believed that by raising the drinking age, they would simply encourage youths to cross state lines to drink—not discourage them from engaging in the practice. In response to the states that did not make the changes they were hoping for, advocates for a higher drinking age began pushing for federal legislation to raise the minimum drinking age across the country. There were many individual members of Congress who were involved in enacting the law. One of those was Frank R. Lautenberg, D-N.J., who proposed the bill in the Senate. Another was Senator Gordon J. Humphrey, R-N.H., who proposed offering benefits to those states that modified their laws rather than penalizing those that did not. Representative James J. Howard, D-N.J., proposed an amendment that would also set a national speed limit at 55 mph. Finally, Senator Lowell P. Weicker Jr., R-Conn., believed that simply raising the drinking age was not sufficient to solve the problem of drunk driving in general. At first, President Reagan condemned the legislation, arguing that it was an infringement on states’ rights. He believed that the drinking age was a decision that should be made by officials in individual states. However, he later changed his opinion and then agreed to support the bill. The change, no doubt, had an influence on the public’s support of the bill as well as members of Congress. The media also had a part to play in the legislative battle over the drinking age. They used statistics to demonstrate the need to increase the drinking age and save lives. This also had an impact on the public’s support of the bill. It may also have affected the support Congress had for the proposal.

The resulting legislation, the 1984 National Minimum Drinking Age Act, did not directly legislate that the nation’s minimum drinking age had to be 21. Instead, it used funding leverage to cajole states to change their laws, stipulating that if a state did not have a minimum drinking age of 21 by 1986, it would lose 10 percent of its federal funding for highway construction. Threatened with losing a major source of federal dollars, the states that had not yet raised their drinking age did so in short order, and by 1988 all states had made their minimum drinking age 21 years old. Studies conducted in the 1980s showed that the Minimum Drinking Age Act had its desired effect, as rates of car accidents involving youths dropped dramatically. Overall, it was estimated that by raising the drinking age to 21, states have decreased the number of night-time, single-vehicle crashes among youths by 13 percent. According to the National Highway Traffic Safety Administration, having the minimum drinking age at 21 saves over 1,000 lives per year. Other studies also found that by raising the drinking age, states were able to reduce rates of vandalism and suicide among youths. In spite of the law, it is estimated that over half of high school seniors drink alcohol, and nearly a third of them drink heavily. Howard Padwa and Jacob A. Cunningham See also: Mothers Against Drunk Driving; Students Against Destructive Decisions

Further Reading Alcohol Policy Information System. http:// alcoholpolicy.niaaa.nih.gov/What_s_New .html. American Medical Association. “Facts About Youth and Alcohol.” http://www.ama -assn.org/ama/pub/physician-resources/ public-health/promoting-healthy-lifestyles/ alcohol-other-drug-abuse/facts-about

National Narcotics Border Interdiction System (NNBIS)  655 -youth-alcohol/minimum-legal-drinking -age.shtml. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Hanson, David J. “The National Minimum Drinking Age Act of 1984.” http:// www2.potsdam.edu/hansondj/youthissues /1092767630.html. Liebschutz, Sarah F. 1985. “The National Minimum Drinking Age Law.” Publius 15(3): 39–51. Palicz, K. “Legislative Analysis of the National Minimum Drinking Age Act.” National Youth Rights Association. http:// www.youthrights.org/research/library/legi slative-analysis-of-the-national-minimum -drinking-age-act/?sid=. Reagan, Ronald. 1984. “Remarks on Signing a National Minimum Drinking Age Bill.” July 17. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=40164. U.S. Government. “Title 23—United States Code: Highways.” http://epw.senate.gov/ title23.pdf.

National Narcotics Border Interdiction System (NNBIS) Established in 1983 by President Reagan, the National Narcotics Border Interdiction System’s purpose was to “monitor suspected smuggling activity originating outside the national borders and coordinate agency seizures of contraband and arrests of persons involved in illegal drug importation” (Shannon 1989, 98). In other words, it was supposed to coordinate federal activities related to stop the flow of drugs into the United States. The NNBIS would work closely with the Drug

Enforcement Administration (DEA) and the Department of Justice in enforcing its plan. It eventually consisted of 13 different task forces that used personnel from various federal and state agencies around the country to coordinate their activities in combating drug trafficking. The creation of the NNBIS was primarily due to the lack of coordination between the many agencies who played a role in stopping drugs at the border, each with their own goals, priorities, and funding. The NNBIS is headed by the vice president and has the following members: secretaries of state, treasury, defense, and transportation, the attorney general, the counselor to the president, the director of central intelligence, and the director of the White House Drug Abuse Policy Office. The NNBIS was created to complement the efforts of the regional Drug Enforcement Task Forces that were operated by the Department of Justice. The NNBIS also monitors suspected smuggling activity originating outside national borders and destined for the United States. In a political rally in 1984, President Reagan said of the new system: We’ve established the National Narcotics Border Interdiction System, under the superb leadership of Vice President Bush, to wage war on drugs. And today drug seizures and arrests are at record levels. I know that Coast Guard men and women stationed here in Mississippi are playing a leading role in this vital effort. In a case that just took place, days ago, the Coast Guard cutter Acushnet, right here in Gulfport, came across a fishing boat that flew no proper flag. The Acushnet pulled alongside, and five Coast Guard officers went aboard. Well, the Coast Guard officers knew for certain something was wrong when they saw that all the hatches had

656   National Narcotics Border Interdiction System (NNBIS)

been nailed shut. In the end, they confiscated almost 4 tons of marijuana, towed the fishing boat into Gulfport, and made six arrests. I know that you’d like to join me in thanking the officers and crew of the Acushnet for a job well done. Reagan continued to praise the actions of the system in 1987 when he said: “Put another way, in 1979 the average Federal sentence for drug dealers was over 50 months. Since then it has climbed steadily to 70 months, and drug convictions have doubled. Some of you may have been involved in the National Narcotics Border Interdiction System that works under the direction of Vice President Bush.” And in 1988, the president’s praise continued in remarks he made at a graduation ceremony at the Coast Guard Academy: Because of that success, the next year we formed the National Narcotics Border Interdiction System, also led by the Vice President, to coordinate Federal, State, and local law enforcement efforts against drug smuggling nationwide. Since the formation of the Border Interdiction System in 1983, annual cocaine seizures involving the Coast Guard are up more than 20 times what they had been. In 1987 I established the National Drug Policy Board in order to coordinate all of the administration’s efforts in this crusade. This board, chaired by Attorney General Meese, has developed a series of comprehensive strategies to reduce both the supply and demand for illicit drugs. In 1984, the NNBIS came under fire after the head of the DEA, Frances Mullen Jr., claimed that the NNBIS was a liability and that it may have hindered the DEA from having a bigger impact. In 1985, the General Accountability Office reported that the

NNBIS was largely ineffective in stopping drug traffickers at the border. Ron Chepesiuk See also: Bush, H. W.; Drug Enforcement Administration; Drug Trafficking; Meese, Edwin

Further Reading Brinkley, Joel. 1984. “Director of Federal Drug Agency Calls Reagan Program ‘Liability.’” New York Times, May 13. http:// www.nytimes.com/1984/05/13/us/director -of-federal-drug-agency-calls-reagan -program-liability.html. Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. Gibson, William E. 1985. “Drug Task Forces Called a Failure.” Sun Sentinel, July 19. http://articles.sun-sentinel.com/1985 -07-19/news/8501290983_1_anti-drug -agencies-border-system-gao. Kraft, Michael, and Edward Marks. 2012. U.S. Government Counterterrorism: A Guide to Who Does What. Boca Raton, FL: CRC Press. National Narcotics Border Interdiction System. http://www.reagan.utexas.edu/archives /speeches/1983/32383c.htm. Reagan, Ronald. 1984a. “Radio Address to the Nation on Drug Abuse.” October 6. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=39198. Reagan, Ronald. 1984b. “Remarks at a Reagan-Bush Rally in Gulfport, Mississippi.” October 1. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=40463. Reagan, Ronald. 1987. “Remarks at a White House Briefing for Members of the National Law Enforcement Council.” July 29. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=34621.

National Organization for the Reform of Marijuana Laws (NORML)  657 Reagan, Ronald. 1988. “Remarks at the United States Coast Guard Academy Commencement Ceremony in New London, Connecticut.” May 18. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=35847. Shannon, Elaine. 1989. Desperadoes. New York: Viking. U.S. Government Accountability Office. 1984. “Justice and Law Enforcement: The Role of the National Narcotics Border Interdiction System in Coordinating Federal Drug Interdiction Efforts.” http://www.gao.gov/ products/123698.

National Organization for the Reform of Marijuana Laws (NORML) The National Organization for the Reform of Marijuana Laws (NORML) is a nonprofit advocacy group that lobbies to change the legal status of marijuana in the United States. It is the oldest and largest organization advocating for the reform of the nation’s marijuana laws. NORML was founded in 1970 by Keith Stroup, and was initially funded by Hugh Hefner, the founder and publisher of Playboy magazine. By its second year, it had assembled an eclectic group ranging from drug-using hippies to lawyers who used marijuana recreationally and civic leaders who believed that the nation’s marijuana laws were too strict. NORML seemed to have achieved a major victory in 1972, when President Richard Nixon’s National Commission on Marihuana and Drug Abuse conducted an exhaustive study of the drug, and found that the drug was largely harmless and recommended reductions in sentencing for marijuana-related offenses. Nixon, however,

did not agree with the commission’s findings, and marijuana remained a Schedule I drug under the Comprehensive Drug Abuse Prevention and Control Act of 1970. Unsuccessful on the national legislative front, NORML turned to the states, where it helped garner publicity for the issue and advised state legislators on what strategies and expert witnesses would be most effective, sometimes paying expenses so outside witnesses could travel to states to testify. Within a few years NORML’s advocacy bore legislative fruit, as in 1973 Oregon ended criminal penalties for smoking the drug, and by 1975, Alaska, California, Maine, Colorado, and Ohio had followed suit. NORML also began an extensive legal program, providing aid to individual defendants and court challenges against the constitutionality of federal antimarijuana laws and the government’s ban on the use of the marijuana for medical purposes. It seemed that NORML was gaining momentum at the federal level as well in 1976, when Jimmy Carter endorsed the decriminalization of marijuana early in his campaign. Once he was elected president, however, Carter backed off his earlier support of marijuana law reform. NORML faced new challenges with the rise of conservatism in the late 1970s and President Reagan’s tough stance on illegal drugs in the 1980s. Nonetheless, NORML had an extremely productive first decade, as all told, it led successful efforts to decriminalize marijuana offenses in 11 states, and significantly lower penalties for marijuana offenses in many others. Today, NORML continues to advocate for marijuana law reform at both the state and federal level, pushing for voter initiatives concerning marijuana laws and for legislative reform. It is active in the media, working to provide a different perspective on marijuana-related issues. NORML also serves as

658   National Organization for the Reform of Marijuana Laws (NORML)

an umbrella group for a national network of citizens who want to end marijuana prohibition and legalize the use of the drug, and it has a network of lawyers in every state that can help individuals who run into trouble for violating federal marijuana laws. NORML does not, however, advocate for marijuana use, nor does it believe it should be completely unregulated. Instead, it focuses on removing criminal penalties for private possession and responsible use of the drug by adults, and wants the law to allow for its cultivation for personal use and casual nonprofit transfers of small amounts of the drug. It believes that like there is for alcohol, there should be a controlled market for marijuana, where consumers could purchase it from safe, legal, and regulated sources. And, as is the case with alcohol, the organization does not advocate its use by children, nor driving while under the influence of the drug. Another major area of concern for NORML is the use of marijuana as a medicine for the relief of pain caused by nerve diseases, nausea, spasticity, glaucoma, and movement disorders, and also its use as an appetite stimulant for patients suffering from HIV/AIDS. On this front, NORML has the support of more than 60 United States and international health organizations, though according to federal law, the drug is still not allowed for medical use. In the 1990s, NORML unsuccessfully brought legal action against the Drug Enforcement Administration in hopes of altering federal laws concerning the medical use of marijuana. In addition, the group actively works to support the right of farmers to cultivate the nonpsychoactive strain of cannabis, hemp, for industrial uses such as food and fiber production. Women who support decriminalizing marijuana can join NORML’s Women’s Alliance, a group of women who support legalization efforts. This organization,

formed in 2010, is a nonpartisan group of educated, prominent, successful women who believe the marijuana should be legalized. They believe that it undermines the family, sends a mixed message to young people, and is not in line with the principles of states’ rights. They help to educate others about marijuana, and have a core group of speakers who are available to meet with the public and the media to discuss marijuana legalization. One of the positions taken by the Women’s Alliance is that the fiscal priorities of marijuana prohibition are failing, wasting billions of dollars each year. Moreover, the prohibition of marijuana violates states’ rights by taking away their right to choose the legal status of the drug. It also expands the reach of government into the lives of law-abiding citizens. The members of the Women’s Alliance support open and honest conversations with young people that present facts rather than myths and scare tactics. They support science-based evidence about medical marijuana. Finally, the members of the Women’s Alliance oppose the sexual exploitation and objectification of women in the businesses related to marijuana. The NORML Foundation is a 501(c)3 nonprofit organization founded in 1997 as a way to educate the public about marijuana and marijuana policy. They do this through weekly press releases to the media, and a regular newsletter. They also work to assist victims of the current laws. Any donations made to the foundation are tax deductible. More information on NORML and its current activities is available at the group’s Web site: http://norml.org/index.cfm?Group_ ID=3374. Howard Padwa and Jacob A. Cunningham See also: Cannabis; Controlled Substances Act; Hemp; Marijuana; Medical Marijuana; Reagan, Ronald, and Nancy Reagan

National Research Council Report on Drug Enforcement Activities  659

Further Reading Anderson, Patrick. 1981. High in America: The True Story Behind NORML and the Politics of Marijuana. New York: Viking Press. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. National Organization for the Reform of Marijuana Laws. “FAQ’s.” http://norml.org/ index.cfm?Group_ID=3418. National Organization for the Reform of Marijuana Laws. “Introduction.” http://norml .org/index.cfm?Group_ID=5493. National Organization for the Reform of Marijuana Laws. “Medical Use.” http://www .norml.org/index.cfm?Group_ID=5441.

National Research Council Report on Drug Enforcement Activities In 1998, the White House Office of National Drug Control Policy sponsored a study by the National Research Academies to review the entire range of data and research that might contribute to informed policy making about illegal drugs. The National Research Council reported in 2001 that although the federal government invests about $12 billion each year in drug-enforcement programs, little evidence exists to determine the programs’ effectiveness. It was noted that the nation’s ability to evaluate whether its drug policies work is no better now than it was 20 years ago, and the assessment of drug-enforcement activities is severely hampered by an absence of adequate, reliable data on both drug consumption and the cost of illegal drugs. According to the chairman of the committee, “It is unconscionable for this country to continue to carry out a public policy of this magnitude and cost without any way of knowing whether, and to what extent, it is having the desired result.”

The final report describes that enforcement activities are composed of both domestic and international aspects. Domestically, antidrug efforts are primarily geared toward prohibiting the manufacture, sale, possession, or use of illicit drugs, whereas the international aspects of enforcement focus had been arrested for drug offenses. This is three times as many as in 1980. This also means that 289,000 drug offenders were incarcerated in state prisons, 12 times the number that had been incarcerated in 1980. At this point, the nation’s drug enforcement measures are not based on scientific evidence that indicates if they are effective in reducing illicit drug use. We do not know enough about how drug markets operate, nor how and why users begin to use drugs, how or when they decide to increase or change their use, how much of the drug they consume, and why they may choose to quit. There is a need for future research to address these gaps in our information about drug use. More analysis is also needed about the costs of the drugs, and how changes in the cost will affect use patterns. Another aspect of research that needs to be improved, according to the council’s report, is the efforts that producers and traffickers undertake to thwart enforcement in one geographic location by moving their smuggling routes or production elsewhere. Furthermore, the council report indicated, additional research is needed to determine how the effects of enforcement activities based on supply-reduction behaviors should be measured, in an effort to pinpoint the typical time lag between successful enforcement operations and changes in the way that producers and traffickers conduct business. In the end, after the committee members reviewed numerous studies that described the effectiveness of a variety of prevention activities, they discovered mixed results.

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While some of the prevention efforts were found to be effective in delaying the initiation of drug use or the frequency of drug use among minors, since most of the research has focused on evaluating school-based approaches, many other strategies have been largely ignored in the research. Moreover, many programs have not been evaluated at all. Some of the programs that have been found to have very little impact on illegal drug use, such as the DARE program, continue to be funded with large allocations. The full report was entitled “Informing America’s Policy on Illegal Drugs: What We Don’t Know Keeps Hurting Us.” It is available on the National Academy Press Web site. Richard E. Isralowitz See also: Drug Abuse Resistance Education; Drug Czar; Office of National Drug Control Policy; Reagan, Ronald, and Nancy Reagan

Further Reading Kleiman, Mark. 1998. “An Informed Approach to Substance Abuse: Drugs and Drug Policy: The Case for a Slow Fix.” Issues in Science and Technology. http://www.issues .org/15.1/kleima.htm. Manski, Charles F., John V. Pepper, and Carol V. Petrie. 2013. “What We Don’t Know Keeps Hurting Us.” Washington, DC: National Academies. http://www.nap.edu/ openbook.php?record_id=10021. National Academy of Sciences. “Data Sorely Lacking on Effectiveness of Nation’s DrugEnforcement Programs.” http://www8.nat ionalacademies.org/onpinews/newsitem .aspx?RecordID=10021.

National Treasury Employees Union v. Von Raab (1989) Von Raab was the commissioner of the Customs Department in the U.S. government.

It was the role of the Customs Department to interdict and seize illegal drugs being smuggled into the country. Von Raab implemented a drug-testing program (a urinalysis) for three categories of employees: those people who wanted to transfer into a position where they would have direct contact with drug interdiction programs; those who carried firearms as part of their job; and those who handled “classified” material. An applicant would be told that their promotion/ hire would be based on the results of the drug screening. The results of the test could not be turned over to any other agency, including prosecutors, without the employee’s consent. Through the testing program, the Customs Service was attempting to exclude employees who may be compromised by their drug use from sensitive positions. The employees’ union filed a lawsuit on behalf of the employees, seeking to overturn the testing requirements because the program was a violation of the Fourth Amendment’s right against illegal search and seizure. So the issue in the case was if the drug testing program implemented by the U.S. Customs Service that required urine tests from any employee who sought a transfer or promotion to particular positions violated the Fourth Amendment provisions concerning search and seizure found in the U.S. Constitution. The U.S. district court ruled that the program was unconstitutional. However, the court of appeals decided that while the program may involve a search under the Fourth Amendment, the search in this case was reasonable given the limited scope and the nature of the position for detecting and halting drug use by their employees. Under review, the Supreme Court held that drug tests for those positions that involve the interdiction of illegal drugs or that require an employee to carry a firearm meet the rea-

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sonableness requirement and therefore do not violate the Fourth Amendment. Justice Kennedy wrote the decision. In it, he noted that the Fourth Amendment typically mandates that a warrant must be issued before conducting a search of an individual, and that warrant must be based on a suspicion that the individual probably committed an illegal act. The justices explained that drug use was endemic in our society, and that a U.S. Customs agent who abused drugs may be in danger of being bribed or blackmailed or otherwise compromised. Further, a customs agent who may be under the influence of drugs when carrying a firearm may be likely to misuse that firearm. Moreover, the Customs Service only sought to perform drug testing on those employees with sensitive information. That drug testing would be done in private, and the results would remain private. Because of those reasons, the Supreme Court ruled that the Customs Service was justified in infringing on a person’s right to privacy. In a dissenting opinion, Justice Thurgood Marshall and William Brennan argued that the other justices had acted too quickly in dismissing the requirement that probable cause be established before conducting a search, as required by the Fourth Amendment. In the end, the decision indicated that the Court believed that there are dangers related to taking illicit drugs in certain positions that include sensitive information or are highrisk occupations, and that employers should have more latitude in requiring drug testing. Nancy E. Marion See also: Drug Screening and Testing; Urinalysis

Further Reading National Treasury Employees Union v. Von Raab, 489 U.S. 656. Justia, U.S. Supreme

Court Center. http://supreme.justia.com/ cases/federal/us/489/656/case.html. National Treasury Employees Union v. Von Raab. ProCon.Org. http://aclu.procon.org/ view.resource.php?resourceID=526. U.S. Supreme Court. Treasury Employees v. Von Raab. FindLaw. http://caselaw .lp.findlaw.com/scripts/getcase.pl?court =US&vol=489&invol=656.

National Youth Anti-Drug Media Campaign The National Youth Anti-Drug Media Campaign is a U.S. government–funded initiative to reduce and prevent drug use among young people. Through the use of television, radio, and other advertising, complemented by public-relations efforts including community outreach and institutional partnerships, the campaign addresses youths directly and indirectly as well as encourages their parents and other adults to take actions known to affect drug use. The campaign was initiated under the Treasury-Postal Appropriations Act of 1998 with Congress-approved funding (P.L. 105-61). Annually, the campaign receives about $180 million to deliver its messages. The Drug Reform Coordination Network (http://www.drcnet.org) reported that this taxpayer-funded advertising campaign had cost $929 million by 2002 and included more than 200 TV commercials using popular performers such as the Dixie Chicks and Mary J. Blige in an effort to turn kids away from drugs. Under contract from the National Institute on Drug Abuse, Westat (a private consulting group) in cooperation with the Annenberg School for Communication at the University of Pennsylvania conducted an evaluation focused on evidence of the campaign’s effects on youths and parents, including recall

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of campaign messages, effects on parents, and effects on youths. From the final evaluation, little evidence was found supporting a favorable effect of the campaign on youths, either directly or through their parents’ exposure to the campaign. In fact, there was evidence consistent with an unfavorable direct effect of the campaign on youths’ cognizance of marijuana. The media campaign has two major focuses: a teen-targeted Above the Influence (ATI) Campaign, and a young adult–targeted Anti-Meth Campaign. Recently, the current media campaign of Above the Influence focuses more on conveying a national message that drug use preventing can be done at the local level with targeted efforts at the community level. This method allows the campaign to reach all teens across the country and encourage them to participate in ATI programming at the community level. The ATI campaign collaborates with other organizations that serve youth populations, such as Drug-Free Community grantees, Boys and Girls Clubs of America, Students Against Destructive Decisions chapters, Girl’s Inc., Girl Scouts, Community AntiDrug Coalitions of America, the National Organization for Youth Safety, ASPIRA, and Y’s (formerly YMCAs). These agencies all work with the media campaign in implementing locally programmed ATI activities with teens. The campaign maintains a strong online presence and communicates with about 300,000 teens through Facebook and its Web site. The campaigns are effective and having positive effect on teens. Teen awareness corresponds with the level of drug-free teen society. However, the campaign is not without its critics. In 1998, New York Times columnist Frank Rich questioned if the fiveyear, $1 billion government ad campaign

would make kids swear off drugs. He poked fun at the ad that involved a young female who smashed eggs with a skillet as a way to show teens about the dangers of drugs. However, he points out that the actress looks like Winona Ryder wearing a tight tank top, and can be perceived to be sexy rather than a drug addict. He questions if the ads will be effective, given the small budget and number of ads, even accusing them of being wasteful. Instead, the money would be better spent on law enforcement, after-school programs, or drug treatment. Some suggested that the ads be replaced with antismoking ads. An in-depth study was done of public service media campaigns such as this one in 2002. The authors note that there is some research that shows that mass media campaigns can be successful, but most studies that examine the effects of mass media campaigns show that they have little or no effect. These campaigns don’t work because most health promotion campaigns have typically been underfunded, which in turn limits the reach and frequency of the messages. Moreover, the funding agency has relied on the goodwill of broadcasters to place the ads in time periods that are frequently watched by the target audience, which doesn’t always happen. Further, not only is the exposure critical, but so is the message. Evidence shows that if the message is presented well, the messages do significantly change behavior. The effectiveness of the messages also depends on the behavior trying to be changed, and the target audience. The researchers studied the potential effectiveness of 30 antidrug PSAs produced by the Partnership for a Drug-Free America. In the end they found wide differences in the effectiveness of the PSAs. Most of the PSAs made adolescents believe that they and their friends would be less inclined to choose drugs or that they would be more confident

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about how to handle those situations in which drugs were offered to them or made available. However, there were other PSAs that seemed to have little or no effect on the teens’ attitudes. There were six PSA ads that had a negative effect on youth perceptions. That means that after watching the six PSAs about drug use, the teens believed that they and/or their friends would be more likely to try drugs. Overall, the study showed that the most effective PSAs concerned heroin and methamphetamine use, while the least effective PSA had to do with marijuana or drugs in general. In the end, the authors of the study recommend that only the PSAs that were more effective in changing teen perceptions should be used in the government’s national antidrug campaign. Alternatively, the authors recommended that any PSAs that have a negative impact on teen perceptions should not be aired. They also recommended that the PSAs that focus on “saying no” to marijuana should be aired with caution. Instead, new ads should be developed that focus more on the negative consequences of smoking marijuana should be developed. Finally, more research needs to be done to determine the relationships between perceived harm, danger, and social norms to the PSA. Nancy E. Marion See also: Drug Abuse Resistance Education; National Drug Control Strategy; Office of National Drug Control Policy

Further Reading Anti-Drug Media Campaign. http://www. whitehouse.gov/ondcp/anti-drug-media -campaign. Carpenter, C. S., and C. Pechmann. 2011. “Exposure to the Above the Influence Antidrug Advertisements and Adolescent Marijuana Use in the United States, 2006–2008.”

American Journal of Public Health 101(5): 948–54. Fishbein, Martin, Kathleen Hall-Jamieson, Eric Zimmer, Ina von Haeften, and Robin Nabi. 2002. “Avoiding the Boomerang: Testing the Relative Effectiveness of Anti­ drug Public Service Announcements Before a National Campaign.” American Journal of Public Health 92(2): 238–45. Library of Congress, Congressional Research Service. 2009. “The War On Drugs: The National Youth Anti-Drug Media Campaign.” Office of National Drug Control Policy. 2010. “National Youth Anti-Drug Media Campaign.” Washington, DC: Office of National Drug Control Policy, Executive Office of the President. Palmgreen, P., E. P. Lorch, M. T. Stephenson, R. H. Hoyle, and L. Donohew. 2007. “Effects of the Office of National Drug Control Policy’s Marijuana Initiative Campaign on High-Sensation-Seeking Adolescents.” American Journal of Public Health 97(9): 1644–49. Rich, Frank. 1998. “Just Say $1 Billion.” New York Times, July 15. http://www.nytimes .com/1998/07/15/opinion/journal-just-say -1-billion.html?ref=frankrich. U.S. Government Accountability Office. 2006. “ONDCP Media Campaign: Contractor’s National Evaluation did not Find That the Youth Anti-Drug Media Campaign Was Effective in Reducing Youth Drug Use.” Washington, DC: U.S. Government Accountability Office.

Native Americans and Substance Abuse Native Americans now have just over 2 percent of the territory they possessed at the time the European conquest began. Their history includes the early reservations, which were little removed from concentra-

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tion camps, the boarding school experience, and insults to their heritage by the general public and government. A history of oppression and a current situation that is little better contribute to dismal Native American health and abuse statistics. American Indian/Alaska Native (AI/AN) population growth between 2000 and 2010 was much greater than the national average, with AI/AN population rising 26.7 percent compared to a 9.7 percent overall increase. The AI/AN share of the total U.S. population rose from 1.5 to 1.7 percent between 2000 and 2010. Native Americans are younger than average, have larger families, and are poorer. Both the poverty rate and the unemployment rate are 25 percent, and on some reservations, for example of the Montana Blackfoot, unemployment reached 69 percent in 2007. Native Americans are more likely to lack medical coverage, so they have higher rates of disease and death. Infant mortality is 8.6 per 1,000 compared with 6.9 per 1,000 overall. They are above average in negative health behaviors such as smoking, obesity, and low physical activity. Only 30 percent have health insurance. They also have higher levels of illegal drug abuse, with methamphetamine use on reservations of particular concern to tribal and federal governments. Life expectancies below the national average are a consequence of poor health, poor health services, and negative health behaviors, including drug and alcohol abuse. Native American youth are particularly susceptible because they often have low selfesteem, are highly stressed, and experience conflicting cultural demands. Many have a weak self-image and confusion about who they are. Adolescent angst and coming to grips with Indianness in a sociocultural environment that is harsh promote Indian abuse of drugs and alcohol. When the dominant cul-

ture promotes experimentation by the young, the young often succumb to the pressures.

Magnitude of the Problem In the United States, there are 9.8 million men and 3.9 million women who are dependent on alcohol or who abuse alcohol. Native Americans are more susceptible to alcohol and are five times as likely as other Americans to become addicted. The 1989 National Household Survey on Drug Abuse by the Substance Abuse and Mental Health Services Administration revealed that while roughly half of all adolescents had experience with alcohol, Native American adolescent rates were closer to 80 percent. A 2002–2005 study showed that 10.7 percent of Native Americans had alcohol use disorder compared to 7.6 percent of all other groups. Among Indians, women were more likely than men to be alcoholic, although women on average drank less. Incidence of fetal alcohol syndrome among Native Americans was higher than average, with some Alaskan rates tripling the national average for nonIndians. The AI/AN alcohol-related death rate of 11.7 percent includes traffic and other accidents as well as alcohol-related disease, homicide, and suicide. In 2007, 13 percent of AI/ANs age 12 and over had experienced alcohol dependence or abuse in the previous year. For the national population, 9 percent experienced alcohol dependence or abuse in the previous year, less than one in 10. One third of the 65,000 Cherokees in Oklahoma are age 17 or younger. These young people have higher rates of abuse of tobacco, alcohol, marijuana, and cocaine than do their white counterparts. Cherokee adults who abuse drugs and alcohol are more inclined to abuse and neglect children or suffer serious injury, and they are more likely to be involved with the police. Cherokee Tribal Child Protective Services reported that 39

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percent of its caseload had substance abuse as a significant factor.

Institutional Support Only 55 percent of AI/AN abusers get treatment from federally funded tribal or Indian Health Service (IHS) facilities. The rest use other public or private facilities. As of 2009, of over 13,000 substance abuse facilities surveyed, 283 were specifically for Native Americans, with tribal government running 172, the IHS running 34, and other organizations running 77 and offering treatment in a Native American language. Thirty-two states had Indian- or Alaska Native–specific facilities. Arizona had 36, followed by New Mexico with 30, California with 26, Washington with 24, Oklahoma with 23, Alaska with 21, Wisconsin with 16, Michigan with 15, and Oregon with 12. AI/AN-specific facilities are more likely than the national norm to offer aftercare and family counseling (long-term services beyond the immediate need)—91 to 78 percent for the former and 85 to 76 for the latter. On the negative side, tribal facilities were more likely than IHS, private, state, local, or community facilities to offer only outpatient facilities. Inpatient detoxification is more effective than outpatient. And Native American–specific facilities were less likely to offer special programs for criminal justice clients—24 to 31 percent. Again, AI/AN facilities tend to offer lesser services. In 2007, there were 13,648 substance abuse facilities, with 259 of them AI/ANspecific. Of the AI/AN-specific facilities, 189 were tribal, 41 were under IHS auspices, and 29 were run by an entity other than the tribes or IHS. Forty-three percent of AI/AN facilities had services in at least one AI/ AN language. Another 76 facilities offered treatment in at least one native language. Fifty-two of the 76 were private nonprofit facilities, 18 were private for profit, and six

were supported by local, state, or federal government. Government facilities may or may not be native-specific. Although the AI/AN population is more rural than the national average, the majority is urban, with 61 percent urban in 2000 compared with 38 percent in 1970. According to a 2009 report, only 40 percent of substance abuse facilities in 2007 were in urban areas; the majority of IHS and tribal facilities were in rural areas. Seventy-three percent of tribal and 63 percent of Indian Health Service facilities were in rural areas in 2007, but 62 percent of privately owned and governmentoperated facilities for Native Americans were in urban settings. Only 4 percent of AI/AN facilities, whether private or government, provided opioid treatment (via methadone or buprenorphine). Users were more likely to get opioid treatment at mixed-client facilities than at IHS or tribal facilities—11 percent of mixed client facilities did, and only 2 percent of IHS or tribal facilities did so.

Alcohol Alcohol is the most dangerous drug—it is available everywhere and deadly to tribal youth. Europeans introduced alcohol to Native Americans. Because the Europeans who provided the first alcohol were binge drinkers for the most part, when they introduced alcohol they introduced binging as well. Currently, Native American alcoholics are continuing a problem that is at least three or four generations old in some families, in some cases even older. Minto is an Alaska Native community with 85 to 90 percent unemployment. Legally, there is no alcohol in Minto, with sale and importation banned, but access for the young is easy. Minto lacks opportunities and resources for healthy and positive activities. A major pastime is drinking to abuse, and alcohol-related death is

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common whether through suicide, exposure to cold weather, or boat and car accidents. Community leaders are worried. In Alaska, addiction took less than a generation to become disastrous. Not until after World War II were restrictions on access to alcohol by AI/ANs lifted. Exposure to alcohol in the 1950s brought the Alaska Native community face to face with the harmful effects of the drug. Alcoholism was a leading cause of death by the early 1970s, and in this same decade the suicide rate, which had been comparable to the national average through the 1950s, began to rise. The 1960s and 1970s also saw increases in other indicators of societal disarray and individual behavioral problems, including among them murder, assault, depression, avoidable accidents, and sex crimes (including against children). As with suicide, there was a direct link between these behaviors and alcohol abuse. Drug abuse, specifically abuse of alcohol, is now the number one problem of Alaska Natives, who have a suicide rate four times the national average, and an astounding 80 percent of all deaths are related to alcoholism or alcohol abuse. Native Americans between the ages of 15 and 24 have a fatal accident rate three times the national average. Suicide is their second leading cause of death. Alcohol kills Native Americans at greater rates than it does the overall population. Cirrhosis and other liver diseases, which are the sixth leading cause of Indian death, are not in the top 10 for whites. Alaska Natives have the highest fetal alcohol syndrome death rate of all, 4.2 per 1,000. While a 1989 study showed that 50 percent of all adolescents used alcohol, the level for Native Americans was 80 percent.

Drugs In May 2009 as alcohol dependence remained a major problem in the Indian

community, drug addiction became an issue requiring attention. Methamphetamine (meth) abusers are also often alcohol abusers. Meth is a prescription drug used to treat attention deficit disorder and obesity; it is also made and distributed illegally by Mexican cartels who manufacture on both sides of the border. Other drug traffickers are Asian, black, and Native American gangs and criminal organizations. Indian country receives its drugs from Mexican cartels, and much marijuana is grown on the reservation. California led in meth incidents; the state has over 100 rancherias (unincorporated hamlets, primitive and often without services or facilities) and reservations on which Native Americans reside. Fifteen percent of Navajo high school students used meth in 2003, and meth is a factor in 40 percent of Navajo reservation crimes. Reservations are a natural drug manufacture site because they are remote, underpoliced, and have plenty of space for making and distributing drugs. The appeal of reservations grew as Mexico tightened importation of precursor chemicals and the United States tightened border control. Small labs using over-the-counter chemicals proliferated in Indian country, and as of 2010, Arizona had a reputation as meth lab for the United States. Other popular drugs are marijuana and cocaine. While cocaine and marijuana use rates for Indians have risen slowly, meth rates have skyrocketed because the drug is cheap and widely available, two factors making it particularly attractive to teens, but not only to teens. The meth problem includes older Indians between the ages of 40 and 50, and huffing paint or gasoline is a precursor for preteen meth abusers. Meth use by AI/ANs was higher than any other ethnicity in 2008, almost double the average. In 2004, the Indian Health Service RPMS Patient Care component and Be-

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havioral Health reporting system recorded 6,875 meth-related encounters. In 2005, the number was 9,577, a 39.3 percent increase in one year. And 2006 was ready to continue the trend. The Office of National Drug Control Policy earmarked part of its funding to an awareness campaign targeting Native Americans. It is the only national antimeth campaign directed at AI/AN. The cost to the federal government was $750,000. It involved federal, state, and tribal officials. The keys were pride and cultural strength. Ad themes included “Pride” and “We don’t need meth.” A Native American ad company created the campaign. Initially, the antimeth campaign involved print and public radio in 2007. When the Partnership for a Drug-Free America and the National Council of American Indians (NCAI) joined in, television spots were added. The spots emphasize native pride and culture. The ads challenge adults to protect their children by talking about drugs and instilling pride in Native American culture. The ads were tested with focus groups across the AI/AN spectrum. Total cost of the three months that the ads ran was $1.5 million in media value but, due to donations, only $750,000 in actual cost. Once the ad campaign expired, the ads were available to communities as public service ads. Some state and tribal officials wanted more money to fight the epidemic, and others noted that the campaign did not address underlying problems. A three-month media campaign is not a solution. In its aftermath, there remains the problem of inadequate mental health treatment, including not enough concern for dealing with depression, suicidal impulses, or other sources of pain that drugs “alleviate.” Underfunded medical programs mean even basic needs are hard to

meet, and special programs are unlikely to be implemented. Nothing in the program, critics said, prevented the epidemic and related problems from returning once the three months lapsed. Nothing in the program pays for cleaning up former meth labs. New Mexico secretary of Indian affairs Alvin Warren noted that the campaign needed to commit resources for treatment, law enforcement, and prevention. In the previous two years, the federal government added 30 additional drug enforcement officers to help police over 500 tribes, and six or seven more were promised for 2010. Critics said it was not enough for reservations, rancherias, and other communities surrounded by meth abuse and with insufficient funds to hire additional police. The National Council of American Indians (NCAI) urged collaboration among tribal, state, and federal agencies. In April 2010, the federal government began its first national campaign targeting meth abuse in Indian country. Indian meth use by then was twice that of any other ethnic group. The campaign involved television, billboard, and print ads in 15 states for three months, April through July. Implementation of the campaign did indicate that the federal government was shifting at least toward the medical model if not toward the traditionalist selfesteem approach to addressing drug abuse. The medical model was at least better than the criminal one. Still, it was a government program, and there was concern about how to overcome Indian country mistrust of the federal government. Critics noted that government had to be explicit that the arrest of users was not the goal of the program. To promote trust on the part of Indians accustomed to arrest and government mistreatment, the implementation of the medical model had to include a strong message and educational component, both stressing making better choices.

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Memorandum of Agreement on Indian Substance Abuse Prevention The following, from the Federal Register, records (in part) an agreement from 2009 between the IHS (Indian Health Service), DHHS (Department of Health and Human Services), BIA (Bureau of Indian Affairs), and (BIE) Bureau of Indian Education to work jointly to develop programs to reduce substance abuse among Indian tribes.

These agencies will continually reaffirm the need for coordinated approaches to prevent child abuse and neglect and its longterm social and economic consequences (poor academic performance, substance use, multiple disorders, suicides, etc.) and promote a full range of effective services for abused American Indian and Alaska Native children and their families.

American Indian youth, ages 12–17, have the highest percentage rate for illegal drug use according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Prevention efforts targeting youth and young adults are the most cost-effective in addressing this problem. It has been clearly demonstrated that the younger an individual is when he/she encounters a prevention message, the better the outcome. . . . The IHS, BIA, and BIE will coordinate delivery of healthcare and wellness support services to boarding school residents and their families. The agencies will support efforts to align policies such that residents have appropriate access to healthcare services including a range of behavioral health services on-site. Such services will, where possible, be part of an integrated, holistic approach to student support that includes appropriate recognition and targeting of interventions to both general student populations and high risk students. . . . The BIA, BIE, and the IHS will obtain input from local tribes on planning initiatives. This will strengthen the coordinated interagency multidisciplinary response for the protection of children and the prevention of child abuse and neglect in American Indian and Alaska Native communities, especially for drug endangered children.

Community Solutions The Department of Education’s Drug-Free Schools and Communities Program asked community workers and specialists in 1988 and 1990 (even before drug abuse became a serious problem) what Native Americans would like to see as solutions to their alcohol problems. They found consensus that abuse was not only an individual, but a family and community problem. Alcoholism was multigenerational, with families recording three to four generations of abuse with more to come. Alcoholism was not a standalone problem but a visible indicator of many hidden problems. Alcoholism is tied to depression, stress, cultural shame, and other problems. In the late 1980s, tribes and other communities were working to resolve their own problems. The underlying assumption was that only Indians could create true solutions to Indian problems. As Native Americans worked on the problems, their sense of optimism grew that they could cure people in their communities with substance abuse problems not only in the present but into the future. They engaged family, school, social service and medical communities, law enforcement, and government in this effort. Another tool they took advantage of in solving their problems was tribal tradition, particularly spiritual values. The Salish and Kootenai of Montana, through the Blue Bay Healing Center, have

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community meetings to discuss the impact of substance abuse in their communities and their feelings about it, determine what is currently being done, develop plans, assign responsibilities, collect resources, train people, and measure progress. Other communities promote youth involvement in heritage programs to enhance self-esteem, sponsor national organizations (such as Boy Scouts, Campfire Girls, the 4-H Club, and Girl Scouts), and establish a full schedule of peer meetings and cultural activities to reduce idle time. The Isleta Navajo tribe made an effort to provide recreation as an alternative to substance abuse, building ball fields, a swimming pool, and a recreation center. The general understanding was that the community had to improve if it expected to improve its young people’s prospects. Early statistics reported a drop of 61 percent in the death rate from alcoholism, but the rate as of 1987 was still three times the national rate. And as of 2011, alcoholism remained a problem for the Isleta Navajo. The 2009 National Survey on Drug Use and Health found that 18.3 percent of AI/ AN 12 or older used illegal drugs within 30 days of responding to the survey. Lifetime use was 64.8 percent, and past-year use was 27.1 percent. AI/AN led all groups in 30-day misuse of prescription drugs. Ongoing initiatives by the White House Office of National Drug Control Policy (ONDCP) include the national Youth Anti-Drug Media Campaign, which was begun in early 2008 and involves pride and culture messages through print, radio, and television. It is still the only national antimeth campaign targeting AI/AN. The Drug-Free Communities Support Program has involved 85 coalitions of AI/AN communities and government since 2006, with 66 still active in 2009. Over the life of the program, 2006 through 2009, $6.1 million was spent, primarily, on workshops, training

sessions, and conferences. As of 2011 AI/AN communities made up 10 percent of participants in Drug-Free Communities. The Access to Recovery Program offers grants for tailoring programs to fit cultural, geographic, and other unique needs of AI/ AN communities. In 2010, the program committed $15.2 million over 5 years. Tribal drug courts put substance abusers into treatment and recovery programs rather than in jail to help break the link between drug use and crime. In 2009, there were 89 such courts, compared with 45 in 2001. The ONDCP also provided funds for increased law enforcement in high-drug-traffic areas, including isolated areas of reservations and rancherias. A threat assessment in 2010 helped to define the scope of the drug problem. This was one of several studies of gangs and other problems associated with drug use and proliferation.

Peyote as an Alternative Treatment of alcoholism often involves the medical model, which in the Euro-American tradition defines alcoholism as a disease. Traditionalist Native Americans do not want to be defined as diseased or sick, so they reject this model. A more effective model, they claim, is assimilative, with AI/AN peoples and the government collaborating in over 360 alcohol abuse eradication programs. Programs should accommodate traditional practices rather than conflict with them. The example of the Lakota Sioux is significant. Lakota Sioux have a rate of alcohol-related deaths seven times the national average, suicide 3.2 times that of whites, high rates of hypertension and coronary disease, and 50 to 90 percent unemployment rates as well as half the tribe below poverty. Some call it historical trauma or unresolved grief due to the European conquest or the boarding school and forced assimilation experiences or dis-

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ease or imprisonment or death by starvation and exposure. For a century, they have been plagued with alcohol abuse, which merely exacerbates the historical problems. Their alcohol abuse came in part through emulation of the white frontiersmen’s tendency toward immoderation, to binge drinking. Whites also used alcohol as a tool to cheat and oppress Indians. And they have in the recent past endured stereotyping by substance abuse counselors who regarded all Indians as alike, that is, drunks. Institutional racism has meant that treatment policies fail to accommodate Native American cultural needs. In the case of peyote, a religious requirement may conflict with an abuse counselor’s recommendation of abstinence from all types of drugs. In fact, some evidence indicates that peyote use in the proper context helps to reduce dependence on other drugs, alcohol in particular. A study in 2005 found that regular use of peyote causes no increase in cognitive or psychological problems. And there are some indicators that it is effective in treating alcohol and drug abuse. The proper context involves tribal custom and practice as well as participation by members of the community and family. Peyote ceremonies entail honesty and shedding excuses for bad behavior, and they are part of tribal healing (as are sweat lodges and talking circles). Use of illegal drugs is rising and abuse of more than one substance at a time is common. Abuse is multigenerational and an indicator of deeper problems that bring about spiritual, mental, emotional, and physical damage. Alcohol and drug abuse is the result of shame, self-hate, depression, and stress. Most important, alcohol and drug abuse are community and family problems, not individual ones. Effective treatment programs should be tailored to Native Americans, including psychological aspects, dealing with

the sense of anger, shame, guilt, or other trauma. John H. Barnhill See also: African Americans and Drug Use; Latinos and Drug Use; Rural Drug Use

Further Reading Alcohol Information. “Alcohol Abuse in Native Communities.” http://www.alcohol -information.com/Alcohol_Abuse_in_ Native_Communities.html in April 2011. Cole, Krystle A. 2008. “Culturally Competent Substance Abuse Treatment for Native Americans.” NeuroSoup, October 15. http:// www.neurosoup.com/cultural_competence _krystle_cole.pdf. Furlow, Bryant. 2010a. “Federal Campaign to Target Meth in Indian Country.” April 23. http://newmexicoindependent.com/52398/ federal-campaign-to-target-meth-in-indian -country#more-52398. Furlow, Bryant. 2010b. “Feds Kick Off AntiMeth Ad Campaign Targeting Indian Country.” April 28. http://newmexicoindepen dent.com/tag/drug-abuse. Gale, Nancy. 1991. “Fighting Alcohol and Substance Abuse among American Indian and Alaskan Native Youth.” ERIC Identifier: ED335207 ERIC Digest, July. http:// www.ericdigests.org/pre-9221/indian.htm. Heller, James. 2009. “Native American Drug Addiction Is Rising.” Tarzana Treatment Centers, May 8. http://www.tarzanatc.org/ blogengine/category/Native-American -Drug-Addiction.aspx. Hochman, Michael E. 2005. “Native Americans’ Use of Peyote Not Harmful.” Biological Psychiatry, November 4. http:// www.mclean.harvard.edu/pdf/news/mitn/ bg051107.pdf. MethResources.gov. “National Native American Anti-Meth Campaign.” http://www .methresources.gov/native_american_camp aign.html in April 2011.

Needle Exchange Programs  671 Nakate, Shashank. 2010. “Native Americans and Alcoholism.” April 12. http://www .buzzle.com/articles/native-americans-and -alcoholism.html. Native American Public Telecommunications, Indian Country Diaries. “Health: Substance Abuse.” http://www.pbs.org/indiancountry/ challenges/abuse.html in April 2011. Salgado, Ernie C. Jr. 2009. “Native American Indian Killers,” July. http://www.theindianre porter.com/blogs/ernie_salgado/indian _killers.html. Substance Abuse and Mental Health Services Administration. 2009. “N-SSATS Report: National Survey of Substance Abuse Treatment Services.” July 9. http://www.oas .samhsa.gov/2k9/192a/192aTribalFac2k9 .htm. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. “The DASIS Report: American Indian and Alaska Native Substance Abuse Treatment Services: 2004.” http://oas.samhsa.gov/2k5/ tribalTX/tribalTX.cfm.

Needle Exchange Programs These programs allow drug users to trade the dirty needles they use to inject drugs for clean ones. The purpose is to stop the spread of AIDS and other blood-borne diseases among intravenous drug users, and through them, to their sexual partners. Needle exchange programs are the most prominent example of the harm reduction approach to drug control. Opponents of needle exchange programs contend that they do not discourage drug use and may actually encourage it. Needle exchange programs have been, and remain, controversial in the United States. Many argue that providing clean needles to addicts encourages continued drug use. The

exchange programs also encourage drug use by nonusers because they remove the danger of disease. In recent years, however, it appears that there is more acceptance of these programs. A group called the Junkie Union established the first needle exchange program in Amsterdam in 1984. In the United States, the first needle exchange program was no more than a single individual, Jon Parker, who distributed clean needles to addicts in New Haven, Connecticut, and Boston. The first comprehensive program providing clean syringes and other services was established in Tacoma, Washington, in 1988. Australia, Holland, and Great Britain have taken the lead in adopting needle and syringe exchange programs, while the United States has lagged behind. In 1994, for example, Australia, a country with 1/14th the population of the United States, has 60 times as many syringe outlets as the United States. In 1998 New York became the first U.S. city to use public money to fund a needle exchange program, but the following year the federal government imposed a ban on its funding of needle exchange programs. Opponents to these programs include Senator Jesse Helms of North Carolina, who, among many others, was concerned that needle exchange programs encouraged drug use. He introduced a bill into Congress that banned all federal funding for needle exchange programs beginning in 1988. In 1992, President George H. W. Bush signed legislation that prohibited the use of federal funds for needle exchange programs. The needle exchange ban lasted until 2009. Although President Clinton agreed with the research showing that the exchange programs do not encourage drug use, his administration did not lift the ban. President George W. Bush did not support needle exchange programs and pressured the United Nations

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A social worker for the medical outreach group Community Initiative hands new syringes to an addict as part of a needle exchange program in Puerto Rico. The program helps cut down on diseases spread from person to person when syringes are shared between addicts. (AP Photo/ Brennan Linsley)

Office on Drugs and Crime to suppress data showing the success of such programs. The ban was lifted in 2010 when the House of Representatives voted in support of the Labor-Health and Human Services-Education appropriations bill, which included language to lift the ban on federal funding for needle exchange programs. The effects of the recently available funding will not be known for several years but it is possible that more needle exchange programs will become available throughout the country and existing programs will be better staffed and offer more services. A partial result of the efforts of these programs is the decline in the incidence of HIV among injection drug users (IDUs) in the United States: 80 percent from 1988–1990 to 2003–

2006. Only the adult transmission category has shown a decline of this magnitude. IDUs continue to account for approximately 12– 15 percent of new HIV infections annually, depending on whether cases with multiple risk factors are included in the total. In June 1997 more than 40 major health advocacy and minority groups, including the National Urban League and the American Public Health Association wrote a letter to President Clinton, urging him to lift the ban. The letter came at a time when the respected medical journal Lancet reported that as many as 10,000 Americans could have avoided HIV infection between 1987 and 1995 if needle exchange programs had been in place, and that caring for the sick people cost the nation $500 million.

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On July 1, 1998, delegates at the World AIDS Conference in Geneva, Switzerland, urged that the number of needle exchange programs worldwide be increased to halt the rising spread of the AIDS virus through intravenous injections. In 1997 the World Health Organization reported that 116 countries reported cases of intravenous drug use and 96 of those reported HIV cases connected to drug injection. Nancy E. Marion See also: Bush, George W.; Clinton, Bill; Common Sense for Drug Policy; Harm Reduction Programs; HIV/AIDS and Drug Use

Further Reading Bush, George. 1992. “Statement on Signing the ADAMHA Reorganization Act.” July 10. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=21218. Clinton, William J. 1998. “Statement on House of Representatives Action on District of Columbia Appropriations Legislation.” August 7. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=54762. Clinton, William J. 1999. “Message to the House of Representatives Returning Without Approval Appropriations Legislation for the District of Columbia.” September 28. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=56604. Clinton, William J. 2000. “Statement on Signing the District of Columbia Appropriations Act, 2001.” November 22. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency. ucsb.edu/ws/?pid=996. Sternberg, Steve. 1997. “Funding Urged for Needle Exchanges.” 1997. USA Today, July 13. United Nations Drug Control Program. 1997. World Drug Report.

Neurotransmitters The chemicals that are responsible for regulating brain function by sending, receiving, modulating, and amplifying messages are known as neurotransmitters. When a neurotransmitter such as dopamine binds to (or attaches to) dopamine receptors on the dendrites of a receiving cell (the postsynaptic cell), that cell produces an electric impulse that triggers the manufacture of the same neurotransmitter—in this case, dopamine. Now a presynaptic cell, the neuron sends the dopamine via its axon into the synaptic gap where it binds to and stimulates the next receiving neuron. As that cell (the postsynaptic cell) fires, the cycle continues. Once the dopamine has stimulated receptors on a postsynaptic cell, it either breaks down in the synaptic cleft or is reabsorbed into the presynaptic neuron for later use. Some drugs like Prozac that treat depression associated with low serotonin levels in the brain are known as serotonin reuptake inhibitors because they inhibit the reabsorption (reuptake) of serotonin from the synaptic cleft back into the cell; this allows the neurotransmitter to remain active in the brain for a longer period of time. The effect a neurotransmitter has depends on the receptors activated on the postsynaptic cell. Combined input from several synapses usually ignites neuronal impulses, and it is simplistic to imagine that a single neurotransmitter triggers a specific action in a receiving cell. Neuromodulators, which many regard as neurotransmitters in their own right, affect the activity of other neurotransmitters by boosting or slowing their activity. The principal neurotransmitters involved in addiction are those that act directly on the reward pathway and result in the neuroadaptation that is the hallmark of addiction. Most of these neurotransmitters fall into three categories: the monoamines, peptides known

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as opioids, and amino acids. A fourth type, acetylcholine, is known both as a “small molecule neurotransmitter” and as a neuromodulator; a fifth group is composed of the endocannabinoids, the receptors for which were not discovered until the late 1980s. In 1921 the Austrian Scientist Otto Loewi discovered the first neurotransmitters. He used two frogs’ hearts and from his experiment he hypothesized that electrical stimulation of the vagus nerve released a chemical into the fluid of chamber #1 that flowed into chamber #2. He called this chemical “Vagusstoff.” We now know this chemical as the neurotransmitter called acetylcholine.

Monoamines The monoamines associated with addiction are dopamine, and norepinephrine, and serotonin. Dopamine As the principal neurotransmitter in the reward pathway that produces a pleasurable high, dopamine plays a central role in addiction. In proper proportions with other neurochemicals, it produces a sense of well-being and contributes to alertness, sexual excitement, mental relaxation, and helps balance aggressive tendencies. Stimulants like methamphetamine and cocaine are agonists of dopamine. Dopamine receptors are like docking stations in the brain for dopamine. When receptors are more plentiful, the brain seems more sensitive to natural reinforcers that promote social closeness and positive life goals, and thus allows the individual to balance these with pleasure-giving activities in a healthy way. Sometimes the brain tries to compensate for the flood of dopamine that drug use creates by reducing the number of dopamine receptors on neurons. Also known as downregulation, this decrease means the addict no longer feels the

pleasure that drug use once produced and begins to lose the ability to experience any pleasure at all. Called anhedonia, this condition is often the result of prolonged drug addiction. One arm of current research into addiction is focusing on how to increase dopamine receptors in individuals with low levels. The principal dopamine receptors associated with drug addiction are the D1 (excitatory) and D2 (inhibitory) receptors. According to brain studies conducted by the National Institutes of Health’s National Institute on Drug Abuse, higher levels of dopamine receptors in the brain help protect against an individual’s succumbing to obesity, drug abuse, or addiction, while lower levels leave the individual more vulnerable. What alarms researchers and addictions specialists is the fact that the increased dopamine deficits that result from drug abuse in individuals who already lack sufficient dopamine receptors may lead to serious neurological diseases as the individual grows older. Dopamine is also present in three other important pathways in the brain; although they do not play as large a role in addiction as the mesolimbic (reward) pathway, they are nevertheless important components of the brain’s dopamine system. They are the nigrostriatal pathway, where dopamine functions in motor control and neuronal death or damage is involved in Parkinson’s disease; the tuberoinfundibular pathway, which includes the hypothalamus and pituitary gland and is involved in learning and hormonal regulation; and the mesocortical pathway, which projects from the ventral tegmental area (VTA) to the prefrontal cortex of the brain and may play a role in producing the symptoms of schizophrenia. Drug use that disrupts the reward pathway also affects these pathways in ways that are not yet understood.

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Norepinephrine Both a hormone and a neurotransmitter, no­ repinephrine—also called noradrenaline—is synthesized from dopamine inside neurons of the central nervous system. Sometimes referred to as the fight-or-flight hormone that primes the body to respond to stress or alarming stimuli, it is involved in regulation of blood pressure and other actions peripheral to the central nervous system. In the brain, norepinephrine acts as a neurotransmitter that contributes to a sense of well-being and a reduction in compulsive behavior. Like serotonin reuptake inhibitors (SRIs) that help keep serotonin active in the synapse where it can continue to exert its influence on postsynaptic neurons, norepinephrine reuptake inhibitors (NRIs) are used in a similar way to treat depression, often by combining them with SRIs to produce serotonin-norepinephrine reuptake inhibitors (SNRIs). Some evidence suggests that NRIs may help prevent the reabsorption of dopamine into neurons, permitting more of the neurotransmitter to remain in the synapses where it can enhance the individual’s pleasurable feelings. Just as low levels of norepinephrine can result in depression, levels that are too high produce anxiety and an elevated heart rate and blood pressure. Agonists of norepinephrine such as cocaine have the same effects. Serotonin Often associated with antidepressants, serotonin is manufactured in the brain by the amino acid tryptophan and is located in the raphé nuclei, a group of neural fibers and cells in the brain stem. Although it elevates an individual’s pain threshold and can enhance one’s sense of well-being, serotonin does not produce the pleasure associated with dopamine. A deficit of the neurotransmitter may contribute to aggressive and compulsive behavior

and is strongly associated with depression. The National Institute of Mental Health reports that in the brains of many people who commit suicide, serotonin levels are found to be nearly depleted. Chronic alcohol abuse also drains the brain’s supply of serotonin by reducing its activity at the synapse. Antidepressants are agonists of serotonin because they boost its effect in the brain. Lysergic acid diethylamide (LSD) is an antagonist. As a modulator of the stress hormones epinephrine and norepinephrine, serotonin is also found throughout the body. Its concentrations in the brain can be positively affected by diet—particularly, it is believed, by carbohydrates.

Opioids Morphine-like substances the body makes are known as endogenous opioids: endorphins, enkephalins, and dynorphins. Alpha-endorphin, beta-endorphin, and gamma-endorphine—especially beta-endorphin—relieve pain and promote a sense of relaxation and peace. The enkephalins inhibit neurochemical transmissions in pain pathways, thus reducing the perception of emotional and physical discomfort. Both opioid groups activate receptors in the mesolimbic dopamine system to produce rewarding effects. The dynorphins, on the other hand, activate different receptors in the pathway. Produced by the cAMP response element-binding protein that plays a key role in gene expression, the dynorphins reduce the amount of dopamine released in the nucleus accumbens. As the pleasurable effects of dopamine are tamped down, tolerance builds, which in turn compels the user to consume more of the addictive substance to obtain the desired effect. Opiate drugs like morphine and heroin bind readily to receptors for endogenous opioids, which helps account for the highly addictive nature of these drugs. Opioid an-

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tagonists like naloxone and naltrexone have been developed to help in the treatment of addiction to opiates.

Amino Acids Glutamate The most common of the brain’s neurotransmitters, glutamate is the excitatory neurotransmitter often paired with GABA as the workhorses of the central nervous system because the number of synapses involving these amino acids in the brain is much greater than that of other neurotransmitters. Glutamate’s function throughout the brain is widespread and critical to overall brain biochemistry and cognitive processes. Because the neurotransmitter is believed to facilitate synaptic plasticity, it has crucial roles in learning and memory. Researchers have conducted numerous studies using amphetamines, cocaine, morphine, nicotine, and alcohol as the stimuli to determine how each drug affects certain glutamate receptors. They compared the dopamine levels produced in response to each stimulus to dopamine levels produced at a later date in response to the same stimulus, and found the latter to be a stronger response. This suggested that when the brain learned that it experienced pleasure for the first time, it strengthened its synaptic connections. Known as long-term potentiation, this phenomenon has a powerful impact on learning and behavior and is a highly significant factor in the course that addictive disease is likely to follow. Alcohol and other depressants are antagonists of glutamate; stimulants are agonists. Gamma Aminobutyric Acid (GABA) GABA, as the other workhorse neurotransmitter in the brain, has a very different effect from its partner workhorse, glutamate.

It inhibits neuron’s postsynaptic response and, if allowed to remain in the synaptic cleft, induces a sense of calm. It is associated with a reduction in compulsive behavior, lower levels of anxiety, heart rate, and blood pressure, and a relaxed state. In alcohol abuse and alcoholism, prolonged drinking modifies GABA receptors such that they cease to function properly. Two GABA receptors in particular are involved in addiction: GABAA and GABAB, whose difference lies in the speed with which they trigger the inhibition of the postsynaptic neuron. Interestingly, although GABA is an inhibitory neurotransmitter, it is excitatory in the immature mammalian brain, and in the adult brain it is synthesized from glutamate, an excitatory neurotransmitter. Common agonists of GABA are the benzodiazepines, which are tranquilizers such as Valium. These drugs, as well as alcohol and barbiturates, enhance the effect of GABA on GABAA receptors. As use of these substances reduces the sensitivity or number of the brain’s GABAA receptors, a process called downregulation, an individual may require more of the drugs to achieve the desired effect. This is known as tolerance. Because GABA and glutamate balance each other exquisitely in a normal brain, a significant disruption of one can result in neurological dysfunction and a wide spectrum of distressing withdrawal symptoms.

Acetylcholine Acetylcholine affects the activities of surrounding neurons, not just the pre- and postsynaptic neurons, and has a broad range of effects throughout the nervous system. Although its primary role is to modulate the body’s voluntary muscular activity, it also plays an important role in addiction by activating dopamine receptors on postsynaptic neurons in the reward pathway. One type

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of receptor for acetylcholine is particularly sensitive to nicotine, and its activation by acetylcholine enhances cycles of learning and reinforcement in the dopamine pathway that contribute to addiction. Acetylcholine is considered a peripheral neurotransmitter because of the critical role it plays in the major muscle groups of the body outside of the brain and spinal cord. There is only one other peripheral neurotransmitter, norepinephrine, whose primary function outside the central nervous system is to help regulate blood pressure.

See also: Addiction; Addictive Personality; Stimulants; Withdrawal from Drug Use

Endocannabinoids Also known as endogenous cannabinoids, meaning they are naturally produced by the body, the endocannabinoids represent a group of chemical messengers involved in long-term potentiation and memory. One such chemical is anandamide, discovered in 1992, that shares some of the pharmaceutical properties of tetrahydrocannabinol (THC), the active ingredient in marijuana. This may explain its role in motivation, pleasure, appetite and food intake, and pain relief. In the brain, endocannabinoids bind to a specific cannabinoid receptor known as CB1, the same receptor to which THC binds, and at one time it was thought that the endocannabinoids might be the body’s marijuana. The human body does not produce THC, however, so the purpose of the CB1 receptor is not completely understood. Another cannabinoid receptor, CB2, is primarily involved in immune system functions. Since the cannabinoid receptors were not discovered until 1988, the role of the endocannabinoids is still not completely understood. Ongoing research has revealed that they may have complex roles in learning, eating behaviors, sleeping patterns, and analgesia. Kathryn H. Hollen

Gutierrez, Rafael. 2009. Co-existence and Co-release of Classical Neurotransmitters. New York: Springer.

Further Reading Addiction Science Research and Education Center, College of Pharmacy, University of Texas. “Dopamine: A Sample Neurotransmitter.” http://www.utexas.edu/research/ asrec/dopamine.html. Addiction Science Research and Education Center, College of Pharmacy, University of Texas. “Drugs Interfere with Neurotransmitters.” http://www.utexas.edu/research/ asrec/drugs.html.

Kauer, Julie A. 2003. “Addictive Drugs and Stress Trigger a Common Change at VTA Synapses.” Neuron 37(4); 549–50. Leonard, B. E. 2007. The Nature of Chemical Neurotransmitters. London: Henry Stewart Talks. Sherman, Carl. 2007. “Impacts of Drugs on Neurotransmission.” National Institute on Drug Abuse. http://www.drugabuse .gov/news-events/nida-notes/2007/10/ impacts-drugs-neurotransmission. Webster, Roy A. 2001. Neurotransmitters, Drugs and Brain Function. New York: Wiley.

Nicotine An alkaloid of the Nicotiana tabacum plant that is native to South America, nicotine is a colorless, poisonous, highly addictive stimulant. It is consumed by users in tobacco products such as pipes, cigars, and cigarettes, or in smokeless substances such as snuff or chewing tobacco. Some e-cigarettes also include nicotine in their products. In the United States, about 70 million people use

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A U.S. marine gathers items to help him quit using smokeless tobacco. Those who quit tobacco often experience headaches and nausea for many weeks. (Christine Cabalo/ Defense Imagery.mil)

tobacco in one form or another, making it second only to alcohol as the most widely abused addictive drug. Although the incidence of smoking has declined in the last 30 years, it remains the leading preventable cause of death, killing nearly half a million people in the United States every year. About 9 million smokers have a chronic disease associated with smoking, and secondhand smoke kills about 70,000 Americans annually. Thousands of dangerous chemicals other than nicotine—including tars, carbon monoxide, and acetaldehyde—are in tobacco products and the smoke they emit compound the harm. Tars, which represent the particulate matter in smoke other than

water and alkaloid compounds such as nicotine, are associated with an increased risk of lung cancer, emphysema, and other respiratory disorders, while carbon monoxide increases the risk of cardiovascular disease. Smoking contributes to cancers of all kinds, not just lung cancer, and smokers die from various types of cancer at 2 to 4 times the rate of nonsmokers depending on how heavily they use tobacco products. Tobacco and nicotine use is the leading preventable cause of disease, disability, and death across the United States today. Only a drop or two of pure nicotine— about 50 mg—can be fatal to someone who ingests it. One cigarette contains anywhere from .5 to 15 mg of nicotine, so someone who ingests a whole cigarette or cigar could become seriously ill. Smoking delivers only 1 to 2 milligrams of nicotine, but even that amount powerfully triggers the adrenal glands to release the stimulatory hormone epinephrine. This raises the user’s blood pressure, respiration, heart rate, and glucose levels. The immediate rush users get after using nicotine subsides within a few minutes of use, causing smokers to reach for another cigarette. Nonsmokers who are subjected to secondary smoke, or cigar and pipe smokers who do not inhale, absorb nicotine and other chemicals through their mucosal membranes. In these cases, the effect of these substances on the brain and body accumulate more slowly, but they are equally as toxic and habituating. Recent studies show that nicotine, while considered less dangerous than heroin or cocaine, is more harmful than many other illegal drugs such as marijuana and Ecstasy, and youth who chew tobacco products are statistically much more likely to take up smoking as a substitute nicotine habit than quit the drug altogether. Nicotine has an affinity for the brain’s acetylcholine receptors, specifically those

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carrying subunit proteins known as alpha4 and beta2. By mimicking the action of acetylcholine and binding to these receptors, nicotine triggers the strong responses in the dopamine pathway that are so powerfully related to addiction. Moreover, it is not broken down in the synapse because some of the other chemicals in tobacco block acetylcholinesterase, the enzyme that normally performs this function. Without the enzyme to metabolize it, nicotine continues to stimulate the neurons to fire and release large amounts of dopamine. Studies with mice in which the alpha4 or beta2 subunit proteins have been removed or enhanced confirm that these particular receptors heavily influence addiction. This may explain why some individuals— those with a large number of these specific receptors—become addicted to nicotine after exposure to only three or four cigarettes. Nicotine addiction often accompanies the abuse of other drugs, especially alcohol. Interestingly, one of the new drugs developed for nicotine addiction, varenicline (Chantix), also seems to be effective in treating alcoholism, a finding that offers further clues into the nature of addiction and how it can best be treated. In 2008, however, this drug was reported to produce serious psychiatric symptoms in some patients, so its future availability is questionable. The health care costs directly associated with tobacco use amount to over $75 billion annually in the United States, and this figure does not include costs associated with the illness and death caused by secondhand smoke, burns, or the perinatal and infant care that smoking mothers and their lowbirth-weight babies require. Lost productivity from smoking-related disease amounts to about $82 billion a year, so estimates of total costs to society exceed $150 billion a year. Because of the health effects of using tobacco and nicotine, many smokers try to quit,

but less than 10 percent can do so successfully for more than a month. They will often turn to products to help them quit smoking such as nicotine substitutes, patches, or medicines. Smokers who quit cold turkey have even lower success rates because of the withdrawal symptoms that occur, which include intense craving, irritability, and decreased concentration and cognitive function. Some smokers turn to overeating, leading to weight gain. Some smokers have joined support groups and other organizations such as Nicotine Anonymous. Modeled on Alcoholics Anonymous, the self-help group was formed in the early 1980s and is one of the largest national organizations today committed to providing a supportive network to smokers and ex-smokers. Many local groups and regional or state mental health facilities offer smoking cessation assistance as well. These may be found through Internet referral sources such as the American Cancer Society and related organizations. In addition to self-help groups, recent decades have witnessed the development of several nicotine substitutes and medications that, combined with behavioral therapy, have helped millions quit more easily. Although some of the substances are sold over the counter, experts strongly recommend that they be used with the advice or supervision of a healthcare professional.

History Tobacco use in the United States probably originated with Native Americans who chewed the leaves and smoked Indian weed in a peace pipe known as a calumet. Spanish conquerors and others introduced tobacco to Europe as the American colonies began to discover its value as a cash crop in England. Once harvested in a more potent form, tobacco was cultivated by the Europeans and

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colonial settlers to produce a milder plant, but it retained its powerful potential to addict. In 1662, records show, settlers were reported to be “so given up” to abuse of nicotine that they needed to smoke several pipes of tobacco a day. By this time, tobacco had become highly significant to the colonial economy despite its already negative reputation as a noxious-smelling and harmful drug. The taste for tobacco products spread rapidly throughout the world, taking different forms based on cultural and regional practices. The Spanish enjoyed cigar smoking while the French indulged in flavored snuff they kept in fashionable, pocket-sized snuff boxes. As slavery increased in the colonies, tobacco production skyrocketed to supply a growing market that had spread to Asia. A machine patented in the early 1800s that produced 200 cigarettes a minute made this more affordable means of ingesting nicotine popular, and by the early 1900s cigarettes began to replace chewing tobacco, pipes, cigars, and snuff. World War I and II fueled an even greater demand; widespread contact among soldiers spread the habit around the world, and women began smoking in vastly greater numbers as they entered the workforce to fill jobs vacated by the nation’s men fighting overseas. Although antismoking leagues had proliferated in the United States, smoking and the use of tobacco products in most urban and suburban areas of the country were regarded as socially acceptable, even sophisticated habits, and the tobacco industry continued to explode. Cigarette production grew by the billions year after year. By 1957, however, when the negative health effects of smoking had become undeniable, U.S. surgeon general Leroy E. Burney officially confirmed the relationship between smoking and lung cancer, a position underscored by 1964’s Report of the Surgeon General’s Advisory Commit-

tee on Smoking and Health. In a country in which nearly half of all Americans smoked in virtually every home, restaurant, or office, this was startling news that, for a time, caused cigarette consumption to drop by 20 percent. It accelerated again, however, and in 1966 President Lyndon Johnson signed a bill requiring cautionary statements to be printed on cigarette packages stating, “Caution: Cigarette smoking may be hazardous to your health.” Cigarette advertising on radio and TV was banned in 1971, and subsequent public health messages were disseminated by the government that raised concerns not only about the relationship between smoking and cancer but also about the harmful effects of secondhand smoke. In the 1980s, it was confirmed that nicotine was indeed the addictive agent in tobacco, something science had until then been unable to verify. U.S. surgeon general C. Everett Koop issued a report entitled The Health Consequences of Involuntary Smoking that definitely identified secondhand smoking as a health risk, leading to tighter legislation to restrict smoking on airline flights, broader regulations on print advertising and sale to minors, and ultimately to a general ban on smoking in public places.

Incidence of Nicotine Use and Addiction Nicotine, along with alcohol and marijuana, is one of the most heavily abused drugs in the United States. Fortunately, the use of tobacco products has declined significantly from peak numbers in 1965, reflecting the success of public service and educational messages about its dangers. Especially encouraging are statistics showing that adolescents and young adults are heeding the warnings in greater numbers than ever before, although children are experimenting with smoking at ever-younger ages. Over 20

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percent of high school students smoke, and statistics show that the earlier a person starts to smoke, the greater the likelihood he or she will become addicted. There is also some concern that the rate of decline in smoking by women has lessened. This is of concern partly because many women continue smoking while pregnant, inflicting health problems on their unborn children and producing low-birth-weight babies. According to the American Lung Association, the use of tobacco and nicotine results in about 90 percent of lung cancer deaths in the United States each year, as well as about 80–90 percent of chronic obstructive pulmonary disease (COPD) deaths. Across the United States, about 8.6 million people have at least one serious illness that can be attributed to smoking. These illnesses may include COPD including chronic bronchitis and emphysema, coronary heart disease, stroke, abdominal aortic aneurysm, acute myeloid leukemia, cataract, pneumonia, periodontitis, and bladder, esophageal, laryngeal, lung, oral, throat, cervical, kidney, stomach, and pancreatic cancers. Smoking is also a major factor in a variety of other conditions and disorders, including slowed healing of wounds, infertility, and peptic ulcer disease. Those who smoke tend to die earlier than nonsmokers. For men, they tend to die 13.2 years before nonsmokers, and for women it is 14.5 years earlier. Experts are concerned about the onslaught of advertising from cigarette companies and are especially dismayed that many tobacco companies deliberately market products designed to appeal to young people. The industry produces flavored cigars and other materials to make them more attractive to teens, and secretly increased the percentage of nicotine in cigarettes from 1998 to 2004 to make them more addictive. They also promote low-yield and cigarette-like products,

advertising them as a reduced-risk tobacco product to encourage adolescents to try them. They also sell flavored cigarettes in pastel colors for girls and young women or the complete line of light-to-regular cigarettes and small flavored cigars with names like “Buffalo” and “Smokin Joe” that are deliberately targeted to young Native Americans. An adolescent’s susceptibility to tobacco as well as to other drugs lies in part in the effect drugs have on learning, memory, and motivation in the developing brain. There is also evidence that other chemicals in tobacco products may be addictive for adolescents in not-yet-understood ways that do not seem to affect adults. To counteract the powerful influences of the tobacco lobby, some public health advisers believe that more vigorous educational campaigns to discourage tobacco use among adolescents and young adults are needed.

“Safe” Cigarettes Despite the advertising claims of marketers, there is no safe cigarette or tobacco product, even those whose nicotine or chemical content has been drastically reduced. First introduced in the 1960s, cigarettes with reduced volumes of certain chemicals now represent a large majority of the cigarette market and are most frequently marketed as light, ultralight, or low-tar cigarettes. Recently, newer products dubbed PREPs (potentially reduced exposure products) or reduced-risk products have been introduced that also claim to lower the harmful effects of smoking. These include the very light cigarettes such as Eclipse as well as lozenges and snuff. Given that nicotine is a toxin, however, even these products—and the smoke they produce if they are burnable—pose a serious health risk. Critics also point out that many users, in an attempt to override the nicotine-reduction properties that cigarette manufacturers build into some

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lighter cigarettes, pinch the ends of filters to block the excess air inhaled with each puff. Other evidence shows that smokers simply use more of the lighter tobacco products to compensate for the lesser amount of nicotine delivered with each cigarette. The so-called natural and herbal cigarettes, some of which are no longer marketed because their claims of safety were effectively debunked, have also been shown to be dangerous. Two imported types of cigarettes— bidis and kreteks—are falsely reputed to be safer alternatives to regular cigarettes but, in fact, have higher concentrations of nicotine and other toxic chemicals than regular cigarettes sold in the United States. Health experts and others emphasize that because it is not known exactly how much tar, nicotine, carbon monoxide, or other chemicals it takes to cause disease, and because it takes many years for some of these illnesses to appear, it is impossible, even irresponsible, to claim that any product containing these ingredients is safe. A 2007 health study revealed that smoking so-called ultralight and light cigarettes is just as harmful to the heart and cardiovascular system as smoking regular cigarettes. Because more than a third of the people who smoke these products believe they are somehow protecting their health, they are less likely to quit smoking or they continue to smoke for a longer period of time, significantly worsening their health. Efforts by the tobacco industry and others to market nicotine water as a safe way to ingest nicotine when smoking is not permitted, such as on airplanes, were shut down in recent years by the Food and Drug Administration (FDA), which denied claims from its manufacturer that the adulterated water should be considered a dietary supplement instead of a drug. Other tobacco industry efforts to market substitute nicotine products have also been rejected by the FDA.

Withdrawal The symptoms of nicotine withdrawal vary from individual to individual, but most people, after 24 hours without cigarettes, show signs of hostility, impatience, irritability, or aggression, and they are less tolerant of stress. Nearly all those who quit experience repeated episodes of craving, sometimes intense, which can last for weeks but slowly diminish over time. Many find this craving intolerable and cite it as the primary reason they return to smoking. Cognitive and motor functions can suffer in the first days and weeks after quitting, and anhedonia, an inability to experience normal pleasures, is a frequent symptom, with a duration and intensity similar to that experienced with other drugs like cocaine or alcohol. Although prescription nicotine products designed to treat addiction have low levels of nicotine and are free of carcinogens and other toxic chemicals, they should be used judiciously because nicotine is a toxic substance. Used in conjunction with behavioral therapy, however, these nicotine replacement therapies are extremely helpful in easing the craving and discomfort of withdrawal. Another significant benefit is that they provide an opportunity for the addict to focus on breaking psychological depen­ dence on cigarettes without being distracted by nicotine cravings. This kind of depen­ dence is often characterized by habits such as reaching for a cigarette when the telephone rings, smoking with morning coffee and after every meal, holding a cigarette to occupy one’s hands during social encounters, or taking cigarette breaks to relieve moments of stress. The smell, sight, and feel of cigarettes and the rituals involved in handling and smoking them become powerfully associated with reward in the brains of smokers. This contributes significantly to the discomfort of withdrawal, which is already

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notoriously difficult due to the craving it produces. Nicotine withdrawal symptoms usually peak about one to three weeks after quitting tobacco. People who have successfully quit have found a number of ways to help them cope with withdrawal symptoms, techniques that are especially important in the first week when symptoms are strongest and the chance of relapse is greatest. When people quit smoking or using smokeless tobacco, they often report one or more of the following symptoms: • Experiencing a strong urge to smoke, dip, or chew • Feeling angry or frustrated • Feeling anxious or depressed • Finding it hard to concentrate • Feeling headachy, restless, or tired • Being hungry or gaining weight • Having trouble sleeping These symptoms are temporary, but cravings or urges to use tobacco may last much longer than other symptoms. After quitting, tobacco users should: • Drink a lot of water and fruit juice. Avoid drinks that contain caffeine or alcohol. • Play with a pencil, paper clip, or other item to occupy the hands. • Try sugar-free gum or hard candies, sunflower seeds, carrots, or celery sticks to replace the oral habit of smoking. • Stay busy. Enjoy activities that are hard to combine with smoking. Go to places where smoking is not allowed. • Change habits. Get up from the table immediately after eating and take a walk. If driving a car is a trigger to smoke, use public transportation or ride with a nonsmoker.

• Brush teeth often to appreciate the feeling of a clean mouth. • Avoid situations and places strongly associated with the pleasure of smoking. • Take advantage of resources that offer support.

Treatment Millions of people successfully quit smoking every year, although some have more difficulty than others. A generation ago, little was available in the way of treatment except programs that focused on a measured and gradual reduction in cigarette use or cold turkey approaches that require the sudden cessation of smoking and lead to withdrawal symptoms lasting for several days or weeks. Many would-be quitters make several attempts to quit before they can quit for good—75 to 80 percent of people who try to quit relapse, sometimes several times. Mark Twain (1835–1910), the prominent American humorist and writer, made a famous comment summing it up: Quitting smoking, he said, was the easiest thing he’d ever done because he’d done it a thousand times. For some, simple economics have proven to be sufficient incentive to quit. Statistics reveal that when New York City raised taxes to over $7 a pack, smoking decreased by 36 percent among 12- to 17-year-olds; in the same age group, evidence shows that a 10 percent rise in the cost of cigarettes produces a 12 percent decline in use. In recent de­ cades, several techniques involving nicotine replacement substances, medications, and behavioral therapies that combine psychological support with skills training to help instill long-term coping strategies have proven very useful. Although many people have claimed success with alternative treatments such as hypnosis, acupuncture, laser therapy,

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herbal supplements, or electrostimulation, there is no scientific evidence to support the efficacy of these methods. When smokers find an approach that does work for them, they usually discover that once they have passed the three-month mark of no smoking, they are able to remain smoke-free. Genetic research is yielding clues to inborn factors related to nicotine addiction just as it is to other addictions. People with a certain variation of the CYP2A6 gene have reduced levels of an enzyme that metabolizes nicotine; this reduction slows the drug’s breakdown and relieves those individuals’ craving and need for nicotine. Theoretically, medications could be developed to inhibit the function of the enzyme in people who do not have the CYP2A6 variation.

Behavioral Therapy Traditionally, behavioral therapies for nicotine addiction have been available through quit-smoking clinics or other forms of faceto-face counseling. In recent years, electronic communications have made many of these services available via telephone and the Internet, which have greatly broadened their access. Nevertheless, most experts stress that active involvement in individual or group counseling in a supportive environment yields the maximum benefit in recovering from an addiction to nicotine or any other substance. Combining these approaches with nicotine replacements or medications can produce even more positive results. Nicotine Replacement Therapies Nicotine replacement therapies (NRTs) include transdermal patches, gum, lozenges, inhalers, and nasal sprays. Many are available over the counter, have a lower level of nicotine than tobacco products, and are generally used with behavioral therapy. They do not provide the pleasurable kick of tobacco

products so the impetus to use them addictively is greatly reduced, but their ability to reduce craving and other symptoms of withdrawal make them valuable treatment tools. One of the earliest of these products to reach the commercial market was Nicorette gum, which was made available by prescription in 1984. Many who disliked the flavor of the gum turned to the transdermal patches that physicians began prescribing in the early 1990s. Although these can now be purchased over the counter, a nicotine inhaler and a spray were also introduced in the early 1990s that are available only by prescription. All of these NRTs seem to have similar levels of success, and the choice smokers make between them is driven primarily by personal preference.

Medication For several years, Zyban was the only FDAapproved medicine available to help smokers quit. Zyban is a low-dose formulation of bupropion, an antidepressant; by rebalancing neurotransmitters in the brain, it relieves some of the intense craving quitters experience and allows them to manage withdrawal discomfort with greater ease and control. With a success rate of 15 to 20 percent one year after use, Zyban does come with some side effects; the most frequently reported include dizziness, insomnia, dry mouth, and constipation. The drug is usually taken for several weeks. Recently, another antismoking drug has become available. Varenicline (Chantix) partially activates the nicotine receptors in the brain so they are blocked from responding to nicotine; it also helps rebalance glutamate levels to reduce the discomfort of withdrawal and seems to tamp down the dopamine reward system. Early results show that if the drug is taken for the prescribed full course of 12 weeks or longer, it helps about 25 percent of users succeed in quitting permanently. It too has side effects, some significant: headache,

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vomiting, strange dreams, and changes in the sense of taste, and a 2008 Food and Drug Administration report stated that it can cause some patients to develop serious depression. An unexpected benefit of Chantix is its effect on alcoholics—it reduces their craving and desire to drink. This is a significant finding because drinking and smoking often go together; some studies suggest that as many as 85 percent of smokers drink heavily, and those who take varenicline to quit smoking may also be able to reduce or quit their drinking as well. An added advantage is that the drug is not metabolized in the liver, an organ likely to be damaged in chronic alcoholics, so it can be used without fear of inflicting further damage. Researchers continue to investigate other medications to treat nicotine addiction. They are also trying to develop vaccines that would stimulate the production of antibodies that could block nicotine’s access to the brain. Kathryn H. Hollen See also: Drug Abuse; Female Tobacco Use

Future Reading American Lung Association. “General Smoking Facts.” http://www.lung.org/stop-smoking/ about-smoking/facts-figures/general-smok ing-facts.html. Benowitz, N. L., and P. Jacob III. 1984. “Daily Intake of Nicotine during Cigarette Smoking.” Clinical Pharmacology & Therapeutics 35(4): 499–504. Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Delnevo, C. D., Jonathan Foulds, and Mary Hrywna. 2005. “Trading Tobacco: Are Youths Choosing Cigars over Cigarettes?” American Journal of Public Health 95: 2123. Federal Trade Commission. 2007. “FTC Releases Reports on Cigarettes and Smokeless

Tobacco.” http://www.ftc.gov/opa/2007/04/ cigaretterpt.shtm. Silagy, C., T. Lancaster, L. Stead, D. Mant, and G. Fowler. 2000. “Nicotine Replacement Therapy for Smoking Cessation.” Cochrane Library. U.S. Department of Health and Human Services. 1998. Nicotine Addiction: A Report of the Surgeon General. Centers for Disease Control and Prevention, Public Health Service, Center for Health Promotion and Education, Office on Smoking and Health. U.S. Department of Health and Human Services. 2003. Targeting Tobacco Use: The Nation’s Leading Cause of Death. Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. 2006. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. U.S. Department of Health and Human Services. 2007. Results from the 2006 National Survey on Drug Use and Health: National Findings. Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. DHHS Publication No. SMA 07-4293. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://apps.nccd.cdc.gov/osh_faq. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco. U.S. Department of Health and Human Services, National Cancer Institute. http:// www.cancer.gov/cancertopics/tobacco. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006. Research Report Series: Tobacco Addiction. NIH Publication No. 06-4342.

686   Nixon, Richard M. (1913–1994) U.S. Environmental Protection Agency. 1992. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, DC: U.S. Environmental Protection Agency.

Nixon, Richard M. (1913–1994) The 37th president of the United States, Richard M. Nixon succeeded in ending U.S. fighting in Vietnam and improving relations with the former Soviet Union and China. The Watergate scandal, however, brought fresh divisions to the country, leading to his resignation. During Richard Nixon’s presidency, many drug-related challenges were addressed. A self-proclaimed “lawand-order president,” Nixon’s drug program addressed drug abuse as a sickness instead of a criminal act. For the first time in the

United States, the treatment of drug addicts trumped law enforcement in terms of attention and political allocation and funding. Nixon began his antidrug program by trying to reduce demand rather than shut off supply and punish users. However, this changed closer to the 1972 election as the administration moved away from a treatment-oriented policy to one of getting tough on drugs and users. In an interview with Nixon’s domestic policy adviser, John Ehrlichman, it was acknowledged, “We knew we were lying about the health effects of marijuana. We knew we were lying about the relationship between heroin and crime. But this is what we were doing to win the election. And it worked.” On July 14, 1969, President Nixon announced a “national attack on narcotics abuse.” In a message sent to Congress, he outlined a recent dramatic increase in drug use, especially by juveniles, noting that all

U.S. president Richard Nixon, left, speaks to Dr. Jerome Jaffe, Special Consultant to the President for Narcotics and Dangerous Drugs, in 1971. They met to discuss Jaffe’s experiences in several foreign countries. (AP Photo)

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parents should express concern about the availability and use of drugs in high schools and junior high schools. The president called the situation a “growing menace to the general welfare of the United States.” The Nixon administration was faced with two significant drug issues: marijuana and methadone. To control demand for these two new drugs, Nixon proposed a reorganization and centralization of all federally sponsored efforts for drug treatment, rehabilitation, education, prevention, training, and research into a new White House agency, the Special Action Office for Drug Abuse Prevention (SAODAP). The White House sought to increase the availability of methadone treatment. To do that, Nixon designated Dr. Jerome Jaffe—a prominent supporter of methadone use in treatment—as his special consultant for narcotics and dangerous drugs until SAODAP could be legally constituted by Congress. When Jaffe began his new responsibilities in 1971, there were 135 federally funded drug-treatment programs. Eighteen months later, the number had tripled to 394. Treatment for heroin addiction was prioritized, and the number of methadone treatment programs increased considerably. With a high rate of addiction among Vietnam soldiers and veterans, Dr. Jaffe and his team established new programs to expand the Veterans Administration’s capability to provide drug treatment. Additionally, the Defense Department initiated a massive urinalysis of all servicemen before they left Southeast Asia. Soldiers using opium-based products including heroin were to be detained so they could receive treatment and rehabilitation. President Nixon informed Congress, “We will be requesting legislation to permit the military services to retain for treatment any individual due for discharge who is a narcotic addict. All of our servicemen must be accorded the right of rehabilitation.”

Shortly after Dr. Jaffe assumed his office, the number of clients in funded treatment programs was estimated at just over 20,000. In about a year, the figure was more than 60,000. As the methadone problem became more pronounced in urban areas or at least received unfavorable publicity, the White House began to distance itself from SAODAP. Dr. Jaffe, who had been promised direct access to the president, was cut off from the White House staff. Jaffe resigned in June 1973. A second issue that the Nixon administration had to address was marijuana. During his presidency, the National Commission on Marijuana and Drug Abuse (the Shafer Commission) conducted a comprehensive study of marijuana and its use. The commission completed its work in 1972 and concluded that the drug was virtually harmless and that users not go to jail for smoking it. Nixon disagreed with his commission. It has been pointed out that the basis of Nixon’s war on marijuana was his prejudice as well as a cultural war. According to the president of Common Sense for Drug Policy, Kevin Zeese, “At a critical juncture when the United States decided how it would handle marijuana, President Nixon’s prejudices did more to dominate policy than the thoughtful and extensive review of his own Blue Ribbon Commission.  .  .  . If we had followed the advice of the experts rather than Nixon’s prejudices we would have less marijuana use, be spending less money on marijuana enforcement and many million less people would have been arrested.” Nixon attempted to work with leaders of other countries to stop drugs from entering into the United States. He met with President Diaz Ordaz of Mexico. He also sought to increase sanctions for those who traffic or use drugs. He believed marijuana to be dangerous and sought to keep sanctions against it.

688   Noriega, Manuel Antonio (1934– )

After the departure of Jerome Jaffe, Robert DuPont was appointed by President Nixon to direct the White House Special Action Office for Drug Abuse Prevention, a position he held until the office terminated in 1975. DuPont, a critic of making drugs more available, has expressed the belief that “[w]hen it comes to getting well from addiction, the best, the most reliable and the most effective path is through active participation in the 12 steps programs, including Alcoholics Anonymous and Narcotics Anonymous” (DuPont 1997). Richard E. Isralowitz See also: Demand Reduction; Commission on Marihuana and Drug Abuse; Special Action Office for Drug Abuse Prevention

Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=4142. Nixon, Richard. 1973b. “Radio Address About the State of the Union Message on Law Enforcement and Drug Abuse Prevention.” March 10. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=4135. Nixon, Richard. 1973c. “State of the Union Message to the Congress on Law Enforcement and Drug Abuse Prevention,” March 14. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=4140.

Noriega, Manuel Antonio (1934– )

Further Reading Common Sense for Drug Policy. 2002. “Nixon Tapes Reveal Twisted Roots of Marijuana Prohibition.” http://www.csdp.org/news/ news/nixon.htm. DuPont, Robert L. 1997. The Selfish Brain: Learning from Addiction. Washington, DC: American Psychiatric Press. Nixon, Richard. 1969. “Special Message to the Congress on Control of Narcotics and Dangerous Drugs.” July 14. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=2126. Nixon, Richard. 1970. “Joint Statement Following Discussions with President Diaz Ordaz of Mexico.” August 21. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=2640. Nixon, Richard 1973a. “The President’s News Conference,” March 15. Online by Gerhard Peters and John T. Woolley, American

Manuel Noriega started off as a friend of the United States, then became its enemy. Noriega, the dictator of Panama, was deposed by a U.S. military invasion, then captured and brought to Miami for trial in 1989. Manuel Antonio Noriega was born on February 11, 1934, in Panama City, Panama, the son of an accountant and his maid in a poor barrio. He attended the National Institute, a well-regarded high school, with the intention of becoming a doctor, but lack of financial resources prevented fulfillment of this career choice. Instead, Noriega accepted a scholarship to attend the Peruvian Military Academy. He graduated in 1962 with a degree in engineering. Returning to Panama, he was commissioned a sublieutenant in the National Guard. Noriega acquired the command of Chiriquí, the country’s westernmost province. In October 1968, military conspirators overturned the civilian government of

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General Manuel Antonio Noriega was the dictator of Panama until he was removed from power. He was charged and convicted of eight counts of drug trafficking, money laundering, and racketeering. (AP Photo/Juana Anderson)

Amulfo Arias. Noriega’s troops seized radio and telephone stations in David, the provincial capital. Omar Efraín Torrijos Herrera, the military head of the province, emerged from the coup as the strongman. From that moment, Noriega’s career blossomed. In 1971, he became useful to U.S. intelligence and at the behest of the Nixon administration, went to Havana to obtain the release of crewmen of two American freighters seized by Fidel Castro’s government. He was already involved in narcotics trafficking at the time. (Panama’s National Guard had been implicated in the heroin trade from the late 1940s.) American officials learned that Noriega was the Panama “connection,” and a high-ranking drug enforcement officer recommended that President Nixon order his assassination, but Nixon demurred because Noriega was useful to U.S. counterintel-

ligence. As head of G-2, Panama’s military intelligence command, Noriega was the second most powerful man in Panama. In 1975, G-2 agents rounded up businessmen critical of Torrijos’s dictatorial populist style, confiscated their property, and sent them into exile in Ecuador. Torrijos said of Noriega, “This is my gangster.” Torrijos died in 1981 in a mysterious plane crash, and in the ensuing two-year contest for power between civilian politicians and ambitious military officers, Noriega emerged triumphant. In late 1983, following his promotion to general and commander of the National Guard, the guard was combined with the navy and air force into the Panama Defense Forces (which also included the national police). The following year Noriega’s choice for president, Nicholas Arditio Barietta, won a narrow victory over Amulfo Arias. But there was widespread fraud in the

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election, and Noriega forced Barietta out. The reasons for Noriega’s actions had less to do with fraud or Barietta’s economic policies than with Barietta’s alleged threat to investigate the brutal slaying of Hug Spadora, who had publicly accused Noriega of being a drug trafficker. In 1985, G-2 agents had taken Spadora from a bus near the Costa Rican border, and in September of that year, searchers found his tortured, decapitated body stuffed in a U.S. mailbag on the Costa Rican side of the border. In addition, in June 1986, New York Times investigative reporter Seymour Hersh reported that Noriega had used his position to facilitate sale of restricted U.S. technology to Eastern European governments. In the process Noriega had earned $3 million. Noriega denounced these and other allegations as a conspiracy of right-wing U.S. politicians looking for a way to undo the Panama Canal treaties before the canal became Panamanian property on December 31, 1999. Yet more allegations about Noriega now surfaced. During the Reagan administration’s covert war against the government of Nicaragua in the 1980s, Noriega helped to supply arms to the Nicaraguan resistance called the Contras. (The U.S. Congress had prohibited any expenditures to bring down the Nicaraguan government.) At the same time, he received arms from Cuba and sold them to Salvadoran leftist guerrillas and supplied Nicaraguan leaders with intelligence reports. Although Noriega was a gunrunner, money launderer, drug trafficker, and double agent, he was still useful to the U.S. government and its policies in Latin America. In June 1987, a former naval officer accused Noriega in the death of Torrijos. Middle-class Panamanians organized street demonstrations, demanding his ouster. Noriega responded by declaring a national emergency. He suspended constitutional rights, shut down the newspapers and radio stations,

and drove his political enemies into exile. Church leaders, businessmen, and students, dressed in white, organized into the National Civil Crusade and went into the streets banging pots and pans. The riot squads dispersed them. By now the Americans were outraged, and in June 1987, the U.S. Senate called for Noriega’s removal. Noriega retaliated by removing police protection from the U.S. embassy; subsequently, a pro-Noriega mob attacked the building and caused $100,000 in damages. From that day, the administration of President Ronald Reagan began looking for a way to bring Noriega down. U.S. economic and military assistance came to an end, and Panamanian bankers began withdrawing their support (Torrijos had transformed the country into an international banking center). As a result, Noriega rapidly lost favor everywhere except among the Panama Defense Forces. In October 1989, the firing on U.S. soldiers passing by the Panamanian Defense Forces headquarters caused the United States to launch a full-scale attack (“Operation Just Cause”) with 24,000 troops on December 20, 1989. Noriega evaded capture for a few days and ultimately took refuge in the Papal Nunciature. Under pressure from Vatican officials, Noriega surrendered to the Vatican Embassy in Panama City on January 3, 1990. He was convicted of cocaine trafficking, racketeering, and money laundering and sentenced to 40 years in federal prison. He was also ordered to pay $44 million to the Panamanian government. The trial was not without controversy, however; in late 1995, there were charges of bribery. The DEA was told that the Cali drug cartel had paid a witness, Ricardo Bilonik, to testify about Noriega’s ties to the Medellín cartel, Cali’s rival. Since then, however, federal prosecutors have determined that the bribery charges were not enough to justify a new trial. In 1999, his sentence was reduced

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to 30 years, making Noriega eligible for parole in 2006. He was incarcerated in a federal U.S. prison in Southern California. In 2010, Noriega was extradited to France and tried for murder and money laundering. He was found guilty and sentenced to seven years in prison. In September 2011, he was granted a conditional release so he could be extradited to Panama to serve a 20-year sentence there. He arrived in Panama in December 2011, and remains incarcerated there. Robert J. Kelly, Joseph D. Serio, and Jesse L. Maghan See also: Cali Drug Cartel; Colombian Cartels; Drug Enforcement Administration; Drug Trafficking; Drug Smuggling; Nixon, Richard M.

Further Reading “Manuel Noriega.” 2010. New York Times, July 7. http://topics.nytimes.com/top/reference/ timestopics/people/n/manuel_antonio_ noriega/index.html. “Manuel Noriega Biography.” 2013. Biography.com. http://www.biography.com/people /manuel-noriega-37714. Noriega, Manuel Antonio. 1997. America’s Prisoner: The Memoirs of Manuel Noriega. New York: Random House. Zamorano, Juan. 2011. “Manuel Antonio Noriega, Former Panama Dictator, Flown Home for Punishment.” Huff Post World, December 11. http://www.huffingtonpost .com/2011/12/11/manuel-antonio-noriega -panama_n_1141838.html.

Nutt, Levi G. (1866–1938) Levi G. Nutt was a pharmacist who rose to prominence as a drug law enforcement official when he became the head of the Narcotic Division of the Prohibition Unit in

the 1920s. He was a key player in the move against maintenance treatment of addicts, and legal crackdowns on violations of the Harrison Narcotics Act. Levi G. Nutt was born in 1866 and began his career as a pharmacist in Ohio. He started working for the Bureau of Internal Revenue in 1901, and later he worked for the federal unit responsible for the enforcement of the Harrison Act. From there, Nutt was appointed head of the Prohibition Unit’s Narcotic Division. When he assumed control over the Narcotic Division in 1920, Nutt had more resources than his predecessors who tried to enforce the provisions of the Harrison Act, as the division’s budget nearly doubled, providing for the employment of 170 agents devoted to narcotics control. In March 1920, Nutt made a tour of the country to visit narcotic clinics to evaluate maintenance treatments given in these institutions, and he generally found them ineffective. Nutt believed that the danger of death from withdrawal was exaggerated, and that the narcotic clinics were part of the drug problem since they provided places where addicts could get their drugs, thus feeding the habit instead of compelling drug users to seek out a cure. Nutt reasoned that efforts at maintenance treatment were pointless anyway, since he believed that most addicts were either mentally deficient or psychopaths, and prone to relapse no matter what care they received. The 1919 cases United States v. Doremus and Webb et al. v. United States, in which the Supreme Court ruled that maintenance treatment of addiction violated the Harrison Act, gave legal backing to Nutt’s approach. Under Nutt’s leadership, the Narcotic Division decided to close narcotic clinics that gave drugs to addicts sometime in late 1919 or early 1920, and the division also opposed the maintenance treatment of almost all ad-

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dicts. By 1923, Nutt’s campaign against the narcotic clinics was complete, as the last of narcotic clinics, in Shreveport, Louisiana, was shut down. By the mid-1920s, Nutt had established a law-and-order approach to the drug problem, sending large numbers of drug-law violators to federal penitentiaries, and he claimed that this approach kept the scourge of narcotic drug addiction from spreading. In particular, he maintained that levels of addiction that did not have medical origins were decreasing. Surveys conducted by the Narcotic Division confirmed this thesis, showing that the estimated number of addicts in the country dropped from 106,025 in 1924 to 91,245 in 1926. Strict enforcement under Nutt led to compliance with the nation’s drug control regime, as doctors became aware of the dangers of giving maintenance treatments to addicts, and fearful of running afoul of the law if they prescribed opiates. In this respect, the Narcotic Division under Nutt achieved its main goal—to cut down on the number of addicts in the United States. Under his leadership, federal appropriations for narcotics control grew substantially, increasing from $1 million in 1920 to $1.6 million by 1930. Nutt also advocated for the creation of the Public Health Service narcotic hospitals in the late 1920s, maintaining that the only way to further reduce the spread of drug addiction was to isolate addicts in institutions. Consequently, he supported the legislation that created public institutions for addiction treatment, but not because he believed addicts could be cured—instead, he believed that isolating them was the most effective way to keep addiction from spreading. Nutt remained the head of the Narcotic Division until early 1930, when links between his family and notorious gangster (and drug trafficker) Arnold Rothstein led to

his removal. Nutt was replaced by Harry J. Anslinger, then the assistant commissioner of the Prohibition Bureau, and the enforcement of narcotics laws was transferred to a new unit, the Federal Bureau of Narcotics. Nutt was transferred to become a field supervisor of alcohol prohibition agents, and then the head of the Alcohol Tax Unit in Syracuse, New York, until he retired. He passed away in 1938. Howard Padwa and Jacob A. Cunningham See also: Anslinger, Harry J.; Narcotic Clinics; Prohibition Unit; United States v. Doremus and Webb et al. v. United States

Further Research Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press.

Nyswander, Marie (1919–1986) Dr. Marie Nyswander was a psychiatrist and psychoanalyst who, with her husband Vincent Dole, developed methadone maintenance for the management of opiate addiction in the 1960s. In addition, she was a strong advocate for viewing opiate addiction as a medical problem, opposing the federal government’s stance that drug addiction was above all a criminal issue. Marie Nyswander was born in Reno, Nevada, on March 13, 1919, and she graduated from Sarah Lawrence College in 1941 and

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then from Cornell Medical College in 1944. In 1945, she began working for the Public Health Service, and did her residency working with drug addicts at the Public Health Service Narcotic Hospital in Lexington, Kentucky. Though she still believed that drug addiction was a condition rooted in psychology, Nyswander was dismayed by the brutal detoxification regimens she saw addicts undergo at Lexington, and soon began campaigning for the authorities to treat addiction as a disease instead of a crime. This ran against the prevailing trends at the federal level, as the Federal Bureau of Narcotics instead advocated handling the drug problem with tighter enforcement of drug laws and stricter punishment of drug law violators, rather than with expanded treatment. In 1956, she advanced her views on addiction treatment with her book, The Drug Addict as Patient. Much like Alfred R. Lindesmith would do nine years later in his book The Addict and the Law, Nyswander began her argument in The Drug Addict as Patient by outlining the history of narcotic control in the United States, telling the story of how the federal government’s interpretation of the Harrison Narcotics Act led to the arrest, prosecution, and intimidation of physicians who prescribed drugs to addicts, and consequently to the neglect of care for addicts. By cutting off all means of legal supplies of narcotics, Nyswander pointed out, the government transformed addicts, even those who were otherwise respectable members of the community, into criminals by virtue of their drug-taking behavior. Instead of using a punitive method, Nyswander endorsed adopting a system similar to the British, who allowed for maintenance prescriptions to addicts who needed them in order to function. To treat addicts, Nyswander endorsed the use of methadone, a synthetic narcotic that was longer acting than heroin, meaning that

its use was less likely to provoke withdrawal symptoms, making it less painful than other withdrawal methods. Nyswander argued that once addicts were stabilized on methadone, psychotherapy was important for their rehabilitation, and she also recommended ambulatory hospitalization treatment, a therapeutic setup where recovering addicts would have lived in hospitals, but gradually been allowed to slowly reintegrate into the community during the day. In the 1950s, Nyswander ran a private practice, where she was one of few private physicians in the country to provide treatment for opiate addicts outside of the Public Health Services narcotic hospitals. In the 1960s, she opened a storefront clinic in Harlem, New York City, where she treated addicts as well. In 1964, Dr. Vincent Dole, a physician at Rockefeller Hospital in New York, invited Nyswander to join a research group he led to study the biology of addiction. Nyswander recruited addicts to participate in studies of drugs to help wean addicts off of heroin during her time working with Dole, and the research she helped lead found that methadone yielded positive results in efforts to cure addicts. Instead of trying to wean addicts off of methadone, Nyswander and Dole maintained some patients on high, nondiminishing doses of the drug. In 1965, Nyswander and Dole got married. Nyswander also worked at Beth Israel Hospital in New York, where she began conducting clinical work with methadone. She also served on several advisory boards, including the Liaison Task Panel of the President’s Commission on Mental Health under Jimmy Carter. Thanks to her pioneering work, Nyswander, along with Dole, received the first annual award from the National Drug Abuse Conference in 1978, and the New York Urban Coalition created an award in her honor, the Nyswander-Dole Award, in

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1982. Nyswander passed away in 1986, at the age of 67, from cancer. Howard Padwa and Jacob A. Cunningham

Kolbert, Elizabeth. 1986. “Dr. Marie Nyswander Dies at 67; Expert in Treating Drug Addicts.” New York Times, April 21: B8.

See also: Dole, Vincent; Lindesmith, Alfred R.; Methadone

Kosten, Thomas R. 1998. “Images in Psychiatry: Marie Nyswander, 1919–1986.” American Journal of Psychiatry 155: 1766.

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press.

Nyswander, Marie. 1956. The Drug Addict as a Patient. New York: Grune and Stratton.

O under the medical necessity defense (that their marijuana use was justified as reasonable, necessary, and appropriate because of their medical needs). Thus, the Cannabis Cultivators Club should remain open as a way to distribute the drug to clients. On the other hand, the federal government argued that marijuana distribution was a federal offense under the Comprehensive Drug Abuse Control Act and the OCBC should be closed. The court ruled that the medical necessity defense did not apply and that the Center was violating federal law. After the decision was announced, the OCBC was told to shut down, but it remained open nonetheless. The OCBC filed two motions: one claimed that the OCBC was immune from liability under federal law, and the other asked the court for permission to continue to distribute medicinal marijuana to those patients who had a doctor’s permission. District Court Judge Charles Breyer denied the OCBC’s petition to continue to operate, because the center did not prove that the federal government’s actions violated a patient’s right to use the drug. Instead, the Judge ruled that the OCBC violated a federal injunction by continuing to operate. The OCBC was forced to close. The center immediately appealed the court’s decision. In 1999, the Ninth Circuit Court of Appeals reversed the original decision, stating that the medical necessity defense protected patients if they could demonstrate that marijuana was part of their medical treatment. The presiding judge amended his original ruling, which permitted the centers to reopen. This time, it was

Oakland Cannabis Buyers’ Cooperative In 1996, California voters passed Proposition 215, the Compassionate Use Act. This new law allowed patients to use medical marijuana. However, this new California law contradicted federal law, particularly the Comprehensive Drug Abuse Control Act of 1970. Under the federal law, marijuana was defined as a Schedule I drug, meaning that is has no recognized medical benefits and a high potential for abuse and was therefore illegal. Officials in the federal government made it clear that despite the new state law, marijuana use, distribution, and possession would remain illegal under federal law, and those who used it would be punished. The Oakland Cannabis Buyers’ Cooperative (OCBC) was a marijuana dispensary that provided medical marijuana for those residents who chose to use it to relieve symptoms of various medical conditions. The OCBC’s customers argued that marijuana had medicinal value and that the federal government had wrongly classified it as a Schedule I drug. Further, because of the new law, the OCBC should be legally permitted to distribute cannabis to patients who had the supervision and recommendation of a physician. Federal officials tried to close the OCBC by filing lawsuits against the center. In 1998, the case was heard in the U.S. District Court (United States v. Cannabis Cultivators Club, 5 F. Supp. 2d 1086, 1992; ND Cal. 1998). The OCBC argued that the clients should be permitted to use marijuana 695

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the federal government’s turn to appeal the Ninth Circuit’s ruling. The case went to the U.S. Supreme Court. The justices on the Supreme Court unanimously overturned the Ninth Circuit’s decision and upheld the District Court’s ruling (United States v. Oakland Cannabis Buyer’s Cooperative, 532 US 483, 2001). They decided that the medical necessity defense could not be used in federal courts as a way to create a legal exception for the distribution of medical cannabis. Judge Clarence Thomas wrote the decision. The justices concluded that Congress had made a “determination of values” when they considered the 1970 law. When they categorized marijuana as a Schedule I drug, they implied that it had no accepted medical value. In doing so, the justices made it clear that federal drug laws take precedence over state laws. They also implied that the medical necessity defense was unlikely to be permitted in federal court. Nancy E. Marion See also: Compassionate Use Act; Controlled Substances Act; Marijuana; Medical Marijuana

Further Reading “Criminal Law and Procedure, Supreme Court Decisions, 2000–2004.” 2006. In Congress and the Nation, 2001–2004, vol. 11. Washington, DC: CQ Press. http://library.cqpress .com/catn/catn01–426–18124–974715. Gerber, Rudy. 2004. Legalizing Marijuana: Drug Policy Reform and Prohibition Politics. Westport, CT: Praeger. Kreit, Alex. 2003. “The Future of Medical Marijuana: Should the States Grow Their Own?” University of Pennsylvania Law Review 151(5): 1787–826. London, Jeffrey Matthew. 2009. How the Use of Marijuana Was Criminalized and Medicalized. Lewiston, NY: Edwin Mellen.

Marion, Nancy E. 2014. The Medical Marijuana Maze. Durham, NC: Carolina Academic Press. Newbern, Alistair E. 2000. “Good Cop, Bad Cop: Federal Prosecution of State-Legalized Medical Marijuana Use after United States v. Lopez.” California Law Review 88(5): 1575–634. Rist, Curtis. 1996. “Weed the People.” People Weekly, October 21. “The Supreme Court, 2001–2004 Overview.” 2006. In Congress and the Nation, 2001–2004, vol. 11. Washington, DC: CQ Press, http://library.cqpress.com/catn/ catn01–426–18124–974624.

Obama, Barack (1961– ) Unlike many politicians, President Barack Obama has been openly candid about his drug use during his youth. Obama wrote in his 1995 memoir, Dreams from My Father, that he used marijuana and “maybe a little blow” (a reference to cocaine) while in high school in Hawaii during the 1970s. Biographer David Maraniss alleged that Mr. Obama was a pot-smoking trendsetter and leader in the “Choom Gang.” In the past, Obama has hinted that his career may have been very different if he had been arrested and charged for these behaviors as a youth, noting that a disproportionate number of young African American men are sent to prison because of low-level drug offenses. It is because of this personal experience that Obama has been working to change the government’s War on Drugs by treating drug abuse as a public health issue rather than a criminal offense. According to President Obama’s Office of National Drug Control Policy, he promises to reduce drug use by 15 percent by 2015. On August 12, 2013, Obama’s attorney general, Eric Holder, announced that there

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would be changes to mandatory minimum prison sentences for drug offenders. The new sentencing guidelines supported by Obama were expected to lower the imprisonment rates of “low-level, nonviolent drug offenders who have no ties to large-scale organizations, gangs or cartels.” Instead, these nonviolent offenders will receive criminal sentences that are “better suited to their individual conduct,” including drug treatment and community service programs, according to the Justice Department. Obama has also ordered that federal prosecutors should back off of the individual, recreational users of certain drugs. This new sentencing structure, which includes lower punishments for some recreational drug users, can be traced back to policies that Obama has supported since his first presidential campaign in 2008. During this campaign, he declared that the “war on drugs was an utter failure.” Since then, Obama has not called his anti–drug use policies a “war.” Instead, he focuses on the need to address the discrimination that is inherent in drug sentencing and on meeting the health care needs of drug addicts and abusers. In December 2013, President Obama commuted the sentences of eight federal inmates who had been convicted of charges related to crack cocaine. All of the offenders had been in prison for at least 15 years. Six had received life sentences. In explaining the commutations, President Obama explained that the eight men and women were originally sentenced when the sentencing policies were governed by a 100-to-1 sentencing disparity between crack and powder cocaine. This disparity was reduced by the Fair Sentencing Act, passed in 2010. Obama said that these inmates would have received shorter sentences had they been sentenced under current drug laws.

President Obama’s approach to fighting drug use is clear in his 2013 National Drug Control Strategy. The foundation of the strategy is that there is a need for a more thorough, scientific understanding of addiction as a chronic disease of the brain that can be successfully treated. In general, the strategy promotes national and communitybased anti–drug use programs intended to prevent substance use in schools, on college campuses, and in the workplace; provides information on effective drug use prevention strategies to law enforcement agencies, communities, and parents; and spreads prevention strategies to the workplace to ensure the safety and wellness of all employees and their families. The strategy also expands treatment options to those who are in need through the Affordable Care Act. Under the act, insurance companies would be required to cover treatment for substance abuse disorders just as they would for any other chronic disease. It also expands treatment and reentry services for those individuals who are incarcerated. In Obama’s National Drug Control Strategy, a number of ideas to reform the criminal justice system are proposed. One of those is to expand specialized drug courts, through which officials attempt to break the cycle of drug use, crime, arrest, and incarceration by diverting nonviolent, first-time offenders into treatment instead of prison. Obama’s strategy also indicates the need for expanding global drug prevention and treatment program. He has also proposed promoting alternative crops for farmers in those areas of the world that are known for producing drugs and expanding and modernizing law enforcement capabilities on the international scene. The Obama administration’s position on the legalization of marijuana has changed significantly in recent years. In a report

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issued in 2010, the Office of National Drug Control Policy argued against legalizing marijuana. The argument was based on a report from the RAND Corporation in that they linked legalized marijuana and decreasing prices with increased use. In the RAND report it was argued that the potential societal costs from legalized marijuana would be higher than any potential tax revenues that could be generated from legalized marijuana. Moreover, the increased use of the drug and the potential for increased harm would, in the long run, create more of a burden on the criminal justice system. However, in recent years, the Obama administration has backed off of strict enforcement of marijuana laws in light of the number of states passing laws allowing for both medical and recreational use. After debating the issue for nearly a year, the administration announced an ending to what they called “marijuana prohibition.” At this time, marijuana remains illegal and tightly controlled under the federal Controlled Substances Act. Technically, the Justice Department could sue the states that have made marijuana legal, but the Justice Department has decided not to pursue those states and have announced that they will not arrest users and sellers, nor will they raid stores and distribution sites. To that effect, the Justice Department sent a four-page memorandum to federal prosecutors across the United States in which they outlined eight priority areas that should be enforced. In other words, the attorneys were encouraged to bring charges only in these eight areas. The eight areas include distribution of marijuana to minors, if marijuana revenue is being displaced to criminal enterprises, trafficking across state boundaries, and growing marijuana on public land. However, if states are unable to control the use of the drug, the federal government has reserved the right to step in and take control. Nancy E. Marion

See also: Fair Sentencing Act (2010); Medical Marijuana; National Drug Control Strategy; Office of National Drug Control Policy

Further Reading Bruce, Mary. 2013. “Obama Commutes Eight ‘Unduly Harsh’ Crack Cocaine Sentences.” ABC News, December 19. http://abcnews .go.com/blogs/politics/2013/12/obama -commutes-eight-unduly-harsh-crack -cocaine-sentences/. Dwyer, Devin. 2013.“Obama’s Own Drug Use a Backdrop to More Lenient Sentences.” ABC News, August 12. http://abcnewsgo .com/blogs/politics/2013/08/obamas-own -drug-use-a-backdrop-to-more-lenient -sentences/. Ingram, David. 2013. “U.S. Allows States to Legalize Recreational Marijuana within Limits.” Reuters, August 29. http://www.reuters.com/article/2013/08/29/us-usa-crime -marijuana-idUSBRE97S0YW20130829. Obama, Barack. 2009. “Remarks at a Virtual Town Hall Meeting and a Question-andAnswer Session.” March 26. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=85916. Obama, Barack. 2010. “Remarks at a Town Hall Meeting and a Question-and-Answer Session.” October 14. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency. ucsb.edu/ws/?pid=88590. Obama, Barack. 2011. “Remarks at a Town Hall Meeting and a Question-and-Answer Session in Cannon Falls, Minnesota.” August 15. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=90721. Office of National Drug Control Policy. 2010. “Marijuana Legalization.” http:// www.whitehouse.gov/ondcp-fact-sheets/ marijuana-legalization.

Office for Drug Abuse Law Enforcement  699 Office of National Drug Control Policy, Office of Public Affairs. 2013. “Fact Sheet: A 21st Century Drug Policy.” http://www.white house.gov/sites/default/files/ondcp/policy -and-research/2013_strategy_fact_sheet.pdf. Savage, Charlie. 2013. “Obama Commutes Sentences for 8 in Crack Cocaine Cases.” New York Times, December 19. http://www .nytimes.com/2013/12/20/us/obama-comm uting-sentences-in-crack-cocaine-cases .html?pagewanted=all&_r=0.

Office for Drug Abuse Law Enforcement During the 1970s, there was an intense concern about crime and drug use by the American public, and many people wanted to see more policies to attack these problems. The Office for Drug Abuse Law Enforcement (ODALE) was established by President Richard Nixon on January 28, 1972, through Executive Order 11641. The new office was placed in the Department of Justice. ODALE was a major new initiative that was aimed at forcing drug traffickers and drug pushers off of American streets. The office would use a variety of government resources to implement an assault on street-level heroin dealers. Employees in the program would work with nine regional offices and special grand juries that would collect and review information about drug traffickers, and then pool that information for use by federal, state, and local law enforcement agencies. ODALE could use resources from the Department of Justice and the Department of the Treasury to assist state and local agencies detect, arrest, and prosecute heroin traffickers more efficiently. The office was headed by Miles J. Ambrose, the Commissioner of Customs. Ambrose would also serve as President Nixon’s special consultant for drug abuse law enforcement.

ODALE would incorporate many different agencies that were responsible for some aspect of the drug war. This meant that there would be a new interagency effort to combat the drug menace that was affecting the streets of America. There were nine federal agencies involved, and their activities would be overseen by the Special Action Office for Drug Abuse Prevention. The Special Action Office established new research opportunities, gathered valuable information on the effectiveness of programs, planned for a new drug training and education center, and assisted in setting up a major program to identify and treat drug abuse in the armed services. Both the Department of Defense and the Veterans Administration sought to expand the available drug treatment options and rehabilitation programs as a way to reduce drug dependence in the armed forces and among veterans. The Cabinet Committee on International Narcotics Control led the efforts at fighting international drug trafficking, and attempts to eliminate drugs at their source. Narcotics control coordinators were sent to affected areas located around the world, and they worked closely with other governments to strengthen antidrug efforts. In the law enforcement arena, there was an increase in the number of new positions in both the Bureau of Narcotics and Dangerous Drugs and in the Bureau of Customs by over 2,000 in a single year. Other programs geared toward training state prosecutors to handle cases under the newly enacted Uniform Controlled Dangerous Substances Act were also instituted. The central goal behind all of these programs was Nixon’s overall approach to the drug menace—that the programs were balanced and comprehensive. He sought to fight against those who trafficked in drugs, help those who have been victimized by drugs,

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and protect those who have not yet been threatened by drugs, but may be. The approach from law enforcement was geared to stopping those who might profit from their offenses and the misery of others. The approach would also go after the heroin dealer on the street, with a group of lawyers and investigators who were intent upon exposing and eliminating heroin sales. At the same time, however, it was important to Nixon to have sufficient quality treatment facilities to handle a possible increase in the number of addicts seeking treatment due to the disruption of the heroin traffic. Unfortunately, over time, the agencies who took part in the program failed to communicate with each other, seeking instead to promote themselves and their agendas. In the end, the effort was weak and fragmented. According to Eva Bertram and the coauthors of Drug War Politics: The Price of Denial, “the harsh enforcement tactics of ODALE’s agents . . . gained it notoriety and eventually helped lead to its dissolution” (Bertram et al. 1996, 20). Over time, ODALE was consolidated with three other federal antidrug agencies (the Bureau of Narcotics and Dangerous Drugs, the Office of National Narcotics Intelligence, and the Customs Service Investigation Unit) to become the Drug Enforcement Administration. Another agency created was the Office of National Narcotics Intelligence, which was responsible for collecting, analyzing, and identifying drug intelligence. Nancy E. Marion See also: Drug Enforcement Administration; Nixon, Richard M.

Further Reading Bertram, Eva, Kenneth Sharpe, and Peter Anders. 1996. Drug War Politics: The Price of Denial. Berkeley: University of California Press.

Nixon, Richard M. 1972. “Statement on Establishing the Office for Drug Abuse in Law Enforcement,” January 28. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=3552. Russell, Jesse, and Ronald Cohn. 2012. Office of Drug Abuse Law Enforcement. Key Biscayne, FL: Bookvika.

Office of National Drug Control Policy (ONDCP) Created by the Anti–Drug Abuse Act of 1988, the Office of National Drug Control Policy (ONDCP) is responsible for overseeing and planning the national strategy for carrying out the government’s activities on drug control. The agency coordinates federal, state, and local efforts to control illegal drug use. It was established as a component of the Executive Office of the President of the United States. The responsibilities of the ONDCP include establishing national priorities regarding drug control, developing strategies and implementing policy, and certifying federal drug control budgets. Additionally, the ONDCP serves as the coordinator of federal agencies involved in combatting illegal drugs. These functions are directly related to the Anti–Drug Abuse Act’s charge to create a “drug-free” America. The management structure of the ONDCP was also determined by the Anti–Drug Abuse Act of 1988. Three leadership positions mandated by the act are the director of the ONDCP (commonly known as the “Drug Czar”), the deputy director for demand reduction and the deputy director for supply reduction, each in charge of offices with the same designation. The Office for Demand Reduction is responsible for the coordination of prevention, treatment, and recovery

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policy for federal agencies, while the Office of Supply Reduction coordinates the international response to drug markets. The director and deputy director positions are presidential appointments subject to confirmation of the U.S. Senate. In addition to the leadership, the Anti–Drug Abuse Act also provided for the organizations structure, requiring an ONDCP Bureau of State and Local Affairs and directed that the bureau be headed by an associate director for national drug control policy. The ONDCP’s management and structure are organized around the principles of supply and demand. While the ONDCP is responsible for reducing demand, availability, and the consequences of illegal drug use in the United States through coordinating the national effort, none of the numerous federal, state, local, and private sector entities responsible for carrying out U.S. drug policy are directly accountable to the organization. In order to align the activities of these organizations, under the auspices of the White House, the ONDCP produces the National Drug Control Strategy, which prioritizes and motivates the organizations directly responsible for combatting drug abuse. The strategy, also mandated by the Anti–Drug Abuse Act of 1988, must be research-based and comprehensive. Along with the National Drug Control Strategy, the ONDCP also produces supplemental strategies for combatting illegal drug abuse. These strategies focus on specific elements in the fight against illegal drugs. There are currently four supplemental strategies: the Prescription Drug Abuse Action Plan, Increasing Security along the Southwest Border, Strategy to Combat Trans­ national Organized Crime, and National Northern Border Counternarcotics Strategy. Together, these plans outline the details of how ONDCP works towards its mandate of controlling drug abuse.

In addition to the strategy the ONDCP directly manages three drug control-related programs: the High Intensity Drug Trafficking Area Program (HIDTA); the National Youth Anti-Drug Media Campaign (Media Campaign); and the Drug-Free Communities Program (DFC). While the ONDCP used to manage a fourth, the Counterdrug Technology Assessment Center, Congress has declined to provide funding for that program since 2010, and it is not mentioned in the 2013 National Drug Control Strategy. The first of the programs, HIDTA was established as part of the original charter of the ONDCP. It has a primary mission of supporting law enforcement in areas considered to be critical drug-trafficking regions of the United States. HIDTA works by enhancing cooperation among law enforcement, assisting in intelligence sharing, providing intelligence to law enforcement agencies, and assisting coordination of law enforcement strategies. There are currently 28 HIDTAs, covering 60 percent of the U.S. population. The second program, the Media Campaign, is a program designed to reach the nation’s youth through both traditional and social media. The program boasts a 88 percent awareness level among its target demographic. Its brand, “Above the Influence,” has a strong social media presence, with one of the largest footprints on Facebook in 2013 for similar organizations. Finally, the DFC provides direct funding and support to community organizations that originate to combat drug use by youth in the communities they represent. Since 2009, the program has dedicated over $390 million towards its mission. These programs compose a very small part of the nation’s overall antidrug mission, and represent about 1/36th of the drug-control budget across all levels of government. Aside from the original mandate in the Anti–Drug Abuse Act of 1988, several pieces

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of legislation, as well as executive orders, have expanded the ONDCP’s scope and authority. The Violent Crime Control and Law Enforcement Act of 1994 brought the assessment of budgets and resources related to the National Drug Control Strategy under the ONDCP’s purview as well as establishing specific reporting requirements in terms of drug use, availability, and treatment. Executive Order (EO) no. 12880, issued in 1993, and later amended by EOs 13008, 12992, and 13023, require the ONDCP to establish an outcome-measurement system for drug control policy. Additionally, these EOs establish that the director of ONDCP is the president’s chief spokesperson. In 1998, the Office of National Drug Control Policy Reauthorization Act passed and expanded the organization’s responsibilities. It also further specified the ONDCP’s mission by requiring the development of, among other elements, a long-term drug control strategy, the development of an outcomes-assessment system to determine the effectiveness of the National Drug Control Strategy, statutory authority for the President’s Council on Counter-Narcotics and the establishment of a Parents Advisory Council on Drug Abuse. The most recent reauthorization of the ONDCP took place with the passing of the Office of National Drug Control Policy Reauthorization Act of 2006. This reauthorization again expanded the mandate of the organization, by creating the position of the U.S. interdiction coordinator and the Interdiction Committee and authorizing the latter to discuss and resolve issues related to interdiction in support of the National Drug Control Strategy. The ONDCP has been subject to criticism in a variety of areas. Foremost among these are the agency’s priorities, as laid out in the National Drug Control Strategy, in terms of the areas in which funding should be directed. While most of the drug control

budget goes towards interdiction and law enforcement programs, critics argue that most of the budget should be going towards treatment and recovery programs. In fact, until recently, the trends had been the opposite, with budgets directed at interdiction growing and those directed at treatment shrinking. The most recent National Drug Control Strategy (2013) seeks to address some of these criticisms by increasing substantially the focus on treatment and including the necessity for law enforcement reform. In addition to the criticisms of the ONDCP’s priorities, the organization was criticized for paying television programs to include antidrug messages. The FCC, though declining to levy a fine against the ONDCP, did indicate that the ONDCP would be required to disclose any sponsorship in accord with federal law. Through the FCC investigation, and subsequent House committee investigations, there was a determination that the ONDCP had reviewed scripts prior to airing, and the ONDCP had paid shows to alter scripts that were considered pro-drug. Since its inception, the ONDCP has had six directors. The first, William J. Bennett, was appointed by President George H. W. Bush in 1989. He had previously served as director of the National Endowment for the Humanities and secretary of education. Bennett served until 1991. The second director of the ONDCP, Bob Martinez (1991–1993), was also appointed by President George H. W. Bush, and had been mayor of Tampa, Florida. Director Lee P. Brown (1993–1995), a former professor at Texas Christian University and chief of police in Houston, was appointed by President Bill Clinton as the third head of the ONDCP. Also appointed by President Clinton was the fourth director, General Barry R. McCaffrey (1996–2001), former head of United States Southern Command. The fifth director, John P. Walters (2001–2009), was appointed

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by President George W. Bush, and had previously served as deputy director for supply reduction in ONDCP. The current director of ONDCP is Gil Kerlikowske, a former police chief of Seattle, appointed by President Barack Obama in 2009. More information on the ONDCP and its activities is available at its Web site: http:// www.whitehousedrugpolicy.gov/index.html. Joshua B. Hill See also: Anti–Drug Abuse Acts; Bush, George H. W.; Drug Addiction and Public Policy; National Drug Control Strategy; Reagan, Ronald, and Nancy Reagan

Further Reading Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Office of National Drug Control Policy. “About.” http://www.whitehousedrugpolicy .gov/about/index.html. Office of National Drug Control Policy. “Reauthorization Act of 1998.” http:// www.whitehousedrugpolicy.gov/about/ 98reauthorization.html. Office of National Drug Control Policy. “The President’s National Drug Control Strategy, January 2009.” http://www.whitehousedru gpolicy.gov/publications/policy/ndcs09 /index.html. U.S. Congress, House Committee on Energy and Commerce. 2006. “Office of National Drug Control Policy Reauthorization Act of 2005.” Washington, DC. USA.gov. “Office of National Drug Control Policy.” http://www.usa.gov/directory/federal/ office-of-national-drug-control-policy.shtml.

Opiates According to the strict definition, opiates are drugs derived from opium, and opioids

are opiate-like substances either made in the body—the endogenous opioids known as endorphins, enkephalins, or dynorphins—or manufactured in a laboratory, such as methadone. The terms are often used interchangeably, however, and the drugs are also referred to as narcotics—although this word is falling into disuse because the meaning, “related to stupor or a stuporous state,” is somewhat imprecise. Opium, the parent drug from which other opiates are derived, comes from the seedpods of the Papaver somniferum poppy. Although the plant can be grown throughout much of the world, only low-morphine-producing varieties may be grown in the West. The stronger morphine-producing varieties are grown in Mediterranean regions of the world, and the importation of the opium derivatives they produce is tightly controlled. The opiates produced naturally from the plant include opium itself, morphine, codeine, and thebaine. Thebaine tends to produce stimulatory rather than depressant effects and is, in itself, not a drug of abuse. However, it is a highly addictive substance converted into synthetic opiates such as oxycodone and oxymorphone or used in the manufacture of opiate-addiction treatment drugs such as buprenorphine. Other derivatives synthesized from the natural substances found in opium are heroin, hydromorphone, and hydrocodone. Drugs that mimic the activity of opium and the opium derivatives but have been created in laboratories are meperidine, dextropropoxyphene, fentanyl, pentazocine, and butorphanol. Methadone, a synthetic agonist developed during World War II as a substitute pain medicine to address a morphine shortage, has since become useful in the treatment of addiction to opiates. Two other drugs have also been developed for treatment purposes: levo-alpha-acetyl-methadol (LAAM) and

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buprenorphine. Based on its medical use and its inherent addictive properties, each opiate, or each substance like a cough medicine that contains an opiate, is placed into one of the Controlled Substances Act’s five schedules. Opiates should not be used with substances like alcohol or other depressants that also suppress the central nervous system, unless they are prescribed by a physician, because the interaction of these drugs can be deadly. When used under medical supervision to relieve pain, opiates are usually not addicting unless the patient is already addicted to drugs. Nevertheless, when the drugs are withdrawn, some pain patients experience discomfort known as hospital flu as their systems adjust to the drugs’ absence. This differs from addiction in that it does not involve compulsive, out-of-control behavior that persists despite negative consequences; it is instead the body’s adjustment to the drug’s absence. Opiates are defined by their morphinelike effects to relieve severe pain. They are also prescribed as antidiarrheals and cough suppressants. They can be injected, smoked, sniffed, delivered via lozenge-like troches that the user lets dissolve in his or her mouth, or inserted rectally in suppositories. As with any drug, the effect depends on the method of administration and the dosage, but opiates’ affinity for the brain’s opioid receptors can result in psychological craving that often persists for a significant period of time after physical dependence has been broken. Under nonmedical conditions, opiates tend to produce drowsiness, a release from tension and anxiety, and a sense of euphoric wellbeing. They can also produce an inability to concentrate, nausea, constipation, and, most threatening, suppression of breathing. Since tolerance builds quickly, cases of opiate overdosing—which can be lethal—are seen often in emergency rooms in cities or states

where drug abuse is widespread. The symptoms of an overdose are pinpoint pupils, confusion, convulsions, and cold, clammy skin. Respiratory depression is often the cause of death. The other significant dangers of opiate use include infections from dirty needles or organ damage from the adulterants added to many street drugs. Examples of the conditions drug use can produce include AIDS, hepatitis, inflammation around the heart or brain, and lung or brain abscesses. These can threaten users’ lives long after drug use has ceased. Withdrawal from opiates can be very unpleasant, taking anywhere from seven to 10 days to run its course, but is seldom life threatening. Early symptoms include yawning, watery eyes, sweating, and restlessness, followed by severe depression, insomnia, cramps, restlessness, diarrhea and vomiting, chills, and goose bumps, the symptom that gave rise to the term “cold turkey.” Powerful pain relievers have an essential role in medicine, but healthcare providers are careful about inadvertently fostering addiction in their patients despite the likelihood that opiates, if used solely to relieve pain, are relatively safe. This continues to be controversial, however, and most physicians prescribe opiates with caution. In the meantime, researchers continue to try to find or synthesize substances that can offer the pain-relieving efficacy of opiates without the addictive properties.

Opiates and Some Commercial Drugs Derived from Them Natural (Nonsynthetic) Opiates • • • •

Codeine (derived from opium) Morphine (derived from opium) Opium Thebaine (derived from opium)

Opium  705

Semisynthetic Opiates (derived from morphine, codeine, or thebaine) • • • •

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov.

Heroin Hydrocodone Hydromorphone Oxycodone

Synthetic Opiates (produced entirely within the laboratory) • • • • •

U.S. Department of Health and Human Ser­ vices, National Institute on Drug Abuse. http://www.nida.gov.

Butorphanol Dextropropoxyphene Fentanyl Meperidine Pentazocine

Opiate Addiction Treatment Drugs • Buprenorphine • LAAM • Methadone Kathryn H. Hollen See also: Drug Classes; Methadone; Opium

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books.

U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Opium The Papaver somniferum poppy, grown since 5000 BCE principally in the Mediterranean regions of the world. The poppy plant grows to a height of about four feet. It produces a brightly colored flower, portrayed in the movie The Wizard of Oz. At maturity, the leaves fall and leave a one- to three-inch seed pod about the size of a walnut. When the pod is cut open, it produces a milky fluid, or sap, that various cultures over the centuries have scraped from its seedpod and set aside to dry. The harvested, dried, tarry substance is opium, a powerful drug that gives morphine and heroin their pain-relieving and addicting properties. It can be dried and rolled into a ball, or crushed into a powder. Each year, the United States alone imports more than 600 tons of opium, in the form of concentrates pulled from the plant for legal, medical uses. It is legally grown in Middle Eastern countries, particularly Afghanistan, where regional and tribal factions that stand to profit handsomely from its cultivation compete with international interests to control and regulate the distribution of its potent product. Opium was used by Greek and Roman doctors, and was brought to China by Arab traders for medical use. The Crusaders bought it from Arab physicians and brought it to Europe. During the 18th and 19th centuries, opium was brought into the United

706  Opium

Opium poppies are used to produce morphine and heroin, which is sold worldwide. (Chrisp543/ Dreamstime.com)

States primarily by East Asian immigrants who had used the drug for centuries. Many medications made in the United States during the 1800s contained opium; one of these, laudanum, was a popular analgesic in liquid form, and many abused the drug by using it as a panacea for all types of physical and sometimes mental complaints. A weaker cousin to laudanum was paregoric, still prescribed today to treat diarrhea. Often cheaper to purchase than alcohol, opium was a common cure for most maladies from diarrhea to diabetes, fever, insomnia, and pain. Opium use was included by Shakespeare in the play Othello. It also appears in the writings of Chaucer, Sir Thomas Browne, and Robert Burton. Addiction to opium became more widespread after the invention of the hypodermic needle in the 1850s, which, by allowing the drug to be injected, elicited a more powerful response. Civil War soldiers who were sent home with morphine kits for use in

treating the chronic pain that resulted from battle injuries brought morphine into the home where women began to use it in the mistaken belief that it was safe. By the last quarter of the 19th century, the opium trade became subject to greater control, so traffickers began to extract its constituents and synthesize them into a wide range of illicit drugs for the recreational market. That industry, synthesizing other drugs with the psychoactive properties of opium and distributing them around the world, continues to grow today. Formerly called narcotics, the drugs derived from opium are more properly known as opiates. Natural derivatives are morphine, codeine, and thebaine; although thebaine is known primarily for its stimulatory effects rather than depressant effects, powerful, semisynthetic analgesic drugs have been synthesized from all of them including hydrocodone, oxycodone, hydromorphone, and heroin. Scientists working to develop substances that mimic the actions of opium

Opium  707

have produced entirely synthetic but extremely powerful opiates like fentanyl, which may be hundreds of times more potent than heroin. Thebaine itself is not used therapeutically and is seldom regarded as a drug of abuse, although the synthetic opiates derived from it are very addicting. Nevertheless, like other opiates, it is listed on Schedule II of the Controlled Substances Act. Morphine is the primary constituent of opium. It is one of the most effective drugs known to relieve pain. Codeine is also produced from the plant. Codeine causes less pain relief and respiratory depression as compared to morphine, but is an effective cough medicine. It is the most commonly used narcotic in the world. Heroin is the third drug produced from opium. It is highly addictive. A new form of heroin from Mexico appeared in the 1980s called black tar heroin, and is called that because of its black, tar-like consistency. It is usually dissolved in water and injected into the user. Many opiate derivatives exist, many of which are widely abused. These include hydrocodone (a cough and pain medication classified as a Schedule II drug); hydromorphone (a pain-relief agent with a high addiction potential); ketobimidone (similar to morphine); oxycodone (a long-lasting painkiller that is highly abused by users); thebaine (a stimulant not used in medicine) and tildine (a pain reliever that can cause coma, convulsions, or respiratory distress in large doses). Scientists have also developed opioids, which are lab-created opiates. They are chemically similar to the opiates. Examples of these are anileridine (an alternative to demorol); etorphine (10,000 times as strong as morphine that can easily cause death); fentanyl (about 100 times more potent than morphine); LAAM (used as a maintenance

drug for narcotic addicts); meperidine (used for relief of pain after surgery); methadone (used as substitute for morphine) and propoxyphene (less potent than methadone). A user will experience short-lived feelings of euphoria followed by several hours of physical and mental relaxation. They may have drowsiness, slow breathing, nausea, slurred speech, a dull facial expression; impaired judgment, and confusion. Because the drugs are addictive, someone can become dependent upon them. Withdrawal symptoms include flu-like symptoms that will last about seven to 10 days. They include runny nose, watery eyes, loss of appetite, cramps, nausea, vomiting, and insomnia. The withdrawal is uncomfortable, but not life threatening. After a detox program, the patient should also be treated or counseled for psychological reasons for the addiction such as depression. Many times, abusers will relapse often before finally staying clean. Street names for opium include Ah-penyen, Buddha, chillum, Chinese molasses, Chinese tobacco, Gee, Pen yan, When-Sehh, and Ze. Kathryn H. Hollen See also: Black Tar Heroin; Heroin; Morphine; Narcotics; Opiates

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcohol-

708   Opium Control Act (1942) ism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Opium Control Act (1942) The poppy plant is cultivated in some parts of the world for its use as a food source and for its oil. However, poppy is also cultivated for its use as a drug in many other parts of the world. The same poppy plant that provides nutrition also produces opium. Before World War II, there was little commercial cultivation of the poppy plant throughout the United States. Poppy seeds had been imported from Europe, but this market was cut back dramatically during the war, primarily because the price of the produce soared from 7 cents a pound to 50 cents a pound. When the price increased so dramatically, many farmers, especially those in California, quickly recognized the potential for quick profits and began growing the plant, but the federal government declared the crops to be illegal. So the Narcotics Bureau began to destroy the poppy crops. The farmers fought the crop destruction. They argued that Congress had not considered their situation when they passed the law. They explained that the poppy seeds

had already been planted when the law was passed on December 11, 1942. Further, the effective date, February 9, 1943, made the situation even worse. In other words, the poppies were not illegal when they were planted, so the federal government could not destroy them. The officials of the Narcotics Bureau responded by putting the blame on the state authorities who had issued the permits for growing poppies, despite the fact that Congress was debating the legislation. It was soon discovered that the U.S. Department of Agriculture had approved the cultivation of the poppy plants by the California farmers. The farmers had been required to file their intentions to plant poppies, and the plans had been approved without debate by the local Department of Agriculture office. As a way to come up with a compromise, a conference was convened and took place at the Office of the Bureau of Narcotics in San Francisco on January 27, 1943. In at­tendance were two local officials of the bureau, the state chief of narcotics enforcement, the attorney for the California Farm Bureau Federation, the chairman of the Committee of California Poppy Growers, and 16 farmers, one of whom admitted that he was not given a permit, but wanted to see whether the seed sprouted or not before requesting one. During the conference, it was agreed that the farmers would be allowed to harvest their poppy crop, but only under the supervision of both state and federal officials. All of the plant residues remaining after the seeds were separated would be destroyed. Neither the federal nor state officials believed that any farmer would want to plant poppies again without requesting a federal license. The federal officials were also under the assumption that the state would no longer give

Opium Dens  709

out permits. But both of these assumptions turned out to be incorrect. The farmers brought their case to federal courts, arguing that the Opium Poppy Control Act was unconstitutional, and that they should be permitted to grow a plant that provided a food source. And because it was a food-based plant, the industry should be regulated by the state and not the federal government. The basic question was simply whether the Opium Poppy Control Act was constitutional. Their case was heard by an emergency court that was composed of a circuit judge and two district judges. The Narcotics Bureau and the district attorney argued that the law was constitutional because of the federal government’s powers to make treaties. They claimed that the federal government had the right to enforce the International Opium Convention of 1912, even if it was contrary to state laws. On August 28, 1944, the three justices decided a unanimously that the Opium Poppy Control Act was indeed constitutional. It was at first thought that the poppy farmers would appeal the decision to the Supreme Court of the United States. However, their chance of overturning the federal law seemed to be very small, and the farmers chose not to appeal, thus bringing an end to the California “Poppy Rebellion.” By September 16, 1944, each of the growers requested permission from the Court to destroy his poppy crop. The destruction of the poppies was then carried out. Nancy E. Marion See also: Opium; Opium Dens; Opium Trade; Opium Wars

Further Reading Chouvy, Pierre-Arnaud. 2010. Opium: Uncovering the Politics of the Poppy. Cambridge, MA: Harvard University Press.

United Nations Office on Drugs and Crime. “The Suppression of Poppy Cultivation in the United States.” http://www.unodc.org /unodc/en/data-and-analysis/bulletin/bullet in_1950–01–01_3_page003.html.

Opium Dens Opium dens were locations where users of opium, particularly smokers of crudely refined opium or raw opium, would congregate and participate in the rituals that were part of opium smoking. They were prevalent in the United States near San Francisco in the 1800s and have been associated with immigration from China and other parts of Asia. In addition, opium dens were prevalent in China and other parts of eastern Asia throughout the 1800s, particularly in Hong Kong, which was frequented by Westerners specifically for the purpose of engaging in opium smoking in these dens. While opium dens have largely disappeared because of significant enforcement efforts over the last century, they remain a significant part of the American cultural imagination. Historically, when used as an intoxicant, opium could either be smoked or eaten. However, because of the unpalatable nature of raw opium, there were a variety of ways to disguise the flavor, including mixing it in drinks flavored with cardamom, cinnamon, or other spices, a method popular in India. Opium smoking, which was primarily Chinese in practice, required a more intense processing before the opium could be used with any effect. This process, which in effect reduced the mass of the opium by about 50 percent and concentrated it greatly, resulted in small, somewhat malleable pills of opium, which could then be smoked. This method of ingestion generated the development of opium dens.

710   Opium Dens

While opium has been used for most of modern history, opium dens flourished with the British expansion into Hong Kong. While the British officially ignored the trade, prohibition under the Chinese government continued, leading to the development of smuggling rings for opium, and opiumdriven piracy. Additionally, when the Chinese attempted to control the trade by setting up a monopoly, the inability to regulate the trade, which by this point was widespread, led to increasing amounts of crime and vice based around the opium trade. In 1847, the Chinese attempted to regulate opium consumption by creating a system to license dens, but this largely failed as well, though it succeeded in creating a large number of dens in Hong Kong and on mainland China. In May 1908, the dens were outlawed by the British in Hong Kong and their other Asian colonies. Many dens were closed between 1909 and 1910, and the operation of an opium den became a crime. However, opium itself was not illegal, nor was the sale or consumption of the drug, and several dens still operated publicly, as the fine for operation was far less than the profit that might be made by some of the larger dens. Enforcement became more significant in 1932, when the Opium Ordinance gave the police new powers to close dens in Hong Kong; by the late 1930s the drug was going out of fashion, and so there were few dens remaining by the end of the decade. With the prospects poor for peasants in mainland China, and potential opportunities for laboring jobs in the United States high, it is unsurprising that large numbers of Chinese individuals immigrated to the United States, particularly in the early and mid-1800s. Many of these immigrants came from regions of China long associated with the opium trade, and brought the habit of smoking opium from China to the United

States. By 1870, smoking opium and opium dens were common in the United States. Opium dens are partly necessitated by the fact that raw or poorly refined opium is difficult to keep lit for smoking, and therefore requires tending by someone. Because of the necessity for individuals to keep the opium lit, there was usually a leader or practitioner who would tend the opium for the users. Users would frequently lie on floors in a circle, with one individual’s head resting on another’s hip, and so on, or rest their heads on specially made pillows. The opium smoker inhales through a special pipe while in this prone position, with his or her head elevated and tilted on its side. Because opium, when smoked, results quickly in the user falling asleep, the use of pillows and reclining positions can be understood as utilitarian. The position makes it much more comfortable for the user to fall asleep quickly, without danger or inconvenience. Opium practitioners were, in traditional opium dens, young boys. They were responsible for not only keeping the opium lit for those smoking it, but also ensuring that the opium “pills” were of the appropriate consistency to spread within the opium pipes to allow the fumes to be inhaled. If the pills were too moist, the opium would not light, and so the pill was dried over a small, specifically designed lamp. When the opium reached the correct consistency, it was placed over the hole of the hollow bowl of the pipe and then held by hand. The unique shape of traditional opium pipes consists of a broad tube, with a smaller tube attached, ending in a tiny bowl, about 2 cm across. The bowl was frequently a hollow chamber with a hole in its roof. The bowl was then inverted over a flame until the opium vaporized, at which point it was inhaled by the user. Opium dens are, in part, part of the American cultural imagination because of their

Opium Trade 

notorious reputation. This was largely developed in the mid- to late 1800s in relation to what many scholars have described as a drug scare—a special type of moral panic specifically related to drug use. While opioids had been used and legally available in the United States for a significant amount of time without a prescription, during the post–gold rush depression in the western part of the country the first law against drugs was passed: the San Francisco anti–opium den ordinance of 1875. As it was related more closely to the group of individuals using the drug than the drug itself, it is clear that the moral panic associated with it was more affiliated with the Asian immigrants who were using the drug than any particular concern about the drug itself. Interestingly, rather than focusing on legislation against opium, the legislation focused directly on the locations where opium was used—namely, opium dens. According to Reinarman (1997), this is in part because of the particular concern that opium dens were where whites came into contact with the Chinese immigrants, and thus would adopt the habits of those immigrants. There were additional concerns that opium dens served as locations where women would be enticed into sexual slavery. Like other drug scares, the scare regarding opium use, and more specifically opium dens, was successful because it took advantage of people’s concerns about an outsider-group that individuals were already concerned with. The scare regarding opium smoking in dens was perhaps a foreshadowing of other scares regarding opiates, particularly heroin, which were to take place in the early 20th century. Overall, opium dens were locations where individuals gathered to engage in the smoking of the drug derived from the opium poppy. In part, the dens were a function of

the necessities for smoking the drug, in particular the need for an individual to assist when the user fell asleep, and for comfort of the user. Special paraphernalia was developed for opium dens, including pillows and pipes, which were often not owned by the user, but rather by the den itself. While prevalent in the 1800s and early 1900s in both parts of Asia and the United States, by the middle of the 20th century, most opium dens had disappeared, because of both eradication efforts by various governments as well as the development of more potent forms of the drug, such as heroin, which drove the use of opium out of style. Because of its affiliation with a drug scare in the late 1800s, opium dens have become part of the cultural imagination of the United States, and serve as a forbear to later drug scares. Joshua B. Hill See also: Addiction; Drug Abuse; Opium; Opium Trade; Opium Wars

Further Reading Booth, M. 1996. Opium: A History. New York: St. Martin’s Press. Miller, G. 1997. Drugs and the Law: Detection, Recognition & Investigation. Longwood, FL: Gould Publishers. Reinarman, Craig. 1997. “The Social Construction of Drug Scares.” In Constructions of Deviance: Social Power, Context and Interaction, ed. P. Adler and P. Adler. New York: Wadsworth Publishing Company.

Opium Trade The cultivation and production of opium and its derivatives is a process that has existed since ancient times. There has been a variety of cultural, legal, and economic considerations that have affected government policies

711

712   Opium Trade

related to opium in many nations. In some countries, opium may be part of the very fabric of the history and culture of that region. In other countries, the use of opium may generally be considered both illegal and immoral. Thus, there exists a great range of reactions to the opium trade from the international community. The opium poppy is the source for opium and heroin. This plant requires a hot and dry climate. Growers simply scatter the seeds across a field, and within roughly three months the poppy is usually mature. When mature, the green, budlike stem is topped with a flower, and the petals of the flower will gradually wither and fall away, leaving a small green pod that is full of poppy seeds. Growers will obtain the milky-white fluid within this pod just before the pod fully matures. This fluid dries and hardens into a dark brown waxy or gummy substance. This substance is raw opium. The raw opium is then put through a series of processes that dissolve it and refine the product into solidified morphine. This morphine is heated at 185 degrees for six hours, at which point the product is refined into an impure heroin product. From this point, the product is treated with water and chloroform to remove impurities, and then the product is further refined through an additional heating process using sodium carbonate and alcohol. The product is then dissolved in alcohol, and hydrochloric acid is added until the product emerges as small white flakes. The flakes are dried under pressure, resulting in the final product typically known as heroin. Before the 1990s, heroin was often diluted significantly to be roughly 5 percent pure heroin product. Mexican heroin often has impurities as a result of this process that cause the product to have a brown or black oily appearance, sometimes referred to as black tar. Drug traffickers prior to the 1990s

would use products such as lactose, flour, or cornstarch to dilute the heroin because these products dissolve well when heated. However, there has been a noticeable trend to not dissolve heroin. During the 1990s and well into the 2000s, heroin has made it to the United States that is up to 90 percent pure. This means that heroin is being cut less and less, and users are able to smoke and snort heroin to get a pleasurable sensation. The opiates, and more specifically heroin, continue to be the main problem drugs worldwide. As an indicator of how opiates impact the global drug market, consider that two-thirds of the treatment demand in Asia, Europe, and Oceania is related to opiate addiction. These three continental regions account for nearly three-fourths of the entire world population. Furthermore, even though cocaine is in such strong demand in the United States, opiates still account for 28 percent of all treatment drugs of choice, whereas cocaine accounts for only 23 percent of such requests. There are a handful of regions around the world where heroin tends to be cultivated. These include the Golden Triangle, the Golden Crescent, Mexico, and more recently Colombia. Each of these source regions is in competition with one another, but the two Asian regions dominate the market on the continent of Asia. These regions of opium and heroin production have their own markets that they tend to cater to, and all four have the climate that is necessary to maximize growing potential for the poppy plant. The Golden Triangle is located within the countries of Myanmar, Thailand, and Laos. The overwhelming majority of the heroin from the Golden Triangle comes out of Myanmar. Also, as with the cocaine industry, there is a strong connection between extremist or guerrilla groups and the opium industry in Burma. Indeed, until 1989 the

Opium Trade 

Shan United Army (SUA) had been known to be instrumental in controlling the production and distribution of heroin from this region. The SUA was at one time simply an insurgent militant group, but over time it has increasingly focused its efforts on funding through the opium trade. Thailand remains the primary transit point from Southeast Asia for heroin that is destined for the worldwide market. In Thailand, much of the drug trafficking activity is controlled by ethnic Chinese, who dominate this part of the world heroin market. These Chinese organized crime groups, known as triads, have links to Hong Kong, and from there the heroin will be subject to worldwide dissemination. The heroin destined for the United States often goes through this route but is destined for other Chinese in the United States who are members of organized crime syndicates known as tongs. The triads and tongs have been found to engage in a variety of crimes on both sides of the Pacific Rim. In North America, tongs and Chinese gangs have been found to be active in both the heroin trafficking and human smuggling industries in New York, Los Angeles, and Seattle as well as in Toronto, Canada. The Golden Crescent is located in Southwest Asia and includes the nations of Iran, Afghanistan, and Pakistan. Southwest Asian opium is grown in remote mountain areas and is mostly transported to crude laboratories near the Afghanistan–Pakistan border region. Most of these laboratories are located in northwest Pakistan. The refined heroin leaves Pakistan through several routes: over land to Iran, by sea through Karachi to the Arabian Gulf and on to Europe, and by air through Islamabad. Before and during the 1990s, the majority of the heroin produced in the Golden Crescent originated in Afghanistan. In 2001 the Taliban banned further growing of poppies within Afghanistan even

though the trade was so enormously profitable. However, shortly after the terrorist tragedy on September 11, 2001, the Taliban instructed farmers to begin growing poppies. Since the collapse of the Taliban, the growing of poppies has become a mainstay of the economy, and a new increase in the heroin industry has been observed in Eastern Europe, undoubtedly fueled by the developments in Afghanistan. It has been estimated that almost 90 percent of the heroin sold in Europe comes from poppies grown in Afghanistan. A discussion of the heroin trade in the Golden Crescent in general, and Afghanistan in particular, would not be complete without mentioning the power that the Afghan warlords have over the drug trade in the region. These factious groups control a drug trade that supplies 10 million drug users throughout Asia and Europe constituting roughly two-thirds of all opiate abusers worldwide. In 2003, profits from international criminal gangs involved with the Afghan opium industry were estimated to be around $30 billion. Because of the growing strength of these groups and also because of associated health effects, neighboring countries have been supportive of the Afghani government’s efforts to stem the trade. Iran has joined in this effort, but its military and police units are outequipped by warlord traffickers whose troops are reported to be equipped with antiaircraft missiles, night-vision goggles, and satellite telephone systems. The Afghani government, in consortium with other surrounding countries and the support of countries abroad (the United Kingdom and the United States), has committed to fighting this trafficking so that the nation can become stabilized. The results of these efforts are yet to be seen, but it would appear from similar attempts in other nations (Thailand and Pakistan) that the nation of Afghanistan may be embroiled in this conflict for several years to come.

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714   Opium Trade

For generations, opium has been grown in remote areas of Mexico’s Sierra Madre region. This area first developed as a major heroin cultivation and production region during the 1970s to cater to the ever-growing demand generated by the United States. Trafficking organizations are now firmly in place in these areas and are involved in all phases of the heroin manufacture and distribution process. Mexican heroin is commonly referred to as black tar or brown heroin because of its coloration due to the impurities that are in the product. This heroin is less refined than standard heroin; is quick, easy, and cheap to manufacture; and requires less equipment and expertise. Since less equipment is involved, Mexican drug manufacturers can evade law enforcement detection much more easily by packing up their mobile cooking camps. Furthermore, since the process is less complicated, more experienced individuals are not needed and thus costs are lower. While the standard white heroin of the Golden Triangle and the Golden Crescent may approach nearly 100 percent purity, Mexican black tar is usually only about 65–85 percent pure. Poppy fields in Mexico are difficult to detect due to the small size of the fields and the ability of Mexican farmers to camouflage their activities. But the primary challenge to detecting poppy in Mexico has to do more with the general corruption within the country’s government. In fact, it is well known that many of the most active and accomplished heroin traffickers have previously been police officers. Although the United States is active in fighting this drug trade and thwarting the corruption in Mexico, graft runs deep and generally prevents officials from stopping the activity of drug families in Mexico. As soon as one is stopped, there is another that is all too willing to fill the ranks.

The advent of heroin cultivation, production, and trafficking in Colombia is a relatively new development, historically speaking, when compared to the other three sources of heroin. The most significant areas of opium poppy cultivation in Colombia fall along the eastern section of the Andes Mountains. Opium poppy cultivation in this mountainous region accounts for the majority of Colombia’s total opium output. Much of the Colombian heroin destined for markets in the United States is smuggled out of Colombia through international airports in Bogotá and Cali. During the 1990s, tactics of smuggling usually included persons carrying the product in hidden areas on their person or in their luggage or personal items. This method of transport could only move small amounts of the drug and was generally a risky process. Recently, traffickers have stepped up the amount that individuals carry by devising suitcases with compartments sewn inside the lining and the clothing packed therein. Also, these traffickers are increasingly using boats and personal planes to move the drug to the United States. In the United States, Colombian heroin is popular because it is much purer than Mexican heroin. In fact, it has been estimated that Colombian heroin meets up to 70 percent of the demand on the East Coast of the United States. It is clear that opium, in the form of heroin, is a drug with a strong international demand. Heroin abuse trends in Eastern Europe and the United States continue to rise at a rapid rate. The demand in Asia is somewhat stable but, given the millions of heroin abusers, will remain indefinitely. In China, the rate of consumption continues to rise, further demonstrating that the heroin cultivation and trafficking industry will continue to have a stable user demand for several more years. Indeed, it would seem

Opium Wars 

that the demand has encouraged the industry to extend beyond the traditional growing zones of the Golden Triangle and the Golden Crescent to other areas that were previously well known such as Mexico and Colombia. Indications such as these demonstrate that organized cultivation, production, and trafficking will continue well into the 21st century. Hua-Lun Huang See also: Colombian Cartels; Drug Cartels; Drug Trade; Drug Trafficking; Golden Crescent; Golden Triangle; Mexican Drug Trade

Further Reading Abadinsky, H. 2003. Organized Crime, 7th ed. Belmont, CA: Wadsworth/Thomson Learning. Drug Enforcement Administration. 2002. “The Drug Trade in Colombia: A Threat Assessment.” Eskridge, C. 2001. The Mexican Cartels and Their Integration into Mexican Socio-political Culture. Huntsville, TX: Office of International Criminal Justice. Hanser, Robert D., Walonda Wallace, and Kaine Jones. “The Global Opium Trade: Cultivation, Production, and Distribution.” In Organized Crime: From Trafficking to Terrorism, ed. Frank Shanty and Patit Paban Mishra. Santa Barbara, CA: ABC-CLIO. http://ebooks.abc-clio.com/reader.aspx?isb n=9781598841022&id=ICRIMEE.462. Moran, N. 2002. “Emerging Trends: Transnational Drug Production and Trafficking.” Crime & Justice International 18(3): 5–7. United Nations Office on Drugs and Crime. 2004. World Drug Report: Volume 1. Vienna: United Nations Office on Drugs and Crime. Young, R. 2012. “World in Brief: Wiping out Opium.” Crime & Justice International 18(3): 19.

Opium Wars The Opium Wars refers to two conflicts between Great Britain and China that lasted from 1839 to 1842 and then again in 1856. Opium use had been a serious social problem in China for a long time. In fact, the Manchu dynasty passed a law in 1729 ordering anyone selling opium to be strangled. In the 18th century, the British citizens fell in love with Chinese tea and wanted to trade for it. But the British did not have any goods that the Chinese wanted. The British soon discovered that they had access to opium after they conquered the Bengal Province in India, and opium was a commodity that they could trade for Chinese tea. Soon China was overrun with opium that had been imported from Britain, and the number of addicts rose dramatically. In 1839, China tried to ban the opium trade and prohibited opium importing from the British companies. However, the British companies that supplied opium to the addicts in China made good profits. Great Britain attempted to end the restrictions China had put on foreign trade by sending its navy and marines to force open the ports. In the dispute, China took action to enforce its prohibition against opium importing. The Chinese emperor ordered an imperial commission to confiscate a shipment of opium and then destroy the laden ship by burning it publicly while in the harbor of Canton. Concerned about its opium trade, Britain retaliated, destroying several coastal cities and easily defeating China. But the Chinese were not prepared to battle the European firepower. Through the treaty of Nanking, Great Britain won trade concessions from China so that the British merchants had exclusive trading rights in major Chinese ports. In addition, China had to sign

715

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over the island of Hong Kong to Britain, and to pay money to reimburse Britain for their losses associated with the war. Within a few years, other foreign powers gained the same, in effect making China a colony of foreign powers. In 1856 a second opium war broke out following the Chinese seizure of another British ship. British and French troops took Canton and Tientsin and forced the Chinese to accept the treaty of Tientsin, to which Russia and the United States were also parties. As a result of the treaty, China agreed to legalize the importation of opium within its borders. Groups of Protestant missionaries and non-Chinese physicians in China initiated the movement to suppress the opium trade in China. International conferences and conventions in 1909, 1918, and 1930 ultimately led to the restriction and prohibition of traffic in opium and opium derivatives, including heroin, morphine, and codeine. Ron Chepesiuk See also: China and the Chinese and Drugs; Opium; Opium Trade

Further Reading Fay, P. W. 1975. The Opium War, 1840–1842. Chapel Hill: University of North Carolina Press. Greenburg, Michael. 1951. British Trade and the Opening of China, 1800– 1842. Cambridge: Cambridge University Press. Hernon, Ian. 2000. The Savage Empire: Forgotten Wars of the 19th Century. Thrupp, UK: Sutton Publishing. Inglis, Brian. 1976. The Opium War. London: Hodder and Stoughton. Lovell, Julia. 2011. The Opium War: Drugs, Dreams and the Making of China. London: Picador.

Organized Crime Drug Enforcement Task Force Program In 1982, the Organized Crime Drug Enforcement Task Force (OCDETF) Program was established as a way to launch a comprehensive attack against organized drug traffickers. The goal of the program was to disrupt and dismantle major drug trafficking groups and their drug laundering operations program. The program remains as the centerpiece of the U.S. attorney general’s strategy to reduce the availability of illicit drugs throughout the country. The OCDETF was originally formed as a task force, bringing together many organizations with the same goal of reducing drugrelated crime, and using the strengths of each of the organizations, working together to reduce drug trafficking. The program included law enforcement personnel on the federal and state level who worked together in the same location. The OCDETF strike forces in major cities around the country targeted the most prominent and most active trafficking organizations. The agents and prosecutors gathered intelligence and disseminated leads throughout the neighboring areas. The program uses the resources and expertise of many federal agencies to organize a national, coordinated attack against major drug traffickers. Some of the agencies involved are the U.S. Attorneys’ Offices; the Bureau of Alcohol, Tobacco, Firearms and Explosives; the Drug Enforcement Administration; the Federal Bureau of Investigation; the Internal Revenue Service; the U.S. Coast Guard; the U.S. Immigration and Customs Enforcement; the U.S. Marshals Service; and the Criminal and Tax Divisions of the U.S. Department of Justice. Additionally, officials from many state and local agencies also participate.

Over-the-Counter Drugs  717

The strategy of the OCDETF is to focus federal resources on attacking the flow of illicit drugs into the country by identifying and targeting the major trafficking groups, eliminating their financial infrastructure through financial investigations and asset forfeiture, redirecting federal drug enforcement resources to align them with existing and emerging drug threats, and conducting expanded, nationwide investigations against all the related parts of the targeted organizations. To do this, OCDETF personnel coordinates the yearly creation of the Consolidated Priority Organization Target List. This is a list of the most prolific international drug trafficking organizations. The OCDETF hopes that a concentrated attack on the components of these organizations will disrupt the drug market and thus reduce the drug supply across the country. Such an attack will also support law enforcement’s efforts in the fight against those groups (i.e., terrorist organizations) whose activities may be supported by the drug trade. The OCDETF also requires its participants to identify major regional priority organization targets as part of the annual regional strategic plan process. The OCDETF Fusion Center is the cornerstone of the OCDETF’s efforts to collect information and intelligence. The Fusion Center was established as a way to enhance the OCDETF’s overall ability to participate in intelligence-driven law enforcement, which is an essential component of the OCDETF Program. The Fusion Center is a comprehensive data collection and management center that analyzes information pertaining to drug trafficking and financial information from multiple sources. Nancy E. Marion See also: Asset Forfeiture; Bureau of Alcohol, Tobacco, Firearms and Explosives; Drug

Enforcement Administration; Federal Bureau of Investigation; United States Coast Guard; United States Immigration and Customs Enforcement

Further Reading Marion, Nancy E. 2010. The Politics of Disgrace. Durham, NC: Carolina Academic Press. U.S. Department of Justice. “Organized Crime Drug Enforcement Task Forces.” http://www.justice.gov/criminal/taskforces /ocdetf.html.

Over-the-Counter Drugs Over-the-counter drugs (OTCs), or nonprescription drugs, are those the public can buy without a physician’s recommendation. Some OTCs relieve aches and pains, while others prevent or cure diseases like tooth decay or athlete’s foot; some OTCs can even help manage recurring problems like migraines. Most of the time, people purchase an OTC drug without first speaking to a physician. They “self-diagnose” their condition and need for a drug. The recommended dose is printed on the label, along with possible side effects and other warnings. The U.S. Federal Drug Administration (FDA) is charged with deciding whether or not a medicine is safe enough to sell as an OTC drug. They can also choose to change a drug from an OTC drug to one that requires a prescription. Even though the FDA deems a drug safe to be sold without a prescription, it does not mean that the drugs are risk-free. There is still the potential for an overdose or for a serious drug or food interaction. It is important to take OTCs correctly as some can be abused. The Over-the-Counter Review Committee is responsible to examine all nonpre-

718   Over-the-Counter Drugs

scription medicines. This committee made three changes in the OTC drugs that are sold in stores. First, the committee recommended that the dosage for certain drugs be increased. The FDA has agreed to this recommendation. One of those drugs is antihistamines, which are now stronger than before. The second recommendation was to remove some drugs from prescription-only to OTC. As a result, some drugs are available OTC that previously were available only with a prescription. Some of these include Actifed, Aleve, Benadryl, Claritin, Prilosec, and Zantac. The third recommendation is that all OTC drugs have labels that are easy to read so that consumers are aware of the dosages and possible side effects. Dextromethorphan is the active ingredient in OTC cough and cold medicines such as NyQuil and Robitussin. Teens abuse cough medicine to get high. This is called “robo-tripping” or “skittling.” An overdose of dextromethorphan can cause euphoria, distortions of color, hallucinations, vomiting, loss of muscle movement, seizures, and drowsiness. When combined with alcohol or other drugs it can cause death. Another cold medicine, pseudoephedrine, is often used to make methamphetamine. One important type of OTCs are analgesics, or pain relievers. They include aspirin, acetaminophen, ibuprofen, and naproxen. These are sometimes referred to as nonsteroidal anti-inflammatory drugs. These drugs reduce swelling in addition to pain (except for acetaminophen). Mixing these analgesics with alcohol can be very dangerous to the users. Aspirin is an analgesic drug (reduces pain), an anti-inflammatory drug, and an antipyretic (lowers elevated body temperature). At the same time, aspirin can cause gastric bleeding, can increase time for blood to clot, and can cause Reye’s syndrome in children.

Acetaminophen (Tylenol) is used as an alternative to aspirin but does not reduce inflammation. However, it may cause liver or kidney damage. It may also increase the effects of other medications. Ibuprofen (Advil, Motrin) also reduces pain, inflammation, and elevated body temperatures. This drug causes less gastric distress than aspirin. Naproxen (Aleve) is an analgesic and anti-inflammatory drug. Long-term use can lead to gastric bleeding. Sleeping aids are another group of OTC drugs. Drugs such as Unisom and Sleepinal are examples of these. Some also have painrelieving products included. Cough and cold remedies are other OTC drugs. There are many types of these drugs, but they can include cough suppressants, an expectorant to reduce mucus in the throat, a decongestant to open the nasal passages and sinuses, and/or an antihistamine to relieve itching, sneezing, watery eyes, and runny nose. Users should be cautioned when it comes to the cough and cold medicines. The antihistamines in some of the products can cause some people to feel drowsy, so they should not drive when taking the drugs. Moreover, some of the products contain a significant amount of alcohol that, when mixed with the antihistamine, could cause some people to become confused. Because of the alcohol, some young people drink these medications to get drunk. Some cough medicines also include dextromethorphan to suppress coughing, but some youth consume large amounts in order to get high. Diet pills are one type of OTC drug that can also be addictive. People who abuse these OTCs can experience nervousness, rapid and irregular heartbeat, high blood pressure, stroke, heart failure, or death. Abuse of another OTC used for weight loss, laxatives, can cause serious dehydration and loss of important minerals.

Oxycodone/OxyContin  719

Other OTCs can also be misused. For instance, abuse of motion sickness pills can cause one to feel high and have hallucinations, plus cause irregular heartbeats, coma, heart attacks, and death. Sexual performance medicines can cause heart problems. Herbal “Ecstasy,” a mix of inexpensive herbs that are legally sold in pill form, can be purchased in gas stations, health food stores, drug stores, music stores, nightclubs, and online. Overuse of herbal “Ecstasy” can lead to muscle spasms, increased blood pressure, seizures, heart attacks, strokes, and death. Nancy E. Marion See also: Analgesics; Ecstasy

Further Reading Levinthal, Charles F. 2012. Drugs, Behavior, and Modern Society. Boston: Allyn and Bacon.

ket around 1940, oxycodone is a drug whose abuse has reached epidemic proportions in certain parts of the United States, and like other prescription drugs, its use is increasing among high school students. The drug is usually obtained by doctor shopping or the illegal diversion of pharmaceuticals. Like all opiates, oxycodone can produce an intense sense of well-being, relaxation, drowsiness and sleepiness, and respiratory depression. Side effects might include dizziness and nausea, constipation, and sweating. Overdosing can lead to coma and death. Tolerance and physical dependence to oxycodone occur rapidly so users need more of the drug to achieve the same effect. Oxycodone can be prescribed by itself. When that happens, it is in the form of Oxy-

National Library of Medicine. “Over-the-Counter-Medicines.” http://www.nlm.nih.gov/med lineplus/overthecountermedicines.html.

Oxycodone/OxyContin Like morphine, oxycodone is a Schedule II drug under the Controlled Substances Act and is a powerful pain-relieving opiate. It is a white, odorless powder that is synthesized from thebaine, one of the natural ingredients in opium. Widely prescribed for its efficacy in treating cancer pain and other severe conditions, the substance is often marketed in timed-release preparations such as Percodan, Percocet, and OxyContin. It is more potent than codeine but less so than morphine. People who abuse the drug usually crush the tablets, then snort or dilute and inject the substance to experience a more rapid and intense rush. First introduced to the U.S. mar-

A bottle of prescription OxyContin in a drug pharmacy. OxyContin is used to reduce pain but can also be very addictive. (AP Photo/Toby Talbot)

720  Oxycodone/OxyContin

Contin. Oxycodone can also be prescribed in combination with other ingredients. One example of this is Percocet. The primary difference between oxycodone and OxyContin concerns the onset of action. OxyContin is a time-release drug, so it acts over a long period of time. Typically, oxycodone medications need to be taken every four to six hours. However, OxyContin lasts for about 12 hours in the body and needs to be taken only twice a day. OxyContin is only available through a physician’s prescription. Because it is heavily regulated, yet highly sought by addicts, many crimes have occurred related to this drug. Many people have been charged with prescription fraud, or even robbery of pharmacies. Some people steal the drug from relatives or friends. Common street names for oxycodone include hillbilly heroin, kicker, OC, and oxy. The average street value of 500 OxyContin (80 mg) pills is about $36,000. Kathryn H. Hollen

Drugs.com. “Oxycodone.” http://www.drugs .com/pro/oxycodone.html.

See also: Controlled Substances Act; Opiates; Opium

U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov.

Further Reading

U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov.

Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books.

Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Kuhn, Cynthia, et al. 2008. Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy. New York: Norton. Pinsky, Drew. 2004. When Painkillers Become Dangerous: What Everyone Needs to Know about OxyContin and Other Prescription Drugs. Center City, MN: Hazelden Foundation.

U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

P veys as an official measurement device for tracking adolescent drug use in America. Their Teaching and Learning Environment Surveys have been vetted and approved by the Office of Safe and Healthy Students as a measure of School Climate. The first surveys were administered to students in grades six through 12. Shortly thereafter, in 1988, the survey was expanded to include students who were in grades four through six. More recently, parents, faculty, and staff were asked to take part in the survey. The initial survey was also expanded to include more data collection concerning a wider range of behavioral influences that are known to have an impact on student learning, such as family relationships, discipline, gang involvement, violence, and safety concerns. Pride Surveys allow for the collection of strictly anonymous data from four population groups: students in grades four through six, grades six through 12, parents, and faculty and staff. The grades four through six surveys ask students to respond to questions pertaining to usage within the past year, tolerance for drug usage, accessibility of drugs, conduct at school, family life and discipline, violent behavior, and more. The survey most often used is the grades six through 12 questionnaire, which asks respondents about the age of onset of usage, perceived risks, ease of obtaining, location of usage, family life, academic achievement, and more. More than 13.7 million students, parents, and faculty members have responded to Pride Surveys. The parental survey is designed to facilitate parental involvement in the schoolbased survey. The parent questionnaire asks

Parents Resource Institute for Drug Education (PRIDE) Surveys Pride Surveys is an independently owned company created to produce a low-cost and effective means of collecting self-report evaluation measures of juvenile participation in drug, alcohol, and tobacco use. The activities of Pride Surveys were once part of the National Parents’ Resource Institute for Drug Education (PRIDE), a nonprofit organization devoted to drug abuse prevention through the education of parents and youth. Pride Surveys split off as its own company in 1998. The objective of Pride Surveys is to provide information to schools and other community-based organizations to help them better understand the activities in which juveniles are participating, with particular emphasis on drug, alcohol, and tobacco use. Juvenile participation in drug and alcohol experimentation and usage has been a concern for decades, with much of the empirical data suggesting a general increase in participation and a general decline in the age of involvement. Measurement techniques and prevention efforts are widespread and take many forms throughout the United States. In 1998, Pride Surveys was designated by federal law as an official measurement of adolescent drug use in the United States. The original Pride Survey was created in 1982 in an effort to bridge the gap between national drug and alcohol usage data and local-level substance abuse-related issues. In 1998 a federal law designated Pride Sur721

722   Parents Resource Institute for Drug Education (PRIDE) Surveys

respondents to report information about their child and their child’s peers at school, in the home, and in the community. Parents are asked to reflect on their child’s behaviors and their own perceptions about drug usage. The faculty and staff questionnaire asks teachers and staff questions pertaining to their perception of student drug use, school safety, knowledge of school drug policies, and more. Pride Surveys provide all necessary questionnaires to be disseminated to a population of juveniles in school. The surveys take approximately 20 minutes to complete and are then returned to Pride Surveys by the contracting agency for thorough analysis. Results are then reported and are compared nationally, across states, and over time. The surveys ask a variety of questions. Surveys begin by asking for personal characteristics such as ethnicity, age, grade level, having a job, whom the child lives with, and finally parental occupation and education level. The second section of a survey asks a variety of student information questions including the grades the student receives and participation in sports team, community, or school activities. Other questions include whether a child’s guardian sets clear rules; if the child or adolescent has been in trouble with the police; if the survey taker uses drugs such as alcohol, marijuana, or tobacco or binge drinks, and whether the child has thought of committing suicide. The surveys then ask students how often in the past year, and in the past 30 days, they have used drugs, how easy drugs are to obtain, and what are the possible negative effects (if any) of drug use. On the final page, survey takers must answer a variety of questions including when they first used drugs, how wrong their parents or friends would view their use of drugs, where they most often use drugs, what is the personal effect of their drug use,

and how they view the safety of the particular school they attend. The Pride Surveys were mentioned by President Clinton in 1998 when he stated that the survey showed that families can influence the behaviors of juveniles. He used the survey to kick off a national antidrug media campaign to reach a goal of cutting teen drug use in half. In 2000, he noted that the surveys indicated that drug use among youth was decreasing. Jeffrey A. Walsh See also: Drug Abuse

Further Reading Clinton, William J. 1998a. “Statement on Action to Cut Teen Drug Use.” June 18. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=56160. Clinton, William J. 1998b. “Statement on Efforts to Cut Teen Drug Use.” June 25. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=56209. Clinton, William J. 2000. “Statement on the 2000 Monitoring the Future Survey.” December 14. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=1289. Finley, Laura L. 2007. Encyclopedia of Juvenile Violence. Westport, CT: Greenwood Press. Greenfield, T. K., and J. D. Rogers. 1999. “Who Drinks Most of the Alcohol in the U.S.? The Policy Implications.” Journal of Studies on Alcohol 60(1): 78–89. International Survey Associates. 2003. “2002–2003 National Summary, Grades 6 through 12.” http://pridesurveys.com/main/ supportfiles/ns0203.pdf. Pride Surveys. “Measuring Student Behavior.” http://www.pridesurveys.com/index.htm.

Partnership for a Drug-Free America  723 Pride Surveys. “Pride Questionnaire.” http:// www.pridesurveys.com/supportfiles/ 612questionnaire.pdf.

Partnership for a Drug-Free America The Partnership for a Drug-Free America (PDFA) is a nonprofit coalition of professionals in the communications industry dedicated to using the media to reduce the demand for illicit drugs in the United States. Though its work supports the federal government’s antidrug education efforts, the organization receives no government funding, as it is financed entirely through donations from corporations, agencies, and private foundations. The Web site helps people find help for personal or a child’s drug use, such as education, screening, and networking. Specifically, for parents, there is a toll-free drug help line, which provides parents with the opportunity to speak to a person specialized in how parents can handle a child who is using drugs. The PDFA Web site also has a search engine allowing visitors to search for particular drugs. For example, if someone searches “alcohol,” the Web site provides background information, long-term and short-term effects, federal classification, if any, and related sources. The PDFA began in 1986, when Phil Jaonou, the chairman of the advertising agency Daley & Associates, introduced the idea of creating an organization to combat the glorification of drug use in the mainstream media. In the mid-1980s, the problems caused by illicit drug use had become prominent in the news, and the government, led by Ronald Reagan, identified it as a major social and public health problem. In this environment, Jaonou found a receptive audience for his idea to create an advertising

campaign dedicated to making youths more aware of the dangers that illicit drugs posed. His work began with a $300,000 grant from the American Association of Advertising Agencies to launch what was originally planned to be a temporary, three-year effort that would spend $1.5 billion to spread antidrug messages though the media. Shortly thereafter, the PDFA set up offices in New York City and hired Dick Reilly to be its first chief officer. The first PDFA advertisement aired on April 13, 1987. Though it fell short of its $1.5 billion goal, the PDFA generated about $150 million worth of advertising in its first three years. Using all major media outlets, including television, radio, the Internet, and print advertisements, the PDFA has, thanks in large part to pro-bono help from many leading advertising agencies, been able to reach the public on both the local and national level for the last 20 years. The PDFA became more ambitious over time, setting itself a goal of disseminating $1 million worth of advertising every day. By 1998, the PDFA became the second-largest advertiser in the United States, spending about five times as much on its messages as Coca-Cola, and trailing only McDonald’s in its annual production of advertisements. The stated goal of this media blitz was to ensure that every single American would receive at least one antidrug message per day. The PDFA has three major goals—to reduce demand for drugs by changing attitudes through the media, to track changes in attitudes towards illegal drugs, and to evaluate the impact that PDFA messages have on them. Towards these ends, the PDFA receives corporate contributions and advertising time, and then a 25-member creative review board reviews submissions for campaign ideas. In order to create content that they think will be effective, the PDFA has chosen to reject

724   Partnership for a Drug-Free America

government funding, since it would likely place limits on what sort of advertisements it could produce and run. This has allowed the group to run some shocking, but very effective advertisements, most famously one from the 1980s that showed how drugs can “fry” people’s brains. In this spot, an egg is shown with the audio caption, “This is your brain.” Then the egg is cracked and fried, at which point the narrator says, “This is your brain on drugs. Any questions?” As with the “This is your brain on drugs” advertisement, the PDFA uses modern marketing techniques in order to ensure that its messages are powerful and impact their target audiences. Over a hundred advertising agencies lend their expertise to the PDFA to assist in their efforts, which target eight primary groups—children, teens, adults, parents, Hispanics, blacks, healthcare providers, and employers. In addition to traditional advertising, the PDFA has also used more innovative advertising techniques, placing inserts into movies and cartoons, putting advertisements on cereal boxes and milk cartons, placing bumper stickers on toy cars, airing ads at gas stations, and taking out advertising space in telephone books. Though many applaud the PDFA’s efforts, the organization also has its critics. Many accuse the group of spreading falsehoods about drug use in its advertisements, and others claim that it focuses more on fear mongering rather than education in the messages it disseminates to the public. In addition, by portraying drug users in such a negative light, some scholars have claimed that the organization hardens public attitudes and makes viewers less likely to support drug-treatment initiatives. Furthermore, the alcohol and tobacco industries were heavy contributors to the organization when it began its work. This led to charges that the PDFA was, by emphasizing the dangers of illicit drugs, neglecting

to highlight the equally dangerous character of legal drugs such as alcohol and tobacco. Today, the PDFA also focuses on highlighting the dangers of alcohol use. Though it stopped accepting funding from alcohol and tobacco companies in 1994, the organization continues to take in donations from the pharmaceutical industry, which also pushes some drugs that have as much harmful potential as illicit substances. Since 9/11, the PDFA has run spots making direct links between drug use and terrorism, a connection that, while containing grains of truth to it since terrorist organizations do engage in drug trafficking, was considered an exaggeration by many critics. Howard Padwa and Jacob A. Cunningham See also: Anti–Drug Abuse Acts; Reagan, Ronald, and Nancy Reagan

Further Reading Buchanan, David R., and Lawrence Walleck. 1998. “This Is the Partnership for a DrugFree America: Any Questions?” Journal of Drug Issues 98(2): 329–56. Partnership for a Drug-Free America. “20 Years of Partnering with Families.” http://www .drugfree.org/General/Articles/Article .aspx?id=cfd5a031–7fc8–43c5–8a22–9b36 eddbf72a&IsPreviewMode=true&UVer=c6 59fb1a-3757–488a-8b8a-9d46c9ce4ba6. Partnership for a Drug-Free America. “About.” http://www.drugfree.org/Portal/About/. Reagan, Ronald. 1988. “Remarks to Media Executives at a White House Briefing on Drug Abuse.” March 7. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=35521. Trudeau, Christine. 2005. “Partnership for a Drug-Free America and Corporate Drug Wars.” http://www.cannabisculture.com /articles/4258.html.

Patent Medicines  725

Patent Medicines Patent medicines were formulas, tonics, and other concoctions that were sold as medicines, both in the United States, and elsewhere, until the early 20th century. These preparations often included habitforming drugs, and historians speculate that they may have led countless numbers of people to ingest harmful chemicals, or become addicted to the substances in these preparations, without even knowing it. It was not until the passage of the Pure Food and Drug Act in 1906 that the contents of patent medicines had to be revealed to the public. The poor, and people who lived in rural areas, often did not have access to health care in the 19th century, and many never saw a doctor unless they had a serious medical problem. Instead of professional medical treatment, they used traditional healing methods and folk remedies to soothe their everyday aches, pains, and worries. People often turned to these remedies for relief from chronic illnesses like asthma and arthritis, psychological problems like depression and alcoholism, and even for more serious infectious diseases like cholera and malaria. Druggists, mail-order services, traveling salesmen, and even pharmaceutical companies sold these medicines to gullible or desperate buyers, claiming that they had found a secret formula that could cure whatever ailed them. The packages for these medicines were almost always unmarked, and rarely had a list of ingredients that permitted buyers to ascertain what they were actually consuming. These tonics were sold as “patent medicines,” even though in fact, the inventors never actually patented the concoctions they sold. Often, this was because the “secret formula” was little more than a mixture of opium derivatives mixed with al-

cohol and other sedatives, along with spices or other chemicals to disguise the taste. Even though they contained potentially addictive substances, these medicines were often marketed to people who should not have been taking such dangerous drugs. Many patent medicines were marketed as “soothing syrups,” and used to calm irritated babies and help them go to sleep. Others were advertised as cures for addiction, but actually contained the drugs they claimed to counteract. Formulas like Opacura and Denarco, for example, were sold to addicts who, desperate for a cure, believed that these medicines would help them kick their habits. Only after taking the medicines for years did many unfortunate addicts realize that the drugs they had been taking to get over their morphine habits actually contained morphine as their main ingredients. At times, it was not until somebody investigated these secret formulas that their actual contents would become public knowledge. Even though the inventors of patent medicines would be publicly disgraced and embarrassed once their dirty secrets were made known to the public, it would not be until after they had sold their concoctions to thousands of unwitting customers. It was not until the first decade of the 20th century that this situation began to change. Reformers and muckrakers—journalists who wrote stories exposing the misdeeds of crooked politicians and big corporations— began agitating for better consumer protection in a variety of areas, including the sale of medicines. Eventually, their work led to the 1906 passage of the Pure Food and Drug Act, which required that the contents of preparations containing alcohol, opium, or opium derivatives be listed on the medicine’s packaging or labeling. Another sphere concerning patent drugs are the impact these drugs had on marketing

726  Peyote

and entrepreneurship in both the colonial and post-Revolution eras. These developments began, as a Native American venture, during the aftermath of the Revolution, while an American business system was being created to replace old patterns. British “patent medicines,” packaged remedies of which some were really patented and some were not, had been widely used in 18th-century America. The American promoter, marketing his pill or potion, certainly profited from the promotional experience of his British predecessor. The two most important reasons for the rise of patent medicines were the unsatisfactory state of health in the nation, and the expansion of ways by which ailing citizens could be confronted with messages of hope. There were many factors that promoted the sale of patent drugs. In the early 19th century, the degree of desperation was greater, or, at least, usually came earlier and more often in the life of the average man. He was panicked by smallpox and yellow fever, but killed more often by the less dramatic respiratory and dysenteric infections. After 1815 urban mortality began to rise. Tuberculosis was on the increase, as were the dread fevers, typhoid, typhus, and yellow, and in 1831 cholera began to stalk the American landscape. Both the isolation of rural life and the tensions of urban factory labor were conducive to psychosomatic disorder. Because many of the causes of diseases were unknown, doctors were unequipped to help people; this in turn resulted in people turning to those who sold these types of drugs. Patent medicine promoters insisted that their remedies would cure, and they usually added that the cure was sure, swift, and safe. They sometimes sought to establish the point by pseudo-statistics, more often by the use of circumstantial case histories, real or fictional, from men of distinction or humble citizens, usually in the grateful language of the testified. With re-

spect to orthodox medicine, patent medicine promoters were ambivalent. They condemned the regular doctor’s barbarous methods, his exorbitant fees, his secret Latin prescriptions, and his high degree of failure. Yet they sought a sort of respectability by pretending to medical degrees they did not possess—as Dyott did—by “trumping up ‘Dispensaries,’ [and] ‘Colleges of Health,’” and by claiming major scientific breakthroughs or that regular physicians were too stodgy or greedy. People who sold these patent drugs over a century ago still have an impact on society today. For example, in important ways, therefore, patent medicine makers blazed a trail, which later makers of soaps and cereals and cigarettes would follow. Howard Padwa and Jacob A. Cunningham See also: Pure Food and Drug Act; Synthetic Drugs

Further Reading Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Morgan, H. Wayne. 1974. Yesterday’s Addicts: American Society and Drug Abuse, 1865– 1920. Norman: University of Oklahoma Press. Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press. Young, J. H. 1960. “Patent Medicines: An Early Example of Competitive Marketing.” Journal of Economic History 20(4): 648–56. http://www.jstor.org/stable/pdfplus /2114405.pdf?acceptTC=true&acceptTC=t rue&jpdConfirm=true.

Peyote Peyote is a spineless cactus found in northern Mexico and the southern part of Texas.

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Navaho Indians take part in a peyote ceremony. They use the drug as part of ancient prayer rituals, and are allowed to do so by the U.S. government. (Carl Iwasaki/Time Life Pictures/Getty Images)

The top of the cactus, which is called a button, contains the hallucinogenic substance mescaline, and three or four of such buttons can produce hallucinogenic effects in users that are similar to those experienced with LSD. Ernst Spath first synthesized mescaline in 1919. During the 1950s and 1960s, peyote’s easy availability led to abuse, especially among college students. Today, adherents of the Native American Church can use peyote regularly and legally as a sacrament or as part of the dance ritual, which is a component of their religious ritual to help the sick, for birthdays, and as part of marriage ceremonies, making it the only drug legally sanctioned by the U.S. government, which classifies the drug as a Schedule I drug. Efforts have been made, however, to have the drug outlawed.

Mescaline belongs to a family of compounds known as phenethylamines, making it quite distinct from the other major psychedelics such as LSD and psilocybin, which belong to the indole family. Many synthetic “designer” psychedelics, such as Ecstasy (MDMA) and 2C-B, are phenethylamines, and are related to the chemistry of mescaline. The chemical structure of mescaline is very similar to that of the neurotransmitters dopamine and norepinephrine, thus the drug can interfere with their actions in the brain. Unlike peyote, however, mescaline can be synthesized in a lab. An important U.S. Supreme Court ruling impacted significantly on the issue of whether peyote could be used in a limited way as an institutional right to freedom of religion. In 1990 a U.S. Supreme Court case, the U.S. De-

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partment of Human Resources vs. Smith ruled that an individual was not beyond the law simply because peyote was used for religious purposes. Believing that this ruling endangered the free practice of religion for all Americans, Congress signed the Native Free Exercise of Religion Act of 1994, which gave full protection to Native American Church members to use peyote in religious ceremonies. Mescaline is most often taken orally in the form of powder, a tablet, a capsule, or liquid. In its liquid form, mescaline can be injected into the user, but this is not a popular way to use it. Users typically ingest between 300– 500 mg, approximately the amount contained in 3–6 peyote buttons. The user will feel the effects within an hour or two, which then gradually disappear within 10–12 hours after administration. Peyote has a bitter taste, and the areas in which it can be grown are limited, which helps explain why it has never been as popular in the drug subculture as other hallucinogens. Peyote is not known to be addictive, but its use can bring a change to visual perception, leading to significant mood changes. The top of the cactus above ground (also referred to as the crown) consists of disc-shaped buttons that are cut from the roots and dried. These buttons are generally chewed or soaked in water to produce an intoxicating liquid. Short-term effects of using peyote can vary based on the particular user. Once ingested, peyote can cause feelings of nausea before the desired mental effects appear, which are altered states of perception and feeling. Other effects can include increased body temperature, heart rate, blood pressure, loss of appetite, sleeplessness, numbness, weakness, and tremors. Effects can be different during each use due to varying potency, the amount ingested, and the user’s expectations, mood, and surroundings.

On some trips, users experience sensations that are enjoyable. Others can include terrifying thoughts and anxiety, fear of insanity, fear of death, or fear of losing control. There can be multiple long-term effects to peyote use as well. Some users experience “flashbacks,” or hallucinogen persisting perception disorder, which are reoccurrences of hallucinations long after ingesting the drug. The causes of these effects, which in some users occur after a single experience with the drug, are not known. Tolerance to peyote or mescaline typically develops rapidly with repeated daily use, generally within 3–6 days. Cross-tolerance may also occur with other drugs including LSD and psilocybin. With a period of abstinence of at least a few days, sensitivity will be restored. Currently, no physical dependence or psychological dependence has been reported, although it may be possible. Ron Chepesiuk See also: Hallucinogens; LSD; Mescaline

Further Reading Center for Substance Abuse Research University of Maryland. “Peyote.” http://www .cesar.umd.edu/cesar/drugs/peyote.asp. Chouvy, Pierre-Arnaud. 2010. Opium: Uncovering the Politics of the Poppy. Cambridge, MA: Harvard University Press. Epps, Garrett. 2009. Peyote vs. the State: Religious Freedom on Trial. Norman: University of Oklahoma Press. Marnell, Tim, ed. 1997. The Drug Identification Bible. Denver: Drug Identification Bible. O’Brien, Robert, and Sidney Cohen. 1984. The Encyclopedia of Drug Abuse. New York: Facts on File. Olive, M. Foster. 2007. Peyote and Mescaline. New York: Chelsea House.

Pharmacology  729 Partnership for Drug-Free Kids. “Peyote.” http://www.drugfree.org/drug-guide/ peyote. “Peyote to LSD: A Psychedelic Odyssey.” 2012. A&E Television Networks, LLC. New York: Films Media Group. Ross-Flanigan, Nancy. 1997. Peyote. Springfield, NJ: Enslow Publishers. Steinberg, Michael K., Joseph J. Hobbs, Kent Mathewson. 2004. Dangerous Harvest: Drug Plants and the Transformation of Indigenous Landscapes. New York: Oxford University Press.

Pharmacology In general terms, pharmacology is the science of how a drug affects the body’s biological systems. The field of pharmacology encompasses the sources of drugs, the chemical properties of different substances, the biological effects of drug use, and any therapeutic uses of drugs. Pharmacology is a science that is basic not only for the medical field, but also to other related fields such as pharmacy, nursing, dentistry, and veterinary medicine. Some pharmacological studies examine the potential effects of chemical agents on subcellular mechanisms, while others examine the hazards of pesticides and herbicides on a person’s body. Another example of research are studies that look into the treatment and prevention of major diseases by using drug therapy. Those who are experts in the field, referred to as pharmacologists, will use molecular modeling and computerized design in order to have a better understanding of cell function. Developing areas in the field of pharmacology include the genomic and proteomic approaches for therapeutic treatments. Because the field integrates knowledge from many related scientific disciplines, pharmacology offers

a unique perspective to solving drug, hormone, and chemical-related problems as they affect human health. Pharmacology can be divided into several different subfields. One of those is neuro­ pharmacology, which is the analysis of how drugs affect components found in the body’s nervous system, including the brain, spinal cord, and the nerves. Those scientists who study in this field, neuropharmacologists, examine drug actions from many different viewpoints. They also use drugs as tools as a way to understand the basic mechanisms of neural function. Another subfield of pharmacology is cardiovascular pharmacology, which revolves around the potential effects that drugs have on the heart, the vascular system, and parts of the nervous and endocrine systems. These researchers analyze the effects that different drugs have on a person’s arterial pressure, blood flow in specific vascular beds, release of physiological mediators, and on neural activity. Molecular pharmacology is another subfield of pharmacology. This subfield deals with biochemical and biophysical characteristics of possible interactions between drug molecules and those found in a cell. Biochemical pharmacology, another subfield, is concerned with the methods of biochemistry, cell biology, and cell physiology as a way to further understand how drugs interact with, and have an influence on, the chemical “machinery” of organisms. Behavioral pharmacology is a subfield of pharmacology that is concerned with the effects of drugs on a person’s behavior. Someone in this field would perform research on topics such as the possible effects of psychoactive drugs on a person’s ability to learn, their memory, wakefulness, sleep, and drug addiction. A person working in endocrine pharmacology would be interested in the study of drug actions that are either hor-

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mones or hormone derivatives, or drugs that may change the actions of normally secreted hormones. Clinical pharmacology refers to the application of pharmacodynamics and pharmacokinetics on patients with diseases and have a significant pharmacogenetic component. Those people who study clinical pharmacology are concerned with how drugs work, or how the drugs interact with the genome. Other areas of interest would be how the effects of a drug can alter the disease process and how disease can alter the effects of a drug. Chemotherapy is another subfield of pharmacology that deals with drugs that are used for the treatment of microbial infections and malignancies. There are many possible jobs for a person who is interested in studying pharmacology. Because there has been a general shortage of pharmacologists in recent years, there is an increasing need for expertise in the field. This means that there is a good chance that those people who graduate in this field will find a job that allows them to use their skills and pursue their own areas of special interest. Some pharmacologists opt to pursue a position in which they will have both teaching and research responsibilities. These are often found in academic settings in universities. They can be found in many areas of the health sciences, including medicine, pharmacology, dentistry, osteopathy, veterinary medicine, and nursing. Government institutions often employ pharmacologists to perform research in agencies such as the National Institutes of Health, the Environmental Protection Agency, the Food and Drug Administration, and the Centers for Disease Control. Scientists in these agencies will take part in basic research that examines the actions and effects of pharmacological agents on bodies. Pharmacology has had huge impacts on society in many ways. Pharmacology has

helped to expand the drug manufacturing industry. Another major contribution of pharmacology has been to advance knowledge about cellular receptors with which hormones and chemical agents interact. New drug development has focused on steps in this process that are sensitive to modulation. Identifying the structure of receptors will allow scientists to develop highly selective drugs with fewer undesirable side effects. Nancy E. Marion

Further Reading American Society for Pharmacology and Experimental Therapeutics. “Explore Pharmacology: Graduate Studies in Pharmacology.” http://www.med.unc.edu/pharm/about-us/ explore_pharmacology.pdf. Brahmachari, Goutam. 2013. Chemistry and Pharmacology of Naturally Occurring Bioactive Compounds. Boca Raton, FL: CRC Press. Hitner, Henry, 2012. Pharmacology: An Introduction. New York: McGraw Hill. Rosenfeld, Gary C. 2014. Pharmacology. Baltimore: Lippincott Williams and Wilkins. Rubin, R. P. 2007. “A Brief History of Great Discoveries in Pharmacology: In Celebration of the Centennial Anniversary of the Founding of the American Society of Pharmacology and Experimental Therapeutics.” Pharmacological Reviews 59(4): 1–356. Zaslau, Stanley. 2014. Lippincott’s Illustrated Q&A Review of Pharmacology. Philadelphia: WoltersKluwer.

Phencyclidine (PCP) Phencyclidine is a recreational, dissociative drug that produces hallucinations in its users. The drug can be found as both a powder and a liquid, but is usually sprayed

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onto another product such as marijuana or tobacco, and then smoked. In this form, it is called “embalming fluid.” Some users dissolve the powder in water or alcohol and use it as a spray. The PCP user can ingest the drug through smoking, inhalation, or injection. It is sometimes also available as a tablet or capsule. In its pure form, PCP is yellowish oil, but on the street can appear as tan or brown because of additives. However, it is usually sold on the street as a white powder. PCP usually has a distinctive, bitter taste. PCP was first synthesized in 1926. After World War II, it was tested as an anesthetic for use during surgery. However, after many patients suffered serious side effects, including hallucinations, delirium, and disorientation, the use of the drug was halted. In 1952, phencyclidine was patented by Parke-Davis pharmaceutical company and sold under the name Sernyl, meaning serenity. Because of its severe side effects, the drug was not used often, and in 1967, it was sold as an anesthetic for veterinary offices. It wasn’t too long before this was discontinued as well. About this time, PCP began appearing on the drug scene in major cities in the United States. The drug has been called “the world’s most dangerous drug” by many because of the intense side effects. Users will generally feel their arms and legs go numb. They may feel “drunk” and exhibit slurred speech, staggering, dizziness, and bloodshot eyes. They may have shallow breathing, profuse sweating, and poor muscle coordination. They may feel euphoric or unattached, as if they are in a trance or somehow “out of their bodies.” Other users experience nausea, vomiting, blurred vision, and drooling. PCP is also associated with hostile behavior that results in violence. Some users feel paranoid and have suicidal thoughts. With higher doses,

the user may become comatose, experience convulsions, or even death. People who have used the drug for long periods often report having memory loss, difficulty with speech and thinking, and depression. Some people have used the drug unknowingly because it is often an additive in other drugs such as marijuana, LSD, or methamphetamine. According to the 2013 “Monitoring the Future” Study, which asks 12th grade students about their drug-related behaviors, 1.3 percent of the respondents reported that they had used PCP in their lifetime; 0.70 percent reported using PCP in the past year; and 0.40 percent reported to have used it in the previous month (NIDA 2013). The National Survey on Drug Use and Health shows that the number of past-year initiates (people who have used the drug for the first time in the past year) decreased from 123,000 in 2002 to 45,000 in 2009 and 2010. However, this may be slightly misleading because PCP is included in a category with also includes other hallucinogens such as LSD, mescaline, and Ecstasy (2011). The number of people visiting hospital emergency departments because of a reaction to PCP increased more than 400 percent between 2005 and 2011, from 14,825 to 75,538 visits. The total number of emergency room visits related to the use of illicit drugs in 2011 was 1.25 million. The largest increase was among patients who were between the ages of 25 and 34. This group saw an increase of over 500 percent. The patients were overwhelmingly male: about two thirds of the visitors were male (SAMHSA 2013). PCP is currently a Schedule II drug under the federal Controlled Substances Act (CSA). It is addictive, so users will often have a psychological dependence, craving, and compulsive drug-seeking behaviors.

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The chemical structure of PCP is an arylcyclohexylamine derivative. It works as an NMDA receptor antagonist but is much more dangerous than other hallucinogens such as ketamine, tiletamine, dextromethorphan, and nitrous oxide. Street names for PCP include angel dust, illy, hog, wack, dust, rocket fuel, or wet. If a cigarette has been sprayed with PCP (or dipped into PCP), it can be referred to as a leak, amp, lovely, fry stick, toe tag, or happy stick. The names given to PCP when it is sprayed on marijuana include supergrass and killer joints. Nancy E. Marion See also: Controlled Substances Act; Hallucinogens; Ketamine; Synthetic Drugs

Further Reading Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. Gahlinger, Paul M. 2004. Illegal Drugs: A Complete Guide to their History, Chemistry, Use and Abuse. New York: Plume. Karch, Steven B. 1998. Drug Abuse Handbook. Boca Raton, FL: CRC Press. Marnell, Tim, ed. 1997. The Drug Identification Bible. Denver: Drug Identification Bible. National Institute on Drug Abuse. Research Report Series. Hallucinogens and Dissociative Drugs (NIH Publication number 01-4209). Washington, DC: National Institute of Health. National Institute on Drug Abuse. 2013. “PCP/ Phencyclidine.” http://www.drugabuse.gov/ drugs-abuse/pcpphencyclidine. National Survey on Drug Use and Health. 2011. Summary of National Findings. NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Rudgley, Richard. 1998. The Encyclopedia of Psychoactive Substances. New York: St. Martin’s Press. Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network. 2013. “Emergency Department Visits Involving Phencyclidine (PCP).” http:// www.samhsa.gov/newsroom/advisories /1311140003.aspx. Zilney, Lisa Anne. 2011. Drugs: Policy, Social Costs, Crime and Justice. Upper Saddle River, NJ: Prentice Hall/Pearson.

Phoenix House Phoenix House is a pioneer organization in the development of modern drug treatment, treating nearly 70,000 people in the United States since its beginning in 1967. Mitchell S. Rosenthall founded Phoenix House, and the CEO is currently Howard Meitiner. Today, as one of the country’s largest private, nonprofit providers of substance abuse treatment and education, Phoenix House provides residential and outpatient treatment for nearly 3,000 adults and adolescents in New York, Texas, California, and New Jersey. However, those are not the only locations of Phoenix House. Other locations include Florida, Maine, Massachusetts, Vermont, and the D.C. area. All of Phoenix House’s programs rely on self-help methods in a group setting and view drug abuse as a disorder affecting the whole person. Phoenix House aims to integrate their clients into society as drug-free, productive, and socially mobile citizens. According to its Web site, Phoenix House is “committed to protecting and supporting individuals, families, and communities affected by substance abuse and dependency. We realize our mission through: A focus on the distinct needs of every person; A holistic approach that seeks to address mental,

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physical, and social health; The innovation of best-in-class prevention, treatment, and recovery programs; and the promotion of greater understanding of addiction.” In New York, the members of Phoenix House must recite the group’s philosophy twice a day: Every person has an inborn dignity and self-pride. But pride is like a young sapling that must be trained, channeled and nurtured until it is able to become deeply rooted and stand alone, self-supported and unshakeable in the conviction that its firm foundation can withstand the test of any ill wind that may attempt to uproot it. An ill wind has stunted the growth of our pride but, with each other’s help, we will, we must dig our roots deeper, make our foundation stronger and learn to combat and defeat all obstacles that stand between us and our goal of maturity, dignity and self-respect. Our symbol, the Phoenix, derives from the Egyptian myth of the great bird, which is said to have destroyed itself by fire and to have risen again from its own ashes. It is what we, who have destroyed our lives by drug addiction, are striving to do: rise from the ashes of our defeat to take our rightful place in society. Society will accept us, for once we have regained our dignity, we will be society. In 1983, Phoenix House opened its first academy, a residential high school for teens who have fallen behind, where they can make up schooling lost to drugs and recapture opportunities for higher education and careers. Eleven Phoenix House academies now operate in seven states. In 2005, the Phoenix House Academy was designated a “model program” by the U.S. Department of Justice, and the federal government subsequently has listed the academy model in the Substance Abuse and Mental Health Ser-

vices Administration’s National Registry of Evidence-Based Programs and Practices. Phoenix House offers a variety of services to drug users. Some of these include services for veterans, adolescents, mental health programs, help for pregnant mothers and children, drug screening and prevention, and adult-related drug programs. Phoenix House also provides detoxification services, as well as sober living and support services. Many of these services are recreational and group activities, such as hikes, picnics, and music recording. Other types of services put emphasis on community involvement and integration. For example, sober living services help train people for employment opportunities, developing support groups, and family reunification. The Phoenix House staff stresses the importance of community service and seeks to raise the community’s awareness of drug use and addiction. They often tie the treatment with community education programs. One example of this took place in Los Angeles, when youth participants held workshops in which they spoke with counselors about how drugs can damage a body, and then held events for Recovery Month to reach out to others. The teens created banners about the dangers of drug use and hung them up. Along with the banners, the teens prepared speeches and presentations about the importance of being sober. There are numerous careers within Phoenix House. People may be employed as director managers, case managers, nurses, housing search specialists, and a wide variety of different types of counselors. Some of these various types of counseling include the areas of Mental Health, Substance Abuse, and Detoxification. Ron Chepesiuk See also: Addiction; Treatment

734   Pizza Connection (1980–1982)

Further Reading Becklund, Laurie. 1989. “Nancy Reagan Drops Support for Proposed Drug Center.” Los Angeles Times, September 1. http://articles .latimes.com/keyword/phoenix-house. DeLeon, George. 1974. Phoenix House: Studies in a Therapeutic Community 1968– 1973. New York: MSS Information Corp. “Phoenix House Philosophy.” 1989. New York Times, October 22. http://www.nytimes .com/1989/10/22/nyregion/phoenix-house -philosophy.html. “The Phoenix House Way.” Phoenix House. http://www.phoenixhouse.org/.

Pizza Connection (1980–1982) In the Pizza Connection case, La Cosa Nostra members distributed heroin imported from Southeast Asia’s Golden Triangle through pizza parlors in the United States, and then transferred the cash generated through New York to Switzerland and finally to Italy, where it was used to buy more heroin. Authorities estimate that at least $25 million was laundered between October 1980 and September 1982. The “Pizza Connection” is the name federal investigators gave to the heroin-trafficking and money-laundering operations of the Italian Mafia, including the suspected criminal activities of the America-based Bonanno crime family. On April 8, 1984, police apprehended Alfano and Badalamenti, two members of the Sicilian mafia, along with 29 others in Spain and the United States and arrested them on charges that they participated in a multinational, $1.65 billion heroin/cocaine smuggling and money laundering conspiracy. The drug trafficking network began in the poppy fields of Afghanistan

and ended up with laundered profits deposited into banks in Switzerland. The operation also included ships in Bulgaria and Turkey, pay phones in Brazil, and pizza restaurants in New York, Oregon, Illinois, and Wisconsin. According to the President’s Commission on Organized Crime, the Pizza Connection case “provided new evidence of the extent to which elements of the La Cosa Nostra and the Italian mafia had jointly participated in narcotics trafficking and the laundering of narcotics proceeds through financial institutions in the United States” (President’s Commission on Organized Crime 1984, 32). However, the money launderers in the Pizza Connection case were not as sophisticated at laundering drug profits as were the Colombian drug cartels in later years. As Robert Powis noted, “The Pizza Connection launderers were frequently bumbling and lacking in knowledge about how to move large quantities of cash inconspicuously” (Powis 1992, 29). The real-life drama would include names such as former New York City mayor Rudy Giuliani, who headed the team that prosecuted Alfano and others involved with the Pizza Connection, and John Gotti, the powerful chief of New York’s Gambino crime family in the mid-1980s and early 1990s. The heroin smuggling network was led by a faction of the Bonanno crime family headed by Salvatore Catalano. The operation tied directly to organized criminal groups in Sicily, the rest of Italy, Switzerland, Spain, and Brazil. Direct evidence of the existence of the network was first obtained in 1980 when couriers were observed transferring enormous amounts of cash through investment houses and banks in New York City to Italy and Switzerland. Tens of millions of dollars derived from heroin sales in this country were transferred overseas in this

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fashion, apparently in violation of the Bank Secrecy Act. Even after federal agents broke the French Connection in the late 1960s, the supply of heroin on the streets did not diminish. New mafia members from Sicily, called Zips, quickly took over role of heroin distributor in the United States. The Zips operated from Brooklyn’s Knickerbocker Avenue, and coordinated their distribution through a business named Pronto Demolition. It is thought that the business partners in Pronto funded the initial purchases of drugs from suppliers in Sicily. The drugs were then distributed through a series of pizzerias in the East and Midwest. The couriers transported cash out of the United States, mostly in denominations of $5, $10, and $20 bills. The cash was usually flown out of the country by private jet to Bermuda, by commodity account transfers between New York City and Switzerland, and various other means. These funds were then channeled from Switzerland or Bermuda back to the drug sources in Italy. The money was used to pay for the raw opium that would be converted into heroin in secret labs in Sicily, to finance additional laboratories, and otherwise to support the overall network of heroin trafficking. One of the couriers for this laundering operation was Franco Della Torre, a Swiss resident. In March 1982, Della Torre deposited slightly more than $1 million in $5, $10, and $20 bills in the “Traex” account at the Manhattan office of the brokerage firm Merrill Lynch Pierce Fenner & Smith. Thereafter, Della Torre made four additional cash deposits totaling $3.9 million in the “Traex” account at Merrill Lynch in late March and mid-April 1982. From April 27 through July 2, 1982, Della Torre made seven cash deposits totaling $5.2 million in a “Traex” account at E. F. Hutton. Between

July 6 and September 27, 1982, Della Torre made 11 similar cash deposits totaling $8.25 million in the account of “Acacias Development Corporation” at E. F. Hutton in Manhattan. Of the total $18.3 million deposited by Della Torre in the Merrill Lynch “Traex” account and the two E. F. Hutton accounts, an undetermined portion was transferred to a “P. G. K. Holding” account at E. F. Hutton. According to Swiss authorities, P. G. K. Holding was listed as an importer and exporter of precious gems. Records of this account reflect that nearly $13 million was eventually transferred out of the United States to pay for commodity futures contracts in Switzerland. Commission interviews established that in April 1982, an E. F. Hutton senior vice president directed an employee to arrange for large cash deposits at Bankers Trust for a then unidentified client. Della Torre arrived at Bankers Trust for the first such arranged deposit with two gym bags filled with small-denomination bills, excused himself from the counting room, and returned a short time later with an additional bag filled with money. After two deposits totaling nearly $4 million were made, Bankers Trust refused to accept further transactions of this nature with E. F. Hutton, ostensibly because of an inability to free employees for counting money. In reality, Banker’s Trust officials were concerned about the legitimacy of the cash deposited, and one official shared those concerns with an E. F. Hutton official. The official responded that E. F. Hutton was making the deposit and that Bankers Trust would not be liable for anything. When interviewed by the commission, this E. F. Hutton official stated that he did not recall this conversation with the Bankers Trust official. According to the complaint, information from confidential sources indicates that

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other indicted members of the heroin network were involved in money laundering activities. Adriano Corti, a member of the Catalano faction, identified himself to a European financier as a principal of COOP Finance in Switzerland. Corti explained that he had a client, a “prominent industrialist,” in New York City, who was interested in transferring $5 million to $6 million cash from the United States to Switzerland. Between October 20 and November 21, 1980, approximately $1.78 million in cash was shipped to Switzerland from deliveries arranged by Corti in New York City. Another confidential source observed approximately $2 million in cash denominations of $5, $10, and $20 bills being delivered in New York City at Corti’s direction between October and December 1980. This source stated that the cash deliveries were made by automobile by several members of the Catalano faction who transported the cash in gym bags, suitcases, and cardboard boxes. Yet another confidential source indicated that another member of the heroin network, Phillip Salamone, customarily transported currency from New Jersey to a location in New York State, where another individual smuggled the currency across the border into Canada. The ultimate destination of the money was believed to be Sicily. As previously stated, the complaint states that agents believe that between October 1980 and February 1981, approximately $6.9 million in cash was collected and transported from New York City to banks in Bermuda and Switzerland. Together with amounts deposited by Della Torre, authorities believe that the heroin network laundered at least $25.4 million between October 1980 and September 1982. Ron Chepesiuk

See also: Drug Smuggling; Drug Trafficking; Drug Trafficking and Organized Crime; Heroin

Further Reading Alexander, Shana. 1998. The Pizza Connection: Lawyers, Money, Drugs Mafia. New York: Weidenfeld and Nicolson. Havens, J. 1993. “‘Pizza Connection’ Legacy Examined.” Rock River Times. http:// rockrivertimes.com/1993/07/01/pizza -connection-legacy-examined/. Marion, Nancy E. 2007. Government versus Organized Crime. New York: Prentice Hall. Powis, Robert. 1992. The Money Launderers. Chicago, IL: Probus Publishers. President’s Commission on Organized Crime. 1984. The Cash Connection: Organized Crime, Financial Institutions and Money Laundering. https://www.ncjrs.gov/ pdffiles1/Digitization/166517NCJRS.pdf. Reppetto, Thomas A. 2006. Bringing Down the Mob: The War Against the American Mafia. New York: H. Holt.

Popular Culture Researchers at the University of Pittsburgh School of Medicine in 2007 examined 297 songs that made it to the top of the Billboard charts in 2005 and found that 93 (33 percent) of them portrayed drug or alcohol use. Some 86 percent of hit rap tunes had drug references, followed by 37 percent of country tunes, 29 percent of R&B/hip-hop songs, 14 percent of rock songs, and 12 percent of pop songs. Twenty-four percent of drug use references were to alcohol, 14 percent were to marijuana, and only 3 percent were to tobacco; 12 percent were to drugs the researchers could not identify. Drugs in pop culture have a heavy influence in soci-

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ety; it is commonplace for drug and alcohol references and outright usage to occur in popular music, movies, and literature; children see drugs in pop culture references in cartoons and movies all the time though they may not realize it; kids emulate the behavior using ordinary items such as candy. Kids may think that drug and alcohol use helps to relieve stress; drugs in pop culture give kids an “image” that is very appealing and cool. Shows like Jersey Shore show young adults drinking excessively while having fun; often people believe that they need to drink to have a good time or to “fit in.” Shows make it seem glamorous, construe the message that it is possible to get away with such activity and live well because of it, and do not show the negative repercussions and accidents that can occur because of usage. A Princeton study in 2010 found several different shows that aired in prime time slots for television shows involved some form of drug use. Shows included: 24, CSI, CSI: Miami, The Good Wife, House, Law & Order, Law & Order: Los Angeles, Law & Order: SVU, NCIS, and NCIS: Los Angeles. It should be noted however that shows such as 24, Law and Order: Los Angeles, and House are no longer on the air. But, in all of television, cable, basic, network, etc., NCIS is the number one drama and the highest rated show. It has also beaten Dancing With the Stars and American Idol a few times in the weekly ratings. The study also released four major findings discussing the relationship between drug uses and television. In TV storylines about the War on Drugs, drug users are typically not arrested. In these TV shows, 65 percent of drug suspects are white, accurately reflecting that the vast majority of drug users (and likely offenders) in the United States are white. Despite the predominance of African Americans and other minorities in U.S. prisons for drug violations, most drug manufac-

turers and dealers in the series studied were white. Prescription drug abuse and methamphetamines were depicted three times more often than recreational marijuana use. Song lyrics in pop culture often depict drug use; in fact many of the most popular songs in contemporary pop culture contain lyrics involving specific drug use. A major drug in song lyrics in pop culture today is the drug Molly, also known as Ecstasy. For example in the Miley Cyrus song “We Can’t Stop” there are lyrics such as “Everyone in line in the bathroom, Trying to get a line in the bathroom,” and “we like to party, Dancin’ with molly, Doin’ whatever we want.” Other examples include Kanye West, “Mercy”; Tyga ft. Wiz Khalifa & Mally Mal, “Molly”; Rihanna, “Diamonds”; Nicki Minaj ft. 2 Chainz, “Beez in the Trap”; Cedric Gervais, “Molly”; and Eminem, “Drug Ballad.” There have been many other songs about drugs and drug use throughout the history of pop culture; songs about drug use are not a phenomena known only to the 2000s. Some examples include “Heroin” by the Velvet Underground (1967), “Lucy in the Sky With Diamonds” by the Beatles (1967), “Cocaine” by Eric Clapton (1980), “Comfortably Numb” by Pink Floyd (1979), “Smoke Two Joints” by Sublime (1992), “Sister Morphine” by the Rolling Stones (1971), “Cocaine Blues” by Johnny Cash (1968), “Under the Bridge” by the Red Hot Chili Peppers (1992), “Rehab” by Amy Winehouse (2006), “Mr. Brownstone” by Guns N’ Roses (1987), “Master of Puppets” by Metallica (1986), and “Mary Jane’s Last Dance” by Tom Petty and the Heartbreakers (1993) just to name some examples. However, portrayals of drug use that are shown on television more often involve prescription drug use rather than recreational drug use. A study completed by researchers at UCLA shows that television advertisements of prescription drugs may be influ-

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encing Americans to believe they are sicker than they really are and this could lead to taking more medication than they actually need. The study was important because, on average, Americans watch up to 16 hours of television ads about prescription drugs every week. The researchers watched the ads that were played during the evening news and prime time slots, looking for factual claims made about the illness the drug is intended to address, the method used to attract the consumer, and also what was revealed about the behavior and lifestyle of the people in the ad. These results show that findings indicate that the prescription drug ads had virtually no educational value, failed to describe what the symptoms of a disease might be, and whether nonmedicinal alternatives such as changes in a person’s lifestyle (like exercise and changes in one’s diet) might also be viable options instead of a medication. In the end, the study results showed that while over 80 percent of the advertisements made some factual claims and presented some rational arguments for using the prescription, most ads contain limited information about causes and symptoms of the target illnesses, their prevalence and risk factors. They also minimize the possibility of reducing the dangers of the disease through healthy lifestyles. Another arena of pop culture that has seen a huge explosion of drug use is athletics. Many different types of drugs, whether prescription, recreational, or performance enhancing permeate sports. Stimulants, anabolic-androgenic steroids, erythropoietin, and other performance-enhancing (ergogenic) substances are used by athletes to increase their competitive edge. Amateur and professional sports authorities have initiated drug education and testing programs to eliminate the use of performance-enhancing drugs (PEDs) in sports. The World Anti-Doping Agency (WADA) and the U.S. counterpart, USADA, coordi-

nate and promote the fight against doping. On an international level, WADA interfaces with the International Olympic committee, the International Sports Federation, the National Olympic committee and the athletes. Many famous athletes have been found to have used performance-enhancing drugs during their careers, including Lance Armstrong, Alex Rodriguez, Barry Bonds, Jose Conseco, Marion Jones, and Roger Clemens. Lance Armstrong finally admitted in 2013 to using PEDs. Barry Bonds, the all-time leader in Major League Baseball regarding home runs, has been found to have used PEDs, while Marion Jones won five medals at the 2000 Olympics in Sydney, Australia, had all of her medals taken away, and even spent time in jail for actions relating to her PED use. In 2009, wide receiver Bo Bowling was arrested and charged with felony possession of marijuana with intent to distribute, misdemeanor charges of possession of a controlled substance, and unlawful possession of drug paraphernalia. Police had found more than 100 grams of marijuana, Xanax, ephedrine, the steroid stanozolol, a digital scale, and more than $1,000 in his apartment. Nancy E. Marion See also: Hip-Hop and Drugs; Steroids; Stimulants

Further Reading “Drug Abuse in Sports.” 2002. Utah Poison Control Center for Health Professionals 4(1): 1–4. Manning, Paul. 2007. Drugs and Popular Culture: Drugs, Media and Identity in Contemporary Society. Portland, OR: Willan Publisher. O’Brian, T. 2012. “How Are Drugs Portrayed in Prime Time?” Digital Journal. http:// www.digitaljournal.com/article/323313.

Porter, Stephen G. (1869–1930)  739 Paddock, C. 2007. “Drug Ads on TV May Influence Americans to Overmedicate.” Medical News Today, January 31. http://www. medicalnewstoday.com/articles/61985.php. “20 of the Most Famous Songs About Drugs.”Mandatory. http://www.mandatory .com/2012/09/12/20-of-the-most-famous -songs-about-drugs/20.

Porter, Stephen G. (1869–1930) Stephen G. Porter was a Republican Congressman from Pennsylvania who became active in the arena of narcotics control in the late 1920s. Though he believed that narcotics control could be made more effective by enacting tougher international controls over drugs, Porter was unsuccessful in his efforts to influence the League of Nations’ drug control efforts. He did, however, succeed in making significant changes in the administration of narcotics control efforts at home, and he was a key player in the creation of public institutions to house and treat addicts. Stephen Geyer Porter was born in Ohio on May 18, 1869, and his family moved to Pennsylvania when he was eight years old. He studied medicine for two years before entering law school and eventually passing the bar exam in 1893, when he began practicing law in Pittsburgh. He worked as the city solicitor of Alleghany and chairman of the Republican State Convention before being elected to Congress, where he served from 1911 until his death in 1930. After Representative Henry T. Rainey, who had been one of the leading proponents of tighter narcotics control in Congress, failed in his re-election campaign in 1920, Porter assumed congressional leadership in questions pertaining to narcotics. Through his involvement with community organizations, Porter was able to garner political

support for more stringent controls over controlled substances. Porter believed that the root of America’s drug problem lay not at home, but rather overseas, and that tighter international control over narcotics would help curb narcotic use domestically by cutting down on the availability of drugs that could be smuggled into the United States. In particular, Porter believed that the Hague Treaty, which governed international narcotics control, needed to have a provision that limited the production of raw opium and coca leaves across the world. Without limitations on the raw materials used to make narcotics, Porter believed, any attempts at narcotics control, even with domestic legislation such as the Harrison Narcotics Act, would fail. To create a system of international control over raw opium and coca leaves, Porter believed that the United States needed to begin by showing the international community that it strongly supported tighter international control measures. In 1923, he took a first step to this end by authoring a House Joint Resolution calling for Britain, Persia, Turkey, Peru, Bolivia, Java, and the Netherlands to restrict their production of raw opium and coca leaves. Later that year, Porter was part of the U.S. delegation to the League of Nations Advisory Committee on Traffic in Opium and Other Dangerous Drugs, where he continued to argue that controls on production were necessary to tackle the problem of drug abuse. The League of Nations adopted Porter’s resolution that December, putting the United States in the odd position of leading the League of Nations’ campaign against narcotics even though it was not a member of the organization. To show that the United States’ drug control intentions were sincere, Porter became active on the domestic front, working in Congress to ban heroin and put forth a congressional resolution that would make the U.S.

740   Porter, Stephen G. (1869–1930)

position clear when countries reconvened in Geneva to consider the next step in international narcotics control. He proposed a bill to ban heroin in April 1924, and testimony in deliberations on his bill highlighted the dangers that the drug posed, especially to U.S. youth. The resulting legislation amended the 1909 Smoking Opium Exclusion Act to prohibit the manufacture of crude opium for the creation of heroin, thus effectively outlawing its production and use in the United States. Porter hoped that by prohibiting heroin, the United States would not only cut down on use at home, but also set an example that would convince other nations to follow suit, thus cutting down on the production of heroin worldwide and making it less likely that foreign heroin could be smuggled onto American shores. Having helped establish solid domestic controls that he hoped would serve as a model for international legislation, Porter led the U.S. delegation to the Second Geneva Conference in 1924. With support from Congress, Porter was uncompromising in his desire to place international limitations on the production of both raw and manufactured opiates. Other nations, however, were unwilling to comply with Porter’s demands. Many opium-producing countries were reticent to place limitations on their domestic production of the drug, and member nations did not agree to ban the manufacture of heroin as the United States had done. Much to the chagrin of European representatives at the conference, Porter and the American delegation walked out of the negotiations in February 1925, refusing to sign an agreement that did not meet their demands. Many Americans supported Porter’s decision to boycott the convention, and Porter’s strong reputation in Congress enabled him to dissuade the State Department from supporting the 1925 Geneva Convention.

Though unable to achieve his goals for a more comprehensive international narcotic control regime, Porter proved effective in advancing drug control legislation on the home front. Porter believed that addicts were victims of a disease, and had long advocated for the creation of publicly funded institutions to help cure drug addiction. In 1929, one of his proposals became law, and authorized the creation of two Public Health Service narcotic hospitals to detain and cure addicts. Porter also worked to increase the efficiency of America’s drug control efforts, both at home and abroad, by creating a government agency to enforce the Harrison Act and represent the United States at subsequent international narcotics control conferences. The Narcotic Division under the Prohibition Unit of the Treasury Department had become subject to charges of corruption under the leadership of Levi G. Nutt, and the Federal Narcotic Control Board, which was created by the Narcotic Drugs Import and Export Act of 1922, had proven ineffective. By uniting domestic and international control under one agency, Porter reasoned, the United States could better coordinate its campaign for more effective drug control both at home and abroad. In addition, by administratively separating narcotics control from the Treasury Department’s apparatus assigned with enforcing liquor prohibition, Porter believed that drug control would benefit, since alcohol prohibition was becoming both difficult to enforce and widely unpopular. In the spring of 1930, Porter’s vision was realized with the creation of the Federal Bureau of Narcotics (FBN) under the leadership of Harry J. Anslinger. Before the FBN could begin its work, however, Porter passed away in Pittsburgh in June of 1930. Howard Padwa and Jacob A. Cunningham See also: Federal Bureau of Narcotics

Porter Narcotic Farm Act (1929)  741

Further Reading Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Darst, Joseph M. 1950. Biographical-Directory of the American Congress, 1774–1949. Washington, DC: U.S. Government Printing Office. Musto. David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Porter Narcotic Farm Act (1929) In response to federal prison overcrowding due to drug addicts incarcerated for violating provisions of the Harrison Act, this law established two prison-based hospitals for drug treatment and research. Called “narcotic farms,” the first facility opened in 1935 in Lexington, Kentucky; the second opened in 1938 in Fort Worth, Texas. Federal prison inmates addicted to drugs could be assigned or transferred to one of these two facilities to serve out their prison sentences while receiving drug treatment; however, success rates were not impressive. Important research on the nature of addiction and the psychopharmacology of drugs was also carried out at the facilities, but substantial ethical questions surrounding the conduct of the research arose over time. The facilities eventually reverted back to prisons in 1975.

Analysis of the Porter Narcotic Farm Act A virtually inevitable consequence of passing criminal laws that include among their sanctions the incarceration of people who abuse drugs is a large increase in the number and percentage of prisoners addicted to drugs. The cost, administrative complexities, and management issues attending the

increases are rarely appreciated prospectively when the legislation is being crafted. The primary motivation for such laws has always been to use the criminal justice system as a means of social control to discourage use in the first place and to punish those who use drugs in disregard of the law. This, in essence, is what “criminalizing” drug use means: management of whatever drug is perceived as the current social menace through enactment of tough criminal sanctions. Following passage of the Harrison Act, mainly intended to curb the use of opiates but with cocaine thrown in for good measure, a predictable course of events ensued, one that would continue to be repeated over the next half-century and beyond: violators of the law’s provisions were arrested, convicted, and incarcerated in federal (and state) prisons. As the number of prisoners arrested for violations increased, the prisons became overcrowded, causing management problems and an increased financial burden on the prison system. Drug policy historian David Musto has provided numerical perspective on the magnitude of these problems as of 1928. Writing about the conditions in the federal penitentiaries in Atlanta, Leavenworth, and McNeil Island, he notes, the three federal penitentiaries had a cell capacity of 3,738 while on the first of April 1928 they had a population of 7,598. Of the prisoners, about 2,300 were narcotic law violators of whom 1,600 were addicted. The wardens did not like to care for addicts—prisons were not equipped to handle them, they smuggled drugs into the prison, and the associations with other prisoners was bad for both groups. To put these figures in further perspective, 2,300 Harrison Act violators represented almost two thirds (61 percent) of the three penitentiaries’ original collective operating capacity in 1928. The 1,600 inmates

742   Porter Narcotic Farm Act (1929)

addicted to drugs represented one-fifth (21 percent) of the overcapacity census of 7,598. Clearly, none of the crafters of the Harrison Act had envisioned that their tax law would engender these kinds of effects on the federal prison system. Nor would they be the last legislators to fail to take into account how such laws affect not only the criminal justice system but also the lives of individuals and their families who are incarcerated and the fabric of the communities in which they live. Thus, one motivation for the construction of separate, dedicated prisons for housing drug-addicted federal prisoners was simply to reduce overcrowding. Another motivation was to relieve other federal penitentiaries of the administrative and management complexities of housing large numbers of addicts. The two institutions built as a result of the Porter Narcotic Farm Act—one in Lexington, Kentucky, which opened in 1935, and one in Fort Worth, Texas, which opened in 1938—embodied larger ambitions as well. Dr. Hugh S. Cumming, who was the Surgeon General of the Public Health Service, delivered the dedication for the Lexington facility. His speech reflected the hope that by providing facilities dedicated to drug treatment and research, those who received treatment could be cured of their addictions while incarcerated and return to society as productive citizens, and that through an active program of research, further advances in the understanding of addiction and treatment could be attained. The U.S. Public Health Service and the Federal Bureau of Prisons jointly handled operation of the prison-based hospitals (or hospital-based prisons as some thought of them). The Lexington “farm,” referred to as “Narco” by its residents and staff, was situated on 1,050 acres of land in rural Kentucky and was a 1,500-bed facility. The sur-

rounding grounds included an actual working farm complete with dairy cows, food crops, and animals raised for slaughter. Inmates participated in operating the farm and carrying out other work-related activities within the institution as part of their rehabilitation. Voluntary patients could be admitted to the narcotics farms as well as prisoners and probationers, resulting in a diverse and sometimes literally entertaining mix. For instance, heroin use was an extensive problem among jazz musicians. It was viewed almost as a right-of-passage to qualify as a “hep cat.” As a result, famous or soon-to-be-famous jazz musicians such as trumpet player Chet Baker, saxophonist Sonny Rollins, and pianist Ray Charles were admitted to the narcotics farms either voluntarily or as the end result of an arrest and conviction. While there, they formed bands that practiced and performed concerts on the lawn for other inmates and staff. The notoriety of prison jazz bands led none other than the commissioner of the Federal Bureau of Narcotics, Harry Anslinger, to quip, “We had more jazz bands in jail in the 1930s than I can count.” Famous actors such as Peter Lorre and Sammy Davis Jr. also spent time on the narcotics farms. William S. Burroughs, beat writer and lifelong heroin addict, chronicled his experiences at Narco in the book Junkie. He noted that the food was “excellent.” The man selected to be the first medical director at Lexington, Dr. Lawrence Kolb, was a leading researcher and expert on drug addiction at the time. He designed a three-phase program that, with only a few adjustments, could be applied as a framework for current prison-based programs: a short phase to address physical withdrawal; a middle phase of rehabilitation and therapy that lasted the majority of the inmate’s prison tenure; and a final phase to prepare for release. In practice,

Porter Narcotic Farm Act (1929)  743

however, recidivism rates were high: over 70 percent and as high as 90 percent by some estimates. Despite the progressive three-phase design, treatment of addiction, now better understood as being a chronic condition where relapse is common (in part, owing to the research done at the narcotics farms), was at a very early stage then. Additionally, the same social-contextual issues that adversely affect prisoners with addiction problems returning to society today were in operation back then and never well addressed: poor family and social support networks, lack of employment opportunities, and a return to environments where alcohol and drugs were readily available and widely used. The Lexington prison included a research facility that eventually became known after 1948 as the Addiction Research Center (ARC). Staffed with some of the brightest researchers culled from the ranks of the Public Health Service, ARC sought initially to investigate basic questions about the nature of drug addiction: Why are some people more susceptible to addiction than others? Why do some relapse and others not? What are the psychological and physiological changes that occur during withdrawal to different drugs? The prison provided a continual source of research subjects and in a time prior to strict human subject oversight, the experimenters were able to conduct investigations that would never be approved today. For instance, some studies provided subjects with drugs over extended periods followed by a sudden withdrawal of the drugs so their physiological response during the withdrawal period could be measured. Research on the nature of addiction eventually gave way to serving as a testing ground for new drugs to determine their relative analgesic versus addicting properties. Such compounds were of interest to the pharmaceutical industry, which wanted

to find drugs useful for reducing pain but which were not habit-forming. They wanted to avoid making the same mistake as when heroin was synthesized. Initially believed to be nonaddicting, heroin was first used as a cough suppressant and a “safer” alternative to morphine and codeine, both of which were used for that same purpose. Addicts who had been clean for some time were reintroduced to drug use again for the purposes of such studies, the justification being there was time enough before their release date for them to go through withdrawal (again) and get clean. ARC researchers also involved unwitting subjects in CIA-sponsored studies as part of a project named MK-ULTRA to gauge the usefulness of experimental drugs such as LSD in interrogations. In 1967, as the facilities in Lexington and Forth Worth neared the end of their exis­ tence as “narcotics farms,” a visiting British researcher made the following observations about the lack of ethical standards at the Lexington facility: “I believe that there is a nightmarish quality to the use of inmates for experimental purposes. One experimenter referred to this category of patients as ‘old dopeys,’ and said that whatever the future of the Lexington operation there would be a need to obtain a “stock” of such human subjects. A free drug experience, better ward conditions, remission of sentence that together constituted quite an inducement” (Edwards 2010, 985). By the 1950s, the initial hopes that accompanied the construction of the narcotics farms had given way to cynicism and disenchantment over the poor treatment results and research that was increasingly deflected from the original goal of understanding addiction to less noble, ethically questionable pursuits. ARC was moved out of Lexington to the medical campus of Johns Hopkins University in Baltimore and eventually be-

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came the intramural research program of the National Institute on Drug Abuse. The narcotics farm in Lexington closed its doors to drug treatment in 1975 and became a federal prison, time having simply passed it by with local, less expensive, and more advanced treatment programs becoming more common across the country. It is presently used as a facility to provide medical care to inmates in the federal prison system. Until a recent documentary movie and book, the narcotics farms were slowly becoming historical arcana. But they mark an important aspect of U.S. drug policy, that being the continued tension between treating drug abuse as a criminal justice problem versus treating it as a public health issue. Located exactly at that intersection, the narcotics farms were the forerunners of the therapeutic community treatment programs that now operate in America’s prisons and the dedicated drug treatment prisons such as the one now in operation at the Sheridan Correctional Center in Illinois. To a large extent, they were harbingers of other efforts such as drug courts, boot camps, and diversion programs that began to spring up in the 1980s to handle yet another large influx of drug-addicted individuals swept into the criminal justice system by yet another round of laws that provided ever more severe criminal sanctions for drug use and possession. James A. Swartz See also: Harrison Narcotics Act; Narcotics; Appendix: Porter Narcotic Farm Act

Further Reading Acker, C. J. 1997. “The Early Years of the PHS Narcotic Hospital at Lexington, Kentucky.” Public Health Reports 112: 245–47. Ball, J. C., W. O. Thompson, and D. M. Allen, D. M. 1970. “Readmission Rates at Lexington Hospital for 43,215 Narcotic Drug

Addicts.” Public Health Reports 85: 610–16. Burroughs, W. S. 2003. Junky: The Definitive Text of “Junk” (50th Anniversary Edition). New York: Penguin Books. Campbell, N. D. 2006. A “New Deal” for the Drug Addict: The Addiction Research Center, Lexington, Kentucky. Journal of the History of Behavioral Sciences, 42, 135–157. Campbell, N. D., J. P. Olsen, and L. Walden. 2008. The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts. New York: Abrams. Edwards, G. 2010. “Seeing America—Diary of a Drug-Focused Study Tour Made in 1967.” Addiction 105: 984–90. Kolb, L., and W. F. Ossenfort. 1938. “The Treatment of Addicts at the Lexington Hospital.” Southern Medical Journal 31: 914–20. Musto, D. 1999. The American Disease: Origins of Narcotics Control. 3rd ed. New York: Oxford University Press.

Predatory Drugs Also known as party drugs or date rape drugs, the principal predatory drugs are flunitrazepam (Rohypnol), ketamine, gamma hydroxybutyric acid (GHB), alcohol, and Ecstasy, which cause a person who ingests the drug to suffer from temporary amnesia or coma. Alcohol is the number one predatory drug in the United States. When a predator seeks to prey sexually on an unsuspecting victim, he or she can administer a tasteless, colorless, odorless drug by surreptitiously dropping it into an unaware victim’s beverage. These drugs can be administered to a person without their knowledge, and affect them very quickly. The duration of the drug varies, depending on the amount of drug in-

Predatory Drugs  745

gested and if the drug is mixed with other drugs or alcohol. Alcohol makes the drugs even stronger and can cause serious health problems—even death. More often than not, the victim will not remember anything after regaining consciousness. This means that they are unlikely to recall the identity of the person or persons who assaulted them. Because the drugs are rapidly eliminated from the body, it may be very difficult for anyone to prove that the drugs were used in the attack. Use of these drugs is widespread. It is most commonly found at rave parties, on college campuses, and in the club scene. These drugs are used for recreation, but also used by those who want to sexually assault another person. Some symptoms that may indicate that they have ingested a date rape drug include relaxation, drowsiness, dizziness, nausea, problems seeing, unconsciousness (black out), seizures, sleepiness, troubled breathing, tremors, sweating, vomiting, slow heart rate, or experiencing a dream-like feeling. Other symptoms include muscle relaxation or loss of muscle control, drunk feeling, problems talking, difficulty with motor movements, confusion, stomach problems, hallucinations, lost sense of time and identity, distorted perceptions of sight and sound, feeling out of control, and impaired motor function. Finally, convulsions, out of body experiences, memory problems, numbness, loss of coordination, and aggressive or violent behavior are symptoms as well. GHB can be easily manufactured and distributed locally, but Rohypnol, a benzodiazepine that is legal as a sleep aid in Mexico and South America, must be smuggled into the United States. In pill form, it can be crushed and snorted, but many tablets are now impregnated with a dye to alert unsuspecting persons to its presence in their beverage. Ketamine is marketed in the United States as

a dissociative anesthetic, but its pharmaceutical properties are diverted to produce the party drug. Given the potential for harm to innocent people that predatory drugs pose, law enforcement officials are particularly committed to preventing their manufacture, importation, availability, or use. Rohypnol (Flunitrazepam) is manufactured and distributed by Hoffman-La Roche. Rohypnol is a pill that is usually prescribed as a sleep aid. It falls under the same category as Librium, Xanax, and Valium, but is about 10 times stronger than Valium. While Rohypnol has never been approved for medical use in the United States, it is legally prescribed in over 50 other countries, including Mexico. The drug is usually smuggled into the United States through one of these other countries. Rohypnol is often used as a predatory drug because it is slipped easily into a person’s drink. It is odorless, tasteless, and dissolves completely in a carbonated beverage. Because of the risk that it can be used in this way, the manufacturer is now manufacturing the pill so that it will turn blue when mixed into a drink. However, predators have learned this and are now serving bluecolored tropical drinks so that the Rohypnol is not detected. The drug is sometimes called the “forget me pill” because of the amnesia it causes when ingested. MDMA (Ecstasy or “Molly”) is usually taken in pill form, but is also available in powder form. If the dose is high enough, MDMA can be lethal. Rapists use it because of the amnesia effect experienced by the victim. It can be detected in the body up to 48 hours. Under federal law, MDMA is a Schedule I drug because it has no approved medical use but a high risk of abuse. When ingested, a user will experience a euphoric effect, which can last up to 12 hours. A user may

746   Predatory Drugs

also experience increased activity, mood swings, and altered perception. Other possible effects of MDMA include a generalized feeling of happiness, emotional closeness to others, sensory enhancement (touch, vision, taste, smell, etc.), an increase in sexual behavior, confusion, anxiety, panic attacks, disorientation, delusions, memory lapses, liver damage, kidney failure, convulsions, coma, stroke, paranoia, and suicide. A 1998 study from Johns Hopkins University found that MDMA may cause permanent brain damage. If a dose is high enough, MDMA may result in death. In a survey of 176 college females, 37 percent reported experiencing at least one drugor alcohol-related sexual assault. Further, 55 percent of female students and 75 percent of male students who were involved in acquaintance rape admitted to having been drinking or using drugs when the incident occurred. Ninety percent of all campus rapes occur when either the assailant or the victim has used alcohol. As many as 70 percent of college students admit to having engaged in sexual activity primarily as a result of being under the influence of alcohol, or to having sex they wouldn’t have had if they had been sober. There are several ways to prevent oneself from becoming a victim of predatory drugs. First, it is important to not leave drinks unattended. Always carry a drink, and do not let anyone hold it except a trusted friend. Second, do not accept drinks, including soda and water, from someone whom you do not know well and trust. Third, when at a bar or club, only accept drinks from the bartender or waitstaff. Fourth, when at a party, do not accept a drink in a bottle or can that has been opened. Finally, always go to parties and bars with friends. An offender is less likely to attempt to assault someone if they know that their potential victim is with a group of

people. Make sure that everyone who came together leaves together. If someone believes that he or she has been a victim of a predatory drug, they should get medical care right away. Kathryn H. Hollen See also: Date Rape Drugs

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. iCAN Foundation Crime Victims Assistance Network. “Predatory Drugs.” http://www .ican-foundation.org/resources/predatory -drugs/. Ketchum, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Ser­vices, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Health and Human Resources, Office on Women’s Health. 2008. “Date Rape Drugs Fact Sheet.” http://www .womenshealth.gov/publications/our -publications/fact-sheet/date-rape-drugs .html. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Prescription Drugs  747

Prescription Drugs Prescription drugs are commonly abused, and it is estimated that there are about 1.9 million prescription drug addicts in the United States. About 33 percent of all drugrelated emergency room visits in 2008 were related to prescription or over-the counter drugs. Moreover, approximately 10,000 babies are born each year addicted to drugs. The prescription drug market is estimated to be over $300 billion a year, and individual dealers can make millions. There is a widespread misconception that prescription drugs are safe to take because they are legal. It is also believed that because the pills come from a manufacturer, they are free from harmful impurities. Nonetheless, prescription drugs are responsible for a large number of drug overdoses and death. Since no drugs are 100 percent safe, and some are lethal in combination with other drugs, the abuse of prescription drugs is of serious concern to health experts. Abuse of these substances is said to occur when someone uses the drug for nonmedical reasons, someone other than the patient uses the drug, or the drug is used in excess of the prescribed amount or frequency. In many cases the pills are not ingested as intended. Some users crush the pills and inject them into the bloodstream instead of taking them as the pill form. Many times, the users share needles with others, increasing the risk of spreading deadly viruses like HIV or hepatitis. Addictive prescribed drugs include depressants, stimulants, and opiates. Some people who have legitimate medical reasons for taking these drugs become addicted when they start to escalate their use above the level indicated on the prescription or they begin to use them for reasons other than the intended purpose. Sedatives prescribed

as a short-term aid to help patients sleep are a good example. The individual may continue taking them after the need for them has diminished, he or she may increase the dosage as tolerance to the drug increases, or the person may begin to take them for the high or the “buzz” during waking hours. When the prescribing physician refuses to write another prescription or refill the old one, the individual starts to consult other physicians or resorts to illegal supply networks to obtain more drugs. This behavior is a classic symptom of a growing addiction. Others begin using a prescription drug because friends introduce them to its recreational value; abuse and addiction often begin this way. Someone who has been prescribed a stimulant for weight management or attention-deficit hyperactivity disorder may share a few tablets of medication with a friend who is feeling tired or is overweight; the new user likes the burst of energy and enthusiasm the drug provides. Soon the individual is looking for more or learning to crush and snort the tablets for greater effect. When the friend is unable to supply his or her needs, the addict may “doctor shop,” steal drugs, or begin to use deadly street drugs like methamphetamine as substitutes. Prescription opiates like OxyContin (oxycodone) and Vicodin (hydrocodone) are also subject to abuse because they powerfully bind to opiate receptors in the brain to produce intense feelings of well-being, relaxation, and euphoria. Prescribed for moderate to severe pain, including chronic pain, there are many formulations on the market and different forms of the drugs can be found in many American households. Health experts are alarmed to find that abuse of prescription opiates has increased significantly among high school students in recent years even as their abuse of other addictive drugs, both legal and illegal, has decreased.

748   Prescription Drugs

A bottle of prescription medication. Addiction to these types of medications is growing in the United States among many age groups. (Amanda Mills/Centers for Disease Control and Prevention)

Central nervous system depressants known as the benzodiazepines are frequently abused. Often referred to as tranquilizers, these drugs relieve anxiety, aid sleep, and promote relaxation and calm. Like pain relievers, they are frequently prescribed and can be so easily obtained over the Internet that they are passed out freely in certain circles. Many mistakenly believe they are safe because they are so often used in everyday social settings. Statistics from the Drug Abuse Warning Network, which keeps records of emergency room admissions that involve illicit drug use, reported in 2004 that two of the most frequently abused drugs seen in emergency rooms are the benzodiazepines and opiates. Many people who abuse prescription drugs are taking other medications; whether these substances are over-the-counter preparations or more powerful prescription drugs, they

can interact in powerful ways to pose very serious risks to users. There are numerous examples of commonly abused prescription drugs. Many abused prescription medications are sleeping medications such as Ambien (zolpidem), Sonata (zaleplon), and Lunesta (eszopiclone), which go by street names such as forget-me pill, Mexican Valium, R2, Roche, roofies, roofinol, rope, rophies. These drugs can be both snorted and swallowed. Intoxication effects include sedation/drowsiness, reduced anxiety, feelings of well-being, lowered inhibitions, slurred speech, poor concentration, confusion, dizziness, and impaired coordination and memory. Some of the risks of overusing these drugs are lowered blood pressure, slowed breathing, tolerance, withdrawal, addiction, increased risk of respiratory distress, and death, especially when combined

President’s Advisory Commission on Narcotic and Drug Abuse (1963)  749

with alcohol. Other drugs include codeine and are often used as cold medicine. Examples include Empirin with Codeine, Fiorinal with Codeine, Robitussin A-C, and Tylenol with Codeine, and go by street names such as Captain Cody, Cody, schoolboy, doors and fours, loads, and pancakes and syrup. Pain relief, euphoria, drowsiness, sedation, weakness, dizziness, nausea, impaired coordination, confusion, dry mouth, itching, sweating, clammy skin, and constipation are potential effects of these drugs. Potential health consequences include slowed or arrested breathing, lowered pulse and blood pressure, tolerance, addiction, unconsciousness, coma, and death; risk of death increased when combined with alcohol or other central nervous system depressants. There are many ways the drugs enter the black market. Dealers often “doctor shop” or “prescription shop,” which means they go from doctor to doctor, getting prescriptions from each one. In some states this is difficult, as they have systems to track prescriptions. In other states, however, there is no tracking of the number of prescriptions one patient can receive. People have also been known to steal the drugs from relatives or friends. In some cases, patients who are prescribed the medications stop taking it, but continue to get a monthly prescription. The extra pills can be sold or given away. Armed robberies of pharmacies are becoming more common, as are doctors who sell drugs to dealers. Kathryn H. Hollen See also: Addiction; Drug Abuse Warning Network; Drug Tolerance; Treatment

Colvin, Rod. 2008. Overcoming Prescription Drug Addiction: A Guide to Coping and Understanding. Omaha, NE: Addicus Books. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketchum, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Kuhn, Cynthia, et al. 2008. Buzzed: The Straight Facts about the Most Used and Abused Drugs From Alcohol to Ecstasy. New York: Norton. Thombs, Dennis L. 2006. Introduction to Addictive Behaviors. 3rd ed. New York: Guilford Press. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2005. Research Report Series: Prescription Drugs Abuse and Addiction. NIH Publication No. 05-4881. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Further Reading

President’s Advisory Commission on Narcotic and Drug Abuse (1963)

Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books.

President Kennedy established the President’s Advisory Commission on Narcotic and Drug Abuse on January 15, 1963, in

750   President’s Advisory Commission on Narcotic and Drug Abuse (1963)

Executive Order 11076. The commission was composed of seven members from outside of the executive branch of the government who were appointed by the president. The purpose of the commission was to develop a report that would include recommendations for legislation geared toward preventing the abuse of narcotic and nonnarcotic drugs by Americans. The committee members were also asked to make recommendations for new ways to provide rehabilitation for those people who were habitual drug users. The third charge to the committee was to review the existing federal programs of any federal agencies that had law enforcement functions related to the prevention of narcotic drug use and to make recommendations to improve the effectiveness of those programs. The interim report of the committee was released in April 1963, and included preliminary recommendations as requested by the president. The commission’s final report was released in January 1964. By this time, Lyndon Johnson was president. The commission’s final report made many recommendations to address the growing drug problem in the United States at the time. The commission members believed that the existing severe penalties for narcotics use did not deter illicit traffic in narcotics and marijuana. They believed that individual drug users could be, and should be, rehabilitated rather than punished, and thus the recommendations focused largely on the treatment of drug users who had a history of drug abuse. One recommendation called for a federal civil commitment statute that would allow for the rehabilitation of narcotics users as opposed to punishment. In that same light, the committee also recommended that the mandatory minimum penalties established in the federal narcotics and marijuana laws that precluded probation or

parole be applied on a limited basis as a way to allow for more rehabilitation. The members of the commission believed that the traffic in illegal drugs should be attacked with the full power of the federal government. Moreover, they deemed the federal government to have the power and the responsibility to prevent the importation, manufacture, and transfer of illegal narcotic drugs. They noted that the federal programs at the time were fragmented and needed a more coordinated approach to federal drug policies. Other recommendations were geared toward educating the public about the effects of narcotics and the potential harm that these drugs could cause. Before he left office, Johnson called on all federal agencies to focus on implementing the antidrug program outlined in the final report of the commission. He also urged agencies to implement programs that were geared toward correcting the conditions resulting from drug abuse, as outlined in the final report. In the end, the commission changed the focus of national drug policy to rehabilitation rather than punishment of drug offenders, and in general brought more public attention to the problems associated with illicit narcotic drug use. Nancy E. Marion

Further Reading Gimlin, J. S. 1967. “Legalization of Marijuana.” Editorial Research Reports 1967 (vol. 11). Washington, DC: CQ Press. http://library.cqpress.com/cqresearcher/ cqresrre1967080900. Johnson, Lyndon B. 1964a. “Letter to Judge Prettyman in Response to Report of the President’s Advisory Commission on Narcotic and Drug Abuse,” January 28. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=26042.

President’s Drug Advisory Council (George H. W. Bush)  751 Johnson, Lyndon B. 1964b. “Statement by the President on Narcotic and Drug Abuse,” July 15. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?pid=26374. Johnson, Lyndon B. 1965. “Special Message to the Congress on Law Enforcement and the Administration of Justice.” March 8. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=26800. Kennedy, John F. 1963. “Executive Order 11076,” January 15. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb .edu/ws/?pid=59015. President’s Drug Advisory Council, Executive Office of the President. 1963. “President’s Advisory Commission on Narcotic and Drug Abuse: Final Report.”

President’s Drug Advisory Council (George H. W. Bush) In 1989, George H. W. Bush created the Drug Advisory Council. Later, in 1991, the council was extended through Executive Order 12696. The goal of the council was to make drug use “socially unacceptable” through a process, coined by William Bennett, chair of the Office of National Drug Control Policy (ONDCP), called “denormalization.” According to the executive order, the council was to be composed of not more than 30 unpaid members who were appointed by the president from among citizens in private life. The purpose of the Council was to make recommendations to the president and the director of the ONDCP concerning the nation’s drug policy, and specifically on developing methods to explain the national drug control policies to the U.S. people. The members were to work with the media and

communications specialists to coordinate efforts for informing the public of the dangers of illegal drug use. The council was also to sponsor forums and seminars in various regions of the country to assist in relaying the nation’s drug policies. The council, mandated to last for two years, was led by William Moss, an oil and gas investor from Dallas. In addition to Mr. Moss, the members included: Alvin Brooks, director of the Kansas City, Missouri, Human Relations Department; Patricia A. Burch of Potomac, Maryland, a founder of the National Federation of Parents for DrugFree Youth; James E. Burke of Princeton, New Jersey, former chairman of Johnson & Johnson; Alvah H. Chapman Jr. of Miami, former chairman of Knight-Ridder; Adm. William J. Crowe Jr., retired, of Alexandria, Virginia, former chairman of the Joint Chiefs of Staff; Lee I. Dogoloff of Silver Spring, Maryland, executive director of the American Council for Drug Education; Robert A. Georgine, of McLean, Virginia, president of the A.F.L.-C.I.O.’s Building and Construction Trades Department; Elsie H. Hillman of Pittsburgh, Republican National Committeewoman for Pennsylvania; Mary L. Jacobson, of Omaha, Nebraska, co-founder of Parent Resources and Information on Drug Education; Sterling Johnson Jr. of Laurelton, New York, special prosecutor of the Special Narcotics Courts, New York City; Ewing Kauffman of Shawnee Mission, Kansas, chairman of Marion Laboratories; Dr. Burton J. Lee III, the White House physician; Brenda Lee, principal of Edison Elementary School, Dayton, Ohio; Tom Landry, former coach of the Dallas Cowboys; Rev. Edward A. Malloy, president of the University of Notre Dame; William J. McCarthy of Arlington, Massachusetts, general president of the International Brotherhood of Teamsters; Ruben B. Ortega, police chief of Phoenix;

752   Presley, Elvis (1935–1977)

Richard D. Parsons of Pocantico Hills, New York, president of the Dime Savings Bank of New York; Sandi Patti Helvering, a gospel singer from Anderson, Indiana; Judge Herman P. Pressler III of the Texas Court of Appeals in Houston; Dr. Jonas Salk, medical pioneer; Richard F. Schubert of McLean, Virginia, former president of the American Red Cross; Roger Smith of Bloomfield Hills, Michigan, chairman of the General Motors Corporation; William French Smith, former U.S. attorney general, Frank J. Tasco of Manhasset, New York, chairman of Marsh & McLennan Companies and chairman of Phoenix House; and Robert Wright of Fairfield, Connecticut, president of the National Broadcasting Company. Bush said that the council was necessary and would help strengthen U.S. values. In creating the council Bush had this to say: Today drugs cost the economy more than $60 billion annually in lost productivity, health care, and other expenses. This harms the ability of our businesses to succeed and compete. By defeating drugs we will help America win in the global economy, we’ll help educate our citizens for a new century, and we’ll open more opportunity than ever for all Americans, preserving one Nation under God. Stopping drug abuse will help put America back to work, instill pride, increase productivity, improve quality, and then again heighten our competitiveness. Stopping drugs will also strengthen the family, reaffirming values like discipline and self-reliance, courtesy, and belief in God. In 1991 Bush extended the council, through Executive Order 12696: By the authority vested in me as President by the Constitution and the laws of the

United States of America, and in accor­ dance with the provisions of the Federal Advisory Committee Act, as amended it is hereby ordered as follows: Section 1. The President’s Drug Advisory Council, established by Executive Order No. 12696, is continued until November 13, 1993. Nancy E. Marion

Further Reading Bush, H. W. 1989. “Executive Order No. 12696 President’s Drug Advisory Council.” November 13. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb .edu/ws/?pid=23542#axzz2i0WrRVB0. Bush, H. W. 1992. “Remarks to the President’s Drug Advisory Council.” July 22. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=21252#ixzz2 i0kJwMUX. Bush, H. W. 1991. “Executive Order No. 12756 Continuance of the President’s Drug Advisory Council.” March 18. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency.ucsb .edu/ws/?pid=23595#ixzz2i0pRvhuI. “President Names 27 to Newly Created Advisory Council on Drugs.” 1989. New York Times, November 14. http://www.nytimes. com/1989/11/14/us/president-names-27-to -newly-created-advisory-council-on-drugs .html.

Presley, Elvis (1935–1977) Elvis Presley was born on January 8, 1935, in Tupelo, Mississippi. His father, Vernon Elvis Presley, was only 18 years and his mom, Gladys Love Presley, was 25. They

Presley, Elvis (1935–1977)  753

Elvis Presley, a rock and roll star from the 1950s through the 1970s, fought drug addiction for many years. He finally succumbed to an overdose in 1977 at the age of 42. (Lynn Goldsmith/ Corbis)

lived in a two-room house that was built by his father. Presley had an twin identical brother, who was delivered stillborn only 35 minutes before Elvis. As a child, Elvis was close to both of his parents, but was especially close to his mother. The family moved to Memphis, Tennessee, in 1948. Presley had no formal training in music and only played music by ear. He liked to attend all-night singing events where he listened to African American spiritual music. As he became more popular, Elvis relied on the Southern Gospel from that time. He also relied on R&B music. In August 1953, Presley went to the offices of Sun Records to record a few songs. After he did that, the boss, Sam Phillips, took note of his name. In January 1956, Presley made his first recordings for RCA in Nashville.

By the end of that year, Presley was a musical sensation. He brought on a whole new era of pop culture and pop music through his dancing, diverse music, and challenging of societal norms and standards for the time. Not only was Elvis a musical star, he also appeared in 33 different movies, as well as multiple appearances on television. Globally, and in the United States, his record sales trail only the Beatles, having sold over a billion records worldwide. He holds the record for amount of gold, platinum, multiplatinum albums, top 40 songs, top 10 songs, and most weeks spent at number one on the billboard charts. Some of these hits were “Heartbreak Hotel,” “Blue Suede Shoes,” “Love Me Tender,” and “All Shook Up.” He also served two tours overseas in Germany, where he met his wife, Priscilla.

754   Presley, Elvis (1935–1977)

Today, Elvis is the king of rock and roll, and perhaps, of the amount of Las Vegas impersonators. Elvis was known for his handsome looks, charisma and charming personality, and humor, and has been regarded as one of the, if not the, most important figures in the history of pop culture, his popularity and influence being rivaled by few. Unfortunately, like many musical artists, one of the things Elvis is remembered for is his drug use. One of the roots of his drug use was his sleeping problems, which worsened after the death of his mother. This caused him to begin using amphetamines. By the time Elvis saw a doctor for his sleeping problems, he was already on a wide array of drugs, and Elvis would use amphetamines before his show and tranquilizers after, a pattern commonly referred to as “uppers and downers.” Elvis began using Dr. Nichopolous as his doctor. Nichopolous claimed to have controlled Elvis’s drug usage, but stated that when Elvis was on the road (which was almost all the time) other doctors would prescribe him medications, one of these being Dr. Thomas “Flash” Newman, who would reportedly prescribe any drug for Elvis at a moment’s notice. In 1973, Elvis overdosed twice on barbiturates and began cancelling shows. Soon after, he was rushed to the hospital for overdosing on cortisone shots for his severe arthritis. By this time, Elvis had also become addicted to Demerol, a very powerful opiate. In response to this Dr. Nichopolous attempted to stop other doctors from prescribing drugs to Elvis, and put him on methadone. Nichopolous is reported to have said that Elvis’s main problem with drugs was that “he sees no problem with it.” After one particular episode in the hospital, Elvis’s doctor and manager searched his apartment, and confirmed what they had feared. In his apartment were several

large jars containing large amounts of prescription drugs. Nichopolous attempted to control Presley’s drug usage by prescribing him very low doses of “uppers and downers” before and after shows, as well as before Elvis went to bed. Presley’s addiction and usage become so bad that Nichopolous eventually began prescribing him placebos, and would spend time making the placebos while on tour with Elvis. Nichopolous spent a year convincing Knoll, the manufacturer of Elvis’s favorite drug Dilaudid, to make a special batch for Presley that contained no active ingredients. Elvis died in 1977 of a heart attack (believed to be a drug overdose). He was found by his daughter, who was only three years old. At the time of his death, Elvis suffered from issues such as glaucoma, high blood pressure, liver failure, and an enlarged colon, all of which were a result in some part of his drug use. A medical board investigated Elvis’s doctor and found that he had signed off on an outrageous number of prescriptions for Elvis. It was discovered he had prescribed 19,000 doses of drugs, 199 coming in the first eight months of 1977. His license was suspended and he was put on probation for three years. He was eventually arrested but acquitted because none of the data stemming from the death of Elvis could be directly connected to Nichopolous’s prescriptions. In 1994 another case examining the death of Elvis was opened up, but again, there was no clear proof that Elvis died of anything more than a heart attack. Nancy E. Marion See also: Barbiturates; Entertainers and Drug Use

Further Reading Bertrand, Michael T. 2000. Race, Rock, and Elvis. Champaign: University of Illinois Press.

Prevention  755 “Elvis Presley Biography.” Elvis Presley: The Official Site for the King of Rock ’N’ Roll. http://www.elvis.com/about-the-king/ biography_.aspx. “Elvis Presley Biography.” Rock and Roll Hall of Fame. https://rockhall.com/inductees/ elvis-presley/bio/. “Elvis Presley Biography.” Rolling Stone. http://www.rollingstone.com/music/artists/ elvis-presley/biography. Guralnick, Peter. 1994. Last Train to Memphis: The Rise of Elvis Presley. New York: Little, Brown. Guralnick, Peter. 2000. Careless Love: The Unmaking of Elvis Presley. New York: Back Bay Books. Guralnick, Peter, and Ernst Jorgensen. 1999. Elvis Day by Day: The Definitive Record of His Life and Music. New York: Ballantine. Rodman, Gilbert B. 1996. Elvis After Elvis, The Posthumous Career of a Living Legend. New York: Routledge. Szatmary, David. 1996. A Time to Rock: A Social History of Rock ’n’ Roll. New York: Schirmer Books. Tillery, Gary. 2013. The Seeker King. Wheaton, IL: Quest Books.

Prevention Although there is no single definition of prevention, it may be defined as those efforts that keep alcohol, tobacco, and other drug problems from occurring. It is essential that at-risk populations (those likely to use drugs and/or alcohol) do not use these substances, to prevent injury, harm, or even death. The first line of defense is often referred to as primary prevention. Here the aim is to create an environment in which alcohol use is acceptable only for those who are of legal age and

only when the risk of adverse consequences is minimal. Also, prescription and over-thecounter drugs are used only for the purposes for which they were intended and by the people for whom they have been prescribed. It is important that other substances such as inhalants and aerosols are used only for their intended purposes. Finally, a critical goal is to ensure that illegal drugs and tobacco are not used at all. When a person is in the early stages of exhibiting problem behaviors associated with the use of alcohol, tobacco, and other drugs (ATOD), secondary prevention or early intervention efforts such as counseling and treatment may be used so that the person ceases to use the harmful substances. Tertiary prevention refers to efforts taken by friends and family members of the user that are attempts to stop the compulsive use of ATOD and/or ameliorate their negative effects. This can be completed through treatment and rehabilitation. Numerous strategies can be utilized to prevent drug use, including information, education, alternative behaviors, and primary and early intervention activities. These interventions focus on reducing risk factors and building protective factors. Several prevention activities or strategies may be used effectively in combination with each other. According to the White House Office of National Drug Control Policy, substance abuse prevention strategies include: • Alternatives—This approach calls for the participation of target populations in constructive and healthy activities such as drug-free dances, youth/ adult-leadership activities, community drop-in centers, and community service activities that exclude drug use. Constructive and healthy activities are designed to offset the attraction to, or

756  Prevention

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otherwise meet the needs usually addressed by, alcohol and other drugs. Community-Based Process—This strategy enhances the ability of the community to more effectively provide prevention and treatment services for alcohol, tobacco, and drug-abuse disorders. Activities in this strategy include organizing, planning, enhancing efficiency and effectiveness of service implementation, interagency collaboration, coalition building, and networking. Some examples include community and volunteer training, multiagency coordination and collaboration, accessing programs and funding needed services, and community team building. Early Intervention—This approach uses activities that are designed to modify the behavior of an early substance abuser. It includes a wide spectrum of activities ranging from user education to formal intervention and referral to treatment provided by a substance-abuse professional. Education—This strategy builds critical life and social skills through structured learning processes. Critical life and social skills include decision making, peer resistance, coping with stress, problem solving, interpersonal communication, and systematic and judgmental abilities. Examples of this strategy include classroom and/or small group sessions, parenting and family-management classes, peer-leader/helper programs, educational programs for youth groups, and groups for children of substance abusers. Environmental—Programs of this nature challenge and change community stan­ dards, codes, and attitudes that tend to tol-

erate, accept, or support the use of drugs in the general population. This strategy is divided into two subcategories to permit distinction between activities that center on legal and regulatory initiatives and those that relate to the service and action-oriented initiatives. Some examples include promoting the review of drug-use policies in school; technical assistance to communities to maximize local enforcement procedures governing availability and distribution of alcohol, tobacco, and other drugs; modifying alcohol and tobacco advertising practices; and product-pricing strategies. • Information—This approach provides knowledge and increases awareness of the nature and extent of drug use, abuse, and addiction, and their effects on individuals, families, and communities. Knowledge and awareness are promoted through available prevention and treatment programs and services. Some examples include clearinghouse/ information resource centers, resource directories, media campaigns, brochures, radio/TV public-service announcements, speaking engagements, health fairs/health promotion, and telephone/computer information lines. • Problem Identification and Referral—This strategy includes activities that identify those who have engaged in illegal or age-inappropriate use of tobacco or alcohol and persons who have begun to use illicit drugs. Effort is generated to assess whether the early alcohol and drug use of the individual can be reversed through education. It does not include any activity designed to determine if a person is in need of treatment. Some examples include employee-assistance programs, studentassistance programs, and educational

Prevention  757

programs related to driving while under the influence or driving while intoxicated. Increased chances of substance use, stress, violence, trauma, and posttraumatic stress are among the reasons people are at greater risk of substance abuse, including relapse to alcohol and drug abuse, addiction, and cigarette smoking. Emotional strain caused by the September 11, 2001, terrorist attacks on the United States and threats of bioterrorism have led large numbers of Americans to seek treatment for substance-abuse problems. For example, “one year after the Oklahoma City bombing three times as many residents of that city reported increased drinking compared with residents of comparatively sized Indianapolis, Indiana. Understandably, rescue workers in Oklahoma City also experienced significant rates of substance abuse, depression, and suicide months and years after the bombing (Columbia University Center of Addiction and Substance Abuse 2001) According to the Center for Substance Abuse Prevention, such events are important reasons for promoting effective prevention efforts in every community. The Center for Substance Abuse Prevention publication Science-Based Prevention Programs and Principles: Effective Substance Abuse and Mental Health Programs for Every Community (2002) summarizes more than two decades of research on prevention programs. It delineates the broad range of influences that can lead to substance abuse or other potentially dangerous behaviors and presents practical community-based ways to curb the risk factors for these behaviors. Effective interventions are identified at the individual, family, peer group, school, community, and

society level; a state-of-the-science review of substance-abuse prevention theory and practice is provided; and a compendium is included of tested and effective model substance abuse–prevention and mental health–promotion programs. The following programs are some examples of “model” prevention initiatives, according to the Center for Substance Abuse Prevention. Keep a Clear Mind (KACM) is a takehome drug education program to be used by older elementary-aged students (eight to 12 years old) and their parents. The material consists of four weekly sets of activities that should be completed by parents and their children together. The program also uses parental newsletters and incentives. KACM lessons are based on a social-skills training model and are designed to help children develop specific skills to help them refuse and avoid the use of “gateway” drugs. This early intervention program has been shown to positively influence known risk factors for later substance use. Specifically, the program aims at increasing a student’s ability to resist peer pressure to use tobacco, alcohol, and marijuana, while at the same time increasing student recognition of the harmful effects of these drugs. Moreover, the program seeks to help students identify and choose positive alternatives to substance use, and decrease their use of tobacco, alcohol, and marijuana. The program is also designed to help parents become effective drug educators and increase the communication between parents and their children, which in the long run will strengthen their relationships. Evaluation of KACM shows that 20 percent of parents who took part in the program indicated that their children had an increased ability to resist peer pressure to use alcohol, tobacco, and marijuana. Specifically, 29 percent indicated a decreased expectation that

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their children would try substances and 14 percent expressed a more realistic view of drug use among young people. Outcomes reported by children who participated show a 9 percent decrease in the students’ perceptions of substance use among peers compared to an 18 percent increase in the control group. There was a 15 percent decrease in KACM participants’ expectations that they would use tobacco, and a 59 percent increase in the number of children who indicated that their parents did not approve of the use of marijuana. Another model program is called Project ALERT, and it is a drug-prevention curriculum for middle-school students who are 11 to 14 years old. The program reduces both the onset of substance abuse and regular use of illicit drugs. The two-year program involves 14 lessons that focus on the substances that adolescents are most likely to use: alcohol, tobacco, marijuana, and inhalants. Project ALERT uses participatory activities and videos to help motivate adolescents against drug use, teach adolescents the skills and strategies needed to resist pro-drug pressures, and establish non-drug-using norms. Through guided classroom discussions and small group activities, peer interaction is stressed to challenge student beliefs and perceptions. Intensive role-playing activities help students learn and master resistance skills. Homework assignments that also involve parents extend the learning process by facilitating parent-child discussions of drugs and how to resist using drugs. These lessons are reinforced through videos that model appropriate behavior. Evaluation of Project ALERT shows that it was effective in preventing experimentation with drugs, especially those who were at risk for becoming regular users and those who had not tried drugs before the program began. It decreased pro-drug attitudes and

beliefs among the teens, including intentions to use drugs, beliefs that drug use is not harmful, and perceptions that many peers use drugs. It also increased beliefs that one can successfully resist both internal and external pressures to use drugs. The program reduced the use of marijuana and cigarettes and the initiation of marijuana use. Fifteen months after the baseline information was collected, results of the program show that marijuana initiation rates were 30 percent lower for ALERT students, current marijuana use was 60 percent lower in adult-led programs, current and occasional cigarette use was 20 percent to 25 percent lower, regular and heavy cigarette use was one-third to 55 percent lower, and antidrug beliefs were significantly enhanced, with many effects persisting into the 10th grade. The third program cited by the Center for Substance Abuse Prevention is the Community Trials Intervention to Reduce High-Risk Drinking (RHRD). This is a multicomponent community-based program that was developed to change the patterns of alcohol use found in people of all ages (for example, drinking and driving, underage drinking, acute or binge drinking, and related problems). The program uses a set of environmental interventions including community awareness, responsible beverage service (RBS), preventing underage alcohol access, enforcement, and community mobilization. For RHRD to be successful, the implementing organization must first determine which program components will best produce the desired results for its community. The RHRD program uses five prevention components: • Alcohol Access—Assists communities in using zoning and municipal regulations to restrict alcohol access through alcohol outlets (bars, liquor stores,

Prison Inmates and Drug Use  759

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•

and so on), density control, and RBS. Through training and testing, RBS assists alcohol beverage servers and retailers in the development of policies and procedures to reduce intoxication and driving after drinking. Responsible Beverage Service— Through training and testing, RBS assists alcohol beverage servers and retailers in the development of policies and procedures to reduce intoxication and driving after drinking. Risk of Driving and Drinking—Increases actual and perceived risk of arrest for driving after drinking through increased law enforcement and sobriety checkpoints. Underage Alcohol Access—Reduces youth access to alcohol by training alcohol retailers to avoid selling to minors and those who provide alcohol to minors, and through increased enforcement of underage alcohol-sales laws. Community Mobilization—Provides communities with the tools to form the coalitions needed to implement and support the interventions that will address the previous four prevention components.

Outcome results show that the RHRD program generated a 51 percent decline in self-reported driving when “over the legal limit” in those communities that had the program compared to those who did not participate, a 6 percent decline in self-reported amounts consumed per drinking occasion, a 49 percent decline in self-reported “having had too much to drink,” a 10 percent reduction in nighttime injury crashes, a 6 percent reduction in crashes in which the driver had been drinking, a 43 percent reduction in assault injuries observed in emergency rooms,

and a 2 percent reduction in hospitalized assault injuries. Richard E. Isralowitz See also: Drug Abuse Resistance Education; Harm Reduction Programs; Treatment

Further Reading DARE America. http://www.dare.com/. Library of Congress, Congressional Research Service. 1996. “Drug Abuse Resistance Education (DARE).” Washington, DC. Project Alert.com. “Substance Abuse Prevention for Grades 7 & 8.” http://www.project alert.com/. Spanagel, R., and K. F. Mann. 2005. Drugs for Relapse Prevention of Alcoholism. Boston: Birkhauser Verlag. Substance Abuse and Mental Health Services Administration, Prevention Research Center. “Community Trials Intervention To Reduce High Risk Drinking.” http://www .pire.org/CommunityTrials/index.htm. Task Force of the National Advisory Council on Alcohol Abuse and Alcoholism. 2002. “How to Reduce High-Risk College Drinking: Use Proven Strategies, Fill Research Gaps.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, National Institutes of Health. http://www.collegedrinkingprevent ion.gov/media/FINALPanel2.pdf.

Prison Inmates and Drug Use Many inmates in America’s prisons are incarcerated as a result of drug-related offenses. Approximately one quarter of those people held in U.S. prisons or jails have been convicted of a drug offense. The United States incarcerates more people for drug offenses than any other country. With an estimated 6.8 million Americans report-

760   Prison Inmates and Drug Use

edly using drugs or dependent on drugs, the growth of the prison population continues to be driven largely by incarceration for drug offenses (Carson and Sabol 2012). The increases in the number of inmates sentenced to prison for drug offenses along with the high reincarceration rate for those on drugs (either for new offenses or for parole violations) are leading to significant overcrowding issues, along with increases in prison costs. Many facilities are stretched beyond their capacity, creating dangerous and even unconstitutional conditions for those housed there. Some states are relying more on correctional alternatives such as community-based programs, house arrest, or diversion programs that remove inmates from prisons and jails and place them instead into treatment programs. Drug courts are the primary way this is done. Alcohol and drugs are involved in the commission of many crimes. Reports indicate that there was alcohol or drug use related to 78 percent of violent crimes committed, 83 percent of property crimes committed, 77 percent of weapons offenses, and 77 percent of probation or parole violations. It is thought that about 458,000 inmates have a history of some kind of substance abuse issues, and were under the influence of either alcohol or other drugs when they committed their offense. Those inmates who have substance abuse issues were more likely to begin their criminal careers at an earlier age than those who do not, and then have more contacts with the criminal justice system (Carson and Sabol 2012). There are many reasons for the high incarceration rates for drug users. It is a crime, both on the federal and state levels, to possess, use, manufacture, or distribute controlled drugs such as cocaine, heroin, marijuana, and amphetamines. Not only is the mere possession and use of an illicit drug

illegal, there are other connections between drug use and crime. Substance abuse plays a role in the commission of many crimes. Drug use may cause the user to become violent, resulting in an assault or even a murder charge. Many drug users commit property crimes (theft) as a way to get money to purchase more drugs. Approximately 16 percent of people in state prison and 18 percent of people in federal prison reported committing their crimes to obtain money for drugs. Some may commit sex-related crimes (prostitution) for money or in exchange for drugs. People who are involved with illegal substances compose a large portion of the prison population across the United States. In the federal prison system in 2011, there were 197,500 sentenced prisoners. Of these, 94,600 were serving time for drug-related offenses, including 14,900 for violent offenses; 10,700 for property offenses, and 69,000 for “public order” offenses (of which 22,100 were sentenced for immigration offenses, 29,800 for weapons offenses, and 17,100 for “other”). Further, more than half of the inmates residing in federal prisons (101,929 or 54 percent) were serving sentences for federal drug offenses, including simple possession of a drug. Of the 1,341,804 inmates being held in state facilities in 2011, there were 225,242 serving time for drug-related offenses. Further, 710,875 were for violent offenses, 245,351 for property offenses, 141,803 for “public order” offenses (which include weapons, drunk driving, court offenses, commercialized vice, morals and decency offenses, liquor law violations, and other public-order offenses), and 18,534 for “other/unspecified” offenses. Many inmates continue to use drugs while in prison. Although drugs are strictly prohibited in all correctional facilities, they are smuggled in by inmates, visitors, or even

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prison employees. When compared to inmates who do not have substance abuse concerns, those taking illegal substances were more likely to be reincarcerated. They are more likely to commit additional offenses when released from the institution. Drug use by prison inmates affects all races and ethnic groups. According to the Federal Bureau of Justice Statistics, of the estimated 225,242 sentenced prisoners under state jurisdiction serving time for drug offenses in 2011, 67,271 were non-Hispanic white (29.9 percent), 91,775 were non-Hispanic black (40.7 percent), 47,479 were Hispanic (21.1 percent), and 18,717 (8.3 percent) were unaccounted for or not specified in the report. Prior drug use among state prisoners remained stable between 1997 and 2004, according to the most recent findings from the Survey of Inmates in State and Federal Correctional Facilities. Over the same period, the percentage of federal inmates who reported prior drug use rose on all measures. For the first time, half (50 percent) of federal inmates reported drug use in the month before their offense, up from 45 percent in 1997 (Carson and Sabol 2012). In some facilities, treatment options are available for addicted inmates. It has been estimated by the Center on Addiction and Substance Abuse that of the 2.3 million inmates currently incarcerated in the United States, approximately 1.9 million are in need of some kind of alcohol and drug treatment program. Unfortunately, only about 11 percent of inmates who need treatment are actually receiving it while incarcerated. Since treatment programs may help inmates stay away from further drug use, it may save taxpayers millions of dollars. Research shows that increased admissions to drug treatment programs are linked to reduced incarceration rates in the future. States with higher drug treatment admission

rates send about 100 fewer people to prison per 100,000 than states that have lower drug treatment admissions. Of the 20 states that admit the most people to treatment per 100,000 residents, 19 had incarceration rates below the national average. Of those states that admitted the fewest people to treatment, eight had incarceration rates that were higher than the national average. Treatment programs that are provided to drug users within a community setting is one of the most cost-effective ways to provide treatment and prevent further crimes. Community-based treatment costs approximately $20,000 less than incarceration per person per year. A study by the Washington State Institute for Public Policy found that for $1 spent on drug treatment in the community, there is a cost savings of over $18 related to crime. In comparison, prisons only yield $0.37 in public safety benefit for every dollar spent. Releasing people to supervision and making treatment accessible to them is an effective way of reducing continued drug use, reducing crime associated with drug use and reducing the number of people in prison. Nancy E. Marion See also: Drug Courts

Further Reading Carson, E. Ann, and Daniela Golinelli. 2013. “Prisoners in 2012—Advance Counts.” Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics. July, NCJ242467, Table 10, p. 11. http://www .bjs.gov/content/pub/pdf/p12ac.pdf. Carson, E. Ann, and William J. Sabol. 2012. “Prisoners in 2011.” Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics. December, NCJ239808, Table 9, p. 9 and Table 10 and 11. http://www.bjs .gov/content/pub/pdf/p11.pdf.

762  Prohibition Justice Policy Institute. 2008. “Substance Abuse Treatment and Public Safety.” http://www.justicepolicy.org/images /upload/08_01_REP_DrugTx_AC-PS.pdf. Justice Policy Institute. 2009. “Pruning Prisons: How Cutting Corrections Can Save Money and Protect Public Safety.” http://www .justicepolicy.org/images/upload/09_05_ rep_pruningprisons_ac_ps.pdf. Justice Policy Institute. 2010. “How to Safely Reduce Prison Populations and Support People Returning to Their Communities.” http://www.justicepolicy.org/uploads/justic epolicy/documents/10-06_fac_forimmediat erelease_ps-ac.pdf. National Center on Addiction and Substance Abuse. “Behind Bars II: Substance Abuse and America’s Prison Population.” http:// alcoholism.about.com/b/2010/03/03/85-of -prison-inmates-need-substance-abuse -treat. Sacco, Lisa N. and Kristin M. Finklea. 2011. “Synthetic Drugs: Overview and Issues for Congress.” Congressional Research Service. Washington, DC: Library of Congress. http://www.fas.org/sgp/crs/misc/R42066 .pdf.

Prohibition Although the concept of alcoholism as a disease had been introduced into U.S. culture by the early 1800s, growing numbers of temperance societies, largely on moral grounds, continued to try to ban the use of alcohol altogether. The Prohibition Act of 1920 was purported to do just that, although many historians believe the law had less to do with controlling alcohol consumption and more to do with legislating morality and behavior as a whole. In an 1825 sermon in Litchfield, Connecticut, the Reverend Lyman Beecher (1775–

1863) became one of the first to speak publicly in support of prohibiting the sale of alcohol in the United States. Although it would be several decades before his wishes became a reality, the next 50 years saw a significant increase in the political influence that temperance groups wielded. One of these, the Women’s Christian Temperance Union (WCTU) that was founded in 1874, failed to close liquor establishments despite its persistent efforts. However, once powerful industrialists like Henry Ford and Pierre du Pont joined the cause and formed the Anti-Saloon League in 1895, it was not long before public drinking establishments were shut down. Still not satisfied, other Americans joined the fight to ban alcohol everywhere, and their efforts, combined with grain restrictions imposed by World War I, served to reduce alcohol manufacture and markedly slowed consumption. In 1914, when Congress was persuaded to enact narcotics control legislation, a public eager for reform demanded that laws be passed to outlaw alcohol consumption as well. The result was the Volstead Act, named after a zealously religious Minnesota congressman named Andrew J. Volstead. Once ratified by the states, the act that became the law known as Prohibition on January 20, 1920, forbade the sale, manufacture, and transport of intoxicating liquors within the United States. As some had predicted and many had hoped, Prohibition failed. Not only did people want to be allowed to continue to drink, there was also considerable public resentment over having free will so blatantly restricted. In an effort to resist the new constraints on behavior, many otherwise lawabiding people began to devise creative ways to get around the legislation. Although alcohol use declined at first, demand quickly surged and a criminal element headed by Al

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During Prohibition, kegs of beer were destroyed in accordance with the law. These kegs of beer were being poured into Lake Michigan in Chicago in 1919. (Bettmann/Corbis)

Capone and others soon flourished to traffic in bootleg liquor and other contraband. It is ironic that the very legislation enacted out of zealous convictions that “demon alcohol” fueled immorality led instead to an unprecedented and historic culture of violence and corruption. To meet the public’s ongoing demand for alcohol during Prohibition, speakeasies and other secret drinking establishments proliferated, and rural Americans learned to manufacture moonshine in backyard stills. Due to the lack of adequate production standards, many thousands of people were poisoned with bootleg liquor full of toxic additives. Many others were incarcerated for illegal trafficking in liquor, even the homemade variety. After the Great Depression decimated the American economy, President Franklin

Delano Roosevelt, elected in 1932 in part on a promise to end Prohibition, cut the program’s funding. The act was repealed in 1933. Kathryn H. Hollen See also: Anti-Saloon League; Eighteenth Amendment; Prohibition Party; Volstead Act; Woman’s Christian Temperance Union

Further Reading Andersen, Lisa M. F. 2013. Politics of Prohibition: American Governance and the Prohibition Party, 1869–1933. New York: Cambridge University Press. Engdahl, Sylvia. 2012. Prohibition. Detroit: Greenhaven Press. Franklin, Fabian. 2005. What Prohibition Has Done to America. Salt Lake City: Project Gutenberg Literary Archive Foundation.

764   Prohibition Party (1920–Present) Hanson. D. J. “Alcohol: Problems and Solutions.” http://www.alcoholinformation.org. Hill, Jeff. 2004. Prohibition. Detroit: Omnigraphics. Mappen, Marc. 2013. Prohibition Gangsters: The Rise and Fall of a Bad Generation. New Brunswick, NJ: Rutgers University Press. Nishi, Dennis. 2004. Prohibition. San Diego, CA: Greenhaven Press. Peck, Garrett. 2009. The Prohibition Hangover: Alcohol in America from Demon Rum to Cult Cabernet. New Brunswick, NJ: Rutgers University Press.

Prohibition Party (1920–Present) The Prohibition Party is a national temperance party originally organized by temperance advocates disenchanted with the anti-alcohol efforts of the Republicans and Democrats. When it was founded in the 19th century, the Prohibition Party thus represented a heightened politicization of the temperance movement, and its political ambitions went far beyond those of previous temperance groups such as the Washingtonians. At the turn of the century, however, the Anti-Saloon League of America (ASL) overtook the Prohibition Party as the political lead in the prohibitionist cause. Despite its decline, however, the Prohibition Party is still in existence today. The Prohibition Party was founded in 1869, but it emerged as an offshoot of the Good Templars, a temperance organization founded in 1859 on principles derived from the Washingtonian movement. Over the course of the 1860s, the Good Templars’ membership grew dramatically, leading it to venture beyond the apolitical, individual focus of the Washingtonians, and move towards a greater politicization of the temperance cause. This new temperance position

was articulated most prominently by James Black, a former Washingtonian and the founder of the Pennsylvania Republican Party, who began calling for a new political party dedicated to making alcohol prohibition the law of the land. This move towards establishing a prohibitionist party emerged from a spring 1869 proposal from the Grand Lodge of the Good Templars. Assembling later that year in Chicago, the convention members argued that none of the existing political parties were willing to adopt a strong policy stance on the question of prohibition. The Republican Party, in particular, was singled out for its moral failures in combating alcohol. Perceived by many to be the nation’s moral party for its stance against slavery, the Republican Party appeared morally exhausted and thus unable to properly take up the cause of prohibition. Attendees of the Chicago convention also argued that Republican politicians played a critical role in weakening or removing antiliquor legislation in some northern states, thus making them unreliable allies in the crusade against alcohol. Hence, on September 1, 1869, in Chicago’s Farwell Hall, the (National) Prohibition Party was born. The newly founded Prohibition Party did not attract huge membership numbers right off the bat. Reconstruction in the South after the Civil War remained the dominant issue in American politics in the 1870s, leaving little room for major policy discussions about alcohol. The party started to gain support in the 1880s, as more Americans became convinced by the argument that the Republicans were not reliable allies in the battle against alcohol. The new prominence of the Prohibition Party was especially visible with the 1884 presidential election, in which they garnered 150,000 votes—up from a mere 10,000 votes four years earlier. The Prohi-

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bition Party received 250,000 votes in the next election (1888), and in the following election (1892), they topped out at 271,000 votes. These numbers, however, never represented more than 2.2 percent of the total votes cast. The reasons for the party’s electoral success in the 1884 and 1888 elections also contain an explanation for their meager gains in 1892. In the 1884 vote, the Prohibition Party was greatly aided by the Woman’s Christian Temperance Union, and, emboldened by increased membership, it was able to advance a more comprehensive national platform and campaign. Prohibition Party leaders thus went beyond sectarian and local concerns, and put forth a party platform based on broad national issues—prohibition being but one of them. The Prohibition Party also took positions on women’s suffrage, poverty, public health, and political corruption, and it sought out allies across the board by appealing to groups ranging from Southern whites to blacks. In 1892, the party continued to broaden its platform, but it began to tackle so many issues that had nothing to do with prohibition (corporate regulation, monetary policy, land ownership policy, lynching, and equal pay for men and women) that it became unclear what the party’s main goals were. After this ambitiously broad platform disappointingly generated a mere 21,000 additional votes for the party in that year’s election, the Prohibition Party effectively split into two wings. By the 1896 election, the party existed in two fairly distinct blocs—a reformist camp that wanted to expand the range of issues the party would campaign on, and a conservative one that wanted to stick to the question of alcohol. This internal split hurt the Prohibition Party tremendously, and it effectively marked the end of its run as a major player in national politics.

In the wake of the Prohibition Party’s split, the mantle of prohibitionist political activity shifted primarily to the ASL. The ASL constituted itself not as a national party along the lines of the Prohibition Party, but rather as a nonpartisan pressure group that was far more successful than the Prohibition Party in affecting antiliquor laws. Despite the rise of the ASL, the Prohibition Party remained in existence, even through Prohibition and its repeal. The Prohibition Party saw the Eighteenth Amendment as an insufficient measure as long as it lacked the support of a prohibitionist political party to guarantee its enforcement. The Twenty-First Amendment, which repealed prohibition, merely confirmed the Prohibition Party’s views, so its passage, too, did not spell the end of the party. The Prohibition Party remains in existence today, but with many de­cades passed since prohibition and its repeal, it is no longer a significant player in national politics. Howard Padwa and Jacob A. Cunningham See also: Anti-Saloon League; Eighteenth Amendment; Volstead Act; Woman’s Christian Temperance Union

Further Reading Andersen, Lisa M. F. 2013. Politics of Prohibition: American Governance and the Prohibition Party, 1869–1933. New York: Cambridge University Press. Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Mendelson, Jack H., and Nancy K. Mello. 1985. Alcohol: Use and Abuse in America. Boston: Little, Brown and Company. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee.

766   Prohibition Unit

Prohibition Unit The Prohibition Unit, which was later renamed the Prohibition Bureau, was the federal agency in charge of enforcing national prohibition from 1919 until 1933, as well as the Harrison Narcotics Act until 1930. Plagued by local and state resistance, understaffing, lack of funding, and corruption, the Prohibition Unit struggled mightily in its efforts to police illegal alcohol, though its Narcotic Division did have some success in enforcing the nation’s drug laws. The Prohibition Unit (renamed the Prohibition Bureau in 1927) was established in December 1919 as a part of the Treasury Department in order to enforce the Volstead Act. It was authorized to seize and sell any vehicles used in the transporting of illegal liquor. It could also close, for up to a year, any place used to manufacture or sell illegal drink, and it could fine first-offense bootleggers up to $1,000 and jail them for six months. Bootleggers who violated the Volstead Act on multiple occasions faced steeper punishments from the Prohibition Unit. It was also empowered to enforce the Harrison Act, as its Narcotic Division cracked down on drug dealers and users, as well as physicians who continued to prescribe opiates in violation of federal policy. Throughout its troubled existence, the Prohibition Unit faced problems when it came to enforcing the nation’s alcohol laws. As national prohibition went into effect in 1920, many advocates of the alcohol ban were realistic about the difficulties involved in garnering immediate and full compliance with the new law. They expected numerous early violations of the Volstead Act, but they also believed that, over time, Americans would comply as they realized the benefits that would come with the nation’s move away from alcohol. Many even believed it

would take a generation before true prohibition became a reality, with it perhaps taking that long before Scientific Temperance Instruction—a public school temperance education program driven by the Woman’s Christian Temperance Union—paid its dividends with a new generation of abstinent young adults. Similarly, temperance advocates argued that compliance would ultimately come because Americans unhappy with prohibition would eventually realize that their duty to follow the U.S. Constitution was greater than their desire for a drink. Ultimately, it seemed logical to conclude that enforcement would not be an enormous task because, after all, enough Americans supported national prohibition to pass a constitutional amendment. Thus no largescale enforcement program was launched, in large part because it was not thought necessary. Instead, it was optimistically thought that the modestly endowed Prohibition Unit would be sufficient to police the liquor ban. The Prohibition Unit was thus poorly equipped to the point of being unable to enforce national prohibition. Some of its shortcomings as an enforcement agency can be traced to the influence of the Anti-Saloon League of America’s (ASL) Wayne Wheeler, who wielded great power in Washington and was the true author of the Volstead Act. Wheeler put the overworked Internal Revenue Service/Treasury Department, as opposed to the Justice Department, in charge of enforcing his Volstead Act since he believed this would allow the ASL to have a greater influence over the government’s prohibition efforts. Wheeler also exempted Prohibition Unit agents from civil service requirements so that he would be able to pick and choose who would work for the agency, but the end result was a unit filled with agents of dubious quality. For example, within the first six

Prohibition Unit  767

years of prohibition, one out of every 12 agents of the Prohibition Unit was fired for acts of corruption such as taking bribes or conspiring to sell illegal liquor. The Prohibition Unit was consequently overhauled in 1927 so its agents had to fulfill civil service requirements, and although it was renamed the Prohibition Bureau as a result, little else changed with regard to its ability to effectively enforce the Volstead Act. Regardless of name, it had deeper difficulties. One major problem was budgetary. Congress allocated the Prohibition Unit an initial yearly budget of $6,750,000, which only allowed for the deployment of 1,526 agents—one for every 71,000 Americans. This inadequate budget increased slightly over the years, but not enough to prevent lowly paid agents from being tempted by the lucrative bribes being offered by bootleggers. Likewise, congressional funds were not sufficient to police the nation’s thousands of miles of unguarded borders from extensive and sophisticated smuggling efforts such as Bill McCoy’s “Rum Row” of alcoholcarrying ships just off the American shore in international waters. Nor did meager congressional funds enable the Prohibition Unit to shut down a sizeable portion of the illegal stills and speakeasies within the country. The underfinanced and understaffed Prohibition Unit admitted that in 1925 it had stopped just 5 percent of the liquor being smuggled into the United States. The Narcotic Division was more successful at enforcing drug laws than the rest of the Prohibition Unit was at carrying out alcohol prohibition, as its squad of about 200 agents was better equipped to handle the relatively manageable challenge of enforcing laws concerning opiates and cocaine. By 1928, almost one-third of the prisoners in federal penitentiaries were there for Harrison Act violations, a sign of the Narcotic Division’s capacity to prosecute and convict large

numbers of drug law violators. Even though violations of alcohol prohibition were much more widespread than infractions of the Harrison Act, there were significantly more drug cases successfully prosecuted. The high number of drug law prisoners led to prison overcrowding, which in part fueled the push for the creation of Public Health Service narcotic hospitals in 1928. The problems with alcohol prohibition enforcement revealed that Prohibition Unit leader John Kramer was ill-equipped to carry out the task of enforcing liquor laws. Kramer had confidently predicted that the law would be obeyed in cities of all sizes and that alcohol would in all ways cease being manufactured, sold, or distributed. Two years later, Kramer admitted that such a promise could not be kept without the greater participation of local and state officials, who were routinely more than willing to let the Prohibition Unit do the work of enforcement—and foot the bill for it. In fact, as prohibition continued, local and state officials became less committed to enforcing the liquor ban, and this extended beyond their minimal financial contributions. Sheriffs, councilmen, and mayors alike often did not want to risk their political livelihoods by angering their constituents who opposed prohibition, especially when the Prohibition Bureau was only minimally successful in its efforts. Popular opinion, too, played a significant role in the local and federal failures to enforce prohibition, as juries frequently refused to convict obvious violators of the Volstead Act. In New York, for instance, there were approximately 7,000 arrests for violations of the Volstead Act between 1921 and 1923, but only 27 of these resulted in convictions. As a result, in 1924, New York City effectively abandoned its enforcement of prohibition. On the narcotics front, the Prohibition Unit was more successful,

768  Prometa

but scandals at the highest levels—especially indications that Narcotic Division head Levi G. Nutt had family links to notorious gangster and drug trafficker Arnold Rothstein—led to organizational upheaval. In 1930, Nutt was replaced as head of the Narcotic Division, and in 1930 the task of enforcing federal drug laws was given to a new federal agency, the Federal Bureau of Narcotics. When it came to alcohol prohibition, the Prohibition Bureau’s organizational overhaul and changes in leadership failed to stop widespread violations of the Eigh­ teenth Amendment and the Volstead Act. A growing national movement to repeal prohibition, too, signaled that the country was moving in a direction that would make the Prohibition Bureau increasingly irrelevant and ultimately obsolete. The Twenty-First Amendment repealed national prohibition in 1933 and spelled the end of the Prohibition Bureau. Howard Padwa and Jacob A. Cunningham See also: Anti-Saloon League; Eighteenth Amendment; Harrison Narcotics Act; McCoy, Bill; Nutt, Levi G.; Prohibition; Volstead Act; Woman’s Christian Temperance Union

Further Reading Clark, Norman H. 1976. Deliver Us from Evil: An Interpretation of American Prohibition. New York: W. W. Norton. Kyvig, David E. 2000. Repealing National Prohibition. 2nd ed. Kent, OH: Kent State University Press. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee.

Prometa Among the many new pharmaceutical drugs that have been created as a method to treat addiction is Prometa, a patented drug developed by Hythiam, Inc. This drug is said to eliminate cravings associated with alcohol abuse and cocaine and methamphetamine addictions, especially when used in combination with nutritional supplements and therapy. However, this drug is not effective for those addicted to opiates or benzodiazepines. For those suffering from alcohol, cocaine, or methamphetamine addiction, they may be required to take Prometa as the result of contact with the criminal justice system. The regimen consists of three prescription drugs, none of which has been approved for the treatment of substance addiction by the U.S. Food and Drug Administration (FDA). To date, Hythiam has not requested approval for their formula from the FDA. Promising a 60 to 80 percent success rate, the manufacturer has combined 3 drugs to create the product: flumazenil, a benzodiazepine antagonist; hydroxyzine, an antihistamine; and gabapentin, a mood stabilizer that helps modulate GABA. Although the FDA has individually approved the 3 drugs for other purposes, they have not been approved in this formulation for this particular use. The treatment is expensive and must be administered as part of a therapeutic regimen supervised by a physician. While the formulation is being investigated for efficacy and safety in clinical trials, some therapists have significant reservations about its use. To date, without definitive study results or hard evidence, many are sus-

Psilocybin and Psilocin (Mushrooms)  769

picious of its marketing claims and are reluctant to recommend it. The treatment involves prescription medications and nutritional supplements that are administered in a process that is copyrighted. Continuing care, or group therapy, follows the medical treatment, and is considered to be a key part of effective recovery for the patient. For someone who suffers from addiction and is starting Prometa, their treatment plan would start with a brief two- to three-day course of prescription medications flumazenil, gabapentin, and atarax, with additional nutritional supplements. Depending on the extent of their addiction or the extent of their symptoms, some patients may need a third day of treatment. This option would be determined by the treating physician. The initial treatment takes place at a hospital facility or clinic that has been licensed and given the rights to use Prometa. After these initial days, a patient would be required to follow a brief course of medical and nutritional supplements that are taken at home for a period of approximately one month. According to officials working with Prometa, a patient undergoing treatment will receive: • • • •

A comprehensive physical exam Medical supervision Medications and nutrients Information about follow-up and continuing care • Treatment with PROMETA involves prescription drugs. These medications are Food and Drug Administration (FDA) approved for uses other than substance dependence, but they have not been approved for use in treating Cocaine Dependence. • Continuing Care—following the initial medical treatment of 2–3 consecutive

days, patients participate in continuing care, such as counseling or group support, which is considered an essential part of the recovery process. The long-term effectiveness of the Prometa treatment process has not yet been shown, and the process has not been approved by the FDA as an antiaddiction drug. Clinical studies are underway to determine the effectiveness of the treatment program. There are at this time over 25 centers in the United States that offer Prometa to addicts. About 330 patients have undergone treatment so far. Kathryn H. Hollen See also: Addiction; Treatment

Further Reading New York State Office of Alcoholism and Substance Abuse Services. 2007. “FYI Prometa.” http://citesource.trincoll.edu/apa/ apagovreportweb.pdf. Prometa. Medical and Behavioral Health Policy Manual. http://notes.bluecrossmn.com/ web/medpolman.nsf/50c2d5c81dd37e6a86 2569bd0054c1b2/61c94b9ef44e388586257 4860070464a/$FILE/Prometa.pdf.

Psilocybin and Psilocin (Mushrooms) Psilocybin and psilocin are the hallucinogenic substances that are found in certain mushrooms—popularly referred to as magic mushrooms—indigenous to South America and the southwestern United States. These substances are among the tryptamines, which are psychoactive chemicals that can be obtained from other natural sources such as seeds or the skin of Buffo toads. The effects of psilocybin or psilocin on users depend on which variety of mushrooms is

770   Psilocybin and Psilocin (Mushrooms)

Magic mushrooms are seen in a grow room in the Netherlands. Psilocybin is the main active chemical in the mushrooms, and its use is illegal in the United States. (AP Photo/Peter Dejong)

harvested, the processes used to extract the drug, and the dosage. Adolescents and young adults tend to abuse this group of tryptamines, whose effects are similar to those of mescaline and LSD. Using the hallucinogens primarily at raves and nightclubs, users may develop nausea and drowsiness followed by hallucinations and distorted perceptions. Some experience anxiety and agitation, even panic, and may display psychotic behavior. Statistics show that nearly 10 percent of high school seniors have used hallucinogens other than LSD at least once, and it is likely that tryptamines are in this group. Although the drugs are not addicting, profound psychological and cognitive dysfunction can result from the use of these powerful psychedelics. Since it is very difficult to distinguish poisonous mushrooms from psilocybin mushrooms, those who use the drug risk lethal toxicity. A number of Schedule I hallucinogenic compounds in the tryptamines family can be

manufactured in the laboratory, including alpha-ethyltryptamine, diethyltryptamine, and dimethyltryptamine. Some must be injected for their effects to be felt, but a tryptamine hallucinogen known as “foxy-methoxy” (N, N-diisopropyl-5-methoxytryptamine) has recently been found to be an orally active psychedelic currently being abused in the United States. Street names for psilocybin-containing preparations include boomers, God’s flesh, hippieflip, hombrecitos, las mujercitas, little smoke, Mexican mushrooms, musk, sacred mushroom, Silly Putty, and simple Simon. Kathryn H. Hollen See also: Hallucinogens; Psychedelic Drugs

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books.

Psychedelic Drugs  771 Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Ketchum, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books, 2003. U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2001. Research Report Series: Hallucinogens and Dissociative Drugs. NIH Publication No. 01-4209. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Psychedelic Drugs The psychedelic properties of LSD and other drugs were discovered by Dr. Albert Hofmann in the 1940s. The drug was studied for its seeming usefulness at treating many psychiatric conditions. For the next 20 years, the drug was studied on over 40,000 patients. The drug seemed to be helpful in treating those who suffered from anxiety disorders and was noted to reduce an individual’s fear of dying. The anesthetist Eric Kast, who was interested in whether LSD’s ability to distort body image could reduce the perception of pain, also studied the potential of the drug for medical reasons. He

compared the analgesic effects of LSD with two other commonly used opiate analgesics, finding that LSD was superior in relieving pain. In further research, Kast studied the ability of LSD to induce a spiritual-type experience that allowed terminally ill patients to deal with the emotional aspects of dying, improve their sleep, and reduce their anxiety for many weeks after the initial treatment. Throughout the 1940s and 1950s, LSD was tested as a potential therapeutic agent for treating psychiatric disorders and alcoholism. In the 1950s and 1960s, the CIA conducted a research program called MKULTRA. One of its purposes was to explore the usefulness of LSD for mind control as a truth serum and as an agent for chemical warfare. Among its many breaches of research ethics, the secretive program used prostitutes to slip LSD into the drinks of their unsuspecting clients, whom CIA agents would then surreptitiously film and observe through two-way mirrors to monitor their reactions. The highly questionable methods and research goals of MK-ULTRA came to light in a subsequent congressional investigation that was hampered by the orders of the CIA director to destroy all documents related to the project, although some misfiled documents survived the purge. Other drugs that are considered hallucinogenic include psilocybin (from mushrooms), mescaline, MDMA (Ecstasy), ketamine (special-K), phencyclidine (PCP or angel dust), DMT, DXM, STP, and nitrous oxide (laughing gas). The drugs differ widely in their potency and also as to whether their primary psychological effects are hallucinatory (e.g., LSD, psilocybin, mescaline) or dissociative (e.g., ketamine, PCP, MDMA). Dissociative effects include feelings of being detached from one’s surroundings, the perception of the world as unreal or dream-like, or feeling detached

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from one’s own body. The 2010 Monitoring the Future Survey, which annually assesses U.S. high school students for changes in drug use, found that 1.8 percent of high school students in the eighth, 10th, and 12th grades used LSD at least once in the past year, with 3.8 percent reporting pastyear use of any hallucinogenic drug (excluding MDMA). Since 1991, the first year the survey began being conducted annually, hallucinogen use peaked at 7.2 percent in 1996 and has slowly declined to the current level. In Ancient Greece, the Eleusinian mysteries required the drinking of a secret potion as part of the initiation ordeal, and Plato made guarded reference to a drug much like LSD in “The Laws.” There is also good evidence that in ancient times the Indian inhabitants of Latin America such as the Aztecs used psychedelic mushrooms. In Mexico’s back country, ceremonies are still carried out by local priests utilizing such mushrooms. Psychedelic drugs were also popular in Native American tribes, the drug of choice being mescaline, or in its natural state, peyote. Psychedelic drugs, particularly LSD, became very popular in the United States as recreational drugs in the 1960s and early 1970s as part of the hippie movement. After that, the use of psychedelic drugs diminished, but they still were used in certain regions and cultures. The drugs again became popularly used in the 1990s, particularly by young people. The effects of a psychedelic drug can be different for different users, or even for the same user. The effect that a drug will have is said to be dependent upon the mind-set and setting of the drug experience. The mind-set refers to the expectations a user has about the drug, and the frame of mind in which the drug is taken. If a person is afraid, or

didn’t intend to take the drug, the experience may be very different from the user who is relaxed and even excited to take the drug. The setting refers to the physical and social environment in which the experience occurs. If the user takes the drug at home or in a relaxed setting with friends, they may experience different feelings than if the user is uncomfortable, tense, or in an unfriendly environment. Nancy E. Marion See also: Ecstasy; Hallucinogens; Hippies

Further Reading Bayer, Linda N. 2000. Strange Visions: Hallucinogen-Related Disorders. Philadelphia: Chelsea House Publishers. Clark, W. H. 1968. “Religious Aspects of Psychedelic Drugs.” California Law Review 56(1): 86–99. http://scholarship.law .berkeley.edu/cgi/viewcontent.cgi?article= 2829&context=californialawreview. Foundation for a Drug-Free World. “What Is an Hallucinogen?” http://www.drugfreewo rld.org/drugfacts/lsd/street-names-for -lsd.html. Langlitz, Nicholas. 2013. Neuropsychedelia: The Revival of Hallucinogen Research Since the Decade of the Brain. Berkeley: University of California Press. “Psychedelic Drug.” 2013. Encyclopedia Brit­ annica. http://www.britannica.com/EB checked/topic/481540/psychedelic-drug. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2001. Research Report Series: Hallucinogens and Dissociative Drugs. NIH Publication No. 01-4209. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Psychotherapeutic Drugs  773

Psychotherapeutic Drugs Psychotherapeutic drugs are those drugs that are used as a way to alter a person’s mood or state of mind. They can be prescription-like drugs such as pain relievers, stimulants, and depressants and are usually prescribed for various types of mental and physical disorders. When used correctly, psychotherapeutic drugs can erase problems that exist in a person’s life for which that patient may not otherwise be able to cope. Psychotherapeutic drugs may be used to treat multiple medical concerns with varying occurrence rates and severities. Psychotherapeutic drugs can be used to treat those suffering from psychosis, which refers to mental disorders such as depression, schizophrenia, and manic-depressive disorders that affect a person’s mood and behavior. This seems to be the case because many emotional problems have a biochemical basis that these drugs can control. However, psychotherapeutic medications often require that patients take them at adequate dosage levels for sufficient length of time, or the drugs may not have the intended effect. Moreover, some of these medications may be addictive for some patients, requiring constant monitoring by physicians and patients. Many psychotherapeutic drugs are prescribed legally by physicians. However, many are obtained illegally through drug deals or illegal connections with those working in the medical field with access to the drug. In recent years, an increasing number of adolescents and young adults have become high-risk patients for early drug addiction problems, especially for psychotherapeutic drugs. This is because more and more young people are being medically treated for psychiatric disorders including depression, bipolar, anxiety, stress, ADD,

and ADHD. Unfortunately, many of these youth are abusing their prescription medicines in an unapproved way, or in a way contrary to their prescribed doses. This is particularly disturbing because those people who misuse and abuse addictive substances at an early age are more likely to become drug addicts as they get older. Some college-aged young adults have also turned to using psychotherapeutic drugs recreationally to relieve stress, study more effectively, and engage in social activities. They sometimes are used to help students focus on their coursework, explaining that the drugs help them to focus. Common drugs used by these age groups include OxyContin, Vicodin, and certain benzodiazepines. Although these users may not want to stop using psychotherapeutic drugs in an abusive manner, if friends and loved ones detect a problem, an intervention or some type of treatment course is strongly recommended. This is because long-term abuse of these drugs may result in major health problems or a permanent change in the brain’s chemistry. In general, antidepressants can be categorized into five different groups, depending on their chemical structures. One of those groups is tricyclics and tetracyclics, which are the “classic” antidepressants that are often used for panic disorders, generalized anxiety disorder, posttraumatic stress disorder, obsessive-compulsive disorder, eating disorders, and pain disorders. There are possible side effects to the drugs, including dry mouth, constipation, blurred vision, urinary retention, fatigue, poor concentration, dizziness, tachycardia, psychomotor stimulation, allergic reactions, weight gain, insomnia, tremors, weight weakness, sweating, vomiting, and nervousness. Examples of these drugs include amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, and trimipramine.

774   Psychotherapeutic Drugs

The second category of antidepressants are monoamine oxidase inhibitors, or MAOIs. These drugs are prescribed less often because they require dietary changes and sometimes interact with other medications a patient may be taking. Some side effects of these drugs are weight gain, edema, sexual dysfunction, insomnia, sweating, dizziness, and blurred vision. Examples of these drugs are brofaromine, isocarboxazid, phenelzine, and selegeline. The third category of these drugs are called serotonin-specific reuptake inhibitors (SSRIs). They are thought of as major antidepressant drugs but are also used to treat bipolar disorder and borderline personality disorder. Common side effects of these drugs include headache, nervousness, insomnia, drowsiness, anxiety, agitation, nausea, diarrhea, and anorexia. Some examples are fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft). The fourth category is a miscellaneous group of drugs made up of those that do not fit into other categories, but can be used to treat depressive disorders in special populations such as those who are medically ill. Side effects differ, depending on the particular drug used, but include headache, insomnia, nausea, restlessness, hypertension, fatigue, weight gain, diarrhea, abdominal cramps, sweating, dry mouth, or sexual dysfunction. Examples of these drugs are bupropion (Wellbutrin), dextroamphetamine, liothyronine, methylphenidate (Ritalin), pemoline (Cylert), trazadone (Desyrel), and venlafaxine (Effexor). Finally, there are medications for anxiety. These drugs are used to treat general feelings of anxiety, but can also be used to treat symptoms of depression, panic disorder, social phobia, bipolar disorder, and substance withdrawal. Side effects are drowsiness, dizziness, insomnia, nausea, nightmares, and hallucinations. Examples include alprazolam

(Xanax), buspirone (BuSpar), chlordiazepoxide (Librium, Libritabs, Lipoxide), clonazepam (Klonopin), clonidine (Catapres), diazepam (Valium, Vlarelease, Zetran), flurazepam (Dalmane), hydroxyzine hydrochloride (Atarax), benactyzine (Deprol), metoprolol (Lopressor), naldolol (Corgard), prazepam (Centrax), quazepam (Doral), and zolpidem (Ambien). Antipsychotic medications are also known as dopamine blockers. They target psychoses that have no known cause, such as schizophrenia, delusional disorder, brief psychotic disorder, manic episodes, and major depressive disorder with psychotic features. The common side effects of these drugs are cardiac effects, vomiting, photosensitivity, reversible pigmentation of the eye, sexual dysfunction, weight gain, allergic dermatitis, vertigo, drowsiness, slurred speech, and muscle spasms. Some of the common antipsychotic medications are acetophenazine (Tindal), chlorprothixene (Taractan), haloperidol (Haldol), ioxapine (Loxitane), pimozide (Orap), promazine (Sparine), thioridazine (Mellaril), and respirine (Serpasil). Antimanic medications affect mood regulations. The side effects are hypotension, constipation, nausea, dry mouth, gastric distress, diarrhea, headache, and general fatigue. They are diltiazem (Cardizem), nimodipine (Nimotop), and verapamil (Calan). Finally, sedatives and hypnotic medications include barbiturates, which are used less frequently because of their high potential for abuse. The side effects are drowsiness, confusion, constipation, blurred vision, edema, vertigo, hyperactivity, lethargy, and headache. They include amobarbital (Amytal), butabarbital (Butisol), chloral hydrate (Noctec), methohexital (Brevital), pentobarbital (Nembutal), secobarbital (Seconal), and zolpidem (Ambien). Nancy E. Marion

Public Health Service Narcotic Hospitals  775

Further Reading Levinthal, Charles F. 2012. Drugs, Behavior and Modern Society. Boston: Allyn and Bacon. “Psychotherapeutic Agents.” Drugs.com. http://www.drugs.com/drug-class/psychoth erapeutic-agents.html. Strauss, Abbey. “An Introduction to Medications and Side Effects.” Bipolarbearexpress. http:// web.archive.org/web/20121210063908/; http://fastlaunch.tripod.com/bipolarbearex press/id10.html.

Public Health Service Narcotic Hospitals The Public Health Service (PHS) narcotic hospitals were institutions that the federal government designed to house, imprison, treat, and try to cure addicts from 1935 through 1974. These two institutions—one just outside of Fort Worth, Texas, the other just outside of Lexington, Kentucky—represented the U.S. government’s first efforts to treat addiction and come up with a cure for it, even though the institutions resembled prisons as much as they did hospitals. Until community treatment of addiction became widespread in the late 1960s, the PHS narcotic hospitals were among the only institutions that offered treatment for addicts in the United States. The PHS narcotic hospitals originated as attempts to fix some of the problems that tight enforcement of drug laws had created. Tougher application of the Harrison Narcotics Act in the 1920s filled federal prisons in the United States with drug-law violators. By 1928, approximately 1,600 out of the 7,598 individuals in federal prisons were addicted to opiates, and there were more violators of the Harrison Act in prison than any other class of offender. Wardens at these

prisons argued that their institutions were not prepared to handle addict inmates, as many smuggled drugs into prison, caused problems with nonaddicted inmates, and relapsed as soon as they regained their freedom. Officials in the Justice Department were also unhappy with the number of addict offenders who wound up in prison, and sought a sentencing alternative for addicts that would be less harsh than prison. In late 1927, members of Congress began making recommendations for alternative ways to detain convicted addicts, and Pennsylvania Republican representative Stephen G. Porter introduced one that became law in 1929. The “Porter Narcotic Farm Bill,” as it was called, authorized the establishment of two U.S. Public Health Service narcotic hospitals, which were referred to as “narcotic farms,” for the confinement and treatment of drug addicts. It took six years for the law to take effect, as the first narcotic farm opened five miles west of Lexington in 1935, and the second opened seven miles southeast of Fort Worth in 1938. The institution near Lexington generally housed addicts from areas east of the Mississippi River, while the one near Fort Worth held addicts from areas west of it. In 1936, these institutions were dubbed “narcotic hospitals” instead of “narcotic farms.” When they opened, the PHS narcotic hospitals were blends of psychiatric institutions and minimum-security prisons. The stated goals of the institutions were rehabilitative. They aimed to minimize the number of relapses among inmates by evaluating them when they first entered the facilities, assigning them to specialized wards and behavioral regimens, and providing social workers to help guide inmates back into society when they were released. Both institutions had farms and dairies (hence the term “narcotic farm”) since it was believed that pastoral

776   Public Health Service Narcotic Hospitals

work was therapeutic for individuals suffering from mental disorders such as addiction. Beyond just soothing the physical pains of addicts in withdrawal, staff at the narcotic hospitals sought to treat the mental and emotional problems that accompanied addiction and withdrawal as well. By the late 1930s, treatment in the hospitals was generally broken down into four distinct elements. First came the stage of drug withdrawal, which usually lasted less than two weeks. Second, addicts were moved to a drug-free environment for recovery, and given several months to adjust to life without drugs. Third, addicts were given psychotherapy in order to encourage and persuade them to stay drug-free. Fourth, addicts were assigned to work either on the farms, in maintenance, or in shops. Addicts who broke the rules of the federal narcotic hospitals were given disciplinary action, which usually consisted of losing privileges or extended sentences. Overall, the recommended duration of treatment at the PHS narcotic hospitals was between four and six months. In spite of this therapeutic program, studies as late as the 1960s still concluded that life in the PHS narcotic hospitals was more like internment in a prison than it was a stay in a hospital or rehabilitation program. In the 1930s and 1940s, the PHS narcotic hospitals were among the only treatment resources available to addicts in the United States since many physicians and hospitals refused to treat addicts. Consequently, admissions to the two institutions grew steadily during these years, from just 823 in 1935 to 3,875 in 1949. What is more, many addicts came to the PHS narcotic hospitals voluntarily in hopes of being cured before they ran afoul of the law, though since they could not be compelled to complete the program, most of them left the institutions before they were cured. When rates of

heroin addiction rose sharply in the early 1950s, so did the number of admissions to the PHS narcotic hospitals, as an average of 4,218 individuals entered them annually during the 1950s. In the 1960s, admissions began to decrease, largely due to the creation of state and local treatment programs that provided treatment alternatives. Admissions rose slightly once again with the implementation of the Narcotic Addict Rehabilitation Act in 1966, though funding issues ultimately led to a decrease in the number of admissions until the hospitals were closed in 1974. In addition to providing treatment for addicts, the hospital at Lexington also became a center for addiction research, led by its first medical director, Dr. Lawrence Kolb. In the 1930s, cures for addiction, and potential morphine substitutes, were tested on inmates at Lexington. Clinical observations at Lexington in the 1940s confirmed Kolb’s belief that most addicts had personality problems, and in the late 1940s, experiments there first showed the potential that methadone had as a substitution treatment for opiate addicts. In 1948, the research division at Lexington was administratively separated from the hospital wing, and became the National Institute of Mental Health’s Addiction Research Center. Among the major projects carried out at the Addiction Research Center were a series of experiments on rats that helped scientists better understand relapse and opioid-seeking behavior, and a study that showed the potential that narcotic antagonists could have on individuals suffering from protracted withdrawal symptoms. In addition to research carried out at the Addiction Research Center, the programs at both Lexington and Fort Worth studied the effectiveness of community agencies and halfway houses in reintegrating ex-addicts into society during the late 1950s and early 1960s.

Public Opinion and Drug Use  777

By the late 1960s, the Narcotic Addict Rehabilitation Act had begun to fund state and local services for the treatment of drug users, and community treatment continued to expand with the passage of the Community Mental Health Services Act. The hospital at Fort Worth closed in October 1971 and was transformed into a federal prison. The hospital at Lexington, on the other hand, was remodeled and modernized so that all of the bars, grilles, and other trappings that made it seem like a prison were removed. The number of staff at Lexington was increased, while the patient population was reduced, leading to more intense therapeutic interactions between staff and patients. However, by the early 1970s, the growth of community addiction treatment reduced the number of addicts who came to Lexington, and funding was gradually redirected from Lexington to local programs as well. In 1974, the hospital at Lexington closed, and like the institution at Fort Worth, it was converted into a federal prison. Howard Padwa and Jacob A. Cunningham See also: Harrison Narcotics Act; Methadone; Narcotic Addict Rehabilitation Act; Porter, Stephen G.

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press. Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Kosten, Thomas R., and David A. Gorelick. 2002. “The Lexington Narcotic Farm.” American Journal of Psychiatry 159(1): 22. Martin, William R., and Harris Isbell, eds. 1978. Drug Addiction and the U.S. Public

Health Service. Rockville, MD: National Institute on Drug Abuse. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

Public Opinion and Drug Use Drug use in the United States has been undergoing changes in recent years, and many have begun to question current U.S. drug policy and argue for its ineffectiveness. There are a variety of factors that may explain one’s perception on drug use; some of these factors explored below are age, education, and political affiliation. Finally, while American perception on marijuana has changed drastically in recent years, culminating in the legalization of recreational use in Colorado and Washington, some drugs such as heroin, cocaine, and performanceenhancing drugs have not seen the same opinion warmth as marijuana. One area American public opinion on drug use has begun to change is in regards to marijuana. A Gallup poll showed a recent change in American public opinion on marijuana use. Now, a majority of Americans (58 percent) report that they believe that marijuana should be legalized. This is far different from the 1969 Gallup poll when the question was first asked. At that time, only 12 percent of respondents were in favor of legalizing marijuana. Not surprisingly, through the 1970s, support for legalization of marijuana more than doubled, growing to 28 percent who favored legalizing the drug. Support for legalization then peaked during the 1980s and 1990s until it reached a 50 percent support rate in 2011. A large reason for the increased support in marijuana legalization can be traced to the support by Independent voters. About

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62 percent of Independent voters now favor legalization, a figure that is up 12 points just from November 2012. During this time, the support for legalization of marijuana among Democratic and Republican voters changed very little. However, there is a clear division between Republicans, who largely oppose the legalization of marijuana, and Democrats. This is made clear in a 2013 poll that indicated that only 35 percent of Republicans favored the legalization of marijuana, whereas 65 percent of Democrats were in favor, and 61 percent of Independents favored legalization. Age, as well as political affiliation, seems to play a role in terms of opinion on marijuana legalization. According to the same Gallup Poll 67 percent of Americans 18–29 favored legalization, while 62 percent of those 30–49 supported legalization, 56 percent of those 50–64 supported legalization, while only 45 percent of those 65 and older saw legalizing as viable. American perception on the severity of the drug problem has also changed slightly in recent decades. In 2000 43 percent of respondents believed drug use was an “extremely serious problem,” by 2005 this had decreased to 37 percent, and in 2009 this fell to 35 percent. In contrast those who believe drug use was only a “moderately serious problem” has increased. In 2000, 15 percent of respondents believed drug use was a “moderate problem,” by 2005 this number had increased to 23 percent, and in 2009 this increased to 26 percent. However, from 2000 to 2009 only 1 percent of Americans believe drug use is not a serious problem. While Americans increasingly support marijuana legalization, one kind of drugs Americans still do not support are performance enhancing drugs (PEDs). With approximately 75 percent of the United States involved in sports in some way, American culture has paid attention to PEDs. One out

of five adults personally knows someone that they believe has taken illegal steroids without a prescription. Fifty-seven percent of the American public can name a negative side-effect of steroid use, and 97 percent of the American public believes that PED use is cheating. The Drug Equality Alliance studied the attitudes of British citizens on particular drug use. They tracked people’s feelings about the relative harmfulness of different drugs. Of the adults questioned, a substantial majority (90 percent) believed that heroin, cocaine, Ecstasy, and amphetamines were either “very harmful” or “fairly harmful.” Interestingly, only one-third of those respondents believed that cannabis (marijuana) was as harmful. With regard to alcohol and tobacco, the opinions tended to vary with the age of the respondent. As the age of the respondent increased, the tendency of the respondent to feel a drug was harmful also increased. Cannabis was thought to be the least harmful of all the drugs. In surveys completed on children, it became clear that the younger people perceived the harmfulness of drugs in very different ways than adults. The children who were aged 11–12 years old thought all illicit drugs (including marijuana) were equally harmful to someone who used them, with the exception of alcohol and tobacco, which were perceived to be much less harmful than other drugs. This was true of other age ranges as well. The survey found that attitudes towards marijuana change considerably as people grow older. By about the age of 15 or 16, young people perceive the dangers of marijuana in about the same way as adults, that is, as among the least harmful of drugs. This is different for alcohol and tobacco. Adults perceive these substances as particularly harmful. The most frequent reasons given by both children and adults for people not taking

Pure Food and Drug Act (1906)  779

drugs were “health reasons” (33 percent and 51 percent) and “just don’t want to take drugs” (27 percent and 56 percent). By comparison only 19 percent of children and 30 percent of adults mentioned “illegality” and 12 percent of children and 17 percent of adults cited “fear of being caught by the police.” Nancy E. Marion See also: Drug Abuse of Drugs; Marijuana; Recreational Abuse of Drugs

Further Reading Department of Justice. “Criminal Justice Statistics.” 2012. http://www.albany.edu/ sourcebook/pdf/t200152011.pdf. Drug Equality Alliance. 2009. “Public Attitudes toward Drugs.” http://www.drugequality.org/files/6.6%20Public%20 attitudes%20to%20illegal%20drugs.doc. Economic and Social Research Council. The Measurement of Changing Attitudes towards Illegal Drugs in Britain. http://www .esrc.ac.uk/my-esrc/grants/R000239295/ read. Siperstein, G. N., N. Romano, G. Iskenderoglu, A. Roman, F. J. Folwer, and M. Drascher. 2013. “The American Public’s Perception of Illegal Steroid Use: A National Survey.” http://www.csde.umb.edu/documents/ SteroidReport.pdf. Swift, A. 2013. “For First Time, Americans Favor Legalizing Marijuana. Gallup Politics.” http://www.gallup.com/poll/165539/first -time-americans-favor-legalizing -marijuana.aspx.

Pure Food and Drug Act (1906) The Pure Food and Drug Act of 1906 marked the first time that vendors in the United States were required to place labels on food,

medicines, and other consumer products that were sold to the general public. At the turn of the 20th century, the most recent federal law governing the sale of drugs had been passed in 1848. Yet by 1900, changes in science, technology, and industry had made this law outdated. Developments in science allowed for the creation of synthetic medicines and processed foods, and the makers of these products learned how to use chemistry to adulterate their products and defraud customers. The makers of patent medicines, for example, would sell unlabeled concoctions that actually contained poisons or habit-forming drugs, but they figured out ways to add ingredients that could mask the taste and smell of the poisons in the formulas they sold. Food producers were also creative with their use of science, using chemicals to transform lowquality ingredients into products that they could sell. With the development of factories and a nationwide transportation network in the late 1800s, it became easier for companies to produce and transport these adulterated products cheaply. The result was that consumers often had no idea what they were actually buying and ingesting. Consequently, the people who purchased these products could become sick, while the businessmen who oversaw these operations became rich. Both public health and morality, it seemed, were put at risk by the freedom manufacturers had to sell products without properly labeling them. Journalistic exposés, like Upton Sinclair’s The Jungle, which detailed the misdeeds of the meatpacking industry, and Samuel Hopkins Adam’s “Great American Fraud” series on the dangers of patent medicines in Collier’s, helped spread awareness of the problems that could arise when corporations and manufacturers could sell products without being obligated to tell the public

780   Pure Food and Drug Act (1906)

what they were selling or how it was made. People concerned with corporations taking advantage of public ignorance and defrauding them began advocating for stricter rules over the labeling of consumer products. Harvey Washington Wiley, a chemist with the Department of Agriculture, and the American Medical Association were particularly concerned with the dangers of unlabeled patent medicines. In 1905, President Theodore Roosevelt began pushing Congress to enact a bill to regulate the trade in food and drugs, and in June of 1906, it finally passed as the Pure Food and Drug Act. The law made it illegal to transport adulterated or mislabeled foods or drugs across state lines, and offenders could have their products seized, or be fined and jailed themselves. Drugs now had to follow standards laid out in the U.S. pharmacopoeia and national formulary; substituting ingredients that were not on the label was no longer allowed, and making false or misleading claims about a food or drug became an offense. Federal scientists from the Public Health Service were also empowered to inspect and certify that medicines were being properly labeled before being sold to the public. The act also gave officials with the Bureau of Chemistry—the federal agency that would later become the Food and Drug Administration—new regulatory powers. Though it did not make it illegal to sell preparations that contained narcotics or alcohol, the Pure Food and Drug Act did mark a significant shift in the sale and distribution of these drugs. By stipulating that patent medicines had to state on their labels if they included alcohol, opium, opium derivatives, cocaine, or other potentially habit-forming drugs, the law made it impossible for the

makers of these formulas to deceive consumers as they had before. Also, many people who may have been unaware that they were consuming habit-forming drugs when they took patent medicines would now know what they were taking. As a result, many consumers stopped purchasing patent medicines that contained these drugs, and the manufacturers of many patent medicines changed their formulas so they no longer included alcohol or narcotics. Thus even before the passage of the Harrison Narcotics Act that placed limits on the availability of narcotics in 1914, and the Volstead Act that prohibited alcohol took effect in 1920, people in the United States began consuming less narcotics and alcohol in 1906. Howard Padwa and Jacob A. Cunningham See also: Food and Drug Administration; Harrison Narcotics Act; Patent Medicines

Further Reading Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Hilts, Philip J. 2003. Protecting America’s Health: The FDA, Business, and One Hundred Years of Regulation. New York: Alfred A. Knopf. Morgan, H. Wayne. 1974. Yesterday’s Addicts: American Society and Drug Abuse, 1865–1920. Norman, OK: University of Oklahoma Press. Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press. Swann, John P. “History of the FDA.” http:// www.fda.gov/oc/history/historyoffda/ default.htm.

Drugs in American Society

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Drugs in American Society an encyclopedia of history, politics, culture, and the law Volume 3: Q–Z

Nancy E. Marion and Willard M. Oliver, Editors

Copyright © 2015 by ABC-CLIO, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, except for the inclusion of brief quotations in a review, without prior permission in writing from the publisher. Library of Congress Cataloging-in-Publication Data   Drugs in American society : an encyclopedia of history, politics, culture, and the law / Nancy E. Marion and Willard M. Oliver, editors.    volumes ; cm   ISBN 978-1-61069-595-4 (alk. paper) — ISBN 978-1-61069-596-1 (ebook) 1. Drug abuse— United States. 2. Drugs—United States. 3. Drug utilization—United States. I. Marion, Nancy E., editor. II. Oliver, Willard M., editor. HV5825.D848 2015 363.290973—dc23   2014017383 ISBN: 978-1-61069-595-4 EISBN: 978-1-61069-596-1 19 18 17 16 15  1 2 3 4 5 This book is also available on the World Wide Web as an eBook. Visit www.abc-clio.com for details. ABC-CLIO, LLC 130 Cremona Drive, P.O. Box 1911 Santa Barbara, California 93116-1911 This book is printed on acid-free paper Manufactured in the United States of America

Contents

Guide to Related Topics,  xv

Alcohol Use,  32

Preface, xxiii

Alcohol-Facilitated Sexual Assault,  37

Introduction, xxv

Alcoholics Anonymous (AA),  39

Chronology: Significant Events in Drug and Alcohol Use through History,  xxxvii

Alcoholism, 42 Alpert, Richard,  47 Alternative Addiction Treatment,  49

VOLUME 1

American Association for the Study and Cure of Inebriety (AASCI),  51

Addiction, 1 Addiction Liability,  7

American Society of Addiction Medicine (ASAM), 53

Addiction Medications,  7

American Temperance Society (ATS),  56

Addictive Personality,  11

Amphetamines, 58

Adolescent Tobacco Use,  13

Analgesics, 60

Advisory Commission on Narcotic and Drug Abuse,  16

Andean Trade Preference Act (1991),  63

African Americans and Drug Use,  17

Anslinger, Harry J.,  65

Al-Anon, 20

Antidepressants, 68

Alateen, 22

Anti–Drug Abuse Acts,  71

Alcohol Bootlegging and Smuggling,  24

Anti-Saloon League (ASL),  73

Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (1992), 27

Anxiety Disorders,  76 Armstrong, Lance,  77 Asset Forfeiture,  80

Alcohol Mutual Aid Societies,  28

Association Against the Prohibition Amendment (AAPA),  82

Alcohol to Subdue Victims,  30 v

vi  Contents

Authors and Drug Use,  84

Bush, George W.,  140

Aviation Drug-Trafficking Control Act (1984), 86

Cabinet Committee on International Narcotics Control,  145

Bad Boys,  89

Caffeine, 146

Barbiturates, 91

Cali Drug Cartel,  148

Barnes, Nicky,  93

Califano, Joseph, Jr.,  153

Barry, Marion S.,  95

Camarena Salazar, Enrique,  154

Bath Salts and Synthetic Cannabis (“K2” or “Spice”), 97

Campaign against Marijuana Planting (CAMP), 156

Beatniks, 99

Cannabis, 157

Behavioral Addictions,  100

Carter, Jimmy,  159

Belushi, John,  103

Center for Substance Abuse Prevention (CSAP), 161

Bennett, William,  106 Betty Ford Center,  107 Bias, Len,  109

Center on Addiction and Substance Abuse (CASA), 163

Binge Drinking,  110

Centers for Disease Control and Prevention (CDC), 164

Biological and Psychological Reasons for Substance Abuse,  114

Central Intelligence Agency (CIA), United States, 166

Black Tar Heroin,  115

Child Sexual Abuse and Substance Abuse, 168

Blanco, Griselda,  117 Blood-Alcohol Content (BAC),  119 Blow,  122 Boggs Act (1951),  124 Boylan Act (1914),  126 Brown, Bobby,  129 Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF),  130

Children of Alcoholics,  170 China and the Chinese and Drugs,  173 Cigarettes, 175 Cigars, 178 Cipollone v. Liggett Group, Inc. et al.,  182 Clinton, Bill,  185 Cobain, Kurt,  188

Bureau of Drug Abuse Control,  134

Coca, 190

Bureau of International Narcotics and Law Enforcement Affairs,  135

Coca-Cola, 193

Bush, George H. W.,  136

Cocaine and Crack,  194 Cocaine Anonymous (CA),  197

Contents  vii

Cocaine Cowboys,  198

Date Rape Drugs,  242

Codeine, 200

Decriminalization, 244

Codependency, 201

Demand Reduction,  245

Colombian Cartels,  202

Dependence, 248

Combat Methamphetamine Act (2005), 204

Depressants, 250

Commission on Marihuana and Drug Abuse, 206 Committee on Drug Addiction (1928–1938), 210 Committee on Drug Addictions (1921–1928), 211 Common Sense for Drug Policy,  213 Compassionate Use Act (1996),  214 Comprehensive Drug Abuse Prevention and Control Act (1970),  216 Comprehensive Methamphetamine Control Act (1996),  218 Compulsions and Impulses,  219 Conant v. Walters,  220 Controlled Substances Act (CSA) (1970), 222 Council for Tobacco Research,  224 The Counterculture and Drugs,  226 Crack Epidemic,  228 Crime Control Act (1990),  230 Crime Victims and Drugs,  232

Designer Drugs,  252 Dimethyltryptamine (DMT),  255 Disease Model of Addiction,  256 Dole, Vincent,  257 Domestic Abuse and Alcohol,  259 Domestic Abuse and Drugs,  262 Drug Abuse,  264 Drug Abuse and Treatment Act (1972),  267 Drug Abuse Control Amendments (1965), 269 Drug Abuse Resistance Education (DARE), 271 Drug Abuse Warning Network,  273 Drug Addiction and Public Policy,  275 Drug Cartels,  279 Drug Classes,  285 Drug Courts,  288 Drug Czar,  290 Drug Enforcement Administration (DEA), 292

Crop Eradication,  234

Drug Interdiction and International Cooperation Act (1986),  295

Cross-Addiction and Cross-Tolerance,  236

Drug Intervention Programs,  296

Dadeland Massacre (Miami, Florida) (1979), 239

Drug Kingpin Death Penalty Act (1988, 1994), 298

Dai, Bingham,  240

Drug Nomenclature,  299

viii  Contents

Drug Paraphernalia,  300

Eighteenth Amendment,  357

Drug Policy Alliance Network,  303

Eisenhower, Dwight D.,  359

Drug Possession,  304

Elders, Joycelyn,  360

Drug Purity,  305

Electronic Dance Music (EDM/House Music), 361

Drug Reform Act (1986),  308 Drug Screening and Testing,  309 Drug Sentencing,  311 Drug Smuggling,  314 Drug Tolerance,  316 Drug Trade,  317 Drug Trafficking,  318 Drug Trafficking and Organized Crime, 321 Drug Trafficking Networks,  324 Drug Typologies,  326 Drug Use Forecasting,  330

Employment Division, Department of Human Resources of Oregon v. Smith,  363 Energy Drinks,  365 Engle v. R.J. Reynolds,  367 Entertainers and Drug Use,  369 Ephedrine and Pseudoephedrine,  372 Escobar, Pablo,  373 European Committee to Combat Drugs, 375 Extradition, 376 Fair Sentencing Act (2010),  379

Drug Watch International,  332

Families Against Mandatory Minimums (FAMM), 381

Drug-Facilitated Rape,  334

Farley, Chris,  383

Drug-Free America Act (1986),  336

Fast and Furious,  386

Drug-Free America Foundation,  338

Federal Alcohol Administration Act (1935), 389

Drug-Free Federal Workplace,  340 Drug-Free School Zones,  341 Drug-Free Schools and Community Act (1988–1989), 343

Federal Bureau of Investigation (FBI),  391 Federal Bureau of Narcotics (FBN),  394 Female Alcohol Use,  396

Drugged Driving,  345

Female Tobacco Use,  399

Drug-Related Asset Seizures,  349

Ferguson v. City of Charleston,  401 Fetal Alcohol Syndrome (FAS),  403

VOLUME 2

Fisher, Guy,  408

E-Cigarettes, 353

Flashbacks, 409

Ecstasy (MDMA),  355

Florida v. Jardines,  411

Contents  ix

Food and Drug Administration (FDA),  413

Hemp, 476

Food, Drug, and Cosmetic Act (1938),  415

Hendrix, Jimi,  478

Ford, Betty,  417

Heroin, 480

Ford, Gerald R.,  419 Four Loko,  421

High-Intensity Drug-Trafficking Areas (HIDTAs), 483

French Connection,  423

Hip-Hop and Drugs,  486

Freud, Sigmund,  424

Hippies, 488

Gateway Drugs,  429

HIV/AIDS and Drug Use,  489

Gateway Hypothesis,  433

Hoffman, Philip Seymour,  491

Ginsberg, Allen,  434

Hofmann, Albert,  493

Global Commission on Drug Policy (2011), 436

Hookah, 495

Golden Crescent,  437 Golden Triangle,  440 Grateful Dead,  443 Green Rush,  446 Guadalajara Cartel,  447 Guillot-Lara, Jaime,  449 Gulf Cartel,  450 Gutka, 454

Hoover, J. Edgar,  496 Ibogaine, 499 Inhalants, 500 International Narcotics Control Act (1989), 503 International Narcotics Research Conference (INRC),  504 Intervention, 505 Intoxication, 507

Hague Convention,  457

Investigational New Drug Program,  509

Haight-Ashbury, 460

Jackson, Michael,  511

Hallucinogens, 462

Jazz Culture,  513

Hangovers, 464

Jellinek, E. Morton,  515

Hard Drugs vs. Soft Drugs,  465

Johnson, Lyndon Baines,  517

Harm Reduction Programs,  467

Jones, Marion,  519

Harrison, Francis,  469

Joplin, Janis,  521

Harrison Narcotics Act (1914),  470

Juárez Cartel,  523

Hashish (Hash),  473

Jung, George,  525

Hazelden Foundation,  474

Kennedy, John F.,  527

x  Contents

Ketamine, 528

Meth Labs,  594

Khat, 531

Methadone, 597

Koop, C. Everett,  534

Methadone Treatment Programs,  598

The La Guardia Report,  539

Methamphetamine, 599

Labeling and the Criminalization Process, 541

Mexican Drug Trade,  603

Latinos and Drug Use,  543 Leary, Timothy,  544 Legalization, 546 Legalized Marijuana,  550 Leonhart, Michele M.,  552 LifeRing, 553 Lincoln, Abraham,  555 Linder v. United States,  557

Military and Drug Use,  606 Minnesota Model,  607 Minorities and Drug Use,  608 Moncrieffe v. Holder,  609 Monitoring the Future Survey,  611 Monroe, Marilyn,  613 Morality Policy,  615 Morphine, 616

Lindesmith, Alfred R.,  558

Mothers Against Drunk Driving (MADD), 617

Long-Term Potentiation,  559

Mullen, Francis,  619

LSD (Lysergic Acid Diethylamide),  560

Nadelmann, Ethan,  621

Lucas, Frank,  563

Naltrexone, 622

Mandatory Treatment,  567

Narcotic Addict Rehabilitation Act (1966), 624

Marihuana Tax Act (1937),  568 Marijuana, 570 Marijuana Businesses,  573 Master Settlement Agreement (MSA), 577 McCaffrey, Barry R.,  580 McCoy, Bill,  584 Medellín Cartel,  585 Medical Marijuana,  588 Meese, Edwin,  592 Mescaline, 593

Narcotic Clinics,  626 Narcotic Control Act (1956),  628 Narcotic Drugs Import and Export Act (1922), 630 Narcotics, 631 Narcotics Anonymous (NA),  632 Nation, Carrie,  635 National Association of State Alcohol and Drug Abuse Directors,  638 National Clearinghouse for Alcohol and Drug Information (U.S.),  639

Contents  xi

National Council on Alcoholism and Drug Dependence (NCADD),  640 National Drug Control Strategy,  643 National Drug Policy Board,  645 National Household Survey on Drug Abuse, 647 National Institute on Alcohol Abuse and Alcoholism (NIAAA),  649 National Institute on Drug Abuse (NIDA), 651 National Minimum Drinking Age Act (1984), 653

Obama, Barack,  696 Office for Drug Abuse Law Enforcement, 699 Office of National Drug Control Policy (ONDCP), 700 Opiates, 703 Opium, 705 Opium Control Act (1942),  708 Opium Dens,  709 Opium Trade,  711 Opium Wars,  715

National Narcotics Border Interdiction System (NNBIS),  655

Organized Crime Drug Enforcement Task Force Program,  716

National Organization for the Reform of Marijuana Laws (NORML),  657

Over-the-Counter Drugs,  717

National Research Council Report on Drug Enforcement Activities,  659

Parents Resource Institute for Drug Education (PRIDE) Surveys,  721

National Treasury Employees Union v. Von Raab,  660

Partnership for the Drug-Free America,  723

National Youth Anti-Drug Media Campaign, 661

Oxycodone/OxyContin, 719

Patent Medicines,  725 Peyote, 726

Native Americans and Substance Abuse, 663

Pharmacology, 729

Needle Exchange Programs,  671

Phoenix House,  732

Neurotransmitters, 673

Pizza Connection,  734

Nicotine, 677

Popular Culture,  736

Nixon, Richard M.,  686

Porter, Stephen G.,  739

Noriega, Manuel Antonio,  688

Porter Narcotic Farm Act (1929),  741

Nutt, Levi G.,  691

Predatory Drugs,  744

Nyswander, Marie,  692

Prescription Drugs,  747

Oakland Cannabis Buyers’ Cooperative, 695

President’s Advisory Commission on Narcotic and Drug Abuse (1963),  749

Phencyclidine (PCP),  730

xii  Contents

President’s Drug Advisory Council (George H. W. Bush),  751 Presley, Elvis,  752 Prevention, 755 Prison Inmates and Drug Use,  759 Prohibition, 762 Prohibition Party,  764

Rockefeller Drug Laws,  802 Rodriguez, Alex,  804 Ruffin, David,  806 Rural Drug Use,  808 Rush, Benjamin,  810 Scarface, 813

Prohibition Unit,  766

Schedule of Controlled Substances (I–V), 815

Prometa, 768

Secondhand Smoke,  817

Psilocybin and Psilocin (Mushrooms),  769

Sedatives, Hypnotics, and Anxiolytics,  818

Psychedelic Drugs,  771

Seniors and Drug Use,  819

Psychotherapeutic Drugs,  773

Sentencing Disparities,  820

Public Health Service Narcotic Hospitals, 775

Sertürner, Friedrich,  822

Public Opinion and Drug Use,  777 Pure Food and Drug Act (1906),  779

Shisha, 823 Shulgin, Alexander “Sasha,”  824 Skinner v. Railway Labor Executives’ Association,  826

VOLUME 3

Smith, Robert Holbrook (“Dr. Bob”),  827

Quaalude, 781

Smokers’ Rights,  829

Raich v. Ashcroft,  783

Smoking Opium Exclusion Act (1909), 831

Randall, Robert,  784 Raytheon v. Hernandez,  785 Reagan, Ronald, and Nancy Reagan,  787 Recovery, 790 Recovery Circles,  792 Recreational Use of Drugs,  794

Sonora Cartel,  832 Soros, George,  833 Special Action Office of Drug Abuse Prevention, 835 Special Narcotic Committee,  836

Reefer Madness,  795

State Drug and Alcohol Control Laws, 837

Ribbon Reform Clubs,  797

STDs and Drug Use,  839

Risk Factors for Drug Use,  799

Steroids, Anabolic,  841

Robinson v. California,  800

Steroids and Sports,  843

Contents  xiii

Steroids in Baseball,  846 Stimulants, 848 Students Against Destructive Decisions (SADD), 850 Studio 54,  852 Substance Abuse and Mental Health Services Administration (SAMHSA),  853 Substance Abuse Services Amendments of 1986, 858 Substance Addiction,  859 Supply-Side Strategy,  864 Surgeon General’s Reports on Tobacco, 866 Synanon, 868 Synthetic Drugs,  870 Syrup, 871 Television and Drugs,  875 Temperance Movement,  879 Terrorism and Illicit Drugs,  882 Terry, Luther,  884 “Texas Heroin Massacre” and Drug Use in the 1990s,  885 THC (Tetrahydrocannabinol),  890 Theories of Drug Addiction,  891 Tijuana Cartel,  894 Tobacco, 897 Tobacco Institute,  899 Tranquilizers, 901 Treatment, 902

Undocumented Immigrants and Drug Use, 913 United Nations Commission on Narcotic Drugs, 914 United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988),  916 United Nations Convention on Psychotropic Substances (1971),  917 United Nations International Conference on Drug Abuse and Illicit Trafficking (1987), 918 United Nations International Day Against Drug Abuse and Illicit Trafficking, 919 United Nations Office on Drugs and Crime, 920 United Nations Single Convention on Narcotic Drugs (1961),  921 United Nations Surveys on Crime Trends and the Operations of Criminal Justice Systems (UN-CTS),  922 United States Bureau of Narcotics and Dangerous Drugs (BNDD),  923 United States Coast Guard,  924 United States Customs and Border Protection, 926 United States Immigration and Customs Enforcement (ICE),  929 United States International Drug Control Efforts, 932 United States National Narcotics Control Act (1956),  934

Truman, Harry S.,  907

United States v. Doremus and Webb et al. v. United States,  934

Twelve-Step Programs,  909

United States v. Flores-Montano (2004),  937

xiv  Contents

United States v. Jin Fuey Moy (1916),  938 Urinalysis, 940 Violent Crime Control and Law Enforcement Act (1994),  943 Vollmer, August,  944 Volstead, Andrew,  946

Appendix: Documents Related to Drug Use in America 1. The First Drug Law in America, 1875, 985 2. Pure Food and Drug Act (1906),  985 3. Harrison Narcotics Act (1915),  990

Volstead Act (Eighteenth Amendment),  948

4. Eighteenth Amendment to the U.S. Constitution (1920–1933),  996

War on Drugs,  951

5. Porter Narcotic Farm Act (1929),  997

Webb et al. v. United States,  952

6. Marihuana Tax Act (1937),  999

Webb-Kenyon Act (1913),  953

7. Richard Nixon’s Special Message to the Congress on Drug Abuse Prevention and Control (1971),  1009

Whiskey Rebellion,  955 White, Walter,  957 White House Conference for a Drug-Free America, 958

8. “Just Say No” Speech by Ronald and Nancy Reagan (1986),  1019

White House Conference on Narcotics and Drug Abuse,  959

9. Executive Order 12564: Drug-Free Federal Workplace (1986) (Ronald Reagan), 1024

Wilson, William G. (“Bill W.”),  960

10. Anti–Drug Abuse Act (1986),  1029

Withdrawal from Drug Use,  961

11. Anti–Drug Abuse Act (1988),  1041

Woman’s Christian Temperance Union (WCTU), 962

12. George Bush: Address to Nation on the National Drug Control Strategy (1989), 1089

Women, Pregnancy, and Drugs,  964 Women, Victimization, and Substance Abuse, 968 Women’s Organization for National Prohibition Reform (WONPR),  971 World Federation Against Drugs,  972

13. Executive Order 12880: National Drug Control Program (1993) (Bill Clinton),  1095 14. Memorandum for Selected United States Attorneys (Medical Marijuana) (2009), 1097

World Narcotics Conference,  973

15. Cole Memorandum (Marijuana Dispensary Raids) (2011),  1100

Wright, Hamilton,  973

Recommended Resources,  1103

Youths and Illicit Drug Use in the United States, 977

About the Editors and Contributors,  1113

Zero Tolerance Policy Program (U.S.), 983

Index, 1117

Guide to Related Topics

Following are entries in this encyclopedia, arranged under broad topics, for enhanced searching. Readers should also consult the index at the end of the encyclopedia for more specific subjects.

Fetal Alcohol Syndrome (FAS) National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Minimum Drinking Age Act Whiskey Rebellion

Addiction/Use Addiction Addiction Liability Addiction Medications Addictive Personality Behavioral Addictions Compulsions/Impulses Disease Model of Addiction Drug Abuse Drug Addiction and Public Policy Substance Addiction Theories of Drug Addiction

Commissions and Boards Advisory Commission on Narcotic and Drug Abuse Bureau of Drug Abuse Control Bureau of International Narcotics and Law Enforcement Affairs Cabinet Committee on International Narcotics Control Campaign against Marijuana Planting (CAMP) Center for Substance Abuse Prevention Center on Addiction and Substance Abuse (CASA) Commission on Marihuana and Drug Abuse Committee on Drug Addiction (1928–1938) Committee on Drug Addictions (1921–1928) European Committee to Combat Drugs Global Commission on Drug Policy National Drug Policy Board National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Institute on Drug Abuse (NIDA) President’s Advisory Commission on Narcotic and Drug Abuse President’s Drug Advisory Council

Alcohol Alcohol Bootlegging and Smuggling Alcohol to Subdue Victims Alcohol Use Alcohol-Facilitated Sexual Assault Alcoholism American Association for the Study and Cure of Inebriety (AASCI) Binge Drinking Blood-Alcohol Content (BAC) Children of Alcoholics Domestic Abuse and Alcohol Female Alcohol Use xv

xvi   Guide to Related Topics

Special Action Office for Drug Abuse Prevention Special Narcotic Committee United Nations Commission on Narcotic Drugs White House Conference for a Drug-Free America White House Conference on Narcotics and Drug Abuse White House Drug Abuse Policy Office

Court Cases Cipollone v. Liggett Group, Inc. et al. Conant v. Walters Employment Division, Department of Human Resources of Oregon v. Smith Engle v. R.J. Reynolds Ferguson v. City of Charleston Florida v. Jardines Linder v. United States Moncrieffe v. Holder National Treasury Employees Union v. Von Raab Oakland Cannabis Buyers’ Cooperative Raich v. Ashcroft Raytheon v. Hernandez Robinson v. California Skinner v. Railway Labor Executives’ Association United States v. Doremus and Webb et al v. United States United States v. Flores-Montano United States v. Jin Fuey Moy Webb et al. v. United States Drug Trafficking Cali Drug Cartel Colombian Cartels Dadeland Massacre (Miami, Florida) Drug Cartels French Connection Golden Crescent Golden Triangle Guadalajara Cartel

Gulf Cartel Juárez Cartel Medellín Cartel Mexican Drug Trade Sonora Cartel Tijuana Cartel

Drugs Amphetamines Anabolic Steroids Analgesics Antidepressants Barbiturates Bath Salts and Synthetic Cannabis Black Tar Heroin Caffeine Cannabis Coca Coca-Cola Cocaine and Crack Codeine Crack Epidemic Date Rape Drugs Depressants Designer Drugs Dimethyltryptamine (DMT) Drug Classifications Ecstasy (MDMA) Ephedrine and Pseudoephedrine Gutka Hallucinogens Hashish Hemp Heroin Ibogaine Inhalants Ketamine Khat LSD Mescaline Methadone Methamphetamine Morphine Naltrexone

Guide to Related Topics  xvii

Narcotics Nicotine Opiates Opium Over-the-Counter Drugs Oxycodone/OxyContin Phencyclidine (PCP) Patent Medicines Peyote Predatory Drugs Prescription Drugs Prometa Psilocybin and Psilocin (Mushrooms) Psychedelic Drugs Psychotherapeutic drugs Quaalude Sedatives, Hypnotics, and Anxiolytics Shisha Stimulants Synthetic Drugs Syrup THC Tobacco Tranquilizers

Entertainment Bad Boys Blow Cocaine Cowboys Electronic Dance Music (EDM/House Music) Entertainers and Drug Use Grateful Dead Haight-Ashbury Hip-Hop and Drugs Hoffman, Philip Seymour Jazz Culture National Youth Anti-Drug Media Campaign Popular Culture Reefer Madness Scarface Television and Drugs White, Walter

Interest Groups Common Sense for Drug Policy Drug Free America Foundation Drug Policy Alliance Network Families Against Mandatory Minimums Mothers Against Drunk Driving (MADD) National Association of State Alcohol and Drug Abuse Directors National Organization for the Reform of Marijuana Laws Students Against Destructive Decisions (SADD) International Bureau of International Narcotics and Law Cabinet Committee on International Narcotics Law Cali Drug Cartel China (Chinese) and Drugs Colombian Cartels Crop Eradication Demand Reduction Drug Cartels Drug Smuggling Drug Trade Drug Trafficking Drug Trafficking and Organized Crime Drug Trafficking Networks Drug Watch International European Committee to Combat Drugs Global Commission on Drug Policy Guadalajara Cartel Gulf Cartel Hague Convention Illicit Drugs and Terrorism Juárez Cartel Medellín Cartel Mexican Drug Trade National Narcotics Border Interdiction System Opium Trade Opium Wars Organized Crime Drug Enforcement Task Force Program

xviii   Guide to Related Topics

Pizza Connection Psychotropic Substances Sonora Cartel Supply-Side Strategy Tijuana Cartel United Nations Commission on Narcotic Drugs United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances United Nations Convention on Psychotropic Substances United Nations International Conference on Drug Abuse and Illicit Trafficking United Nations International Day Against Drug Abuse and Illicit Trafficking United Nations Office on Drugs and Crime United Nations Single Convention on Narcotic Drugs United Nations Surveys on Crime Trends and Operations of Criminal Justice Systems United States International Drug Control Efforts World Federation Against Drugs World Narcotics Conference

Law Enforcement Asset Forfeiture Bureau of Alcohol Tobacco, Firearms and Explosives (ATF) Camarena Salazar, Enrique Central Intelligence Agency (CIA) Drug Czar Drug Enforcement Administration (DEA) Extradition Fast and Furious Federal Bureau of Investigation (FBI) Federal Bureau of Narcotics (FBN) Food and Drug Administration (FDA) High-Intensity Drug-Trafficking Areas (HIDTAs) National Narcotics Border Interdiction System

Office for Drug Abuse Law Enforcement Organized Crime Drug Enforcement Task Force Program United States Bureau of Narcotics and Dangerous Drugs (BNDD) United States Coast Guard United States Customs and Border Protection United States Immigration and Customs Enforcement (ICE)

Legislation Alcohol, Drug Abuse, and Mental Health Reorganization Act (1992) Andean Trade Preference Act (1991) Anti–Drug Abuse Acts Aviation Drug-Trafficking Control Act (1984) Boggs Act (1951) Boylan Act (1914) Combat Methamphetamine Act (2005) Compassionate Use Act (1996) Comprehensive Drug Abuse Prevention and Control Act (1970) Comprehensive Methamphetamine Control Act (1996) Controlled Substances Act (1970) Crime Control Act (1990) Drug Abuse and Treatment Act (1972) Drug Abuse Control Amendments (1965) Drug Interdiction and International Cooperation Act (1986) Drug Kingpin Death Penalty Act (1988, 1994) Drug Reform Act (1986) Drug-Free America Act (1986) Drug-Free Schools and Communities Act (1988–1989) Fair Sentencing Act (2010) Federal Alcohol Administration Act (1935) Food, Drug, and Cosmetic Act (1938) Harrison Narcotics Act (1914) International Narcotics Control Act (1989) Marihuana Tax Act (1937)

Guide to Related Topics  xix

Narcotic Addict Rehabilitation Act (1966) Narcotic Control Act (1956) Narcotic Drugs Import and Export Act (1922) National Minimum Drinking Age Act (1984) Opium Control Act (1942) Porter Narcotic Farm Act (1929) Pure Food and Drug Act (1906) Smoking Opium Exclusion Act (1909) Substance Abuse Services Amendments (1986) United States National Narcotics Control Act (1956) Violent Crime Control and Law Enforcement Act (1994) Volstead Act (Eighteenth Amendment) Webb-Kenyon Act (1913)

Marijuana/Medical Marijuana Campaign Against Marijuana Planting Cannabis Conant v. Walters Legalized Marijuana Marihuana Tax Act (1937) Marijuana Marijuana Businesses Medical Marijuana Oakland Cannabis Buyers’ Cooperative Reefer Madness THC Movies. See Entertainment Music Brown, Bobby Cobain, Kurt Electronic Dance Music (EDM/House Music) Grateful Dead Haight-Ashbury Hendrix, Jimi Hip-Hop and Drugs Jazz Culture

Jackson, Michael Joplin, Janis Popular Culture Presley, Elvis

People Alpert, Richard Anslinger, Harry J. Armstrong, Lance Barry, Marion S. Bennett, William Bias, Len Blanco, Griselda Brown, Bobby Bush, George H. W. Bush, George W. Clinton, Bill Cobain, Kurt Dai, Bingham Dole, Vincent Eisenhower, Dwight C. Elders, Joycelyn Escobar, Pablo Farley, Chris Ford, Betty Ford, Gerald R. Freud, Sigmund Ginsberg, Allen Guillot-Lara, Jaime Harrison, Francis Hendrix, Jimi Hoffman, Philip Seymour Hofmann, Albert Hoover, J. Edgar Jackson, Michael Jellinek, E. Morton Johnson, Lyndon B. Jones, Marion Joplin, Janis Jung, George Kennedy, John F. Koop, C. Everett Leary, Timothy Leonhart, Michele M.

xx   Guide to Related Topics

Lincoln, Abraham Lindesmith, Alfred McCoy, Bill Meese, Edwin Mullen, Francis Nadelmann, Ethan Nixon, Richard M. Noriega, Manuel Antonio Nutt, Levi G. Nyswander, Marie Obama, Barack Porter, Stephen G. Presley, Elvis Randall, Robert Reagan, Ronald, and Nancy Reagan Ruffin, David Rush, Benjamin Sertürner, Friedrich Shulgin, Alexander Smith, Robert “Dr. Bob” Holbrook Soros, George Terry, Luther Truman, Harry S. Vollmer, August Volstead, Andrew White, Walter Wilson, William “Bill” Griffith Wright, Hamilton

Prevention Drug Abuse Resistance Education (DARE) Intervention Prevention Drug-Free School Zones Research Centers for Disease Control and Prevention Drug Abuse Warning Network International Narcotics Research Conference Investigational New Drug Program National Clearinghouse for Drug Abuse Information and Education

National Council on Alcoholism and Drug Dependence National Household Survey on Drug Abuse National Research Council on Drug Enforcement Activities Substance Abuse and Mental Health Services Administration (SAMHSA)

Social and Cultural Issues African Americans and Drug Use Alcohol-Facilitated Sexual Assault Biological and Psychological Reasons for Substance Abuse Child Sexual Abuse and Substance Abuse Children of Alcoholics Codependency Counterculture and Drugs Domestic Abuse and Drugs Drug Intervention Programs Drug-Facilitated Rape Fetal Alcohol Syndrome (FAS) Intervention Hippies Latinos and Drug Use Military and Drug Use Native Americans and Substance Abuse Popular Culture Prison Inmates and Drug Use Public Opinion and Drug Use Recreational Use of Drugs Rural Drug Use Seniors and Drug Use Steroids in Baseball Steroids and Sports Women, Pregnancy, and Drugs Women, Victimization, and Substance Abuse Youth and Illicit Drug Use in the United States Temperance American Temperance Society Anti-Saloon League

Guide to Related Topics  xxi

Association Against Prohibition Amendment Eighteenth Amendment Prohibition Prohibition Party Prohibition Unit Temperance Volstead Act Woman’s Christian Temperance Union Women’s Organization for National Prohibition Reform (WONPR)

Tobacco Adolescent Tobacco Use Cigarettes Cigars Cipollone v. Liggett Group, Inc. et al. E-Cigarettes Master Settlement Agreement Nicotine Female Tobacco Use Secondhand Smoke Smokers’ Rights Tobacco Tobacco Institute Treatment Addiction Medications Al-Anon Ala-Teen Alcoholics Anonymous Alcohol Mutual Aid Societies Alternative Addiction Treatment American Society of Addiction Medicine

Betty Ford Center Cocaine Anonymous Drug Courts Drug Intervention Programs Harm Reduction Programs Hazelden Foundation Intervention LifeRing Mandatory Treatment Methadone Methadone Treatment Programs Minnesota Model Narcotics Anonymous Needle Exchange Programs Phoenix House Public Health Service Narcotic Hospitals Recovery Recovery Circles Synanon Treatment Twelve-Step Programs Urinalysis

Youth Adolescent Tobacco Use Child Sexual Abuse and Substance Abuse Electronic Dance Music (EDM/House Music) Hip-Hop and Drugs National Youth Anti-Drug Media Campaign Parents Resource Institute for Drug Education (PRIDE) Surveys Youths and Illicit Drug Use in the United States

Q in domestic secret libraries or smuggled into the country from secret labs in other countries. Historically methaqualone was first synthesized in the 1950s in India. It was introduced in America in the early 1960s and became a popular recreational drug by the late 1960s. In 1973 the drug was placed on Schedule II, which prohibited possession and prescription of the drug. Other formal names of Quaalude include Cateudil, Dormutil, Hyminal, Isonox, Melsed, Melsedin, Mequelone, Mequin, Methadorm, Mozambin, Optimil, Parest, Renoval, Somnafac, Toquilone Compositum, Triador, Tuazole. Quaalude also has informal names that include: bandits, Beiruts, blou bulle, disco biscuits, Ewings, flamingos, flowers, genuines, Lemmon 714, lemons, Lennons, lovers, ludes, mandies, Qua, Quaaludes, quack, quad, randy mandies, 714, soaper, sopes, sporos, Vitamin Q, and wagon wheels. Ron Chepesiuk

Quaalude “Quaalude” is a brand name under which the synthetic depressant methaqualone has been sold. Once thought to be nonaddictive and safer than other drugs, Quaalude was originally prescribed for daytime sedation and to help people sleep. It was seen by many doctors as a viable alternative to barbiturates. It gives users a pleasant feeling, as if they are drunk. There was widespread abuse of the drug and high demand on the black market, especially on college campuses. Many students would mix Quaalude with wine, in a mixture called “luding out.” It also was given the nickname “love drug” because it lowered a user’s inhibitions for sexual behavior. In 1977, 23-year-old Freddie Prinze, from the TV series Chico and the Man, was addicted to Quaalude. He took a dozen pills and then shot himself. Later that year, 42-yearold Elvis Presley died from taking too many drugs, including Quaalude and Valium. In the early 1980s, as more and more people were dying from overdoses, Quaalude was removed from the market and methaqualone was rescheduled as a Schedule I drug, indicating it had no medical use and a high potential for abuse. Subsequently, it became harder to obtain in the United States because of controls that included a 1984 law making their possession illegal except for research purposes. Methaqualone is no longer manufactured by any pharmaceutical company, but it is still available as an illicit drug. The drug is either manufactured

See also: Depressants; Presley, Elvis

Further Reading Carroll, Marilyn. 1985. Quaaludes: The Quest for Oblivion. New York: Chelsea House Publishers. Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly. Gass, Justin T. 2008. Quaaludes. New York: Chelsea House Publishers. O’Brien, Robert, and Sidney Cohen. 1984. The Encyclopedia of Drug Abuse. New York: Facts on File.

781

782  Quaalude “The Quaalude Lesson.” Frontline. http:// www.pbs.org/wgbh/pages/frontline/meth/ faqs/quaaludes.html.

Ziemer, Maryann. 1997. Quaaludes. Springfield, NJ: Enslow Publishers.

R (previously Ashcroft v. Raich, 545 U.S. 1 [2005]). In this decision, the Supreme Court justices decided that Congress has the right to regulate interstate commerce. Further, Congress can also prohibit the possession of marijuana when state law permits medical use of the drug and the substance is grown and used locally and noncommercially through their power to regulate commerce. By banning patients from growing their own marijuana for medical use, it was a way for Congress to prevent or limit access to marijuana use for all purposes. The justices held that Congress’s Commerce Clause power extended to intrastate, noncommercial possession or cultivation of marijuana because of the potential impact that medical use of marijuana could have on the national market for the product. In making this decision, the justices struck down the California law that exempted patients or caregivers from criminal prosecution if they possessed or grew marijuana for medicinal purposes if it was recommended or approved by a physician. They pointed out that federal drug laws did not include such an exemption. The justices explained that under the Controlled Substances Act, marijuana is a Schedule I drug and is therefore strictly regulated by the federal government. They decided that the Commerce Clause can be applied to individuals in California who grow marijuana for their own personal, medical reasons. Additionally, under the Supremacy Clause, the federal regulation of marijuana superseded any state laws. The court found that the medical marijuana law in California did not provide

Raich v. Ashcroft (2003) In August 2002, the Drug Enforcement Administration raided the residence of Diana Monson, where Angel Raich was living at the time. Monson and Raich both suffered from serious medical conditions and used medical marijuana regularly to relieve their symptoms. Angel Raich was the wife of a lawyer for the Oakland Cannabis Buyers’ Cooperative, Robert Raich. After the raid, Raich argued that the federal government violated the defendants’ Fifth, Ninth, and Tenth Amendment rights, as well as their rights under the Commerce Clause of Article 1 of the Constitution. Specifically, Raich argued that the attorney general of the United States, John Ashcroft, inappropriately seized the patients’ marijuana that was privately grown by patients and caregivers inside the state of California. Raich further argued that Ashcroft violated the defendants’ civil rights and the law by harassing, raiding, arresting, and prosecuting Raich and others. Raich lost her case in District Court (248 F. Supp. 2d 918 [ND Cal. 2003]) when the justices decided that the federal agents acted appropriately in upholding federal law. She then filed an appeal in March 2003 in Ninth Circuit Court of Appeals. The Ninth Circuit Court reversed the decision of the district court (352 F 3d 1222 [2003]). The case was then appealed further. In 2004, the Supreme Court agreed to hear the case. In 2005, the Supreme Court ruled against Raich (545 U.S. 1) in a 6–3 vote. The case was now Gonzales v. Raich 783

784   Randall, Robert (1948–2001)

a federal defense if an individual is arrested for growing or possessing marijuana. In other words, all marijuana activity in California is illegal and subject to federal prosecution. During the process, the Partnership for a Drug Free America and the Community Rights Council government filed amicus curiae briefs with the court to support the position held by the federal government. Other briefs were filed in favor of the defendants by the Cato Institute, the Institute for Justice, NORML, libertarian organizations, and other groups that were opposed to the War on Drugs. The governments of California, Maryland, and Washington also filed briefs supporting the defendants. The attorneys general of Alabama, Louisiana, and Mississippi filed a brief supporting the defendants on the grounds of states’ rights. Nancy E. Marion See also: Controlled Substances Act; Medical Marijuana; Oakland Cannabis Buyers’ Cooperative

Further Reading Cohen, Peter J. 2006. “Medical Marijuana, Compassionate Use, and Public Policy: Expert Opinion or Vox Populi?” Hastings Center Report 36(3): 19–22. Kreit, Alex. 2003. “The Future of Medical Marijuana; Should the States Grow Their Own?” University of Pennsylvania Law Review 151(5): 1787–826. Marion, Nancy E. 2013. The Medical Marijuana Maze. Durham, NC: Carolina Academic Press.

Randall, Robert (1948–2001) Robert Randall was diagnosed with glaucoma at age 24. Doctors told him that the disease would cause him to be totally blind before he turned 30. His medical doctors

gave him prescription drugs to help the pain, but nothing worked. He soon discovered that his symptoms were relieved after smoking marijuana. He began to grow marijuana plants as a way to supply himself with the drug, and was arrested in August 1975 for possession and cultivating marijuana. Using the Common Law Doctrine of Necessity to defend his actions in court (i.e., claiming that there was a justification for breaking the law and that there was no reasonable alternative; he should not be held liable for his actions because the act was necessary to prevent a greater harm), he convinced a federal superior court that it was a medical necessity for him to use marijuana to treat his medical condition. In 1976, he brought charges against the Food and Drug Administration (FDA), the Drug Enforcement Administration, the National Institute on Drug Abuse, the Department of Justice, and the Department of Health, Education, and Welfare. The criminal charges against Randall were eventually dropped, and in 1976 he became the first American to gain legal access to marijuana for medical purposes. At that time, the federal government began providing him with FDA-approved medical marijuana. With that, he became the first American to receive marijuana from the federal government for the treatment of a medical disorder. He received his first shipment of government cannabis in November 1976. The marijuana was sent through the U.S. mail to a doctor’s office. The doctor purchased a 250-pound safe in which the marijuana was stored. Randall would go to the doctor’s office when he needed the drug. Two years later, the federal government tried to halt the shipments, but he sued and won. He became a long-term user of marijuana, and over those years, the marijuana use helped to prevent Randall from going totally blind. Randall was diagnosed with

Raytheon v. Hernandez (2003)  785

AIDS in November 1994, and died on June 2, 2001, at the age of 52 because of complications related to the disease. Randall felt obligated to help others who suffered from glaucoma and other diseases such as cancer. He worked to expand the right for other ill people to have access to medical marijuana. He assisted doctors and other groups learn more about the medical effects of marijuana. He worked with UCLA’s Marijuana Research Project, and Johns Hopkins and Chapel Hill Duke University Eye Center. Through this research, he discovered that oral THC and smoked marijuana had different effects on the body. He often appeared in the news media and gave interviews as a way to educate the public and to get support for medical marijuana. He fought for state ballot initiatives that would allow for medical marijuana, including ones in New Mexico, Florida, Louisiana, Illinois, West Virginia, and Virginia. He also joined the fight to change the federal law to recognize medical marijuana. Randall and his wife, Alice O’Leary, founded the Alliance for Cannabis Therapeutics and the Marijuana AIDS Research Service. Nancy E. Marion See also: Marijuana; Medical Marijuana

Further Reading Randall, Robert C., and Alice M. O’Leary. 1998. Marijuana Rx: The Patients’ Fight for Medicinal Pot. New York: Thunder’s Mouth Press.

Raytheon v. Hernandez (2003) In this case, the Supreme Court held that a blanket no rehire policy by a company against former employees with personal

conduct violations was not disparate treatment under the Americans with Disabilities Act (ADA) against those discharged for testing positive for drug use. In particular, it ruled that the use of a disparate impact test by the Ninth Circuit was inappropriate in a disparate treatment analysis. “Disparate treatment” means that “the employer treats some people less favorably than others because of their race, color, religion, sex, or [other protected characteristic]” (Teamsters v. United States, 431 U.S. 324, 335, n. 15 [1977]). “Disparate impact” means that the employment policy is neutral on its face to people of different characteristics but that it falls more heavily on one group than another without any business necessity justification. The case revolved around Joel Hernandez, who worked as a product test specialist for Hughes Missile Systems (“the company”) until July 11, 1991. At this time, he was given a drug test and the results indicated that he had used cocaine, which he later admitted. Because he violated the company’s workplace conduct rules, Hernandez was forced to resign. His record at the company indicated “discharge for personal conduct.” It stated nothing about drug addiction. On January 24, 1994, with recommendations from his pastor and an Alcoholics Anonymous counselor, Hernandez applied to be rehired by the company. He noted in the application that he had previously worked with the company, so the application reviewer, Joanne Bockmiller of the company’s Labor Relations Department, examined why Hernandez left. Bockmiller stated that the company had an unwritten policy against rehiring employees fired for workplace misconduct, so she rejected Hernandez’s application. After the rejection, Hernandez filed a charge of discrimination with the Equal Employment Opportunity Commission (EEOC) for violation of the ADA. The company

786   Raytheon v. Hernandez (2003)

responded to the EEOC that the ADA exempted from protection those who illegally used drugs and that there was no evidence of rehabilitation. Based on the presence of the recommendations, however, the EEOC decided that there was reasonable cause to believe that Hernandez was not hired based on a disability and issued him a right-to-sue letter. Throughout the discovery phase of the civil proceeding, Hernandez argued only the disparate treatment theory that the company rejected his application because he was a drug addict. During summary judgment proceedings, however, he raised the new theory that even if the company neutrally applied a no rehire policy to all who violated personal conduct rules, such a policy would have a disparate impact against former drug users and so violate the ADA. The district court summarily judged against Hernandez’s disparate treatment theory and refused to consider the disparate impact claim because it was made in an untimely fashion. The Ninth Circuit Court of Appeals reversed the decision of the district court. Although it agreed with the district court on the untimeliness of the disparate impact claim, the circuit court disputed the district court’s findings on the disparate treatment claim. In particular, it held that despite the facial lawfulness of the company’s no rehire rule, it was unlawful when applied to former drug addicts whose only offense was testing positive for drug use. In particular, the Ninth Circuit stated that the policy screened out people with a record of addiction (see Grano v. Department of Development of Columbus, 637 F.2d 1073, 1081 [C.A.6 1980]) and that the company had raised no business necessity defense. The case was then appealed to the U.S. Supreme Court, which agreed to hear the case. By a 7–0 decision, the Supreme Court

vacated the decision and remanded it back to the lower courts. Justice Thomas, writing for the court, stated that the Ninth Circuit had used a disparate impact analysis on a disparate treatment claim. The Grano screening standard, as stated in the case, applied only to disparate impact claims, as did the requirement of a business necessity justification under Teamsters. He stated that the company policy was legitimate and nondiscriminatory under the ADA as far as disparate treatment was concerned. The only rightful question remaining to the Ninth Circuit, according to Thomas, was whether sufficient evidence existed for the jury to possibly conclude that the company’s stated reason for the rejection was pretext. On remand, the Ninth Circuit Court determined that there was sufficient evidence for a jury to conclude that the company’s stated reason for the rejection of the hiring application was pretext and without credence (Hernandez v. Hughes Missile Systems Co., 362 F.3d 564 [9th Cir. 2004]). It reviewed Hughes’s statements, the company’s favorable written policies for part-time and temporary workers, and the fact that nobody from Hughes could identify the origin and scope of the original policy and concluded that a jury could conclude, as an issue of material fact, that the policy was not considered in the rehiring decision. Since there was a genuine issue of material fact, the circuit court maintained its reversal of the district court’s grant of summary judgment. Nancy E. Marion See also: Alcoholics Anonymous; Drug Addiction and Public Policy

Further Reading “Raytheon Co. v. Hernandez.” Legal Information Institute. http://www.law.cornell.edu/ supct/html/02–749.ZO.html.

Reagan, Ronald (1911–2004), and Nancy Reagan (1921– )  787 “Raytheon v. Hernandez.” Oyez. http://www.oyez .org/cases/2000–2009/2003/2003_02_749/. “Raytheon v. Hernandez.” Leagle. http://www. leagle.com/decision/2003584540US44 _1580.

Reagan, Ronald (1911–2004), and Nancy Reagan (1921– ) More than any other presidency in U.S. history, the tenure of Ronald Reagan (and his wife, Nancy) in the White House marked a high point in presidential enthusiasm in the War on Drugs. Both enthusiastic in his desire to eradicate the drug problem, and shrewd enough to use the drug problem as an issue that he could capitalize on for political gain, Reagan brought the U.S. campaign against illicit drugs to new heights. Before Reagan entered the White House in 1980, the United States had already been waging a campaign against illicit drug use for nearly a century. As far back as 1914, when the Harrison Narcotics Act first placed federal restrictions on the transfer and use of opiates and cocaine, the federal government had sought to limit drug use and trafficking, and pieces of legislation such as the 1951 Boggs Act, the 1956 Narcotic Control Act, and the 1970 Comprehensive Drug Abuse Prevention and Control Act created a progressively tougher, more thorough drug control regime in the United States. In spite of these measures, rates of drug use grew from the 1960s through the 1980s, particularly with the rise of amphetamine, cocaine, and crack use. From the beginning of his presidency, Reagan sought to tackle the drug problem head-on, with a focus on cutting off illicit supplies of narcotics through international efforts abroad and tougher penalties for drug-related offenses at home. Reagan believed that illicit drugs

represented one of the gravest dangers facing the nation, and promised to establish a policy to crack down on illicit drug production and trafficking. In the early 1980s, he announced a plan to hire 900 new drug law enforcement agents and 200 more federal prosecutors, to establish drug task forces in major cities, and to build $150 million worth of new prisons to house drug-law offenders. In particular, Reagan targeted the growing drug trade in the Miami area, creating a new task force led by Vice President George H. W. Bush to address the problem in 1982. Reagan sent a slew of federal law enforcement agents to South Florida, bolstering the presence of the Federal Bureau of Investigation; the Customs Service; the Bureau of Alcohol, Tobacco and Firearms; and the Internal Revenue Service in order to investigate drug-related crimes, stop the proliferation of weapons in the drug trade, and crack down on money laundering operations. By 1985, the government had seized 25 tons of cocaine and 750 tons of marijuana in South Florida, though it is questionable how successful the task force was, since the street price of cocaine in the region dropped dramatically at the same time the government was carrying out its intensive operations there. To help better coordinate the nation’s drug control efforts, Reagan put the FBI in charge of drug enforcement and investigations, giving it authority over the Drug Enforcement Administration. In 1981, he authorized intelligence agencies to investigate and take an active role in breaking up international drug rings. He also issued an executive order in 1982 that strengthened the Office of Policy Development to help the president oversee prevention, treatment, and rehabilitation programs. To further enhance drug law enforcement, Reagan also convinced Congress to amend the law so the Department

788   Reagan, Ronald (1911–2004), and Nancy Reagan (1921– )

U.S. president Ronald Reagan at his desk in the White House. Reagan took a very conservative approach to drug control, and along with his wife, Nancy, supported the anti-drug “Just Say No” program for children. (Library of Congress)

of Defense could provide military training, intelligence, and equipment to law enforcement agencies when they went after drug traffickers, and he also enabled members of the Army, Navy, Air Force, and Marines to operate military equipment for civilian law enforcement agencies carrying out drugrelated operations. In 1982, these arrangements were codified by law with the passage of the Department of Defense Authorization Act. The 1984 Comprehensive Crime Control Act strengthened the interdiction efforts of drug law enforcement authorities, and the Controlled Substances Registration Protection Act of that same year increased penalties for stealing drugs regulated by the Comprehensive Drug Abuse Control and Prevention Act from pharmacies. The 1984 Bail Reform Act made it more difficult for individuals accused of breaking drug laws to get out on bail. Reagan also increased the budgets for

drug control dramatically, as funding for drug-law-related programs nearly doubled between 1981 and 1986. Most importantly, the Reagan administration saw the passage of the Anti–Drug Abuse Acts of 1986 and 1988, providing billions of additional dollars to fight drug abuse and trafficking, and stiffening penalties for drug-law offenses. According to the Reagan administration, these measures increased the prices of controlled substances on the black market, a sign that they were becoming increasingly difficult to procure illegally. These domestic measures were bolstered by increased international efforts to crack down on drug production and smuggling, particularly in Latin America. Despite these efforts, however, drug abuse remained a prevalent social problem in the 1980s, and seeing that some of Reagan’s initiatives were not as effective as planned, many intellectuals began advocating for the

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legalization and decriminalization of controlled substances. To complement the supply-reduction efforts of her husband, First Lady Nancy Reagan also became an outspoken leader in the battle against addiction during her time in the White House, most notably with her “Just Say No” public health campaign. The idea behind the campaign was that by teaching children to say “no” to drugs from the start, the government could decrease interest in illegal drugs, and thus cut down on demand, over time. Inspired by Reagan’s campaigning, thousands of “Just Say No” clubs and organizations were established across America. Nancy Reagan, the former actress, also appeared on the ABC situation comedy Diff’rent Strokes to promote the antidrug policy. Though its supporters say the campaign has been good since it spread awareness of the dangers of drugs, critics claimed that it had little impact on rates of drug use, and that it simplified what are the often complex issues surrounding drug addiction. Overall, the presidency of Ronald Reagan saw the War on Drugs reach new heights, as the government toughened laws and increased expenditures in order to crack down on the drug traffic. Though he saw pieces of legislation that expanded treatment options for addicts go through Congress during his presidency, Reagan’s term was one marked by a tough, law-and-order approach to the drug problem that harkened back to the federal government’s strategies in the 1950s. These efforts to address the drug problem with increased law enforcement ultimately yielded mixed, if not ineffective, results, as did the campaign led by Reagan’s wife to discourage youths from experimenting with controlled substances. Ronald Reagan on October 14, 1982, openly stated that illicit drug use was a threat to the national security of the United States.

The term “War on Drugs” used by Reagan was originally coined by Richard Nixon. Reagan in 1988 created the Office of National Drug Control Policy to coordinate drug-related legislative, security, diplomatic, research, and health policy throughout the government. Howard Padwa and Jacob A. Cunningham See also: Anti–Drug Abuse Acts; Drug Addiction and Public Policy; Drug Enforcement Administration; Drug Smuggling; Koop, C. Everett; Mullen, Frances; Terry, Luther

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. Glass, Andrew. 1982. “Reagan Declares ‘War on Drugs,’” Politico, October 14. http://www.politico.com/news/stories/ 1010/43552.html. Musto, David F., ed. 2002. Drugs in America: A Documentary History. New York: New York University Press. Reagan, Nancy. 1989. My Turn: The Memoirs of Nancy Reagan. New York: Random House. Reagan, Ronald. 1982. “Radio Address to the Nation on the Federal Drug Policy.” http:// www.presidency.ucsb.edu/ws/?pid=43085# axzz2iZ84KMbF. Reagan, Ronald. 1996. The Uncommon Wisdom of Ronald Reagan: A Portrait in His Words. Boston: Little, Brown and Company. Reagan, Ronald. 2011. An American Life. New York: Simon and Schuster.

790  Recovery Wallace, Chris. 1986. First Lady: A Portrait of Nancy Reagan. New York: St. Martin’s Press.

Recovery The concept of recovery is sometimes difficult to define, because the process (what works) is different for each person. According to Nora Volkow of the National Institute on Drug Abuse, true recovery from addiction starts when the addict begins to reintegrate into society without the need for drugs. It has to do with drug addicts choosing to turn their lives around and make positive changes in their lives. It continues as a lifelong process because the struggle to avoid using drugs is ever-present even though craving will have long since passed. Once addicts have gained a few years of sobriety, they face a special danger: confident that they have beaten their addiction, they let down their guard and experiment with the drug “just this once” to see what will happen. Tragically, most addicts find themselves addicted again. There is no real cure for addiction as there is with other medical diseases. Our knowledge of recovery is limited, and relies more on anecdotal evidence rather than scientific research. During the first few weeks of recovery, once the acute phase of withdrawal and craving has passed, addicts may experience the euphoria that comes with feeling better than they have for a long time. Inevitably, this is followed by a letdown when they discover that sustaining the good feelings in the face of life’s ups and downs is not always possible. This can be a difficult time, especially if they are suffering from anhedonia, a substance-induced neurological condition in which their ability to feel pleasure from much of anything except their drugs is blunted. Treatment counselors

can assure addicts that this is a temporary stage of recovery that occurs while the brain is relearning normal responses to stimuli. There are six steps that have been identified for recovery: (1) Abstaining from alcohol and other drugs; (2) Separating from people, places, and things that promote chemical use and establishing a social network that supports recovery; (3) Stopping compulsive, self-defeating behaviors that suppress awareness of painful feelings and irrational thoughts; (4) Learning how to manage feelings and emotions responsibly without resorting to compulsive behaviors or the use of chemicals; (5) Learning to change addictive thinking patterns that create painful feelings and self-defeating behaviors; and (6) Identifying and changing the mistaken core beliefs about self, others, and the world that promote the use of irrational thinking. Recovery is easier when there are family and social support networks, but, even so, many people have several false starts before they can maintain a year or more of sobriety. It is also easier for younger people; the brain must become rewired for recovery to take place, and young brains, because of their plasticity, adapt to this process more readily. However, research shows that for many people, recovery was achieved through their own choices and strategies rather than through a treatment program. Once withdrawal has been completed and treatment is geared toward any co-occurring disorders, counseling and therapy can help recovering addicts begin to learn new ways of coping and developing new behavioral patterns. Relapses may occur, and although many feel they are signs of failure, treatment specialists insist relapse is a normal part of recovery that merely reinforces the chronic nature of the disease. It takes time to change the brain, and until that happens, many addicts in recovery must make careful choices

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about their activities to avoid triggers to use—even happy triggers like vacations, holidays, and family get-togethers. The term “sobriety” used frequently by addicts and those in the treatment field means more than abstinence from alcohol or drugs. It is a state of mind that former addicts cultivate to bolster their recovery and enrich their lives; it embodies a willingness to grow emotionally and psychologically, to take personal responsibility for managing their disease, and to transform or reject whatever attitudes, behaviors, or relationships helped fuel their addiction in the first place. The beginning phase of recovery involves an alcohol or drug detox to remove any unwanted chemicals from the body. This phase is followed by an intensive addictive recovery therapy, which last mostly between 28 and 90 days. After a successful recovery a rehab support group is needed to keep the addict on track. For many years, the U.S. recovery movement was based on past successes. These studies have built on the experiences of addicts who have successfully “recovered” and used them as resources to develop a better understanding of addiction issues. These programs rely on sobriety (abstinence from alcohol and nonprescribed drugs): improvement in health (physical, emotional, relational), and citizenship (participating in the community). One theory of treatment and recovery for addictions is the therapeutic community (TC). This is one of the first formal treatment approaches that is explicitly recovery oriented. In the TC process, the primary goal of treatment is recovery, which is defined as behavioral changes made by the addict in terms of their lifestyle and identity. These changes may involve abstinence from all nonprescribed drug use, elimination of social deviance, and development of accepted social behavior. In this program, the drug abuse is

viewed as a disorder of the entire person, or the areas of functioning. In other words, when that person took the drug, there were cognitive, behavioral, and mood changes, and even medical problems. There may be changes in moral values. The addition is a symptom of a person’s problems. Moreover, drug abusers are seen as having psychological dysfunction and social deficits that need to be addressed. The goal with TC is to change the negative patterns of behavior, thinking, and feelings that may cause someone to abuse drugs, and develop a responsible, drug-free lifestyle. The key element to TC is the community, which distinguishes it from other treatment methods. This involves the use of the community to facilitate social and psychological change in the abuser. The community must provide physical, social, and psychological context for individuals to change themselves. The community sets the expectations for how an individual should act, then assesses and responds to the individual’s progress. Researchers have also been focusing on the differences in treatment options needed for female addicts. Female addicts may often enter the recovery process with a different set of problems and needs when compared to those of male addicts. Many of the women have been emotionally, physically, and/or sexually abused and thus are in need of treatment apart from their drug use. Many also are involved in sex work as a way to finance their drug addictions or as way to cope with their jobs. Kathryn H. Hollen See also: Addiction; Alcoholics Anonymous; Treatment

Further Reading Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton.

792   Recovery Circles Gorski, T. T. 1990. “The Cenaps Model of Relapse Prevention: Basic Principles and Procedures.” Journal of Psychoactive Drugs 22: 125–33. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2007. The Science of Addiction: Drugs, Brains, and Behavior. NIH Publication No. 07-5605. Yates, Rowdy, and Margaret S. Malloch, 2010. Tackling Addiction: Pathways to Recovery. Philadelphia: Jessica Kingsley Publishers.

Recovery Circles Native American recovery circles represented the first temperance movements in North America. Likely emerging independently of non–Native American temperance efforts, Native American efforts to curb alcohol use began in the 18th century and linked temperance and abstinence to Native revitalization and spiritual revival. Nineteenthcentury Native American alcohol-abuse recovery programs were marked by an incorporation of Christian elements, while 20thcentury efforts have, to a large extent, built off the Alcoholics Anonymous (AA) model. Predating the first temperance movements among European immigrant communities, reports of a Native American “seer” preaching against the use of alcohol among the Shawnee and Onondaga exist from as early as 1737. By the end of that decade, numerous Native American preachers in the Northeast and Great Lakes region were singling out alcohol use as a key factor in the decline of Native traditions. Building upon this linkage between alcohol use and cultural decline, six Delaware Prophets, each of whom utilized

their own tales of recovery from alcohol abuse, fashioned recovery circles, or abstinence-based cultural revitalization movements, which began in the mid-1740s and lasted until the mid-1760s. The most famous of the Delaware Prophets, Neolin, called for abstinence from alcohol as a means of personal purification and cultural unity among Native Americans. In fact, in his plea for abstinence, Neolin saw sobriety as a means of freeing Native peoples from the pernicious influence of whites. Once freed from the oppressive and exploitative grip of alcohol, which Neolin saw as a colonial tool of domination, he believed that Native Americans of the region could recapture a lost unity and forge a kind of pan-Indian identity. Recovery circles of the 18th century thus explicitly linked cultural revitalization to a rejection of foreign influences, with alcohol representing the most dangerous import. In the 19th century, though, abstinencebased, Native American revitalization movements integrated elements of Christianity into their programs for cultural revitalization via abstinence. For instance, the Handsome Lake Code was preached by an alcoholic Seneca named Handsome Lake who nearly drank himself to death. After miraculously recovering from what, according to the reports of the time, appeared to be his death on June 15, 1799, an alive and sober Handsome Lake extolled a code that, among other significant features, centered upon his people’s resurrection and revitalization through sobriety. Unlike the recovery circles started by the Delaware Prophets, however, the Handsome Lake Code, which incorporated a number of Christian elements, such as the tale of his resurrection, became institutionalized and enjoyed a life well beyond that of its founder. The code, also known as the Longhouse Religion, was organized into a formal church, and by 1845 started utilizing

Recovery Circles  793

a standardized approach to dealing with alcohol abuse recovery and prevention, as well as mechanisms for preserving its culture. The Native American Church represented another 19th-century effort to combat alcohol abuse and preserve Native American cultural traditions via the co-opting of Christian traditions. Started by a Comanche known as Quanah Parker, the Native American Church advocated the use of peyote in recovery from alcohol abuse. Like Handsome Lake, Parker was an alcoholic who quit drinking as a result of a near-death experience. Unlike Handsome Lake, however, Parker’s revelation came while under the influence of peyote, and the vision he received was of Jesus Christ instructing him to abstain from alcohol and to encourage his people to use peyote. Parker thus took what had been a practice of the north Mexican tribes, infused it with Christian components, and spread the gospel of peyote-induced, direct experiences of Jesus through a group of itinerant roadmen. Though the use of a controlled substance like peyote may seem a questionable route to sobriety, studies have documented alcoholics successfully abstaining from drink after becoming members of the Native American Church. Peyote is used sparingly within the Native American Church, so members’ ability to quit drinking may well result from the traditional practices and cultural activities in which individuals within the Church are expected to participate. A different 20th-century approach to combating alcohol abuse in Native American communities comes from AA. From its first meeting—the encounter of two alcoholics in 1935—until today, AA has been centered on members standing in front of the group to make personal declarations or tell their life stories. Over time, AA developed its Twelve-Step Program and Twelve Traditions as guiding components, and these texts

reflect, to a certain degree, AA’s Protestant origins. Likely as a result of significant differences between Protestant elements in AA’s makeup and Native American religions and traditions, Native Americans generally did not find traditional AA activities as helpful in their quest for sobriety as other members did. To meet the needs of Native American alcoholics, AA has crafted a Native American version of its Twelve-Step Program that seems to better fit the contours of Native American life and culture, particularly in highly acculturated urban centers. In general, this version of AA incorporates Native American symbols and practices of a pan-Indian nature, and some of AA’s Steps and Traditions are reworded to better reflect Native American religious ideas and motifs. Changes are also made to the typical AA meeting structure in order to better mesh with Native American cultural practices. A more recent development in Native American sobriety programs has been the Wellbriety Movement. Championed and developed by the nonprofit organization White Bison, Wellbriety incorporates the Red Road concept of all Native Americans traveling upon a balanced and harmonious path as a symbol of a clean and detoxified people. In general, Wellbriety and White Bison employ pan-Indian imagery and ideas in working towards community development and traditional well-being via increased Native American sobriety. Howard Padwa and Jacob A. Cunningham See also: Addiction; Alcohol Mutual Aid Societies; Alcoholics Anonymous

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO.

794   Recreational Use of Drugs Coyhis, Don L., and William L. White. 2006. Alcohol Problems in Native America: The Untold Story of Resistance and Recovery. Colorado Springs, CO: White Bison. Humphreys, Keith. 2004. Circles of Recovery: Self-Help Organizations for Addictions. New York: Cambridge University Press. O’Brien, Suzanne J. Crawford, ed. 2008. Religion and Healing in Native America: Pathways for Renewal. Westport, CT: Praeger.

Recreational Use of Drugs More Americans than ever before are using marijuana for recreational use or for enjoyment. This means that they use a drug only for a pleasurable effect or to get “high” as opposed to alleviate a medical symptom or disease. They could be used to alter one’s mood or stave off consciousness. For a short time, the drugs can make a person feel euphoric, relaxed, and powerful. They can take a user away from unpleasantness, unhappiness, and pain. They can help a user escape from stress, or act as a form of rebellion against parents, the government, or society. Or they can help an individual be more outgoing in a social situation. But sometimes the line between medical use and recreational use is blurry. A drug can be prescribed to an individual for a specific reason, such as pain relief. That same drug can also be abused by the patient, or even by someone else. A patient may be given a physician’s prescription for morphine after surgery for pain reduction. That person could take the medicine more often than needed, or could sell it to another person. Recreational drug use became popular in the post–World War II period in the United States. Smoking became sexy, and hav-

ing a drink at lunch was accepted behavior. These were not regarded as taking drugs. But recreational drug use exploded during the 1960s. Youth were experimenting with drugs their parents would not touch. Taking drugs was seen as an act of defiance against the older generation. Marijuana, LSD, and heroin became more accepted, especially in the middle class. In the 1980s, the popular recreational drug was cocaine. Despite concerns about the safety of the drug, current statistics show that about 48 percent of Americans say they have experimented with using marijuana. This is happening despite federal laws that criminalize the distribution and possession of the drug. Many who support the recreational use of the drug rely on the concept of “responsible drug use.” This is the idea that a person can use drugs for relaxation without allowing it to negatively affect other aspects of their lives. Currently, people are legally allowed to use alcohol for recreation or relaxation, and are able to maintain full employment and personal lives. Some argue that recreational drug use is no more of a health risk than other activities such as boxing or car racing. Many Americans feel this should be the same policy regarding marijuana. Washington and Colorado became the first states to legalize recreational marijuana in the November 2012 general election. A resident can possess the drug in limited quality if they are over the age of 21. About 21 states and the District of Columbia have passed some kind of law that legalizes marijuana in some way. Most of these states allow for the medical use of marijuana with a doctor’s recommendation and with other conditions. The potential monetary benefit for federal, state, and local governments is a major

Reefer Madness  795

selling point for legalization or decriminalization of marijuana. It is estimated that marijuana sales could top $10 billion in a few years. The market for the drug and paraphernalia could have a major boost on the economy of a state or local government. Researchers and physicians are concerned about both the short- and long-term effects of the drug on a user’s mind and body. Some physicians have raised concerns about the effect of smoking marijuana on a person’s lungs, or the possibility of cancer-causing agents in the leaves of the plant. The longterm effect on the brain is also unknown. These concerns become even more pressing as new growing techniques have increased the potency of some strains of marijuana. One concern is that these stronger kinds of cannabis may fuel a rise in addiction. However, the federal government does not support clinical trials of marijuana use, either for recreation or for medical purposes, so these effects are not fully understood at this time. Nancy E. Marion See also: Addiction Liability; Cannabis; Hemp; Marijuana; Medical Marijuana

Further Reading Berlatsky, Noah. 2012. Marijuana. Farmington Hills, MI: Greenhaven Press. Ferner, Matt. 2013. “Colorado First State in US to Adopt Rule for Legal, Recreational Marijuana.” Huffington Post, September 10. http:// www.huffingtonpost.com/2013/09/10/color ado-first-state-rules-marijuana_n_3902602 .html. Governing the States and the Localities. 2013. State Marijuana Law Map. http://www.gove rning.com/gov-data/state-marijuana-laws -map-medical-recreational.html. Holland, Julie. 2010. The Pot Book: A Complete Guide to Cannabis: Its Role in Medi-

cine, Politics and Culture. Rochester, VT: Park Street Press. Khamsi, Roxanne. 2013. “Is Recreational Pot Use Safe?” Scientific American. http://www.salon.com/013/05/23/is_ recreational_potuse_sae_partner/print. Lee, Martin A. 2013. Smoke Signals: A Social History of Marijuana—Medical, Recreational and Scientific. New York: Scribner. Pacula, Rosallie Liccardo. 2013. Assessing the Effects of Medical Marijuana Laws on Marijuana and Alcohol Use: The Devil Is in the Details. Cambridge, MA: National Bureau of Economic Research.

Reefer Madness Reefer Madness was a movie made by the U.S. Federal Bureau of Narcotics in 1936 in which a pusher lures teenage students to try marijuana. After using the drug, a murder, a suicide, and a rape occur. The movie was intended to educate the public about the horrors of narcotics. Reefer Madness, originally called Tell Your Children, reflected the prevailing attitude toward marijuana in the 1930s. The movie revolves around a couple, Mae Coleman and Jack Perry, who sell marijuana. Mae’s customers are usually around her own age, whereas Jack sells to teenagers. Ralph Wiley, another drug dealer and former college student, and Blanche help Jack sell marijuana to young people. Students Bill Harper and Jimmy Lane go to Mae and Jack’s apartment. Jack has no marijuana, so Jimmy offers to drive him to buy more. They go to Jack’s supplier. Jimmy asks for a cigarette and instead, he gets a joint. On the way back to the apartment, Jimmy is unable to drive safely and runs over a pedestrian, who later dies. Bill then begins to have an affair with Blanche. Jimmy’s sister, Mary (also Bill’s

796   Reefer Madness

The 1936 movie Reefer Madness was made to teach young people about the dangers of using marijuana. It has since developed a cult following, and was even turned into a musical production. (Bettmann/Corbis)

girlfriend), goes to Mae’s apartment to look for Jimmy. Mary accepts a joint from Ralph, assuming it is a tobacco cigarette. Ralph makes a pass at her. When she refuses, he tries to rape her. Bill comes out of the bedroom, and has a hallucination that Mary stripped for Ralph. Bill attacks Ralph and they begin to fight. As they are fighting, Jack tries to break them up. He hits Bill with the butt of his gun. The gun accidentally fires, killing Mary. To hide his guilt, Jack puts the gun in Bill’s hand, who was unconscious. He wakes Bill up. Bill, seeing the gun in his hand, believes he has shot Mary. While Bill is on trial, Ralph goes insane with guilt. The

film implies that Ralph’s insanity was because of his use of marijuana. The dealer tells Jack to shoot Ralph so he will not tell the police the truth. Later, Jack goes to the apartment and Ralph is there. Ralph senses that Jack wants to kill him, so he kills Ralph by punching him. The police arrest Ralph, Mae, and Blanche. Mae tells the police what really happened, and Bill is released from prison. Blanche is to testify against Ralph, but doesn’t want to, so she commits suicide by jumping out a window. Ralph is then committed to an asylum. The story is told through a principal at a PTA meeting. At the end of the movie, the principal tells parents that this could happen to them. He encourages parents to talk to their children about the dangers of marijuana and drug use. In the 1960s, Reefer Madness became a cult movie among young drug users and abusers when they saw that the movie’s content was completely at odds with the effect that they said marijuana actually had on them. Another similar movie was Marijuana: Weed with Roots in Hell and Devil’s Harvest. The exaggerated message sent in these movies may have undermined the credibility of other warnings issues by the government about other drugs and behaviors. In 2001 an off-Broadway satire of the film was produced, and in 2005, a film, based on the musical, was produced. Ron Chepesiuk See also: Cannabis; Drug Abuse; Federal Bureau of Narcotics; Marijuana

Further Reading Goode, Erich, ed. 1969. Marijuana. Chicago: Atherton. Hoerl, Arthur. 1936. Reefer Madness. San Diego, CA: Legend Films.

Ribbon Reform Clubs  797 Scott, Miller. “Inside Reefer Madness: Background and Analysis.” http://www.newlinet heatre.com/reeferchapter.html. Studney, Dan, and Kevin Murphy. 2008. Reefer Madness: The Movie Musical. New York: Ghostlight Records.

Ribbon Reform Clubs The Ribbon Reform Clubs were a group of abstinence-based societies that provided mutual aid for men who were heavy drinkers. They constituted a major part of the Gospel Temperance Movement of the late 19th century, and members of groups like the Blue Ribbon Movement and the Red Ribbon Reform Club were identifiable by their colored lapel ribbons, which designated their pledge of abstinence from alcohol. Ribbon Reform Clubs could boast of millions taking the pledge by the mid-1880s, but by the end of the decade they were overtaken within the temperance movement by prohibitionist forces. The Blue Ribbon Reform Club began in New England in the early 1870s under the leadership of reformed drinker Joshua Knox Osgood, who underwent a religious conversion experience, ceased drinking, and subsequently persuaded eight of his drinking companions to join him in signing a pledge of abstinence from alcohol. As more men in the group pledged abstinence and mutual support for one another in achieving this goal, members began donning blue ribbons on their lapels to designate their commitment to an alcohol-free lifestyle. As a result of the group’s iconic symbol, they came to be known as “the temperance reform club and blue ribbon movement.” This group blossomed into the Blue Ribbon Movement only after leadership passed from Osgood to Francis Murphy, a harddrinking, Irish Catholic–born hotel keeper

living in Portland, Maine, who found himself in jail in 1870 for violating liquor sales laws. While behind bars, Murphy, like Osgood, underwent a religious conversion that led him to Protestantism and sobriety. Shortly after his release, Murphy began delivering evangelically infused speeches across New England on the virtues of abstinence and quickly convinced throngs of drinking men to take the pledge. He held days-long meetings in public halls that featured personal testimonies from reformed drinkers and, of course, Murphy’s own moving oratory. Inspired men who took the pledge at these revivalist events formed the bases of local Blue Ribbon clubs, so named because Murphy’s followers wore the same symbolic blue lapel ribbon that Osgood had originally introduced. By the 1880s, the Blue Ribbon Movement had grown into hundreds of local chapters spread across 28 states. This remarkable expansion had much to do with Murphy’s nonconfrontational approach within the temperance movement. Guided by the movement’s motto of “With Malice toward None and Charity for All,” Murphy differed from prohibitionists within the movement by refusing to chastise saloon owners or ostracize drunks. Instead, Murphy emphasized the importance of moral suasion, identification with the plight of the drunkard, Christian salvation, and mutual aid. As an alcohol mutual aid society, Blue Ribbon clubs operated in a similar fashion to the Washingtonians, who, in the middle of the 18th century, democratized the temperance movement by appealing to, and identifying with, lower- and middle-class drinkers. Just as the Washingtonians employed moral example, testimonials, and support groups, Blue Ribbon club meetings served as a kind of therapeutic replacement for the saloon and the male camaraderie it provided. And similarly to the Washingtonian model, members of the Blue Ribbon movement found

798   Ribbon Reform Clubs

that providing mutual aid and support to drinkers helped keep themselves abstinent. The Blue Ribbon Movement’s success can also be attributed to its connections to another prominent temperance group, the Woman’s Christian Temperance Union (WCTU). After being invited to Chicago in 1874 by Frances Willard, the WCTU’s president at the time, Murphy made such an impact in the city that 11 new reform clubs sprang up in the city upon his departure. Similarly, within 10 weeks after a speech he delivered on November 26, 1876, in Pittsburgh, 40,000 residents of the city signed a pledge of abstinence and became members of the Blue Ribbon Movement. However, the Blue Ribbon Movement’s most significant expansion took place not in big cities like Chicago and Pittsburgh, but rather in midsized towns and in the West, where the temperance movement previously had little success. While Murphy was able to garner an impressive number of followers after his speeches, the Blue Ribbon Movement had a tougher time keeping its members within the fold, as by the late 1880s, prohibitionism became preeminent within the temperance movement. Another prominent Ribbon Reform Club was the Red Ribbon Reform Club, which, like the Blue Ribbon Movement, was led by a reformed drinker who inspired new members to take a pledge of abstinence. The Red Ribbon Reform Club was founded by Henry A. Reynolds, a physician and surgeon who lost his medical practice as a result of his drinking problem. After signing a pledge of abstinence at a temperance meeting in 1874, Reynolds began speaking about his history with alcohol and launched a reform club of his own in Bangor, Maine, either in 1874 or 1875. With the motto of “Dare to Do Right,” Reynolds’s club held meetings that resembled those of Blue Ribbon clubs in their emphasis on mutual support, a male camaraderie

to replace the saloon experience, and the importance of Christianity in remaining sober. And Reynolds’s clubs, again like Murphy’s movement, soon expanded as a result of its collaboration with the WCTU, which began in 1876. Club meetings would typically take place on weeknights, with public WCTU meetings held on weekends. In the same year that Reynolds partnered with the WCTU, he adopted a red lapel ribbon as the club’s symbol of membership and abstinence. As the Red Ribbon Reform Club, Reynolds’s movement spread to the Midwest, and it did so with the support of the YMCA, as well as Methodist, Congregationalist, and Baptist churches. Reynolds did not, however, team up with prohibitionist elements within the temperance movement, and perhaps as a result, the Red Ribbon Reform Club faded in significance by the late 1880s. Ribbon Reform clubs such as the Blue Ribbon Reform Movement and the Red Ribbon Reform Club began as small clubs in the 1870s and blossomed into alcohol mutual aid societies with millions of members pledged to abstinence within a decade. By the end of the 1880s, however, Ribbon Reform Clubs were overtaken within the temperance movement by prohibitionist forces, in particular the Anti-Saloon League of America. Howard Padwa and Jacob A. Cunningham See also: Alcohol Mutual Aid Societies; AntiSaloon League; Prohibition; Woman’s Christian Temperance Union

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press.

Risk Factors for Drug Use  799

Risk Factors for Drug Use Those who suffer from drug use, drug dependence, or drug addiction often suffer from multiple and often interrelated sociological, biomedical, and psychological factors. The following review describes some of the major considerations. The environment where a person lives can be a major influence on their behavior regarding the use and abuse of drugs. If a person lives in an environment that is poverty stricken and deteriorating, there is a good chance that there will be drug use present. Those who live in these neighborhoods typically have other personal and family problems that may contribute to drug use. The disproportionate amount of crime and drug problems that are prevalent among low-income people and families has been widely covered by sociological research and literature. Such problem behavior, however, is also common to those who reside in middle- and upper-class neighborhoods. Facts and statistics clearly indicate that drug use and abuse are problems that are common across all social classes. A person’s family situation plays a major role in shaping their personality and behavior. Events such as a parental divorce, arrest, a lack of closeness between parents and children, parent and sibling drug use, family disorganization, mental illness, low educational aspirations for the children, lack of parental involvement in the child’s activities, weak parental control and discipline, death or absence of a parent, and emotional, physical, and/or sexual abuse are factors that have been found to be linked to drug use. If a person experiences more of these factors, they are more likely, then, to turn to drugs as a coping mechanism. A person’s relationship with their peers is often linked to possible drug use patterns. If a person’s friends are using drugs, a person

may be more prone to use drugs. This can occur on two levels. First, they can learn how to use drugs (how to purchase them and from whom, how to inject them or smoke them), but they also learn about the drug subculture. Thus, drug use can be learned through a person’s associations and interactions with others who may already be involved with drug use. A person’s peer interactions may become a means by which a person can receive emotional gratification, recognition, reinforcement, security, self-protection, and defense for problem behavior. A person’s association with substance-using peers tends to be a very strong predictor of substance use. The school has a significant role in the socialization process of young people, and thus, it can be an important factor associated with possible drug use. Research shows that the relationship between a negative school experience and drug use is strong. For example, if a young person has negative attitudes toward school, accompanied by low academic achievement and aspirations, especially if they are accompanied by disciplinary problems, they may be more likely to use drugs. Furthermore, if a teen is frequently absent from school, it may be more likely that they will use drugs. Some would argue that a teen who listens to music with drug themes or watches television shows that contain drug themes will be more likely to use drugs. Since motion pictures and television have become a major source of entertainment, the effects of the media on behavior have been the subject of much public concern. It has long been recognized that movies, television, and popular music portray an excessive amount of drug-use behavior and make it acceptable. Further, research has found that youths who spend more time watching television and listening to drug-related music are more likely to use drugs.

800   Robinson v. California (1962)

The labeling process is a method that may impact the likelihood of using drugs. Some users are labeled as deviant simply because they do not share the values or adhere to the social norms regarding personal conduct and attributes that are defined by society. Although the process of identifying deviance involves the use of normative definitions that may vary over time, the essential nature of deviant behavior associated with the use of drugs and problem behavior is that it reflects a departure from the norms of a particular society. Once a person is labeled as a drug user, it is difficult to escape that persona. When it comes to drug behavior, it seems that a cyclical pattern of events tends to occur. Drug use takes place, resulting in labeling of the individual, which in turn leads to more deviations, more penalties, and still more deviations. All the while, hostilities and resentment are built up, culminating in official reactions that continue to label and stigmatize the user. This situation is often used by authorities to justify even greater penalties that reduce offenders’ noncriminal options and coerce them into a career of systematic norm violations, including drug use. Certain individuals are predisposed to using drugs because of their genetic makeup. It appears that addiction patterns run in families. This can be made worse when genetic factors are mixed with poor environmental and personality factors. This can lead to a significantly higher level of drug abuse or alcoholism in certain individuals or groups of people. The National Institute of Drug Abuse reports that genetic factors play a major role in the progression from drug use to abuse and dependence. Richard E. Isralowitz See also: Addiction Liability; Addictive Personality; Alcohol Use; Drug Abuse; Biologi-

cal and Psychological Reasons for Substance Abuse

Further Reading Mayo Clinic. “Drug Addiction: Risk Fact­ors.” http://www.mayoclinic.org/diseases-cond itions/drug-addiction/basics/risk-factors/ con-20020970. National Institute on Drug Abuse. “Preventing Drug Use among Children and Adolescents (In Brief): What Are Risk Fac tors and Protective Factors?” http://www .drugabuse.gov/publications/preventing -drug-abuse-among-children-adolescents/ chapter-1-risk-factors-protective-factors/ what-are-risk-factors. Time to Act: The Partnership at Drugfree. org. “Is Your Teen at Risk for Drug Use: Risk Factors.” http://timetoact.drugfree.org/ think-learn-risk-factors.html. Wright, Douglas A., and Michael Pemberton. 2004. “Risk and Protective Factors for Adolescent Drug Use: Findings from the 1999 National Household Survey on Drug Abuse.” Rockville, MD: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies.

Robinson v. California (1962) In this case, 370 U.S. 660 (1962), the Supreme Court ruled under the Eighth and Fourteenth Amendments that drug addiction could not be classified as a crime. This case started when Officer Brown arrested Lawrence Robinson. Brown thought he saw discoloration, scarring, and needle marks on Robinson’s arms and so took him to the Central Jail in Los Angeles on the grounds that Robinson was an addict. The following morning, Officer Lindquist, a 10year veteran of the Narcotic Division of the

Robinson v. California (1962)  801

Los Angeles Police Department, examined Robinson and came to the same conclusion. Both officers alleged that Robinson had admitted to occasional drug use. California law, § 11721 of the California Health and Safety Code, made addiction to narcotics a criminal offense punishable by at least 90 days in prison. In the Municipal Court of Los Angeles, Robinson claimed that he admitted nothing to the officers and that the marks resulted from an allergic condition. The jury was instructed by the judge that the California statute made either “use” or “addiction” a crime. The judge indicated that “use” meant the act of using and “addiction” meant a status for which the defendant could be found guilty at any time before he reformed. Based on that, the jury found Robinson guilty. Robinson appealed the decision, and the state appeals courts upheld the constitutionality of the conviction. Although Robinson died before his appeal papers were even filed, the Supreme Court heard the case anyway. The decision was written by Justice Potter Stewart. Although the Supreme Court usually construes laws in such a way that saves them from unconstitutionality, Stewart could not constrain the meaning of this law to only the punishment of “use” of drugs because California courts had already ruled on the meaning of the law. Since the state courts had already indicated that the law included punishment for the status of “addiction,” the Supreme Court could not exclude that meaning when considering its constitutionality. While noting that the states had great latitude to control drug use and punish or rehabilitate users, Stewart held that they could not punish a person with criminal sanctions simply because they had a disease. Although the 90-day sentence is not cruel or unusual as a punishment by Eighth Amendment

standards for a crime in the abstract, Stewart noted that it is cruel and unusual when applied to a disease like addiction. By the Fourteenth Amendment, this holding extends to state punishments, like California’s. Justice William O. Douglas, in his concurrence, explained further why he thought treating drug addicts as criminal was cruel and unusual. Drawing on the history of treatment of the insane—which first began as physical punishment before evolving into the management of a disease—Douglas stated that the approach to drug addiction was developing in a similar way. Douglas cited numerous reports and medical experts to demonstrate that expert opinion viewed addiction as a disease. And while the community can punish one who has a disease for a transgression through acts, Douglas stated that it could not punish someone for simply having a disease because it is out of proportion to the offense and therefore cruel and unusual. Justice Tom Clark also presented a dissenting opinion. In his opinion, he wrote that the state, in a study in the 1950s, had already acknowledged drug addiction as a disease and approached the problem systematically. Part of this system was civil commitment, under § 5355 of the California Welfare and Institutions Code, for two months to three years for addiction that went beyond a user’s volitional control. Clark then said, while downplaying the criminal nature of § 11721, that the three-month penalty for addiction was meant to help cure addicts by denying them access to the drug. Justice Douglas countered these assertions in his concurrence, stating that the drafters of § 11721 meant to punish, not to cure, those who the state could not civilly commit under § 5355. Justice Byron White stated in his dissent that the real purpose of the California law was to punish the use of narcotics, and that in barring punishment for addiction, the Court

802   Rockefeller Drug Laws

was opening the way to barring punishment for drug use. In Powell v. Texas, however, the court upheld a Texas law against public intoxication on the grounds that knowledge about alcoholism was inadequate; thus, the potential use of Robinson for restricting punishments on drug use closed. Nancy E. Marion See also: Addiction; Drug Abuse

Further Reading “Robinson v. California.” CaseBriefs. http:// www.casebriefs.com/blog/law/crimin al-law/criminal-law-keyed-to-dressler/ general-defenses-to-crimes/robinson -v-california/. “Robinson v. California.” FindLaw. http://case law.lp.findlaw.com/scripts/getcase.pl?court =us&vol=370&invol=660. “Robinson v. California.” Legal Information Institute. http://www.law.cornell.edu/ supremecourt/text/370/660. “Robinson v. California.” Oyez. http://www.oyez .org/cases/1960–1969/1961/1961_554/.

Rockefeller Drug Laws The Rockefeller drug laws were a set of statutes passed in the New York Legislature during the tenure of Gov. Nelson Rockefeller. The statutes, in whole, had the effect of dramatically increasing the penalties for drug use in the state of New York, and created mandatory minimum sentences for drug users of 15 years to life. The laws were passed in the early 1970s and stemmed from the perceived failures of earlier policies, such as methadone maintenance and other forms of drug treatment. They served, early on, as one of the models for the country, but by the turn of the century, were largely considered a failure, as drug use did

not seem to be affected by the passing of the legislation. The Rockefeller drug laws were developed in a highly politicized context. The public perception of drug use, particularly among African American populations, was that “addicts” and “pushers” were out of control. In particular, heroin was considered a major social problem, and though it was historically associated with poor communities, more white, middle-class youths were becoming addicted. Additionally, with the stress of the Vietnam War, many soldiers were using heroin, of a purity and quality that was much higher than that available within the United States. By the late 1960s, with the social upheaval caused by the civil rights movement as well as the backlash against the Vietnam War, the public was convinced that the nation was headed toward disaster. In 1971, Nixon responded to this social problem by declaring drug abuse “public enemy #1” and officially declared a “War on Drugs.” For the previous decade, beginning with the Metcalf-Volcker Law of 1962, Governor Rockefeller had focused on drug use as a disease, and addicts as those who nee­ ded therapeutic intervention. The MetcalfVolcker Law was designed to allow drug users to avoid long prison sentences thro­ ugh enrolling in therapeutic treatment programs. Another law, signed by Governor Rockefeller, in 1970, allowed methadone maintenance as a strategy for the treatment of drug abuse. However, both of these policies were considered failures, as there were consistent conflicts over where to establish methadone clinics, and few success stories from the program. By the early 1970s Rockefeller had seemingly reconsidered his “treatment” approach to drug use, and began touting more punitive approaches to the problem. In January of 1973, Rockefel-

Rockefeller Drug Laws  803

ler proposed that a new penalty structure for the sale of drugs be introduced. Specifically, he recommended that any sale of hard drugs, regardless of quantity, result in life in prison, and he requested that any opportunities for plea-bargaining or probation/parole be eliminated. Responses to Rockefeller’s proposal ranged widely. Several legislators, and a significant portion of the public, rallied behind the proposal, while national civil rights organizations like the American Civil Liberties Union and Legal Aid strenuously opposed it. Many claimed that it was only introduced because the governor needed to remake his image as a liberal Republican into something more in keeping with a larger, conservative national party. Many from the African American community opposed the proposed legislation, but there were also African Americans who supported the law, particularly those from the middle and upper classes. Despite the staunch opposition to the harsh penalties imposed by the laws, the legislation passed the state legislature with relative ease. While many of the critics of the law were treatment experts or those with other professional expertise, politicians found great traction with the general voting public with the “get tough” rhetoric. Crime, and along with it, harsh penalties for drug use, were becoming a valence issue. The effects of the Rockefeller drug laws were immediate and widespread. Prison populations jumped dramatically. In 1973 there were 14,400 inmates in the New York State prison system. By 2002, there were 70,700—an increase of 500 percent in less than 30 years. Additionally, the rate of incarceration increased dramatically during the same period, with approximately 3.75 of New York’s population being imprisoned. That represented the highest rate in the state’s history. The high impact of drug of-

fenses held true, even when accounting for the overall crime drop in New York during the late 1990s. In addition to affecting the population of the state of New York, the Rockefeller drug laws also had a much wider-ranging impact. Similar laws were quickly adopted in places like Michigan, which had a set of nearly identical policies in place by the following year. Over the next several, many more states adopted similar laws or three-strikes-style laws, with dramatically increasing severity of punishment for additional offenses. As was the case in New York, the Rockefeller-style laws in other places had a dramatic effect on incarceration rates. The nation’s prison population went from 330,000 in 1973 to 2.3 million in 2010, and despite generalized widespread support at the outset, the laws lost much traction over subsequent years, as many saw them as failures. In 2009, New York overhauled the Rockefeller drug laws, reducing punishments across the board, and doing away with many of the provisions that were originally considered essential to the laws. Critiques of the Rockefeller drug laws are wide ranging. Many have claimed that they were ineffective, racist, and costly in terms of both spending on prisons and loss of population due to incarceration. The laws are considered ineffective by many because of the relatively small impact that the increased rates of incarceration seemed to have on drug use. In fact, there was a strong correlation between states that had higher levels of punitiveness (like those states with Rockefeller drug laws–style legislation) with higher levels of drug use. Additionally, the impact of the Rockefeller drug laws has fallen disproportionately on minority communities, despite the well-documented equality of drug use across ethnicities.

804   Rodriguez, Alex (1975– )

The Rockefeller drug laws, passed in the early 1970s, were some of the most punitive pieces of legislation passed since the Boggs Act of 1952. They raised mandatory minimum sentences for possession and sale of illicit substances in New York, and through this, had a large effect on the state’s prison population. In addition, they were used as a model by many states around the country, and are blamed by some for the huge increase in prison population in the United States from 1973 on. Despite the laws’ general popularity at the time of its passing, they are considered by most to have failed, as they did not have the intended effects of reducing the amount of drugs available, and they are considered by many to be racist because of the laws’ disproportionate effect on minority communities. While the original Rockefeller drug laws were repealed or changed in 2009, many similar laws still exist in states around the country, making the Rockefeller drug laws some of the most important pieces of legislation for illegal drugs in U.S. history. Joshua B. Hill See also: Boggs Act; Drug Abuse; Heroin; Methadone; Nixon, Richard M.

Further Reading Alexander, M. 2011. The New Jim Crow: Mass Incarceration in the Age of Colorblindness. New York: New Press. Drucker, E. 2002. “Commentary: Population Impact of Mass Incarceration under New York’s Rockefeller Drug Laws: An Analysis of Years of Life Lost.” Journal of Urban Health: Bulletin of the New York Academy of Medicine 79: 1–10. Fortner, M. J. 2013. “The Carceral State and the Crucible of Black Politics: An Urban History of the Rockefeller Drug Laws.” Studies in American Political Development 27: 14–35.

Gray, M. 2009. “A Brief History of New York’s Rockefeller Drug Laws.” Time. http://content.time.com/time/nation/article /0,8599,1888864,00.html. Kohler-Hausmann, J. 2010. “‘The Attila the Hun Law’: New York’s Rockefeller Drug Laws and the Making of a Punitive State.” Journal of Social History 44: 71–95. Mann, B. 2013. “The Drug Laws That Changed How We Punish.” Morning Edition. http:// www.npr.org/2013/02/14/171822608/the -drug-laws-that-changed-how-we-punish. New York Civil Liberties Union. 2009. The Rockefeller Drug Laws: Unjust, Irrational, Ineffective. New York, NY: NYCLU Press.

Rodriguez, Alex (1975– ) Alex “A-Rod” Rodriguez made his Major League Baseball (MLB) debut in 1994 as a shortstop for the Seattle Mariners. He was drafted out of high school and was the first pick overall. Since then, he has played for the Texas Rangers, and is currently the third baseman for the New York Yankees. It is noteworthy that Alex Rodriguez has received both the first and second largest contracts in the history of the MLB. Once considered to be at least first ballot hall of famer, and possibly the greatest hitter in the history of baseball, since 2007 and the onset of his performance-enhancing drug (PED) scandal, both his reputation and averages have taken a hit. The following is a brief timeline of the history of Rodriguez’s PED scandal dating back to 2007: Dec. 15, 2007: The Mitchell Report outs nearly 100 MLB players as dopers, but Alex Rodriguez is not named. Jose Canseco insists that A-Rod is dirty. Dec. 16, 2007: Rodriguez goes on 60 Minutes to tell Katie Couric he’s never used

Rodriguez, Alex (1975– )  805

Alex Rodriguez, also known as “A-Rod,” is a star third-baseman for the New York Yankees. He admitted to using steroids during his baseball career and was suspended for part of the 2014 season as punishment. (Dreamstime. com)

PEDs. “I’ve never felt overmatched on the baseball field,” he says. Feb. 7, 2009: Sports Illustrated reports Rodriguez tested positive for steroids under the MLB’s anonymous survey testing in 2003 and was warned about tests in advance by players’ union official Gene Orza. Feb. 17, 2009: A-Rod holds a news conference to confess he used steroids in 2001, 2002, and 2003, that he got them from the Dominican Republic, and that his cousin, Yuri Sucart, was involved in procuring them. He says the steroid he used was called “boli” or “bole”—street terms for Primobolan. Feb. 20, 2009: The Daily News reports that A-Rod is close with Angel Presinal, a

trainer banned from baseball after a 2001 incident involving an unmarked gym bag full of steroids. March 7, 2010: Canadian sports guru Anthony Galea, busted sending an assistant across the U.S. border with doping products, confirms he treated Rodriguez but insists he never provided human growth hormone. June 2, 2011: The MLB investigates reports that cousin Yuri is still traveling with A-Rod. Jan. 31, 2013: Rodriguez is linked to Anthony Bosch, founder of the Biogenesis clinic in Miami, a source of PEDs for dozens of pro athletes. April 12, 2013: Sources reveal that A-Rod purchased evidence related to the Miami clinic. While many other players were only suspended 50 games, the MLB originally suspended Rodriguez for 214 games. After challenging that suspension in court, the suspension was limited to 162 games; however, if the Yankees make the playoffs, that suspension will be effective for the playoffs as well. Stated more simply, Rodriguez will be suspended for the entire 2014 season. However, Rodriguez has stated that he plans to continue challenging the suspension. According to Tony Bosch, the inspiration for Rodriguez’s drug use was Manny Ramirez, and Bosch was asked by Rodriguez what drugs Ramirez took in 2008 and 2009. Other rumors have also begun to surface about his reported drug use. According to a Bosch interview, Rodriguez was scared to inject himself, and had others do it for him. That being said, Rodriguez would reportedly take gummies before games that would provide him with a testosterone boost. According to Bosch, Rodriguez wanted to be the first player in the 800-homerun club, the Rodriguez legal camp told Bosch to move to

806   Ruffin, David (1941–1991)

Colombia “until this all blows over,” and that after he turned down the Colombia deal his (Bosch’s) ex-girlfriend received text messages stating that Bosch would “not live to see the end of the year.” Rodriguez had this to say about his suspension: The number of games sadly comes as no surprise, as the deck has been stacked against me from day one. This is one man’s decision, that was not put before a fair and impartial jury, does not involve me having failed a single drug test, is at odds with the facts and is inconsistent with the terms of the Joint Drug Agreement and the Basic Agreement, and relies on testimony and documents that would never have been allowed in any court in the United States because they are false and wholly unreliable. This injustice is MLB’s first step toward abolishing guaranteed contracts in the 2016 bargaining round, instituting lifetime bans for single violations of drug policy, and further insulating its corrupt investigative program from any variety defense by accused players, or any variety of objective review. . . . No player should have to go through what I have been dealing with, and I am exhausting all options to ensure not only that I get justice, but that players’ contracts and rights are protected through the next round of bargaining, and that the MLB investigation and arbitration process cannot be used against others in the future the way it is currently being used to unjustly punish me. I will continue to work hard to get back on the field and help the Yankees achieve the ultimate goal of winning another championship. I want to sincerely thank my family, all of my friends, and of course the fans and many of my fellow

MLB players for the incredible support I received throughout this entire ordeal. Adam Stilgenbauer See also: Steroids and Sports; Steroids in Baseball

Further Reading Nightengale, B. 2013. “Alex Rodriguez Suspended for 2014 Season.” USA Today, January 11. http://www.usatoday.com/story/ sports/mlb/2014/01/11/alex-rodriguez-susp ended-162-games/1586466/ O’Keefe, M., and N. Vinton. 2013. “A Look Back at Alex Rodriguez and His History with Performance-Enhancing Drugs.” Daily News. http://www.nydailynews.com/sports/ baseball/yankees/timeline-a-rod-doping -demise-article-1.1315627. Oz, M. 2013. “11 Fascinating Details We Learned during the ‘60 Minutes’ Story about A-Rod.” Yahoo Sports. http://sports. yahoo.com/blogs/mlb-big-league-stew/11 -fascinating-things-learned-rod-story -60-minutes-075847896—mlb.html.

Ruffin, David (1941–1991) David Ruffin was born in Mississippi in 1941 and began writing songs at a very young age. He was born in Whynot, the third son born to Elian Ruffin, a Baptist minister, and Ophellia. His mother died when he was very young, and therefore was raised by his father who was a Baptist minister. Reportedly Ruffin’s father was a very strict parent who was sometimes physically abusive to the children. Ruffin often sang in the church choir, and, along with his siblings, traveled all over the state as part of a family gospel group. They performed as the opening act for local artists. As his early career began to

Ruffin, David (1941–1991)  807

take off, Ruffin met the likes of Elvis Presley, Berry Gordy, Mahalia Jackson, and Little Richard. At 15, Ruffin went to Hot Springs, Arkansas, with jazz musician Phineas Newborn. He also sang with the Dixie Nightingales and another group called the Soul Stirrers. In 1957 he met Berry Gordy Jr., who was at the time a songwriter who had dreams of opening his own record company. He signed with the Temptations under Motown records because of his performances in local and statewide talent shows, and the connections he had developed long the way. While part of the Temptations, he was able to release hit songs such as “My Girl”; however, his solo career was not nearly as successful as his career with the Temptations. Ruffin was the front man for the Temptations, and consequently received most of the media focus. However, not just being the front man was the reason for Ruffin’s media attention: his cocaine habit and erratic behavior also caught the eye of the media. Ultimately, one of the major reasons Ruffin was fired from the Temptations was because of his cocaine use. Ruffin missed multiple rehearsals and performances because of his attitude and cocaine use, and when the band got together for a reunion tour, Ruffin missed out on many performances because of drugs. According to Otis Williams, Ruffin was funny and hardworking when he first joined the Temptations, yet as the media added to his ego, Ruffin acquired a drug habit. Arthur McDougal, a producer at Motown, said he tried to help Ruffin overcome his drug problem, but said that Ruffin would just ignore his help, and claimed that McDougal was lecturing. Ruffin’s girlfriend said that she also was unable to help Ruffin with his cocaine problem. In 1987 Ruffin was put in prison for his drug

use, and his girlfriend reported that he had a couple brief stints in rehab. While Ruffin would come out of rehab clean and often be clean for a period of time, he would always relapse. In 1991, Ruffin rented a limousine with a friend, Donald Brown. The two men went on a drug binge in a crack house in Philadelphia. It is thought that they smoked 10 vials of crack cocaine in less than one hour. Ruffin collapsed. Someone drove him to the hospital and dumped his body in front of the building. Police are not sure who left his body, just that the limo left very quickly. Doctors were on the scene very quickly but were unable to help Ruffin, and he passed away very early in the morning of June 1, 1991, at the age of 50. Nancy E. Marion See also: Addiction; Cocaine and Crack

Further Reading “David Ruffin Biography.” Bio True Story. h t t p : / / w w w. b i o g r a p h y. c o m / p e o p l e / david-ruffin-21174455?page=2. “David Ruffin–Biography.” IMDB. http:// www.imdb.com/name/nm0749278/bio. Francis, Joel. “David Ruffin.” The Daily Record. http://joelfrancis.com/tag/david-ruffin/. Lewis, C. 1991. “David Ruffin Joins a Long List: I Have to Wonder What Demon Is Eating Away at People, Causing Them to Resort to Drugs to Ease Their Pain.” The Inquirer. http://articles.philly.com/1991 -06-05/news/25785717_1_drug-overdose -illicit-drugs-drug-problem. McMurray, Clay. 2012. “The Story of David Ruffin.” Unsung, March 5. Silver Spring, MD. Ribowsky, Mark. 2010. Ain’t Too Proud to Beg: The Troubled Lives and Enduring Soul of the Temptations. Hoboken, NJ: John Wiley & Sons.

808   Rural Drug Use

Rural Drug Use Drug use among those living in rural areas has been increasing in recent years. A study published by the National Center on Addiction and Substance Abuse at Columbia University found that, based on 1999 data, illegal drug use among adolescents in small-town and rural America is increasing so quickly that it is almost at alarming rates. The report indicated that students in eighth grade in rural areas are 104 percent more likely than eighth graders who live in urban areas to use amphetamines, include methamphetamines, and 50 percent likelier to use cocaine. Students in this age group in rural areas are also 83 percent more likely to use crack cocaine, and 34 percent likelier to smoke marijuana than eighth-graders who reside in urban areas. The results of the study also showed that eighth graders who lived in rural areas were 70 percent likelier to have been drunk, and 29 percent likelier to drink alcoholic beverages than those in the same age group who reside in urban areas. These youth were more than twice as likely to smoke cigarettes, and nearly five times likelier to use smokeless tobacco than urban teens. The same patterns hold true for older youth as well, according to this study. The results indicated that use rates in rural areas among 10th graders was higher than those for students living in larger, urban areas for every drug except marijuana and Ecstasy. Illicit drug use of cocaine, crack, amphetamines, inhalants, alcohol, and smokeless tobacco, was higher among 12th graders for those in rural areas than those in urban centers. Treatment patterns among those living in urban and rural settings also differ. Research shows that those who use drugs in an urban setting are more likely to use cocaine and

heroin, while those using drugs in rural environments report more use of alcohol, opiate pain relievers, and stimulants. Research by the Substance Abuse Mental Health Services Administration shows that the urbanization level of a community can impact both the types of treatment services offered and the use of those treatment options services that are available for substance abuse treatment. While substance abuse treatment admissions for both urban and rural settings had similar distributions between males and females, the treatment admissions in rural settings were less racially and ethnically diverse, and had younger clients. Clients categorized as non-Hispanic white made up 77.1 percent of the rural admissions and 38.1 percent of urban admissions. Over one third of rural admissions (34.2 percent) were younger than 26 years old, whereas in an urban setting they compose less than a quarter of the treatment admissions (23.5 percent). Over 60 percent of both the urban and rural clients admitted for treatment reported having no health insurance. Those admitted for treatment in rural and urban settings differed with regard to both the primary substance abused and the frequency of the drug’s use. Those drug users who were admitted for treatment in rural areas were more likely than those abusers living in urban areas to report primary abuse of alcohol (94.5 versus 36.1 percent) or nonheroin opiates (10.6 vs. 4 percent). More­ over, those treated in urban programs were more likely than those in rural programs to report that their primary drug abused was heroin (21.8 vs. 3.1 percent) or cocaine (11.9 vs. 5.6 percent). The data also show that those users from urban treatment programs were almost twice as likely as those in rural treatment programs to report daily use of their primary substance when they

Rural Drug Use  809 Demographic characteristics among urban and rural admissions aged 12 or older: 2009 Urban admissions (Percent)

Rural admissions (Percent)

69.9% 30.1%

68.3% 31.7%

38.1% 33.7% 22.7% 1.3% 4.2%

77.1% 8.7% 6.6% 5.5% 2.1%

7.1% 16.4% 60.6% 15.9%

8.3% 25.9% 55.4% 10.5%

Gender Male Female Race/ethnicity Non-Hispanic White Non-Hispanic Black Hispanic American Indian or Alaska Native Other Age Aged 12 to 17 Aged 18 to 25 Aged 26 to 49 Aged 50 or Older

began a treatment program (43.1 vs. 23.5 percent). Those entering into treatment programs in rural areas were a bit younger when they first began abusing drugs than those in urban treatment programs. Those in rural programs reported beginning to abuse drugs when they were between the ages of 15 and 17 (32.1 vs. 26.7 percent). They were also less likely to report first use at age 18 or older (32.7 vs. 45.6 percent). The drug users in rural and urban treatment programs were also different in terms of the referral, the type of treatment received, and the number of previous treatment admissions. Those receiving treatment in rural treatment programs were more likely than those receiving treatment in urban programs to be referred by the criminal justice system (51.6 vs. 28.4 percent) and less likely to be self-referred (22.8 vs. 38.7 percent). Other differences exist. Those in rural admissions were more likely to receive regular outpatient care (63.2 vs. 43.8 percent), but

were less likely to have extensive treatment histories than those being treated in urban settings. The table above shows some statistics about rural drug use in the United States. Nancy E. Marion See also: Addiction; Cocaine and Crack; Minorities and Drug Use

Further Reading Cronk, C. E., and P. D. Sarvela. 1997. “Alcohol, Tobacco, and Other Drug Use Among Rural/Small Town and Urban Youth: A Secondary Analysis of the Monitoring the Future Data Set.” American Journal of Public Health 87(5): 760–64. Moore, Robert M. 2001. The Hidden America: Social Problems in Rural America for the Twenty-First Century. Selinsgrove, PA: Susquehanna University Press. Neal, Rome. 2000. “Rural Teen Drug Use Soars.” CBS News, January 26. http://www .cbsnews.com/2100-201_162-153577.html.

810   Rush, Benjamin (1745–1813) Substance Abuse and Mental Health Services Administration. “A Comparison of Rural and Urban Substance Abuse Treatment Admissions.” http://www.samhsa.gov/data/ 2k12/TEDS_043/TEDSshortReport043urb anRuralAdmission. Van Gundy, K. 2006. Substance Abuse in Rural and Small Town America. Durham: University of New Hampshire, Carsey Institute. http://www.carseyinstitute.unh.edu/public ations/Report_SubstanceAbuse.pdf.

Rush, Benjamin (1745–1813) In 1773, Benjamin Rush, from the Commonwealth of Pennsylvania, contributed several editorial essays to the papers about the patriot cause and was a member of the American Philosophical Society. In June 1776, he was elected to attend the provincial conference to send delegates to the Continental Congress. He was appointed to represent Philadelphia that year and signed the Declaration of Independence. While in medical school, Rush learned that distilled beverages were strong central nervous system stimulants, and that their excessive use was thought to be unhealthy. He wrote a long essay in which he wrote that “spirituous liquors are unnecessary; and secondly, that they are mischievous and often produce the diseases they are intended to obviate.” While traveling in the backcountry of Pennsylvania, he was appalled at the frontiersmen for building stillhouses on nearly every plot of land. He described the quantity of whiskey drunk in these places as “immense.” Further, he described the effect of the alcohol on the settler’s industry, health, and morals as terrible. He said with continued use, the frontiersmen would suffer discomfort and vomiting in the morning, and

tremors that could only be stopped by taking another dose of alcohol. Further, they would have “dropsy” (which in today’s medical community may be considered to be cirrhosis), obstruction of the liver, madness, palsy, and apoplexy. A prominent physician, abolitionist, and professor of chemistry, Benjamin Rush was appointed to serve as the surgeon general of the Continental Army in 1776. He became a representative for the temperance movement that was sweeping the country. In his famous Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind published in 1785, Rush corrected erroneous notions about the mental and physical diseases of the body and mind that plagued the drinker of distilled liquors. He described drunkenness as a disease resembling certain hereditary,

Dr. Benjamin Rush was a signer of the Declaration of Independence. He was one of the first to believe that alcoholism was a disease, and advocated treatment for alcoholics instead of punishment. (Library of Congress)

Rush, Benjamin (1745–1813)  811

family, and contagious diseases. His theories on the problem of alcoholism would eventually become the seeds of alcohol addiction treatment in the United States. He wrote: “Strong liquor is more destructive than the sword. The destruction of war is periodic, whereas alcohol exerts its influence upon human life at all times and in all seasons.” Rush began his campaign against alcohol at a time when whiskey production was on the rise. Local distilling was a way that farmers could convert grain into a form that was more easily stored or shipped. The use of alcohol was also on the rise at that time. This was a concern to Rush. In other writings, Rush said that “a people corrupted by strong drink cannot be a free people.” He also advised people to give up alcohol “suddenly and entirely.” During the colonial period, most people were not concerned with drunkenness; it was neither troublesome nor stigmatized behavior. Although Rush had no concern with wine and beer, he felt that the consumption of distilled liquor over time could be lethal, and he was the first American to call chronic drunkenness a distinct disease. Rush’s efforts did not have much of an impact on the drinking habits of early Americans during his lifetime. However, he served as a leader to political and religious groups who, like him, believed that alcohol consumption was immoral and led to poverty, a disorderly society, and civil disobedience.

Because of his speeches against the abuses of alcohol, later generations of temperance workers would come to refer to Benjamin Rush as the “father of the temperance movement.” Richard E. Isralowitz See also: Addiction; Alcohol Use; Temperance Movement; Treatment

Further Reading “Benjamin Rush (1746–1813).” Penn Biographies. http://www.archives.upenn.edu/ people/1700s/rush_benj.html. “The History of Pennsylvania Hospital.” Penn Medicine. http://www.uphs.upenn.edu/pah arc/features/brush.html. Katcher, B. S. 1993. “Benjamin Rush’s Educational Campaign against Hard Drinking.” American Journal of Public Health 83(2): 273–81. Meranze, Michael, ed. 1988: Benjamin Rush: Essays: Literary, Moral and Philosophical. Schenectady, NY: Union College Press. Rush, Benjamin. 1970, 1948. The Autobiography of Benjamin Rush: His Travels Through Live Together with His Commoplace Books for 1789–1813, ed. George W. Corner. Westport, CT: Greenwood Press. “Signers of the Declaration of Independence: Short Bibliographies on the 56 Declaration Signers.” http://www.ushistory.org/declarat ion/signers/rush.htm.

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S (F. Murray Abraham), one of Frank’s associates, to purchase cocaine from a group of Colombian dealers. Tony and Angel meet with the Colombians, but the deal goes awry resulting in Angel’s death. Manny and Chi Chi rush into the apartment, killing the Colombians before the Colombians have a chance to execute Tony. Tony and Manny begin to suspect Omar of setting them up and take the drugs and the money directly to Frank, who is impressed. He hires Tony and Manny. Tony and Omar are sent by Frank to Bolivia. They are to make a deal with Alejandro Sosa (Paul Shenar). Distrustful of Omar, Tony makes unsanctioned transactions but is confronted by Omar who returns to Miami to discuss the matter with Frank. After Omar’s departure, Sosa tells Tony that Omar is actually an informant for the police. He tells Sosa that although he never trusted Omar, Frank was trustworthy. When Omar comes back Sosa kills him in front of Tony. Sosa and Tony reach an agreement, but Sosa makes sure that Tony knows he can never betray Sosa. Frank is outraged by Tony’s actions in Bolivia and Omar’s death. This causes Frank to sever his business relationship with Tony. Tony sets up his own organization and begins pursuing Elvira Hancock (Michelle Pfeiffer), Frank’s girlfriend, and proposes to her. Tony runs into Elvira at a nightclub and while talking to her about the proposal, is interrupted by a visibly angry Frank. The two men get into an argument, resulting in Frank and Elvira’s departure. Tony then spies his younger sister, Gina (Mary Elizabeth Mastrantonio), dancing

Scarface Scarface is a 1983 American film that chronicles the rise of Tony Montana (Al Pacino) from refugee of the 1980 Mariel Boatlift to head of a cocaine cartel. The film was directed by Brian De Palma with a screenplay adapted from the 1932 movie of the same name. The original film tells the story of a Prohibition-era gangster and was directed by Howard Hawks, to whom the 1983 film was dedicated. At first, reviews of the film were mixed. Critics cited the graphic language and the extreme violence. Miami’s Cuban community was also upset at the film’s portrayal; stereotyping Cubans as criminals, drug traffickers, and killers. Eventually the film reached the status of a cult hit and many aspects of the movie have been parodied.

Plot It is 1980 and Tony Montana and his best friend, Manny Ribera (Steven Bauer), arrive in Miami as part of the Mariel Boatlift. Like their fellow Cuban refugees, Tony and Manny are sent to a refugee camp and are joined by their friends Angel (Pepe Serna) and Chi Chi (Angel Salazar). To leave the refugee camp, Manny makes a deal with a drug kingpin named Frank Lopez (Frank Loggia). In exchange for green cards, Manny agrees to assassinate the former Cuban government official responsible for the murder of Frank’s brother. The assassination is carried out and Tony and the others are released from the refugee camp. The four are hired by Omar Suarez 813

814   Scarface

Scarface is a 1983 drama about a drug kingpin in Miami. The film starred Al Pacino and made over $65 million. (Universal Pictures/Photofest)

with another dealer. He later catches them ducking into a bathroom where he discovers Gina snorting cocaine. Fiercely protective of Gina, Tony forcefully removes the drug dealer. This sparks an argument between Gina and Tony, who then slaps Gina for challenging him. Manny witnesses this and takes Gina home. She reveals her attraction to Manny, but is rebuffed. Manny had earlier remarked on Gina’s beauty, which had angered Tony. Manny knew Tony must never see him and Gina together. Meanwhile, back at the club, Tony is assaulted by a couple of gunmen. He manages to escape and is able to kill them. Tony’s chief suspect in the attempt on his life is Mel Bernstein (Harris Yulin), a corrupt detective with the Miami Police Department. Prior to his confrontations with Frank and Gina, Tony had been squeezed by Bernstein for protection money. Tony also believes Frank and Bernstein are working together.

He and Manny go to Frank’s office and find Bernstein there. Tony is able to expose Frank as the mastermind behind the failed hit. After pleading for his life, Frank is killed by Manny; Tony kills Bernstein. Frank’s elimination allows Tony to seize control of Frank’s empire and marry Elvira. He forms a business relationship with Sosa and becomes inordinately wealthy. Things, however, begin to fall apart. First, Elvira develops an addiction to cocaine, which causes her and Tony to drift apart. Next, Tony’s own paranoia erodes his friendship with Manny. By now Manny has become dissatisfied with his role in the organization, which is essentially head of security. Finally, Tony is caught in a police sting operation and is charged with money laundering and tax evasion. Now facing the possibility of a threeyear prison sentence and a hefty fine, Sosa offers Tony a deal that would keep him out

Schedule of Controlled Substances (I–V)  815

of prison: assassinate a Bolivian journalist who is about to expose Sosa during a speech at the United Nations in exchange for Sosa connections within the U.S. government dropping all charges against Tony. Before going to New York, Tony stops in Miami and asks Manny to manage the operation while he is in New York fulfilling his agreement with Sosa. Tony and Elvira get into a fight after he calls her a junkie with whom he would never want children. In retaliation, Elvira tells Tony she is leaving him. Tony leaves for New York accompanied by Chi Chi and Alberto (Mark Margolis), who is Sosa’s top enforcer. Alberto rigs the journalist’s car with a remote-control bomb. Sosa has given Alberto specific instructions to follow the journalist and detonate the bomb when he reaches the United Nations Headquarters. The following day, Tony and Alberto watch as the journalist and his wife and children get into the car. Horrified at the prospect of killing the journalist’s family, Tony tries to convince Alberto to abort the mission. When he refuses, Tony kills him. Consumed with rage, Sosa calls Tony and reminds him of the warning he issued Tony when they had first met: Tony must never betray Sosa. When Tony returns to Miami, he learns that Gina has been missing since he went to New York. Tony’s mother (Miriam Colon) tells him she followed Gina one night and gives a Tony the address. He goes to Coconut Grove and finds the address. Inside the mansion Tony finds Manny and Gina together. Before Gina can surprise him with the news of her marriage to Manny, Tony shoots and kills Manny. Tony and his associates take a devastated Gina to Tony’s home. While Tony sits at his desk snorting a mound of cocaine, Sosa’s men have been surrounding the mansion, stealthily eliminating Tony’s guards. A heavily drugged Gina enters, accusing Tony of

wanting to keep her all to himself. Shortly after Gina shoots Tony in the leg, one of Sosa’s men storms the office and shoots Gina. Tony kills the man then ruminates over Gina’s lifeless body. In his final stand from the staircase, Tony opens fire on Sosa’s men killing several of them. Although Tony is himself shot multiple times, he manages to survive until he is mortally wounded with a shot to the back. As Scarface ends, Tony’s body has fallen from the staircase into the fountain below.

Box Office Scarface grossed $45,598,982 in the U.S. market and an additional $65,884,703 worldwide. Stacy O’Hara Leiter See also: Drug Trafficking

Further Reading Scarface (1932). Internet Movie Database. http://www.imdb.com/title/tt0023427/. Scarface (1983). Internet Movie Database. http://www.imdb.com/title/tt0086250/. Scarface (1983). Movieclips.com. http:// movieclips.com/dkCJ-scarface-movie -videos/.

Schedule of Controlled Substances (I–V) The Controlled Substances Act (CSA) was passed by Congress in 1970 as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. The bill was signed into law by President Richard Nixon. The CSA is the federal policy that regulates the manufacture, importation, possession, use, and distribution of drugs in the United States. All of the drugs and other substances that are “controlled” substances (i.e., limited in

816   Schedule of Controlled Substances (I–V)

some way by the government) under the CSA are divided into five categories, called schedules. The complete list of drugs in each is schedule is updated and published annually in Title 221 Code of the Federal Regulations. Drugs are assigned into a schedule based on whether they have a currently accepted medical use for treatment of a medical condition or disease, their potential for abuse and addiction, and the likelihood that they may cause dependence if abused. According to the CSA, the drugs placed in Schedule I currently have no accepted medical use, along with a lack of accepted safety for use even under medical supervision, and a high potential for abuse. Some examples of Schedule I substances are heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, and 3, 4 -methylenedioxymethamphetamine, otherwise known as Ecstasy. Drugs placed into Schedule II of the CSA are those substances having a high potential for abuse that can lead to severe psychological or physical dependence by the user. Examples of Schedule II drugs include opiates such as hydromorphine, methadone (Dolophine), meperidine (Demerol), oxycodone (OcyContin, Percocet), fentanyl (Sublimaze, Duragesic), morphine, opium, and codeine. Schedule II stimulants include amphetamine (Adderall), methamphetamine (Desoxyn), and methylphedidate (Ritalin). Amobarbital, glutethimide, and pentobarbital are examples of Schedule II depressants. Drugs categorized as Schedule III substances under the CSA have less potential for abuse than the substances placed in Schedules I or II. Use of these drugs could lead to moderate or low physical dependence or high psychological dependence. Examples of Schedule III narcotics include combination products containing less than 15 milligrams

of hydrocodone per dosage unit (Vicodin), products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine), and buprenorphine (Suboxone). Examples of Schedule III nonnarcotics include benzphetamine (Didrex), phendimetrazine, ketamine, and anabolic steroids such as Depo-Testosterone. Drugs placed in Schedule IV of the CSA are those substances that have a low potential for abuse relative to the drugs found in Schedule III, Schedule II, or Schedule I. Examples of the drugs placed in this category include Alprazolam (Xanax), carisoprodol (Soma), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), midazolam (Versed), temazepam (Restoril), and triazolam (Halcion). The last schedule of drugs, Schedule V substances, are those that have a low potential for abuse relative to substances listed in the above categories. They consist primarily of preparations containing limited quantities of certain narcotics such as cough syrups that contain no more than 200 milligrams of codeine per 100 milliliters or per 100 grams. These are products such as Robitussin AC, Phenergan with Codeine, and exogabine. Nancy E. Marion See also: Controlled Substances Act

Further Reading Department of Justice, Drug Enforcement Administration Office of Diversion Control. “Title 21 Codes of Federal Regulations.” http:// deadiversion.usdoj.gov/21cfr/2108cfrt.htm. Library of Congress, Congressional Research Service. 2008. Controlled Substances Act: Regulatory Requirements. Washington, DC. Library of Congress, Congressional Research Service. 2006. Regulatory Requirements under the Controlled Substances Act. Washington, DC.

Secondhand Smoke  817 Marion, Nancy E. 2013. The Medical Marijuana Maze. Durham, NC: Carolina Academic Press. Miller, Gary J. 2005. Drugs and the Law: Detection, Recognition and Investigation. Charlottesville, VA: Gould Publications.

Secondhand Smoke Also known as environmental tobacco smoke, passive smoke, or sidestream smoke, secondhand smoke refers to the toxic mix of chemicals given off by burning tobacco products as well as the smoke that is exhaled by smokers. In this mix are carcinogens as well as particulate matter and noxious ingredients such as formaldehyde, cyanide, carbon monoxide, ammonia, and nicotine. It affects the people who do not smoke, but who are around those who do, contributing not only to cancer but also to asthma and other respiratory diseases, allergies, heart disease, and cardiovascular disorders such as stroke. So potent are the chemicals in secondhand smoke that nonsmokers exposed to it on a regular basis have a 25 to 30 percent increased risk of developing heart disease or cancer. In children, secondhand smoke can cause severe forms of these diseases and even, in some cases, sudden infant death. Children who are exposed to secondhand smoke are more likely to suffer from a variety of medical concerns because they are inhaling the toxins and cancer-causing substances that are present in cigarettes. Since infants’ bodies are still developing, they are especially vulnerable to the poisons found in cigarette smoke. Young children who are around smokers have an increased risk for sudden infant death syndrome, acute respiratory infections, ear problems, and severe asthma with more frequent attacks. In fact, the U.S. Environmental Protection Agency

has calculated that secondhand smoke worsens asthma in 200,000 children each year. When children are around adults who smoke, they are likely to have slower lung growth, which increases their risk of being diagnosed with many other health problems. Among infants and children, secondhand smoke causes bronchitis and pneumonia, and increases the risk of ear infections. These effects are also seen in babies whose mothers smoked, or were around smokers, when they were pregnant. It is very difficult for nonsmokers to “just stay away” from those who smoke as a way to avoid the health concerns of secondhand smoke. There are many situations where nonsmokers are exposed to secondhand smoke, including restaurants, bars, and other places where people gather. Many people are surrounded by smokers at work. As a way to avoid this, many states are passing laws that make it illegal to smoke in restaurants and office environments. Some college campuses are even going smoke-free. The statistics surrounding secondhand smoke are alarming. According to the Cen­ ters for Disease Control, secondhand smoke puts into the air the same poisons that can be found over toxic waste dumps. These poisons irritate the eyes and cause watering, swelling, and itching. Secondhand smoke can be attributed with causing 30 times as many lung cancers deaths as other types of air pollutants. In a crowded restaurant that allows the patrons to smoke, the smoke can be the equivalent of six times the pollution of a busy highway. Secondhand smoke has been blamed for causing 300,000 lung infections in infants and children each year, and killing 3,000 nonsmokers each year due to lung cancer. Kathryn H. Hollen See also: Cigarettes; Cigars; Nicotine; Tobacco

818   Sedatives, Hypnotics, and Anxiolytics

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Chastain, Zachary. 2013. Tobacco: Through the Smoke Screen. Broomall, PA: Mason Crest. Federal Trade Commission. 2007. http://www .ftc.gov/opa/2007/04/cigaretterpt.shtm. U.S. Department of Health and Human Services. 1988. Nicotine Addiction: A Report of the Surgeon General. Centers for Disease Control and Prevention, Public Health Service, Center for Health Promotion and Education, Office on Smoking and Health. U.S. Department of Health and Human Services. 2003. Targeting Tobacco Use: The Nation’s Leading Cause of Death. Centers for Disease Control and Prevention. U.S. Department of Health and Human Services. 2006. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. U.S. Department of Health and Human Services. 2007. Results from the 2006 National Survey on Drug Use and Health: National Findings. Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. DHHS Publication No. SMA 07-4293. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. “Smoking & Tobacco Use.” http:// www.cdc.gov/tobacco. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. “Smoking and Tobacco Use: Frequently Asked Questions.” http://apps.nccd.cdc.gov/osh_faq/topic .aspx?TopicID=8. U.S. Department of Health and Human Services, National Cancer Institute. “Smok-

ing.” http://www.cancer.gov/cancertopics/ tobacco/smoking. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006. Research Report Series: Tobacco Addiction. NIH Publication No. 06-4342. U.S. Environmental Protection Agency. 1992. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, DC: U.S. Environmental Protection Agency.

Sedatives, Hypnotics, and Anxiolytics Sedatives, hypnotics, and anxiolytics (SHAs) are substances such as benzodiazepine, carbamate, and barbiturate medications that are used to treat anxiety, insomnia, muscle tension, and to aid in alcohol or drug withdrawal. They work on a person’s central nervous system (CNS) to slow it down. Some examples of these drugs are: Barbiturates: phenobarbital, amobarbital, secobarbital Benzodiazepines: Valium, Ativan, Librium, Xanax Others: methaqualone (Quaalude); flunitrazepam (Rohypnol); Gamma-hydroxybutyrate (GHB, liquid X, easy lay) The oldest hypnotic was chloral hydrate, which was synthesized in 1832. This was sometimes called a “Mickey” and was slipped into a drink of a person who then passed out. In 1864, German scientist Johann Friedrich Wilhelm Adolf von Baeyer discovered barbituric acid, which led to barbiturates. These were found to be terribly addictive, so the search began for a safer alternative. Scientists came up with benzodiazepines, such as Librium. Not long after that, Valium was approved, then Mogadon

Seniors and Drug Use  819

and Dalmane. Doctors used these new drugs instead of barbiturates because they were thought to be nonaddictive. They are also not as toxic as barbiturates. Sedatives are used to reduce anxiety and reduce agitation or excitement. Hypnotics are used to cause drowsiness and sleep. They both work on the CNS and slow down brain activity. In short, these drugs impair sending and receiving of neurological impuses in the brain, decrease the time before sleep comes, and increase the total amount of time spent asleep. They also lower a person’s blood pressure and slow the heart rate. They have legitimate medical uses. In some instances they may be used to control high blood pressure. They can be over-thecounter sleep aids. Barbiturates are used to treat seizure disorders such as epilepsy. But these medications may also be sold on the street and used for recreational purposes. The potential side effects of these drugs include drowsiness, impaired judgment, diminished motor skills, amnesia, slurred speech, slowed reactions, decreased reflex reactions, coma, and cardiorespiratory arrest. In higher doses, side effects may include vertigo, nightmares, aggression, and an altered perception of time and space. Serious side effects include anemia, impaired liver function, headaches, blurred vision, and depression. Those people who become dependent upon these drugs may suffer withdrawal symptoms. These can be insomnia, tremors, convulsions, dizziness, irrational fears, and rapid mood changes. One of the benzodiazepines, Rohypnol is sometimes used in sexual assaults. Also called roofies, rophies, or a “date rape drug,” it can be slipped into a victim’s glass unknowingly. The recipient will quickly feel the effects and will feel very relaxed. The victim is at risk for a sexual assault. When the effects of the drug wear off, the victim

will have no memory of what happened. Although this drug has been made illegal, it can still be purchased on the black market. Nancy E. Marion See also: Barbiturates; Date Rape Drugs; Quaalude

Further Reading Gahlinger, Paul M. 2004. Illegal Drugs: A Complete Guide to Their History, Chemistry, Use and Abuse. New York: Plume. “Sedative, Hypnotic or Anxiolytic Depen­ dence.” MD Guidelines. http://www .mdguidelines.com/sedative-hypnotic-or -anxiolytic-dependence. Walker, Ida. 2013. Sedatives and Hypnotics: Deadly Downers. Broomall, PA: Mason Crest.

Seniors and Drug Use The elderly are at a higher risk of abusing prescription medications than any other age group. This is because they often take more than one prescription medicine each day, which increases the risk for mistakes. This is compounded by the fact that many of their medications are prescribed by more than one doctor. The elderly may become dependent on drugs that are prescribed to deal with joint pain, sleeping problems, or injuries from falls. They may also have prescription drugs to help them cope with the sadness over losing loved ones. In some cases, being far away from other family members may increase the risk of drug dependence among seniors. Loneliness and mental health issues, coupled with preexisting alcohol and drug habits, have caused many older adults to abuse controlled substances in their golden years. Alcohol can have significant interactions with prescribed medications. When seniors

820   Sentencing Disparities

mix alcohol with their prescribed medications, either intentionally or inadvertently, or overuse their prescribed medications, there can be serious consequences, including a possible overdose or death. Older Americans are also increasingly using nonprescription drugs. A recent study by the Substance Abuse and Mental Health Services Administration found an increase in illicit drug use by adults 50 years of age and older. This included an increase in nonmedical use of prescription drugs by women aged 60–64. This could be the result of the aging baby boomers. The researchers found that about 4.7 percent of older adults have used an illegal drug in the prior year. Overall, men had a higher rate of drug use for all types of drugs. However, women had a higher rate of nonmedical use of prescription drugs than men, used primarily for self-medication to cope with loneliness and stress. The drugs used are sometimes single drugs, but other times there were more than one drug reportedly used. The most common prescription drugs abused are benzodiazepines (diazepam, alprazolam, clonazepam, and loraxepam) and opiates (oxycodone, hydrocodone, morphine, and methadone). When treating seniors who are abusing drugs, it is important to eliminate the drugs not used for medical purposes. Moreover, the emotional concerns must be addressed through counseling and support. Tips for a healthy lifestyle should be stressed. Caregivers can watch for the warning signs of a substance abuse problem in an older friend or family member: changes in sleep patterns; changes in appetite that cannot be attributed to other reasons; increased falling; frequently changing physicians to get multiple prescriptions; filling prescriptions at multiple pharmacies; new onset of irritability or agitation; periods of confusion;

and empty liquor bottles in the garbage or recycling bucket. Nancy E. Marion See also: Addiction; Alcohol Use; Prescription Drugs

Further Reading Aging Care. 2012. “Seniors and Prescription Drug Addiction.” http://www.agingcare .com/Articles/seniors-and-Prescription -Drug-Addiction-133459.htm. “Geezer Drug Use to Have Ripple Effect.” 2010. CBS News, January 8. http:// www.cbsnews.com/news/geezer-drug -use-to-have-ripple-effect/. Johns Hopkins Medicine Alerts. 2012. “Drug Abuse and the Elderly.” http:///www.johns hopkinshealthalerts.com/reports/prescrip tion_drugs/3363–1.html. May, Luella. 2010. “Statistics Show Drug Abuse in Seniors Is Rising.” NaturalNews.com . http://www.naturalnews.com/028858_sen iors_drug_abuse.html##ixzz2oAKRGTrL. Partnership for Drug-Free Kids. 2011. “Elderly at Risk for Prescription Drug Abuse.” http:// www.drugfree.org/join-togetherddiction/ elderly-at-risk-for-prescription-drug-abuse. “Prescription Drug Abuse in the Elderly.” FamilyDoctor.org. http://familydoctor.org /familydoctor/en/diseases-conditions/opiod -addiction/prescription. Substance Abuse and Mental Health Services Administration. 2011. “Illicit Drug Use Among Older Adults.” http://store.samhsa .gov/product/Illicit-Drug-Use-among-Older -Adults/NSDUH 11–0901.

Sentencing Disparities A recent report by the U.S. Sentencing Commission found that in recent years, the prison sentences of black males were nearly

Sentencing Disparities  821

20 percent longer than sentences handed down to white males for similar crimes. The racial gap for sentencing disparities has widened since the restoration of discretionary sentencing in 2005, in which the judge has the discretion, or choice, as to the most appropriate sentence for a convicted offender. In the end, the Sentencing Commission recommended that federal judges pay more attention to sentencing guidelines that provide suggestions for sentencing, based on the past record of the offender, the seriousness of the event, the presence of a weapon, and other factors. The report also suggested that the courts should scrutinize sentences more closely. The commission, however, was careful to avoid the implication of racism among federal judges, citing the difficulty of measuring the many “legal considerations” on which sentencing decisions are based. The findings and recommendations made in the report drew criticisms from those who claimed that the commission’s focus on sentencing, the very end of the criminal-justice system process, ignored the fact that there were many opportunities for bias at earlier stages of the system, such as at arrest, charging, or during plea negotiations. As a way to reduce sentencing disparities, many jurisdictions created sentencing guidelines. The guidelines provide a minimum and maximum sentence that should be (in some cases must be) handed out on offenders. They take into effect the seriousness of the offense, the defendant’s prior record, and other factors. The guidelines were intended to alleviate the discretion, or choice, that judges have when sentencing. This way, all defendants will be treated equally, regardless of their age, race, or other characteristic. It is hoped that, with guidelines, sentencing will be more fair and there will be less disparity in the sentencing for similar offenses.

Sentencing disparities became a big issue when Congress passed the Anti–Drug Abuse Act of 1986. Under this law, the sentences for offenders convicted of possessing crack cocaine were harsher than the sentences given to those convicted of possessing powder cocaine. Many said this was racist because crack-cocaine offenses are more often committed by black offenders, whereas powder-cocaine offenses are most often committed by white offenders. Congress reduced the disparity in 2010 in the Fair Sentencing Act, which was signed by President Obama. The sentencing guidelines, created as a way to reducing sentencing disparities by judges, were reviewed by the U.S. Supreme Court in the 2005 case U.S. v. Booker. In that case, the court struck down a 1984 law that required federal district judges to impose a sentence that was within the range of the federal sentencing guidelines, which were set by the commission. In the two years after the Booker ruling, sentences of black offenders were, on average, 15.2 percent longer than the sentences of whites who had committed similar offenses, according to the Sentencing Commission report. Between December 2007 and September 2011, the most recent period covered in the report, sentences of black males were 19.5 percent longer than those for whites. The analysis also found that black males were 25 percent less likely than whites in the same period to receive a sentence below the guidelines’ range. The Sentencing Commission released a similar report in 2010. This time, it found that the racial disparities were less pronounced than previously. Specifically, sentences of black males were only 14.5 percent longer than whites, as opposed to nearly 20 percent previously. After the 2010 Fair Sentencing Law was passed, there were many questions about

822   Sertürner, Friedrich (1783–1841)

whether the new standards applied retroactively to the thousands of inmates who were sentenced before the new law. In May 2013, a federal appeals court addressed this issue when they held that the new sentencing structure should apply retroactively to all cases. Further, failure to do so would be unconstitutional. In their decision, the Sixth Circuit Judges Gilbert Merritt and Boyce Martin wrote: The old 100-to-1 crack cocaine ratio has led to the mass incarceration of thousands of nonviolent prisoners under a law widely acknowledged as racially discriminatory. There were approximately 30,000 federal prisoners (about 15 percent of all federal prisoners) serving crack cocaine sentences in 2011. Thousands of these prisoners are incarcerated for life or for 20, 10, or 5 years under mandatory minimum crack cocaine sentences imposed prior to the passage of the Fair Sentencing Act. More than 80 percent of federal prisoners serving crack cocaine sentences are black. In fiscal year 2010, before the passage of the Fair Sentencing Act, almost 4,000 defendants, mainly black, received mandatory minimum sentences for crack cocaine. [. . .] The Fair Sentencing Act was a step forward, but it did not finish the job. The racial discrimination continues by virtue of a web of statutes, sentencing guidelines, and court cases that maintain the harsh provisions for those defendants sentenced before the Fair Sentencing Act. If we continue now with a construction of the statute that perpetuates the discrimination, there is no longer any defense that the discrimination is unintentional. The discriminatory nature of the old sentencing regime is so obvious that it cannot seriously be argued that race does

not play a role in the failure to retroactively apply the Fair Sentencing Act. A “disparate impact” case now becomes an intentional subjugation or discriminatory purpose case. Like slavery and Jim Crow laws, the intentional maintenance of discriminatory sentences is a denial of equal protection. Nancy E. Marion See also: Anti–Drug Abuse Acts; Cocaine and Crack; Fair Sentencing Act; Obama, Barack

Further Reading Flatow, Nicole. 2013. “Federal Appeals Court: Drug Sentencing Disparity Is Intentional Racial ‘Subjugation.’” ThinkProgress, May 18. http://thinkprogress .org/justice/2013/05/18/2032401/federal -appeals-court-drug-sentencing-disparity -is-intentional-racial-subjucation/. Palazzolo, Joe. 2013. “Racial Gap in Men’s Sentencing.” Wall Street Journal, February 14. http://online.wsj.com/article/SB10001 4241278873244320045783044637898580 02.html. U.S. Sentencing Commission. 2012. “Report on the Continuing Impact of United States v. Booker on Federal Sentencing.” http://www .ussc.gov/Legislative_and_Public_Affairs/ Congressional_Testimony_and_Reports/ Booker_Reports/2012_Booker/Part_A.pdf.

Sertürner, Friedrich (1783–1841) While still a young pharmacist’s apprentice, Sertürner isolated the psychoactive agent morphine from the opium plant. His accomplishment is especially important because it was not only the first such agent extracted from opium, but also the first alkaloid obtained from any plant. Sertürner named his new discovery after the Greek god of

Shisha  823

dreams, Morpheus, for its powerful analgesic and sedative properties. Friedrich Wilhelm Adam Ferdinand Sertürner was born in Neuhaus, Prussia, on June 19, 1783. His parents were in service to Prince Friedrich Wilhelm, who was also his godfather. When both his father and the prince died in 1794, he was left without means of support and, therefore, was apprenticed to a court apothecary by the name of Cramer. One of the topics in which he became interested in his new job was the chemical composition of opium, a plant that had long been known for its powerful analgesic and sedative properties. By 1803, he had extracted from opium seeds a white crystalline powder clearly responsible for the pharmacological properties of the plant. He named the new substance morphine and proceeded to test its properties, first on stray animals available at the castle, and later on his friends and himself. His friends soon withdrew from the experiments because, while pleasurable enough in its initial moderate doses, the compound ultimately caused unpleasant physical effects, including nausea and vomiting. Sertürner continued, however, to test the drug on himself, unaware of its ultimate addictive properties. Sertürner was awarded his apothecary license in 1806 and established his own pharmacy in the Prussian town of Einbeck. In addition to operating his business, he continued to study the chemical and pharmacological properties of morphine for a number of years. His work drew little attention from professional scientists, however, and he eventually turned his attention to other topics, including the development of improved firearms and ammunition. During the last few years of his life, he became increasingly depressed about his failure to interest the scientific community in his re-

search on opium. He withdrew into his own world and turned to morphine for comfort against his disillusionment with what he saw as the failure of his life. He did receive some comfort in 1831 when he was awarded a Montyon Prize by the Académie Française, sometimes described as the forerunner of the Nobel Prizes, with its cash award of 2,000 francs. By the time of his death in Hamelin, Prussia, on February 20, 1841, however, the scientific world in general had still not appreciated the enormous significance of his research on morphine. Until Sertürner’s work, the opium used for medical reasons varied drastically in potency from one batch to the next. This made it very difficult for doctors to prescribe the drug as they were never fully aware of what the effect would be. On some occasions, the opium would even be lethal. Sertürner became the first chemist to isolate the active ingredient in the plant and make it possible for doctors to use it safely. David E. Newton See also: Morphine; Opium

Further Reading Curtis, Robert H. 1993. Medicine. New York: Atheneum Books.

Shisha Shisha is a flavored tobacco mixture that is burned in a hookah, or water pipe. Shisha is sweetened with honey, molasses, fruit, and other ingredients. The hookah pipe uses coals to heat the shisha, and the smoke that is created passes through tubes and water so it is cooled before it is inhaled. Although smoking shisha is a relatively new phenomenon in the United States and health data on American users is not yet

824   Shulgin,  Alexander “Sasha” (1925–2014)

available, the known risks of smoking tobacco apply to shisha. According to the American Cancer Society, several types of cancer, such as of the lung, mouth, and gums, have been linked to smoking a hookah pipe, as well as other negative health effects. Some users believe that smoking the mixture through a hookah pipe reduces or removes the toxic compounds, but this has not been shown to be the case. It is thought that as the smoke passes through the water, some of the dangerous compounds are removed, but research shows that many toxins remain in the water-filtered smoke. These dangerous compounds include nicotine, which is the highly addictive compound in tobacco smoke. The shisha smoke from just one pipe can have the same amount of tar and nicotine as 20 cigarettes. It can also have high levels of carbon monoxide. Consequently, hookah users suffer the same effects of nicotine use (e.g., increases in blood pressure and heart rate and changes in dopamine production in the brain) that occur in cigarette smokers, but because of the carbon monoxide they can also lose consciousness. Like other delivery methods, smoking tobacco through a hookah allows many of the harmful ingredients to pass to the smoker. The smoke from shisha contains carcinogens (cancer-causing substances). It is sometimes laced with drugs like narcotics or psychoactive drugs. Smoking shisha can result in lung problems for the users. Passing around an uncleaned hose can spread infections including herpes or tuberculosis or even a common cold or flu. A water pipe can be a breeding ground for bacteria and germs. Sharing a water pipe with a sick or infected person raises the odds of being infected. Smoking shisha can also result in a decreased lung function. Most of the shisha smoked in the United States is imported from the Middle East in

prepackaged units that are distributed by U.S. companies. However, many U.S. firms are now manufacturing their own tobacco products suitable for smoking in a water pipe to meet the growing demand emerging from hookah cafes springing up in urban areas and university towns. Introduced primarily by Arab Americans, shisha use is rapidly spreading among other groups in the United States, particularly among high school and college students of all ethnic backgrounds. Some users apply the term “shisha” to the water pipe in which the substance is smoked. Kathryn H. Hollen See also: Hookah; Nicotine; Tobacco

Further Reading Saadawi, Ryan T. 2012. Total Metal Analysis in Hookah Tobacco—An Initial Study. Cincinnati: University of Cincinnati. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco.

Shulgin,  Alexander “Sasha” (1925–2014) Shulgin was arguably the best known and most highly regarded advocate of so-called designer drugs within the scientific community. He is thought to have synthesized and tested more than 200 psychoactive compounds in his life and has written a number of important books and articles on the properties and potential benefits of such substances. Because of his work in psychedelic compounds, he is often called the “godfather of psychedelics.” Alexander Shulgin, widely known as “Sasha,” was born in Berkeley, California, on June 17, 1925, to Theodore and Henrietta, both school teachers. He graduated from

Shulgin,  Alexander “Sasha” (1925–2014)  825

high school at the age of 16 and received a full scholarship to Harvard University. His tenure at Harvard was cut short, however, with the beginning of World War II, during which he served with the U.S. Navy in both the North Atlantic and Pacific campaigns. After the war, he returned to Berkeley, where he eventually earned his BA in chemistry at the University of California in 1949 and his PhD in biochemistry at 1954. He completed his postdoctoral studies at the University of California at San Francisco (UCSF) in pharmacology and psychiatry. After working for a year at the BioRad Laboratories company, he took a position with Dow Chemical, where he was a research scientist from 1955 to 1961 and senior research chemist from 1961 to 1966. Shulgin’s most significant accomplishment at Dow was to develop a pesticide known as physostigmine, a substance that was to become one of Dow’s best-selling products. In appreciation of Shulgin’s work, Dow provided him with a laboratory of his own where he was allowed to work on projects that were of special interest to him. One of those projects turned out to be the synthesis and study of psychedelic compounds. Shulgin later reported that his interest in psychedelics was prompted by his first experience in taking mescaline in 1960. As a result of that experience, he told an interviewer from Playboy magazine in 2004, he had found his “learning path,” the direction he wanted the rest of his career to go. In 1965, Shulgin decided to leave Dow in order to enter medical school at UCSF. He left that program after only two years, however, to pursue his interest in psychedelics. That decision posed a problem for both Shulgin and the U.S. Drug Enforcement Administration (DEA), the federal agency responsible for control of illegal

drug use in the United States. Although its primary function is to discourage the development and use of illegal drugs, the DEA apparently saw some benefit in Shulgin’s work, and they agreed to a special dispensation that allowed him to synthesize and study a number of otherwise illegal substances. That relationship eventually worked out well for both partners, as it permitted Shulgin to pursue the studies in which he was most interested and provided the DEA with invaluable information on substances about which it might otherwise have little or no information. In 1988, for example, he wrote Controlled Substances: Chemical & Legal Guide to Federal Drug Laws, a book that has become a standard reference for DEA employees. He analyzed over 230 psychoactive compounds, evaluating them for their psychedelic potential. Shulgin introduced MDMA, or Ecstasy, to psychologists in the late 1970s to be used in psychotherapy. For a time, Shulgin would test his drugs on himself, but he soon asked his friends for help. They created a rating scale for the drugs. The Shulgin rating scale would rank drugs based on their visual, auditory, and physical effects. Shulgin kept records of all of the effects, many of which have been published. Shulgin’s special relationship with the DEA ended in 1994 when the agency raided his Berkeley laboratory and withdrew his license to conduct research on illegal substances, claiming that he had failed to keep proper records. Some observers believe, however, that the agency’s actions were prompted by a book that Shulgin and his wife Ann had written a few years earlier, PiHKAL: A Chemical Love Story. (The PiHKAL of the title stands for “Phenylethylamines I Have Known and Loved.”) The Shulgins later wrote a second book about another group of psychedelic substances,

826   Skinner v. Railway Labor Executives’ Association (1989)

TiKHAL: The Continuation. In this case, the title word TiKHAL stands for “Tryptamines I Have Known and Loved.” Shulgin’s most recent book is somewhat more technically oriented, The Simple Plant Isoquinolines (with Wendy E. Perry). In 2008, his first two laboratory books were scanned and placed online. Many people consider these to be cookbooks for making illegal drugs. David E. Newton See also: Drug Enforcement Administration; Ecstasy; Psychedelic Drugs

Further Reading Shulgin, Alexander. 1988. The Controlled Substances Act: A Resource Manual of the Current Status of the Federal Drug Laws. Lafayette, CA: Alexander T. Shulgin. Shulgin, Alexander. 1992. Controlled Substances: A Chemical and Legal Guide to the Federal Drug Laws. Berkeley, CA: Ronin Publishing. Shulgin, Alexander. 1997. TIHKAL: The Continuation. Berkeley, CA: Transform Press. Shulgin, Alexander, and Wendy E. Perry. 2002. The Simple Plant Isoquinolines. Berkeley, CA: Transform Press. Shulgin, Alexander T., and Ann Shulgin. 2007. PIHKAL: A Chemical Love Story. Berkeley, CA: Transform Press.

Skinner v. Railway Labor Executives’ Association (1989) Since the mid-1800s, railroad companies in the United States have prohibited their employees who operate trains from possessing alcohol or being intoxicated while on duty. Any employee involved in an accident would have to undergo blood and urine testing. The Association of American Railroads later expanded this policy so that employees

could not possess or use other drugs. These restrictions were found in “Rule G,” part of the industry-wide operating code. The usual penalty for violation of Rule G was dismissal from the company. In 1985, the Federal Railroad Administration (FRA), located within the Department of Transportation, concluded that the efforts by the industry to halt drug and alcohol use by employees were not adequate. The FRA decided to create a new series of regulations to supplement the existing Rule G. The new policies, found in Subpart C, required that all of a train’s crew members, in the case of an accident, would have blood and urine samples taken and tested for the presence of drugs by the FRA laboratory. Another section, Subpart D, authorized, but did not require, railroads to administer breath or urine tests (or both) to any employee who violated certain safety rules. In response, the Railway Labor Executives’ Association and some of its member labor organizations brought suit in federal district court to question the new regulations, arguing the drug testing was unconstitutional under the Fourth Amendment to the U.S. Constitution and the guarantee, specifically, against an unreasonable search and seizure. The court granted summary judgment for petitioners, deciding that the new regulations did not violate the Fourth Amendment. The court of appeals reversed the lower court’s decision, stating that a requirement of particularized suspicion is essential to a finding that toxicological testing of railroad employees is reasonable under the Fourth Amendment. The court stated that such a requirement would ensure that the tests, which reveal the presence of drug metabolites that may remain in the body for weeks following ingestion, are confined to the detection of current impairment. The Supreme Court held that the government’s interest in assuring

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safety on the nation’s railroads constituted a “special need” that justified a departure from standard warrant and probable-cause requirements in searches. Preventing accidents, the goal of most railroad regulations including the one in this case, argued Justice Kennedy, was such a significant concern that it warranted reduced “expectations of privacy” for railroad employees. A dissenting opinion, written by Justices John Marshall and William Brennan, provided another point of view to the debate. They stated that the issue in this case is not whether declaring war on illegal drug use is good policy. It has become apparent that ridding our society of these drugs is important. The issue in this case is if the government’s choice to collect and test the railroad worker’s blood and urine is a violation of the Fourth Amendment. While the need for action against drugs is great, the need to keep vigilant against unconstitutional action is also great. According to Justices Marshall and Brennan, when we allow fundamental freedoms to be sacrificed in the name of either real or perceived needs (i.e., the drug war), we sometimes regret it. The case opened the opportunity for random drug testing of public employees who are in “safety sensitive” jobs. Nancy E. Marion See also: Marijuana; National Treasury Employees Union v. Von Raab

Further Reading Skinner v. Railway Labor Executives’ Assoc. Oyez. http://www.oyez.org/cases/1980–198 9/1988/1988_87_1555. U.S. Supreme Court. Skinner v. Railway Labor Executives’ Assn., 489 U.S. 602 (1989). FindLaw. http://www.caselaw.lp.findlaw .com/cgi-bin/getcase.pl?court=us&vol=489 &invol=602.

Smith, Robert Holbrook (“Dr. Bob”) (1879–1950) A physician from Akron, Ohio, “Dr. Bob” cofounded Alcoholics Anonymous (AA) with Bill Wilson (1895–1971) in 1935. A surgeon who had suffered for years with alcoholism, Smith learned to drink in medical school at Dartmouth and discovered early in his drinking career that he could treat his morning jitters from the previous night with alcohol. Smith also observed that he seemed to recover more quickly than his friends from headaches the next day, making him think that he was an alcoholic from the start. He reportedly went to class fully prepared, but was unable to enter the classroom because of suffering jitters caused by drinking the night before. His partying ways and bouts of intoxication nearly prevented him from graduating from medical school, and he was required to stay for two extra semesters and remain sober as a requirement for graduation. Smith managed to finish and become a medical intern, during which time he managed his drinking. He married and opened his own medical practice in Akron, where he specialized in colorectal surgery. Holbrook continued to drink alcohol throughout. He realized he needed help, so he checked himself into numerous treatment programs, to no avail as his friends would smuggle alcohol into the hospitals for him. As Smith moved through young adulthood and his drinking worsened, he developed two phobias that further fueled his compulsive behavior: a fear of not sleeping and a fear of running out of alcohol. He drank heavily in the evenings so he could sleep, took sedatives in the mornings to control his withdrawal symptoms, and by early afternoon began lining up that evening’s supply of liquor. At one time, his concerned

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father brought him back to his childhood home in Vermont for a period of drying out. He returned to Ohio after several months and stayed sober until Prohibition was enacted into law in 1920. Smith viewed Prohibition as an excuse to resume drinking, reasoning that the difficulty of obtaining alcohol would serve as a built-in safeguard against drinking too much, forcing him to be moderate. As it turned out, Prohibition allowed physicians to obtain unlimited supplies of alcohol, so it was a relatively short time before Smith was drinking heavily again. According to his own accounts, he found a wide range of secret places in which to hide his liquor supply from his wife, including the coal bin, over cellar beams, in fur-lined gloves, even in cracks in his basement floor, and he had a standing agreement with his bootlegger to hide the alcohol deliveries in the back steps to his house. He and his wife lost many of their friends during this time, as he would get so drunk at these social occasions, no one wanted to be with him. At one point, Smith carried out his “beer experiment” in which he allowed himself to drink as much beer as he wanted, because no one ever got drunk on beer. In the end, he continued to get drunk but also gained weight. Balancing his drinking with his medical practice and family was a struggle for Smith. Smith married Anne Ripley in January of 1915. She became very interested in the ideas of the Oxford group, and encouraged her husband to be involved with them. As his drinking worsened, Smith’s medical practice suffered as he disappeared for days in patterns of bingeing and recovery. Although he had previously sought help from various sources, it was not until he joined the evangelical Oxford Group that he began to have hope that he might be able to quit. He envied the evident health and

emotional well-being of the group members, which they attributed to spirituality. Smith and his wife attended many lectures by Frank Buchman, the founder of Oxford Group, and attended meetings, but it was not helping him with his addiction. Nonetheless, Smith was receptive when another Oxford Group member named Bill Wilson, who was visiting Akron and struggling with his own alcohol cravings, asked to meet with him. Talking for hours, the two men formed an immediate bond, marveling over their discovery that discussing their feelings with each other, another alcoholic who truly understood what the other had endured, could be healing. Smith relapsed briefly not long after their meeting, and made inquiries to find any alcoholics in the Akron area that he could talk to. He was immediately referred to Henrietta Sieberling, a leader in the Akron Oxford Group. Sieberling was instrumental in establishing AA, and some say without her help, AA would never have been established. Smith took his last drink in June of 1935, the month and year that he and Wilson founded AA. The date of June 10 is celebrated as the anniversary of the group’s creation. In the meantime, they worked with numerous alcoholics to help restore them to sobriety, and by 1939, AA had produced its famous Twelve Steps to recovery. Smith reported four reasons why he continued to help others with their addictions to alcohol. One was his sense of duty. Two was the fact that it was a pleasure to help others. Three was because through helping others, he was repaying a debt to the man who helped him. And the fourth reason was that every time he helped others, it was a form of insurance policy for himself against a possible slip. Called the “Prince of Twelfth Steppers” by Bill Wilson because of the thousands of alcoholics the physician had helped, Smith

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remained abstinent for the rest of his life. He succumbed to prostate cancer in 1950. Kathryn H. Hollen See also: Alcohol Use; Alcoholics Anonymous; Recovery; Treatment; Twelve-Step Programs

Further Reading Alcoholics Anonymous. 1976. Alcoholics Anonymous (The Big Book). 3rd ed. New York: Alcoholics Anonymous World Services. Cheever, Susan. 2004. My Name Is Bill. Bill Wilson: His Life and the Creation of Alcoholics Anonymous. New York: Simon & Schuster. “Origins of AA—Henrietta Sieberling.” Transcripts of Henrietta’s Remarks Presented on Founder’s Day, June 10, 1971, given by John F. Sieberling. http://www.barefoots world.net/aaorighenriettas.html. Smith, Bob, and Sue Smith. Children of the Healer: The Story of Dr. Bob’s Kids. Center City, MN: Hazelden Foundation, 1993. Smith, Bob Holbrook. “Dr. Bob’s Nightmare.” http://www.aa.org/bigbookonline/en _drbobnightmare.pdf.

Smokers’ Rights The notion of “smokers’ rights” emerged in response to a nonsmokers’ rights movement that began in the early 1970s. With grassroots nonsmoking organizations successfully generating local and statewide smoking restrictions to protect the public from the health hazards of secondhand smoke, an embattled tobacco industry claimed that smokers’ rights were being violated. Casting smoking as a basic liberties issue, tobacco companies attempted to foster a countervailing smokers’ organization that ultimately failed, despite

public relations moves like the promulgation of a Bill of Rights for smoking, to generate a genuine smokers’ rights movement. The first groups to argue for smoke-free air as a nonsmokers’ right drew upon the civil rights, antiwar, and environmental movements as inspirations. Composed of volunteer activists, organizations like Americans for Non-Smokers’ Rights and Group Against Smoking and Pollution (GASP) advanced the notion that nonsmokers had a right to breathe smoke-free air. On the local level, these groups aggressively pushed for the passage of local and state ordinances that would regulate smoking in places of public accommodation like restaurants and office buildings. Beyond their legislative efforts, GASP members went directly to restaurant owners, and numbers of them agreed to create nonsmoking sections in their businesses well before the passage of any laws mandating such areas. Despite the fact that science had yet to conclusively prove the serious health hazards of secondhand smoke, the nonsmokers’ rights movement helped enact a number of public smoking restrictions across the country and in the nation’s skies. By 1973, nonsmoking sections existed on all airlines, and in that same year, Arizona became the first state to ban smoking in buses, theaters, elevators, museums, and libraries. Two years later, in large part as a result of the Twin Cities chapter of the Association for Non-Smokers’ Rights, Minnesota passed the first statewide Clean Indoor Air Act, which, among other things, forbade smoking in all public places unless specifically allowed. The number of similar smoking restrictions multiplied in subsequent years, so that 80 percent of the nation’s population lived in areas that were covered by these laws by the mid-1980s. The tobacco industry did not passively accept these tremendous changes to the place

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of smoking in public life, and one of their tactics to combat the nonsmokers’ rights movement was to help foster a countermovement in support of what was dubbed “smokers’ rights.” This mimicking went beyond a similarity in names, as the tobacco industry explicitly linked their movement, as had nonsmokers’ rights groups, to the civil rights movement. Similarly, in response to the American Cancer Society’s Great American Smokeout, which encouraged smokers to quit, Philip Morris distributed a Great American Smoker’s Kit, a pamphlet that encouraged smokers to convince nonsmokers that smoking was a basic right. Further casting smoking as an American freedom imperiled by the zealotry of the nonsmokers’ rights movement, Philip Morris went so far as to distribute a Bill of Rights for smoking to its customers. Among the rights afforded to smokers according to this document were the right to accommodation in the workplace and public places and the right to freedom from undue government intrusion. And in order to help transform these ideas into an organization and movement capable of rivaling the nonsmokers’ rights drive, the tobacco companies helped fund the National Smokers’ Alliance (NSA). This allegedly grassroots organization, which claimed around 3 million members, was in fact industry-led and created with the assistance of a public relations firm. Largely seen for what it truly was, the NSA was unable to develop a movement on par with the nonsmokers’ cause. When these efforts largely failed, the tobacco industry attempted to shift the terms of the nonsmokers’ rights debate by stressing the need for accommodation. The Accommodation Program, launched by Philip Morris in the early 1990s, stressed that the best way to resolve the increasingly contentious issue of public smoking was not through legislating smoking restrictions, but

rather via mutual respect between smokers and nonsmokers. Still casting smoking bans as an unwarranted government intrusion in the personal lives of smokers, Philip Morris claimed that tolerance and accommodation could prevent the supersession of either group’s rights. If hotels, restaurants, and bars voluntarily set aside public spaces for smokers, as Philip Morris’s pamphlets suggested, the rights of both groups would be protected and increased legislation would be unnecessary. The 1990s nonetheless marked an expansion of smoking restrictions in public places across the country, and the accomplishments of the smokers’ rights movement paled in comparison to the achievements of the nonsmokers’ rights movement. Smokers’ rights campaigns and a policy of encouraging accommodation proved insufficient to halt a growing number of smoking bans that emerged to protect nonsmokers from secondhand smoke. Ultimately, once science confirmed the serious health hazards posed by secondhand smoke, the public and government determined that nonsmokers’ access to clean air effectively trumped smokers’ traditional freedom to smoke in public places. Howard Padwa and Jacob A. Cunningham See also: Nicotine; Secondhand Smoke; Tobacco

Further Reading Brandt, Allan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America. New York: Basic Books. Cordry, Harold V. 2001. Tobacco: A Reference Handbook. Santa Barbara, CA: ABC-CLIO. Goodman, Jordan, ed. 2005. Tobacco in History and Culture: An Encyclopedia. Detroit: Thomson Gale.

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Smoking Opium Exclusion Act (1909) The Smoking Opium Exclusion Act of 1909 was the first federal law targeting the importation of narcotics into the United States. Its impact, however, was limited, since it was hastily crafted for political reasons, and its provisions soon became unnecessary with the passage of the Harrison Narcotics Act of 1914. Nonetheless, the legislation did mark a new step in the federal government’s campaign against recreational drug use. As the habit of smoking opium became more prominent among non-Chinese populations in the 1870s, many local municipalities and state governments throughout the Western United States began passing laws banning the practice. These laws had limited impact, however, and many reformers believed that federal legislation that would make it either too expensive or risky to smoke opium would be the most effective way to curb the practice. The problem, however, was that many believed the federal government did not have the authority to pass legislation on social problems like drug use—such powers were thought to be reserved for the states. In the early 1880s, some members of Congress introduced legislation that would have increased the import duties on opium that was prepared for smoking, taxed its domestic manufacture at a higher rate, or even banned its importation altogether. None of these measures passed. By the early 1900s, however, the push to institute tighter domestic controls over opium smoking in the United States began gaining momentum. The renewed push for opium control came not so much from a growing opium problem at home as it did from international concerns. As the United States prepared for the first international opium conference at Shanghai in 1909, the U.S. delegation led by Hamilton Wright

wanted the United States to have a model law in place to show that its desire to institute a global drug control regime was sincere. If the United States began pushing for international controls without having any effective drug laws on the books at home, they feared, the United States would be open to charges of hypocrisy, and the conference would fail. Though Wright would have preferred a piece of comprehensive drug control legislation (like the Harrison Act he eventually helped become law in 1914), it would have been too complicated and controversial to pass such sweeping legislation before the conference began. Instead of aiming to control all narcotics, Wright and Secretary of State Elihu Root pushed for more modest legislation by proposing a bill that would have prohibited the importation and use of opium that was already prepared for smoking. By narrowly tailoring the legislation to avoid affecting the commerce in morphine, heroin, or other preparations, Root and Wright maximized the likelihood that the law would pass; unlike manufactured opiates and medicinal preparations that included opium, there was no major industry or lobby behind smoking opium, meaning that opposition to such a law would be relatively weak. The act was proposed as a bill in January of 1909, and became law that February, less than a week before the meeting at Shanghai began. For Wright and others in the U.S. delegation, the law passed just in time for them to show the world that the United States was taking action to curb drug use at home, and to allow them to argue that other countries should do the same. Aside from bolstering the case of the U.S. delegation at Shanghai, the Smoking Opium Exclusion Act was a watershed in the history of U.S. drug policy. It was the first nationwide policy aimed specifically at recreational drugs (the Pure Food and Drugs Act

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of 1906 concerned medicines). It banned the importation of opium that was prepared for smoking, and inflicted punishments of up to $5,000 or 2 years in prison for violations. Even more importantly, it made the opium habit a more expensive and dangerous one to maintain. The import ban made smoking opium increasingly scarce in the United States, and as a result, it became extremely expensive. Though this may have discouraged some from smoking the drug, it also created incentive for smugglers and illicit dealers to start doing business in the drug since it could be very profitable. Also, many people who had been smoking opium began switching to other, more potent derivatives of opium, like morphine and heroin, which were not covered by the ban. It would not be until 1914, when the more comprehensive Harrison Act took effect, that these other substances would become subject to equally stringent government controls. Howard Padwa and Jacob A. Cunningham See also: Harrison Narcotics Act; Opium; Pure Food and Drug Act

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press.

Sonora Cartel Headed by drug trafficker Miguel CaroQuintero and his two brothers, Jorge and Genaro, this drug-trafficking organization

was based in Sonora, Mexico, and was created after the Guadalajara cartel broke up. As one of the oldest and most established drug cartels, the group specialized in the trafficking of marijuana. Like other Mexican drugtrafficking organizations, however, the cartel diversified and also trafficked in cocaine and methamphetamine. It had direct ties to the Colombian cartels that supplied the cocaine to the Sonora Cartel. Under Caro-Quintero’s leadership, the Sonora Cartel exported between two and four tons of marijuana a month into Colorado between 1985 and 1988. The marijuana was then distributed across the United States by airplane and car. The cartel used several ranches in the northern border state of Sonora to store drugs before smuggling them to the United States, principally through routes extending into California, Arizona, Texas, and Nevada. Miguel Caro-Quintero was born in Mexico in 1963. Miguel is the brother to the cofounder of the Guadalajara cartel, Rafael Caro-Quintero, who was arrested by law enforcement for the brutal torture and murder of Drug Enforcement Administration (DEA) special agent Enrique Camarena Salazar. Although Miguel Caro-Quintero has been the subject of several arrest warrants in the United States, he has denied being a drug trafficker and claims to be an innocent rancher. Miguel was arrested in 1992 in Mexico, but he was able to use a combination of threats and bribes to get a Mexican judge to dismiss the charges against him. He claims the DEA is unfairly punishing him because of his brother’s role in the Salazar murder, which Miguel says Rafael did not do. Officials have never linked Miguel to the crime. Miguel was extradited to the United States in February 2009, and in January 2010, he was sentenced to 17 years in prison in Denver for his conviction on racketeering and drug charges.

Soros, George (1930– )  833

The Sonora Cartel has largely fallen apart, and has merged with the Tijuana and Sinaloa cartels. Miguel’s brother Rafael is currently in jail for his part in the torture and murder of Salazar. Ron Chepesiuk See also: Cali Cartel; Camarena Salazar, Enrique; Drug Cartels; Drug Enforcement Administration; Mexican Drug Trade; Tijuana Cartel

Further Reading Abernethy, Samantha. 2010. “Miguel Angel Caro Quintero, Former Sonoran Cartel Boss, Convicted in Denver.” Huff Post Denver, February 4. http://www.huffington post.com/2010/02/04/miguel-angel-caro -quinter_0_n_449654.html.

fortune by founding and managing an international investment fund. Soros has been active as a philanthropist since 1979. He has provided financial support for the Drug Policy Alliance (previously the Lindesmith Center), a leading drug policy and research institute that was directed by Ethan Nadelmann, who has been described by Rolling Stone magazine as the point man for drug policy reform efforts. Soros has also helped finance marijuana referenda in California and Arizona. Soros became involved in the drug issue because of a commitment to the concept of open society. The open society is based on the recognition that “we act on the basis of imperfect understanding and our actions have unintended consequences. . . . An open

Bauder, Julia. 2008. Drug Trafficking. Detroit: Greenhaven Press. Bewley-Taylor, David R. 2012. International Drug Control. Cambridge, MA: Cambridge University Press. Grayson, George W. 2010. La Familia Drug Cartel: Implications for U.S.-Mexico Security. Carlisle, PA: Strategic Studies Institute, U.S. Army War College. U.S. Senate Committee on Foreign Relations. 1997. Mexico and the Southwest Border Initiative. Statement of Thomas A. Constantine, Director, DEA. March 12. http://www .usdoj.gov/dea/pubs/congrtest.

Soros, George (1930– ) Born in Budapest, George Soros survived Nazi occupation and left communist Hungary in 1947 for England. He attended the London School of Economics, graduating in 1952. In 1956, Soros moved to the United States where he accumulated a large

George Soros, hedge fund manager and chairman of Soros Fund Management, LLC, appears in front of the House Oversight and Government Reform Committee in 2008. Soros has contributed large sums of money to campaigns to legalize marijuana. (EdStock/ iStockphoto.com)

834   Soros, George (1930– )

society that recognizes fallibility is a superior form of social organization to a closed society that claims to have found all the answers.” In an article that he wrote for the Washington Post, Soros (1997) stated: I have devoted much of my energies and resources over the past two decades to promoting the concept of open society in formerly communist countries. I have started to pay more attention to my adopted country, the United States, because I feel that the relatively open society we enjoy here is in danger. There is nothing new about this peril; it is a characteristic of open societies that they are always endangered. Our drug policies offer a prime example of adverse, unintended consequences. There is perhaps no other field where our public policies have produced an outcome so profoundly at odds with what was intended. But those who are waging a “war on drugs” refuse to recognize this fact. They consider all criticism subversive. To suggest the possibility that the war on drugs may be self-defeating is tantamount to treason in their eyes. This was confirmed by their reaction to the approval of the drug policy ballot initiatives in California and Arizona. Soros believes “a drug free America is a utopian dream. Some form of drug addiction or substance abuse is endemic in most societies. Insisting on total eradication of drug use can only lead to failure and disappointment. The war on drugs cannot be won; but, like the Vietnam War, it has polarized our society” (Soros 1997). Soros is a big supporter of both recreational and medical marijuana. He feels that criminalization of the drug has not prevented marijuana from becoming the most widely used drug in the United States and around

the world. Instead, it has resulted in negative consequences such as billions of dollars in tax money for enforcement and incarceration, millions of arrests (most for small amounts of marijuana), and crime and violence. He argues that the laws are enforced unfairly, with minorities punished more harshly than whites. The people that benefit the most from keeping marijuana illegal are the criminal organizations in Mexico and elsewhere. Soros has funded multiple campaigns in support of medical marijuana. Some of the campaigns he has supported include those in Alaska (1988); Arizona (1996, 1998, 2000, 2002); California (1996, 2000); Colorado (1998, 2000); District of Columbia (1998, 2002); Florida (2000, 2002); Maine (1999); Massachusetts (2000); Michigan (2002); Nevada (1998, 2000); Ohio (2002); Oregon (1998, 2000); Utah (2000); and Washington (1997, 1998). Richard E. Isralowitz See also: Drug Policy Alliance Network; Medical Marijuana; War on Drugs

Further Reading “George Soros.” 2013. Forbes. http://www .forbes.com/profile/george-soros/. George Soros.com. http://georgesoros.com/. Shahid, Aliyah. 2010. “George Soros to California: Legalize Recreational Marijuana, Endorse Proposition 19.” New York Daily News, October 26. http://www.nydailynews .com/news/national/george-soros-california -legalize-recreational-marijuana-endorse -proposition-19-article-1.193225. Soros, George. 1997. “The Drug War Debate; The Drug War ‘Cannot Be Won’; It’s Time to Just Say No to Self-Destructive Prohibition.” Washington Post, February 2. http:// www.mapinc.org/drugnews/v97/n000/a03 .html.

Special Action Office of Drug Abuse Prevention  835 Soros, George. 2010. “Why I Support Legal Marijuana.” Wall Street Journal, October 26. http://online.wsj.com/news/articles/SB 1000142405270230346700457557445070 3567656. Wearden, Graeme. 2013. “George Soros Backs Guatemalan President’s Call to End War on Drugs.” The Guardian, January 23. http:// www.theguardian.com/business/2013/ jan/23/george-soros-guatemala-war-on -drugs.

Special Action Office of Drug Abuse Prevention The Special Action Office of Drug Abuse Prevention (SAODAP) was created by President Richard Nixon on June 17, 1971. SOADAP became the central authority of all the major federal drug abuse prevention, education, treatment, rehabilitation, training, and research programs. The head of SAODAP was a director who was accountable to the president, so the office was located within the Executive Office of the President. SAODAP was intended to operate for only three years with the option of extending its operations for an additional two years. The director of SAODAP would create working agreements with other federal agencies. Through these agreements, each agency would apply their particular skills and resources to the fight against drug abuse. That way, the problems of drug abuse and addiction could be solved more efficiently. SAODAP was given the authority to use all of the available resources found within the federal government to help identify problems, and then direct resources to solving those problems. It was thought that centralizing the activities of all of the individual agencies would mean an elimination of bureaucratic red tape, and jurisdictional disputes between

agencies would no longer exist. It was hoped that the Special Action Office could implement a more comprehensive coordinated attack on the national problem of drug abuse. SAODAP was also given the ability to develop methods to monitor the success of programs, and the capabilities to evaluate the programs. This way, they could realistically determine which activities and techniques were producing results. The evaluations would then be tied to the planning process so that knowledge about success or failure results could guide the selection of future plans and priorities. In addition to interagency agreement and the Program Plan approach, the office would have the ability to award grants or make contracts with industrial, commercial, or nonprofit organizations. This would only happen if there was no federal agency that had the skills to undertake that task. It could also happen if, for some reason, it would be faster, cheaper, or more effective to grant or contract with an agency outside of the government. The director was responsible for setting specific objects for the agencies to accomplish within the first three years of its exis­ tence. These objectives would target such areas as reduction in the overall national rate of drug addiction, reduction in drug-related deaths, reduction of drug use in schools, impact on the number of men rejected for military duty because of drug abuse, and so forth. A primary objective of the office would be the development of a reliable set of social indicators that accurately show the nature, extent, and trends in the drug abuse problem. Nancy E. Marion See also: Nixon, Richard M.

Further Reading Nixon, Richard M. 1971. “Special Message to the Congress on Drug Abuser Preven-

836   Special Narcotic Committee tion and Control.” June 17. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presid ency.ucsb.edu/ws/?pid=3048. Nixon, Richard M. 1972. “Statement on Establishing the Office for Drug Abuse in Law Enforcement.” January 28. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=3552.

Special Narcotic Committee The Special Narcotic Committee (SNC) was a committee formed by the Treasury Department to study narcotics control and recommend changes in the law and its administration in 1918 and 1919. Ultimately, the SNC influenced the federal stance towards narcotics and drug control by authoring a bill that strengthened the provisions of the Harrison Narcotics Act, and also by conducting research that advanced the federal government’s assertion that narcotic drug use was actually increasing, not decreasing, after the passage of the Harrison Act in 1914. The SNC was formed in the spring of 1918, when Commissioner of Internal Revenue Daniel C. Roper proposed the creation of a committee to examine narcotics control more closely. Treasury Secretary William McAdoo appointed the committee on March 25, 1918, in hopes that it could help overturn the Supreme Court’s decision in Jin Fuey Moy v. United States—which established that possession of narcotics was not a punishable offense under the Harrison Act—and advance arguments against the maintenance treatment of addiction. The committee was chaired by Representative Henry T. Rainey (D-Ill.), and also included former chief of pharmacology for the U.S. Public Health Service, Reid Hunt; A. G. DuMez, also of

the Public Health Service; and Deputy Commissioner of the Internal Revenue Bureau B. C. Keith. One of the SNC’s first accomplishments was the tightening of restrictions over narcotics under the Harrison Act. Through provisions Rainey added to the Tax Act of 1918, the SNC was able to close many of the loopholes in the Harrison Act that had become clear in the Jin Fuey Moy Supreme Court case. For one, Rainey’s legislation instituted a tax of one cent per ounce of narcotics, thus establishing that the Harrison Act was indeed a revenue measure. What this meant was that any individual in possession of a package containing narcotics that did not have a tax stamp could be brought up on charges of illegal possession unless they could produce a prescription from a physician to prove that they had the drugs for medical purposes. The more important accomplishment of the SNC was the June 1919 release of its final report, titled Traffic in Narcotic Drugs. The report was based largely on a questionnaire survey given to the 173,000 physicians and pharmacists who had registered with the federal government under the Harrison Act. The response rate to the survey was relatively low, between 30 percent and 40 percent, so the SNC extrapolated numbers from those who responded to come up with the rough estimate that there were 250,000 addicts in treatment in the United States. Assuming that only a minority of addicts ever sought out treatment, the SNC concluded that there were over 1 million addicts in the country, and that per capita consumption of opium was higher in the United States than in any other industrialized nation. As historian David F. Musto points out, the numbers reported by the SNC in the report were probably gross exaggerations, but they were still cited as evidence that the drug problem was growing (Musto 1987, 138).

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Traffic in Narcotic Drugs also predicted that the number of addicts would continue to grow, since alcohol prohibition would lead many drinkers to turn to narcotics. It also warned of the growing size and scope of the black market for drugs, and the development of increasingly organized drug rings that smuggled narcotics across the Canadian and Mexican borders. Traffic in Narcotic Drugs also addressed the question of addiction and maintenance treatment. With the Supreme Court’s antimaintenance decisions in the Doremus and Webb cases in 1919, the report predicted that many addicts would become desperate for narcotics, and it recommended that both the federal and local governments provide medical care for them as they underwent detoxification. However, the SNC did not endorse any form of medical treatment for addiction, and warned that the likely result of limited availability could be that addicts would become violent. Addiction, therefore, became more than just a medical problem that afflicted addicts; given the high numbers of addicts estimated in the SNC report, and the belief that they could become violent if denied their drugs, it also became a potential menace to public safety. Even though it was only in existence for little more than a year, the SNC had a lasting impact on the trajectory of narcotic drug policy in the United States. By closing loopholes in the Harrison Act and spreading fear about the spread of narcotics addiction, the work of the SNC contributed to the hardening of attitudes towards both drug users and traffickers in the 1920s. Howard Padwa and Jacob A. Cunningham See also: Harrison Narcotics Act; United States v. Doremus and Webb et al. v. United States; United States v. Jin Fuey Moy

Further Reading Acker, Caroline Jean. 2002. Creating the American Junkie: Addiction Research in the Classic Era of Narcotic Control. Baltimore: Johns Hopkins University Press. “More than 1,000,000 Drug Users in U.S.” 1919. New York Times, June 13. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

State Drug and Alcohol Control Laws The federal government became involved in regulating the use of opiates and cocaine in 1914, the use of alcohol in 1919, the use of marijuana in 1937, and the use of other potentially habit-forming substances after World War II. Yet before these controls were instituted nationwide, several states and localities instituted their own controls over these substances. The first major substance to become subject to state controls was alcohol. The colony of Georgia tried to ban alcohol in 1735, but the law proved ineffective and was repealed in 1742. Beginning with the work of Benjamin Rush in the late 18th century, however, modern conceptions of alcoholism began to develop in the United States. Temperance societies and other groups that advocated for the prohibition of alcohol became increasingly powerful over the course of the 19th century, as over 5,000 of them emerged nationwide by the 1830s, and they had well over a million members. Though many of these groups originally focused on convincing citizens to voluntarily limit their alcohol consumption, they became more militant as they grew in numbers, first preaching abstinence from alcohol, and then moving

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on to advocate for legal prohibition of the substance when they found that voluntary pledges to stop using alcohol excessively did not keep people from developing drinking problems. By the middle of the 19th century, many politicians joined the cause, leading to four distinct waves of state prohibition laws. The first wave began with Maine’s 1851 law banning the manufacture of intoxicating liquor, allowing only municipal agents to sell it, and limiting its use to industrial and medicinal purposes. Police in Maine were empowered by the law to search and seize illicit alcohol, and individuals who violated the statute were heavily fined and jailed if they were repeat offenders. The Maine law served as a model for advocates of prohibition elsewhere, and by 1855, 15 other states had passed similar laws. Resistance from ethnic groups and the liquor industry ultimately led to the repeal of many of these statutes. The second wave of state prohibition laws came in the 1880s and 1890s, as groups such as the Woman’s Christian Temperance Union and the Prohibition Party began to gain influence. Political pressure led 17 states, beginning with Kansas in 1880, to hold referenda on alcohol prohibition, though only four of them wound up instituting it. At the beginning of the 20th century, groups such as the Anti-Saloon League of America resumed pressuring states to pass laws banning alcohol. Many of the state laws that were passed in the early 20th century banned the use of alcohol, though some of them allowed for the importation and production of liquor, thus limiting their effectiveness. By 1917, two years before Congress passed the Volstead Act, 31 states had some form of alcohol prohibition. After the passage of the Eighteenth Amendment, a fourth wave of state prohibition laws took hold, as states sought to modify their laws

to be in harmony with the national prohibition regime. By 1933, when prohibition was repealed, every state except for Maryland had passed a prohibition law at some point in the previous century. When national prohibition was repealed, many states repealed their bans on alcohol, though some persisted for a long time. Oklahoma, for example, did not repeal its prohibition law until 1959, and the last state prohibition statute to be taken off the books was Mississippi’s law, which was rescinded in 1966. While other substances were not as widely controlled by state laws in the late 19th and early 20th centuries, many states did have statutes controlling their use for nonmedicinal purposes. Pennsylvania was the first state to regulate morphine with an 1860 law that controlled the drug with its antipoisons law. In the late 19th century, several states, such as Ohio and Nevada, passed laws banning opium smoking, and limiting to druggists the right to sell opium. In 1897, Illinois became the first state to take action against cocaine, banning its sale or transfer except with a doctor’s prescription. Anticipating the sweeping federal legislation that was to come with the Harrison Narcotics Act in 1914, some states, such as West Virginia, New York, and Indiana, passed more comprehensive laws in the first decade of the 20th century, stipulating that cocaine and opiates could only be sold and used for medicinal purposes. In 1913, Tennessee passed a narcotics control act that allowed addicts to receive prescriptions for opiates legally, in hopes of cutting off the illicit market for the drugs. In 1914, months before the passage of the Harrison Act, New York passed the Boylan Act, which was the first piece of state legislation that allowed for the civil commitment of drug addicts. The Boylan Act, however, was the exception, as most state laws were looser, with most of them merely stipulating that

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narcotics could only be dispensed with a prescription, and that narcotic prescriptions could not be refilled. The sanctions for violating many state laws were light, inflicting only fines or short prison terms on individuals convicted of breaking them. This became worrisome for enforcement officials with the Federal Bureau of Narcotics (FBN), since they wanted the help of state and local police in cracking down on offenses related to drug use and drug dealing not covered under the Harrison Act, and also with the enforcement of federal rules governing drug possession, use, and dealing. In 1932, most states took a major step towards filling in gaps in federal drug control policy and enforcement by adopting the model law issued by the Uniform State Narcotic Act, thus harmonizing state drug laws so that they buttressed the Harrison Act and giving states a share of the responsibility for enforcing the nation’s drug laws. The four states that did not adopt the Uniform State Narcotic Act, though they did not have identical legislation, had very similar laws governing the sale and use of narcotics. In the 1950s, after the Boggs Act stiffened federal penalties for drug-law violators, the FBN again pushed for states to adopt equally tough laws. When the Comprehensive Drug Abuse Prevention and Control Act reclassified drugs in 1970, it once again became important for states to make their antidrug laws consistent with the federal scheme for controlling them, leading to the issuing of another uniform state drug law act. With the passage of the Anti–Drug Abuse Act of 1988, yet another model state drug law was issued, this time recommending not only uniform enforcement measures, but also suggesting prevention, treatment, and rehabilitation laws for both alcoholics and drug users. In spite of these moves to

harmonize state drug laws, there are still some discrepancies between state and federal narcotic control laws today, particularly when it comes to penalties for marijuana possession and the questions surrounding medical marijuana. In these cases, federal law technically trumps state law, though sometimes the federal laws are not enforced as strictly as state laws. Howard Padwa and Jacob A. Cunningham See also: Anti-Saloon League; Boylan Act; Eighteenth Amendment; Federal Bureau of Narcotics; Volstead Act; Webb-Kenyon Act; Woman’s Christian Temperance Union

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Blocker, Jack, Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Burns, Eric. 2004. The Spirits of America: A Social History of Alcohol. Philadelphia: Temple University Press. Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Earlywine, Mitch. 2002. Understanding Marijuana: A New Look at the Scientific Evidence. Oxford: Oxford University Press. Musto, David F. 1987. The American Disease: Origins of Narcotic Control. Expanded Edition. New York: Oxford University Press.

STDs and Drug Use Sexually transmitted diseases (STDs) or sexually transmitted infections are typically acquired through sexual contact. They pass

840   STDs and Drug Use

from person to person in blood, semen, or vaginal and other body fluids. STDs can also be transmitted nonsexually, such as from a mother to a baby during pregnancy or childbirth. They can also be transmitted through blood transfusions or sharing needles to inject drugs. Sexually transmitted infections have many symptoms: sores or bumps on the genitals or in the oral or rectal area; painful or burning urination; discharge from the penis; vaginal discharge; unusual vaginal bleeding; sore, swollen lymph nodes; lower abdominal pain; and rashes. Those who use drugs or alcohol are more likely to contract an STD than those who do not abuse drugs. When a person is under the influence of a drug, they are less likely to make good choices about their sexual behavior. They are more likely to have sexual contact without a condom, have multiple sexual partners, and/or have sex with a casual partner. This becomes even more dangerous when users exchange sex for drugs or money. Some drug users may not be aware that they have contracted an STD, and will continue to have sexual partners, spreading the disease to even more people. A person who abuses drugs or alcohol may also be more susceptible to contracting an infection in other ways. The substance abuse may affect a body’s immune system, reducing a body’s ability to fight off the virus. Moreover, certain drugs, in particular crack cocaine and amphetamines, may delay a male’s ejaculation. This means that there may be longer or more vigorous sexual activity, which increases the possibility of physical trauma. This, then, makes it easier to transmit the virus to a partner. The use of alcohol is linked to higher rates of STDs among youth, and those who drink and use drugs are even more likely to be diagnosed with an STD. This is especially true for females. The Substance Abuse and

Mental Health Services Administration reports that young people who drink heavily are twice as likely to have an STD than those who do not drink or use drugs. The most common types of STDs that addicts may contract include: • Chlamydia: the most common form of STD in the United States, caused by a bacterial infection. It is most likely to affect the genitals and eyes. • Gonorrhea: caused by a bacterial infection and can cause damage to many parts of the body if not treated. • Genital Herpes: caused by a viral infection. This can cause sores on the genitals, in some people for many years after the infection first occurs. • Genital Warts: caused by the Human Papilloma Virus (HPV). This can appear as soft growths of skin that appear on the mucous membranes of the genitals. • Viral Hepatitis: can include hepatitis A, B, and C. This can cause inflammation of the liver and can be life threatening in some people. • Syphilis: a bacterial infection that is largely eradicated in the United States. • HIV: a virus that affects the normal functions of the immune system. Many factors explain why drug users are more likely to contract an STD. One is that they are more likely to make poor decisions when they are intoxicated or under the influence of a drug. Drugs also lower people’s inhibitions, so they are more likely to engage in sexual activity. Drug users are also more likely to engage in risky behavior. If symptoms of a disease do appear, addicts are likely to ignore them, or to refuse to seek medical help. In this case, what would have been a treatable disease may become much

Steroids, Anabolic 

more serious. If they do seek medical help, drug addicts may not have the money to purchase necessary medication, or may not use the medication as required. In some cases, the medication may interact with the recreational drug of choice. Nancy E. Marion See also: HIV/AIDS and Drug Use; Needle Exchange Programs

Further Reading DARA Thailand. “Addiction and Sexually Transmitted Diseases.” http://alcoholrehab .com/alcohol-rehab/addiction-and-sexually -transmitted-diseases/. DrugAbuse.org. 2013. “The Link Between Drug Abuse and STDs.” http://www.drugsabuse .org/the-link-between-drug-abuse-and-stds/. Hwang, Lu-Yu, Michael W. Ross, Carolyn Zack, Lara Bull, Kathie Rickman, and Marsha Holleman. 2000. “Prevalence of Sexually Transmitted Infections and Associated Risk Factors Among Populations of Drug Abusers.” Clinical Infectious Diseases 31: 920–26. http://cid.oxfordjournals.org /content/31/4/920.full.pdf. Mayo Clinic. “Sexually Transmitted Diseases.” http://www.mayoclinic.com/health/ sexually-transmitted-diseases-stds/DS 01123. Substance Abuse and Mental Health Ser­vices Administration. 2007. “Heavy Drinking and Drug Use Linked to Higher Rates of Sexually Transmitted Diseases Among Young Adults.” http://www.samhsa.gov/ newsroom/advisories/0703281912.aspx. Sutton, Amy L. Sexually Transmitted Diseases Sourcebook: Basic Consumer Health Information about Sexual Health and the Screening, Diagnosis, Treatment, and Prevention of Common Sexually Transmitted Diseases (STDs), including Chancroid, Chlamydia, Gonorrhea, Herpes, Hepatitis. 2013. Detroit, MI: Omnigraphics.

Steroids, Anabolic Anabolic steroids, as distinguished from other steroids, promote tissue growth. Most are more properly called anabolic-androgenic steroids because they are based on a natural androgen, testosterone. Human growth hormone, produced by the pituitary as somatotropin, is another anabolic steroid. It stimulates cellular growth and division to build muscle and strength but comes with significant side effects such as gynecomastia (breast enlargement in boys and men) and other serious disorders. Anabolic steroids are legally produced to treat conditions related to stunted growth or testosterone deficiency, but they are often illegally synthesized for an illicit market that uses them primarily to enhance athletic skills and performance. In 1991, out of concern over a growing underground market for the drugs, the U.S. Congress decided to regulate anabolic steroids by placing them on the Controlled Substances Act (CSA) schedule. These testosterone-derived drugs are not addictive in the same way that alcohol or cocaine is addictive. However, their effects on the user can be as rewarding as the effect of a psychoactive drug. For athletes or others who yearn to have a more muscular body, who have issues with poor selfesteem, or who are driven psychologically to excel at their chosen sports, the drugs can help deliver the desired results; achieving their particular goal can give users enough of an emotional boost to keep them using the dangerous drugs despite negative consequences, a behavior that is the hallmark of addiction. The perceived rewards that initial use of these drugs may provide are eventually replaced by the irritability, delusions, restlessness, insomnia, and hostility they are capable of producing.

841

842   Steroids, Anabolic

In recent years, growing reports of adolescent use of anabolic steroids has raised concerns among policymakers, the sports industry, and healthcare professionals about the dangers these drugs pose. In contrast to past use by professional athletes, the abuse of anabolic steroids today has grown significantly among high school and college students who want to boost muscle mass and improve athletic performance. Studies funded by the National Institute on Drug Abuse report that even 8th graders—albeit a small percentage—admit to having used steroids at least once. The Centers for Disease Control and Prevention, which also conducts surveys of high school students throughout the United States, reported in 2005 that 4.8 percent of high school students have used steroid pills or shots without a prescription. Anabolic steroids were developed originally to treat conditions characterized by deficient levels of testosterone such as delayed puberty, or, on an experimental treatment basis, osteoporosis. In veterinary medicine, they are used as growth supplements or to enhance physical features such as the texture of an animal’s hair or coat. Originally diverted from these legitimate uses to illicit use, steroids are now smuggled in from other countries for sale in the United States or manufactured in clandestine laboratories. Often counterfeit drugs are sold to unsuspecting users. So pervasive are illegal anabolic steroids that they can be purchased at gyms, sports competitions, or even ordered by mail. Taken orally, administered intramuscularly by means of an injection, or rubbed on the skin, anabolic steroids are “cycled,” “stacked,” or “pyramided” by users to minimize side effects and avoid tolerance. Cycling involves periodic instances of taking multiple doses of steroids and stopping again; stacking refers to the use of several

drugs simultaneously; pyramiding describes the slow escalation of dosage followed by a de-escalation. Despite these tactics, the use of anabolic steroids can cause significant side effects and serious damage, especially to the liver and cardiovascular system, and promote aggressive behavior and mood swings. Other side effects are also daunting. Men may suffer from premature and permanent balding, impotence, breast enlargement, testicular atrophy, and high blood pressure. Women may develop more masculine features, such as facial hair or a deeper voice, as well as smaller breasts and fewer menstrual cycles. Both sexes can develop acne. Alarmingly, adolescents who take these drugs are at risk for stunted growth, and users can suffer serious damage to the heart. Under the CSA, anabolic steroids have been placed on Schedule III with severe penalties for sale or distribution. Possession of illegal steroids carries a maximum penalty of one year in prison and a minimum $1,000 fine for a first offense. Those who wish to restrict or cease their use of anabolic steroids often resort to other illegal steroids such as insulin, tamoxifen, or human chorionic gonadotropin. Dietary steroids such as dehydroepiandrosterone are also being used to substitute for anabolic steroids, and Congress is considering adding these to the CSA’s controlled substances list. In 2004, an Anabolic Steroid Control Act was passed to place additional steroids under Schedule III and expand the Drug Enforcement Administration’s regulatory and enforcement authority over steroid use. All major sports organizations, including the International Olympic Committee, National Collegiate Athletic Association, National Basketball Association, National Football League, and the National Hockey League, have banned the use of anabolic

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steroids by their athletes, and some organizations have also banned the steroid precursors androstenedione. They also conduct urine testing to ensure compliance. There are over 100 different kinds of anabolic steroids, which are available only by prescription. Some are Deca-Durabolin (nandrolone decanoate), Depo-Testosterone (testosterone cypionate), Dianabol (methandrostenolone), Durabolin (nandrolone phenylpropionate), Equipoise (boldenone undecylenate), Oxandrin (oxandrolone), Anadrol (oxymetholone), and Winstrol (stanozolol). Street names include Arnolds, gear, gym candy, juice, pumpers, roids, stackers, and weight trainers. Kathryn H. Hollen See also: Drug Classes; Steroids and Sports; Steroids in Baseball

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Helmenstine, Anne Marie. “Anabolic Steroids: Performance Enhancing Drugs.” http:// chemistry.about.com/od/medicalhealth/a/ anabolicsteroid.htm. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. National Institute on Drug Abuse. 2012a. “Drug Facts: Anabolic Steroids.” http:// www.drugabuse.gov/publications/drug facts/anabolic-steroids. National Institute on Drug Abuse. 2012b. “Ste­ roids, Anabolic.” http://www.drugabuse .gov/drugs-abuse/steroids-anabolic.

U.S. Department of Health and Human Services, National Institute on Drug Abuse. http://www.nida.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006. Research Report Series: Anabolic Steroid Abuse. NIH Publication No. 06-3721. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea. U.S. Department of Justice, Drug Enforcement Administration. 2004. “Anabolic Steroids: A Dangerous and Illegal Way to Seek Athletic Dominance and Better Appearance: A Guide for Understanding the Dangers of Anabolic Steroids.” Washington, DC: U.S. Department of Justice.

Steroids and Sports More properly designated as anabolicandrogenic steroids (AAS) because of their bodybuilding (anabolic) and masculinizing (androgenic) effects, steroids are synthetic versions of the male sex hormone testosterone that are illicitly used by, among others, athletes in order to enhance their physical performance and appearance. Though they have been banned by the International Olympic Committee since 1975 and prohibited by nearly every sporting organization, they are nonetheless taken by a significant, though ultimately unknown, number of athletes in a variety of sports, with weightlifting, cycling, football, and baseball being among the most prominent. Athletes who take steroids tend to use AAS in stacks and cycles, going well beyond the level of steroids that might be medically prescribed. This practice leads some steroid users to have many problems, including psychological addiction, physi-

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ological withdrawal issues, and a bevy of adverse side effects. AAS were developed in the mid-1930s, shortly after scientists first isolated testosterone. It is not known when steroids were first used illegally, but the first reports of steroid use date back to 1954 and describe male and female Russian athletes, weightlifters in particular, taking AAS in order to increase their weight and muscle strength. Steroid use among U.S. athletes also first took place within the world of weightlifting, with the York Barbell Club in York, Pennsylvania, emerging as the site of much experimentation in the late 1950s and early 1960s. Hoping to help Americans fare better against their steroid-using, Russian competitors, Dr. John Ziegler developed Dianabol—a steroid

designed to be less androgenic than other AAS—and administered it, along with amphetamines, to U.S. Olympic weightlifters. Competitive weightlifters’ use of AAS was hardly the only example of the Cold War being reflected in international athletics, as U.S. Olympians in a variety of sports took steroids in the 1950s. Many of the athletes on steroids in this era felt that AAS were a kind of wonder drug, while others likely took them because they felt they simply could not compete with athletes who were on steroids. In response to this phenomenon, the International Olympic Committee began to ban drug use among athletes in 1968. The prohibition covered some 20 stimulants and narcotics, but steroids were not among the banned substances.

Professional baseball player Sammy Sosa, right, of the Baltimore Orioles, testifies before the Government Reform Committee concerning the use of steroids in baseball. In 2003, he tested positive for performance-enhancing drugs, an allegation he denied. (AP Photo/Gerald Herbert)

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The omission of AAS from the list was not an indication that steroid use was minor among Olympians, for steroid use by U.S. athletes was fairly widespread at the 1968 Mexico City Games. Instead, the International Olympic Committee did not ban steroids because no reliable test for AAS existed at that point. In addition, science was as yet unsure of the precise amounts and ratios of steroids that naturally occur in the body, thus making AAS detection even more difficult. It is probably safe to assume that AAS use factored significantly in Olympic competitions up until the mid-1970s, when the detection of exogenous testosterone in urine became scientifically possible. The International Olympic Committee consequently banned AAS in 1975. The 1976 Olympic Games in Montreal were the first to feature athletes being tested for steroids, and numerous competitors were disqualified from it and subsequent Olympiads or stripped of the medals they unfairly won. In what is perhaps the most famous case of this, Canadian sprinter Ben Johnson had his gold medal taken away after testing positive for an AAS at the 1988 Summer Olympic Games in Seoul, South Korea. Despite catching Johnson, the International Olympic Committee was widely seen as insufficiently policing its athletes’ use of steroids. A decade later, it agreed to implement the antidoping rules and regulations of the independent World Anti-Doping Agency, which was created in the aftermath of a 1998 drug-use scandal that rocked the Tour de France. The Olympics are hardly the only athletic competition to have been tainted by the illicit use of steroids. AAS use had become an institutionalized staple in professional football by 1963, when the San Diego Chargers distributed oral steroids for players to take at their team meals. The origin of this practice may be traced to the team’s strength coach,

Alvin Roy, who had been affiliated with the U.S. weightlifting team. Baseball, too, has a checkered history with AAS, and it is generally believed that steroids made their way into the game sometime in the mid- to late 1960s. Steroids became a far more significant element on the diamond in the last two decades, and it is now common to refer to a “steroid age” in baseball’s history. Discussion of AAS in baseball came to the forefront when sluggers Mark McGwire and Sammy Sosa both surpassed the game’s long-standing single-season home run rec­ ord. In the course of their much-publicized pursuit of the record, McGwire admitted to using androstenedione, a muscle-building supplement that was legal at the time but has subsequently been banned by Major League Baseball, the World Anti-Doping Agency, and other sports organizations. In 2003, baseball banned steroid use and began testing for it, and 5.77 percent of 1,438 anonymous urine samples tested positive for AAS. In 2005, Congress held hearings investigating the use of AAS among baseball players, and McGwire stated that the game had a steroid problem, though he refused to answer questions about his own drug use. In the wake of these hearings, Major League Baseball commissioner Bud Selig hired, in March 2006, former Maine senator George Mitchell to launch an independent investigation into steroid use in the sport. The resulting Mitchell Report, which was released on December 13, 2007, implicated 86 players. In addition to the aforementioned congressional hearings, the government became involved in the issue of steroids and sports as a result of its investigation of the Bay Area Laboratory Co-Operative (BALCO), which began in August 2002 and focused on the alleged money laundering and illegal distribution of steroids and other performanceenhancing drugs by BALCO’s founder,

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Victor Conte. Internal Revenue Service agents subsequently linked BALCO to a number of high-profile athletes, including baseball home-run king Barry Bonds and Olympic sprinter Marion Jones. Such highprofile cases seem to have done little to diminish the athletic world’s interest in AAS, however, as athletes in a variety of sports continue searching for an illicit medical edge. Howard Padwa and Jacob A. Cunningham See also: Food and Drug Administration; Steroids, Anabolic

Further Reading Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press. Rosen, Daniel M. 2008. Dope: A History of Performance Enhancement in Sports from the Nineteenth Century to Today. Westport, CT: Praeger. Taylor, William N. 1991. Macho Medicine: A History of the Anabolic Steroid Epidemic. Jefferson, NC: McFarland. Taylor, William N. 2002. Anabolic Steroids and the Athlete. Jefferson, NC: McFarland. Wadler, Gary I., and Brian Hainline. 1989. Drugs and the Athlete. Philadelphia: F.A. Davis Company. Westreich, Laurence M. 2008. “Anabolic Androgenic Steroid Use: Pharmacology, Prevalence, and Psychiatric Aspects.” Psychiatric Times 25(1): 47–53. Yesalis, Charles E., ed. 1993. Anabolic Steroids in Sport and Exercise. Champaign, IL: Human Kinetics Publishers.

Steroids in Baseball What was once the oldest, purest pastime in America has now become marked by controversy, stained by an asterisk. Since the

moment the string ball wrapped in white leather landed just past the wall in right center field of AT&T Park in San Francisco, giving Barry Bonds his record-breaking 756th career home run, no player has been able to excel in the game of baseball without being suspected or accused of having used performance enhancing drugs (PEDs). Many believe that the asterisk next to any steroidfueled record—noting that the record-breaking effort was achieved not through talent and practice but through drugs—now stands for an era that has brought shame to and stained baseball, often considered the purest American pastime. What has become known as the “Steroid Era” has plagued the game and claimed such “victims” as Mark McGwire, Alex Rodriguez, Roger Clemens, Jose Canseco, and Barry Bonds. No player has been above suspicion, and even the innocent have sustained injury due to this regrettable period as players, such as David Ortiz amid his 2013 world championship season with the Boston Red Sox, have been wrongfully challenged with little to no reason beyond excellence. Many believe that the entirety of the sport has been infected by the choices and actions of a few. One of the earliest instances of the Steroid Era came in 1998 as Cardinals’ first baseman, Mark McGwire, and Cubs’ outfielder, Sammy Sosa, raced to break the single season home run record of 61 set by Roger Maris in 1961. The first to reach the elusive 62nd home run, McGwire finished the season with 70 home runs, while Sosa ended with 66. Three seasons later, McGwire played his final game in professional baseball, and in 2005 he appeared before Congress on the subject of PEDs, but he refused to answer any questions, repeatedly claiming that he was not there, “to talk about the past.” He also stated, when asked if he would serve as a spokesman against

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steroid use, that, “My message is that steroids is bad. Don’t do them.” Finally on January 11, 2010, McGwire admitted to the use of PEDs during his career, and apologized to, in the following months, manager Tony La Russa, Major League Baseball Commissioner Bud Selig, the Maris family, and all of baseball. His admission of having used illicit substances is believed to have been largely inspired by his choice to step back into professional baseball and accept the role of the hitting coach of the St. Louis Cardinals. The single-season home run record was broken by Barry Bonds in 2001 as he let fly 73 home runs. On December 13, 2007, a 409-page document written by George J. Mitchell was filed and sent to Bud Selig. Entitled “Report to the Commissioner of Baseball of an Independent Investigation into the Illegal Use of Steroids and Other Performance Enhancing Substances by Players in Major League Baseball,” this infamous report came to be known as the Mitchell Report. The study covered more than a year and a half and names 89 players who were believed by Mitchell to have been using or had used anabolic steroids or human growth hormones. The report divides the players into three categories based on the means employed by the player to acquire the substances. The sections were the Bay Area Laboratory Co-Operative (BALCO), Kirk Radomski, and the Internet. The majority of the players named in the report were said to have acquired substances from New York Mets batboy Kirk Radomski, who held a client list of over 300 pros and desperately hopeful amateurs. After being arrested and confessing to having supplied players with PEDs, he served five years’ probation. In a tell-all book, Bases Loaded, he tells the story of his experiences with players as well as agents who used and advocated the use of steroids.

Another book that chronicles the corrupt nature of baseball behind the scenes was the shocking Juiced, by former superstar Jose Canseco, an Oakland Athletics outfielder famous for his towering home runs. In his book, Canseco admits to using steroids and names several others whom he claims to have used steroids throughout their careers. He also seems to advocate steroids and their use, though claiming only to condone the substances in some people. Highly controversial and causing uproar among players, fans, and baseball officials, the book entirely helped greatly to darken the lens through which baseball is viewed. Barry Bonds has become baseball’s top public enemy. Before becoming the most notorious man in, perhaps, all of sports, he began his career with the Pittsburgh Pirates as the highly speculated son of former All Star and Gold Glove winner, Bobby Bonds. Going to San Francisco, where he would play 15 of his 22 seasons, after the 1992 season, Bonds accumulated seven National League Most Valuable Player awards, eight Gold Glove awards, and 12 Silver Slugger awards. After his career, he was brought to trial, accused of perjury when he stated before a grand jury that he had not knowingly and willingly taken PEDs or had allowed himself to be injected by anyone who was not a doctor. Despite the jury’s voting to convict Bonds on three counts of perjury, the vote was not unanimous and hence the charges were disregarded. Bonds was, however, declared guilty on the charge of obstruction after he avoided directly answering questions regarding his alleged acquiring of drugs. Though it was hoped that the Steroid Era was at an end after the admissions of McGwire, Canseco, and other stars as well as the Mitchell Report’s bringing the shady underside of baseball to light, the 2013 sea-

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son saw new accusations and guilt. Thirteen players including, most notably, New York Yankees’ third baseman Alex Rodriguez, Texas Rangers’ outfielder Nelson Cruz, and Detroit Tigers’ shortstop Jhonny Peralta, were suspended in a single announcement. All players named in the scandal, with the exception of Rodriguez, who was the only player to challenge the sentence, were suspended for 50 games. Rodriguez was given a suspension of 211 games, the longest drugbased suspension not for life ever issued by Major League Baseball, but the sentence was later reduced to the 2014 season, including postseason if applicable. Even after the reduction, the 162-plus game suspension is still the longest suspension in baseball history for such charges that were not for life. Ryan Braun, an outfielder in the Milwaukee Brewers’ organization, was also suspended, in a different action, for 65 games, the remainder of the 2013 season at the time. Anthony J. Marion See also: Rodriguez, Alex; Steroids, Anabolic; Steroids and Sports

Further Reading Associated Press. 2005. “Statements by Mark McGwire to Congress in 2005.” January 12. Sporting News MLB. http://www .sportingnews.com/mlb/story/2010–01–11/ statements-mark-mcgwire-congress-2005. “Barry Bonds.” Baseball Reference.com. http:// www.baseball-reference.com/players/b/ bondsba01.shtml. “Barry Bonds Found Guilty of Obstruction.” 2011. ESPN.com, April 14. http:// sports.espn.go.com/mlb/news/story? id=6347014. Fish, Mike. 2012. “A Steroid Life in Baseball’s Fast Lane.” ESPN.com, January 28. http://sports.espn.go.com/espn/otl/news/ story?id=3855867.

Greenberg, Chris. 2013. “MLB Suspensions: A-Rod Among 13 Players Suspended but Only One to Appeal PED Punishment.” Huffington Post, August 5. http://www.huffi ngtonpost.com/2013/08/05/mlb-suspens ions-drugs-biogenesis_n_3707913.html. Levinthal, Charles F. 2012. Drugs, Behavior, and Modern Society. Boston: Allyn and Bacon. “Mark McGwire.” Baseball Reference.com. http://www.baseball-reference.com/players /m/mcgwima01.shtml. Mitchell, George J. 2007. “Report to the Commissioner of Baseball of an Independent Investigation into Performance Enhancing Substances by Players in Major League Baseball.” http://files.mlb.com/mitchrpt.pdf. “Mitchell Report.” Baseball Almanac. http:// www.baseball-almanac.com/legendary/ Mitchell_Report.shtml. “Ryan Braun Suspended Rest of Year.” 2013. ESPN.com, July 23. http://espn.go.com/ mlb/story/_/id/9500252/ryan-braun-milw aukee-brewers-suspended-remainder -2013-season.

Stimulants By boosting levels of glutamate, the excitatory neurotransmitter of the brain, stimulants—also known as uppers or speed—tend to increase energy and alertness, elevate mood, and suppress appetite. They raise blood pressure, heart rate, and respiration; in high doses, they can cause heart arrhythmias and seizures. Common stimulants include amphetamines, anorectic drugs (appetite suppressants), caffeine, cocaine and crack, dextroamphetamine, khat, methamphetamine, methcathinone, methylphenidate, and nicotine. Powerfully active in the dopamine reward pathway, stimulants can be highly addictive

Stimulants  849

depending on the innate addictive potential of the individual drug and the method of administration. Smoked, snorted, or injected stimulants produce an intense high known as a “rush” or “flash” and tend to keep users coming back as tolerance quickly builds. Usage often occurs in spurts of bingeing that can continue for days until delirium, psychotic behavior, or lack of a drug supply forces the user to crash. A withdrawal period of deep depression, anxiety, craving, and extreme exhaustion can follow. So great is the euphoric burst from smoked, snorted, or injected stimulants like crack cocaine that the user ignores the tremors, dizziness, chest pains, vomiting, paranoia, agitation, panic, and aggression that can accompany binges. If stimulants are combined with antidepressants or cold medications containing decongestants, the user may have a life-threatening reaction to the compound effect of the drugs. Stimulants can be a performance-enhancing drug, used by many to ward off fatigue. Subject to the Controlled Substances Act regulatory schedules, stimulants may be legitimately prescribed and used under medical supervision for conditions like obesity or attention deficit/hyper-activity disorder, for which Ritalin is a frequent treatment; when used for this purpose and in the dosage prescribed, Ritalin is not associated with addiction. Several new drugs to combat obesity have been developed to replace the amphetamines that were once used for this purpose. Like other Schedule III and IV drugs with amphetamine-like effects, these are subject to abuse and are often distributed through illicit markets. They include benzphetamine (Didrex), diethylpropion (Tenuate, Tepanil), mazindol (Sanorex, Mazanor), phendimetrazine (Bontril, Prelu-27), and phentermine (Lonamin, Fastin, Adipex). Although there is no specific medication indicated for the treatment of stimulant

addiction, once the user has ceased using the drugs, antidepressants may be used to help manage the depression that is often the result of stimulant withdrawal. Another approach is to reduce the stimulant gradually while behavioral therapy is used to help users avoid relapse triggers and develop new lifestyle habits. Many stimulants are not prohibited by law and thus legally available. One of those is caffeine. This is a mild stimulant used by most people in coffees and sodas. In small quantities, it can sharpen senses, reduce fatigue, and improve energy. It comes from coffee beans and kola nuts. Another is nicotine, which is a psychoactive drug that is found in tobacco products such as cigarettes, cigars, and gums. When a user smokes a cigarette, dopamine is released into the body. Taurine is used in energy drinks and stimulates a person’s mental and physical abilities. Ephedrine is often used help a user concentrate. It is sometimes said to be better than caffeine for this reason. Students and others take ephedra herbal supplements. Betel is used in Southeast Asia. The betel nut chewed, sometimes wrapped in a betel leaf. It is often used at social gatherings and to enhance concentration and alertness. Pseudoephedrine, otherwise known as Sudafed, is used in cough syrups, but it also can be used as a mild stimulant. Another ingredient in cough suppressant medicine is DXM, or dextromethorphan. In large doses this can cause hallucinations. In a recent study, scientists sought to determine the relationship between stimulants and the sudden and unexplained death in children and teenagers. By examining 564 cases of sudden death of people ranging in age from 7–19 years, they found that in 1.8 percent of sudden deaths, the youths were taking stimulants (methylphenidate). In other words, there was support to prove

850   Students Against Destructive Decisions (SADD)

an association between the use of stimulants and sudden unexplained deaths among young people. The popularity of energy drinks is becoming a concern. These drinks act as a stimulant for people who are fighting fatigue and are looking to improve their concentrations. They generally contain large amounts of caffeine. Unfortunately, some users have had adverse reactions and have even died as a result of using these products. The FDA recently posted adverse-event reports for Monster Energy and Rockstar Energy. 5-Hour Energy Shots have also been linked to adverse reactions. The purpose of these reports is to warn other users that the products have harmed someone, but they do not prove that the product caused the harm. The high level of stimulants in these products have been linked to heart attacks, miscarriage, irregular heartbeat, diarrhea, vomiting, or psychotic disorders. Kathryn H. Hollen See also: Amphetamines; Cocaine and Crack; Methamphetamines

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. DeNoon, Daniel J. 2012. “More Deaths, Illnesses Linked to Energy Drinks.” WebMD News Archives, November 16. http:// www.webmd.com/diet/news/20121116/ more-deaths-illness-energy-drinks. Gould, Madelyn S., Timothy Walsh, Jimmie Lou Munfakh, Marjorie Kleinman, Naihua Duan, Mark Olfson, Laurence Greenhill, and Thomas Cooper. 2009. “Sudden Death and Use of Stimulant Medications in Youths.” American Journal of Psychiatry 166: 992–1001.

Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Home Box Office, in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism. 2007. Addiction: Why Can’t They Just Stop? Documentary. Inciardi, James, and Karen McElrath. 2011. The American Drug Scene: An Anthology. New York: Oxford University Press. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. U.S. Department of Health and Human Ser­ vices, National Institute on Drug Abuse . http://www.nida.gov. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.sam hsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Students Against Destructive Decisions (SADD) Students Against Destructive Decisions (SADD, originally known as Students Against Driving Drunk) began in 1981 after the alcohol-related deaths of two teens in separate crashes in the span of one week in Wayland, Massachusetts. Central to this community-based advocate group is a signed contract between young people and their parental figures that pledges youths to making safe decisions, particularly with regard to avoiding the perils of drinking and driving. SADD currently has approximately 10,000 chapters across the nation’s middle schools, high schools, and colleges.

Students Against Destructive Decisions (SADD)  851

SADD began its organizational life as Students Against Drunk Driving in response to the death of two high school hockey players in Wayland, Massachusetts. Wayland High School hockey coach and health instructor Robert Anastas teamed up with 15 students to create a student-based, anti–drunk driving organization. Initially limited to Wayland High School’s juniors and seniors, SADD quickly grew beyond its small beginnings, and by the following year it had developed into a national organization with chapters in Massachusetts, Arizona, North Carolina, Connecticut, New York, New Jersey, Florida, Pennsylvania, and Maine. Currently, SADD has chapters in all 50 states and in Canada, and some 350,000 active members participate in these chapters. The focal point of SADD is the Contract for Life, a document designed by Anastas and his students that, once signed by a young person and his or her parents (or another adult/parental figure), commits the student to making safe and sound decisions. In particular, a student agrees to call home for advice and/or transportation, at any hour and from any place, in the event that he or she has been drinking or their friend or date who is driving has been drinking. For their part, parents in turn pledge to either retrieve, with no questions asked at the time, their child from any place and at any hour, or pay for a taxi to bring their child home. Parents additionally promise to themselves seek safe and sober transportation home when they have had too much to drink. According to SADD, by 1990, more than 5 million such contracts had been signed. The original Contract for Life has since been amended, with the document now additionally including declarations, on the student’s part, to do his or her best to abstain from alcohol and drugs. The student furthermore agrees to always wear a seat belt.

These alterations reflect SADD’s 1997 decision to rename itself Students Against Destructive Decisions and thus dedicate itself to helping teens protect themselves against more than just drunk driving. As part of SADD’s enlarged mission to help students facing a variety of destructive decisions, the organization developed educational materials on issues such as HIV and AIDS, smoking, teen violence, depression, and suicide. In addition, SADD has taken the somewhat controversial stand of not endorsing or condoning certain programs or activities that may, or at least intend to, reduce teenage drunk driving. For example, SADD rejects Safe Ride or Designated Driver programs for young people out of the belief that they encourage and enable the use of alcohol by underage youths. To spread its message on campus and throughout communities, SADD holds peerled classes, theme-focused forums, teen workshops, conferences, and rallies. SADD also engages in legislative work, actively lobbying for anti–drunk driving laws. Information regarding SADD’s various activities is available from their Web site, http://www .sadd.org, and through Decisions, a newsletter published by SADD’s national office. Howard Padwa and Jacob A. Cunningham See also: Mothers Against Drunk Driving

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Jacobs, James B. 1992. Drunk Driving: An American Dilemma. Chicago: University of Chicago Press. Ross, H. Laurence. 1992. Confronting Drunk Driving: A Social Policy for Saving Lives. New Haven, CT: Yale University Press.

852   Studio 54 Students Against Destructive Decisions. “History of SADD.” http://www.sadd.org/history .htm. Students Against Destructive Decisions. “SADD’s Mission.” http://www.sadd.org/ mission.htm.

Studio 54 Studio 54 was a New York City nightclub that was the gathering place of celebrities and renowned for an atmosphere that tolerated—and even encouraged—open drug use, namely cocaine. The club opened on April 26, 1977, and was located at 254 West 54th Street in a building that was once owned by CBS. The studio had been home to the classic game show Password and the beloved children’s show Captain Kangaroo. The club was founded by native New Yorkers Steve Rubell and Ian Schrager, who had become friends while attending Syracuse University in the late 1960s. The two friends were complete opposites: Rubell was “hyper, loud, and always up for a party” while Schrager was “cool, retiring, and business-minded” (Essortment). Rather than conflicting, the men’s disparate personalities meshed well. Together, they owned and operated the world’s most famous nightclub. Prior to venturing into the nightclub industry, Rubell and Schrager had opened a chain of steakhouses in the outer boroughs. They had some success with their first nightclub, the Enchanted Garden. As with the steakhouses, the Enchanted Garden was limited by its Queens location. The pair set their sights on a Manhattan location and the respectability that came with it. As to the profitability of nightclubs versus restaurants, Rubell realized concentrating on the sale of alcohol would be more lucrative. Upon finding the empty studio, the pair began an extensive renovation that was spearheaded

by Rubell. This included the suspension of a large man-in-the-moon above the dance floor. The party began when an equally sizable hanging spoon was raised to the moon’s nose, causing it to light up. Once the club opened, Schrager and Rubell played quite different roles. Schrager spent much of his time in the office maintaining the business’s books while Rubell partied with celebrities like Andy Warhol, Truman Capote, and Liza Minnelli. The club even drew political figures such as Jackie Onassis, Margaret Trudeau (then the wife of Canadian prime minister Pierre Trudeau), and Hamilton Jordan, chief of staff to President Jimmy Carter. In a sign of decadence, to celebrate Bianca Jagger’s thirtieth birthday a white horse was furnished so that Jagger could ride it into the club. The celebrity pampering did not stop there. As a gift to Warhol on his birthday, Rubell presented a garbage can stuffed with dollar bills (Essortment). Studio 54 became an overnight sensation and a global symbol for the “decadence and hedonism of the ‘Me Decade’” (Essortment). Entry to the club, however, was limited to only those that were judged to be sufficiently glamorous by Rubell. Those that did not meet his standards would be treated to stinging criticism. This did not diminish Studio 54’s allure with the public; rather, it only intensified it. In its inaugural year, Studio 54 pulled in an estimated $7 million. Musically speaking, Studio 54 had a minimal impact. While the club did host live performances by chart toppers Donna Summer and Gloria Gaynor, patrons were fed a stan­ dard mix of dance hits. Besides, the real entertainers were the DJs, the club’s staff, and the celebrity clientele. In an odd symmetry, the life span of the club mirrored the popularity of disco: as long as disco dominated the music scene, Studio 54 dominated New York City’s club scene.

Substance Abuse and Mental Health Services Administration (SAMHSA)  853

Disco dancers at Studio 54 in 1978. The club was known for excessive drug use by its patrons. (AP Photo)

Although Studio 54’s official end came on February 4, 1980, with a party appropriately titled “The End of Modern-Day Gomorrah,” the club’s demise started in December 1979 (History Channel 2014). When Internal Revenue Service agents raided the club, they found cash-filled garbage bags either stuffed into walls like insulation or simply scattered on the floor. More surprisingly, Schrager—who had proven to be poor at managing the club’s books—had kept detailed records of gifts given to celebrity clients (e.g., cocaine). Schrager and Rubell were each handed sentences of 3.5 years. A deal the pair made with prosecutors reduced their sentence to just 13 months. The pair quickly returned to the nightclub business upon their release and opened another highly successful club, the Palladium. They also ventured into the hotel business and found great success. In July 1989, Rubell died from septic shock

and hepatitis. Schrager is still a hotelier and leads a quiet life. Stacy O’Hara Leiter See also: Cocaine and Crack; Entertainers and Drug Use

Further Reading “Studio 54 History.” Essortment. http://www .essortment.com/studio-54-history-21125 .html. “Studio 54 Opens.” 2014. History Channel. http://www.history.com/ this-day-in-history/ studio-54-opens.

Substance Abuse and Mental Health Services Administration (SAMHSA) The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency under the U.S. Department of Health

854   Substance Abuse and Mental Health Services Administration (SAMHSA)

and Human Services devoted to helping individuals with mental health and substance abuse problems lead fulfilling lives. SAMHSA aims to do this by supporting research into mental health and substance abuse problems, and by funding programs that aim to identify at-risk individuals, prevent the development of mental health and substance abuse disorders, and provide support for individuals suffering from mental illness and addiction. SAMHSA was established on October 1, 1992, when the federal government’s mental health and substance abuse agencies were overhauled. The Alcohol, Drug Abuse, and Mental Health Administration, which had been established in 1974, was dismantled, and the research components of the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and the National Institute of Mental Health were subsumed under the National Institute of Health. The service components of these agencies were united under a new organization—SAMHSA. The agency’s mission is to ensure that all individuals with mental illness and substance abuse problems have the opportunity to lead a fulfilling life that includes an education, a job, a home, meaningful personal relationships, and a family. Through its centers and offices, SAMHSA administers grant programs and contracts to support state and local efforts to expand and enhance programs that can provide early intervention for individuals at risk for developing mental health or substance abuse problems. The organization aims to increase the availability and range of substance abuse treatment and mental health recovery programs that serve Americans in their communities. SAMHSA has four main programs. Its Center for Mental Health Services works to ensure that scientifically backed methods for preventing and treating mental illness are

practiced throughout the country, and aims to improve access to mental health care by removing barriers that keep people with mental illness from receiving the services they need. The Center for Mental Health Services also aims to improve mental health throughout the country, and it tries to facilitate the effective rehabilitation of people with mental illness. Its Center for Substance Abuse Prevention provides national leadership in the development of policies, programs, and services that aim to prevent the abuse of illicit drugs, alcohol, and tobacco. To do this, the Center for Substance Abuse Prevention disseminates information on best practices in substance abuse prevention, and works with state and local authorities, as well as community organizations, to help them apply these practices effectively. The Center for Substance Abuse Treatment aims to bring effective alcohol and drug treatment programs to every community in the country by expanding the availability of effective treatment and recovery services for individuals suffering from alcohol and drug problems, and it also works to reduce the barriers that keep addicts from getting the services they need. Its fourth major division, the Office of Applied Studies, collects, analyzes, and disseminates data on mental health and drug-related problems. Among its major programs are the National Survey on Drug Use and Health, the Drug Abuse Warning Network, and the Drug and Alcohol Services Information System. Today, SAMHSA has several priority program areas. They include programs that focus on treating co-occurring disorders (for people who have mental illness and addictions), increasing the nation’s substance abuse treatment capacity, transforming the public mental health system, instituting more effective suicide prevention programs, working to prevent homelessness, and checking

Substance Abuse and Mental Health Services Administration (SAMHSA)  855

the spread of diseases such as HIV/AIDS and hepatitis, which are often related to substance abuse disorders. Each year, SAMHSA conducts a survey of people aged 12 and older across the United States to determine trends in substance abuse and provide information about the use of illicit drugs, alcohol, and tobacco. The 2011 National Survey on Drug Use and Health shows that an estimated 22.5 million Americans aged 12 or older were current (past month) illicit drug users, meaning they had used an illicit drug during the month prior to the survey interview. This estimate represents 8.7 percent of the population. In this case, the term “illicit drugs” include marijuana/hashish, cocaine (including crack), heroin, hallucinogens, inhalants, or prescription-type psychotherapeutics (pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically. According to the survey findings, marijuana was the most commonly used illicit drug in 2011. There were 18.1 million pastmonth users. Moreover, there were 1.4 million current cocaine users aged 12 or older, comprising 0.5 percent of the population. The number of persons who were past-year heroin users in 2011 (620,000) was higher than the number in 2007 (373,000). Hallucinogens were used in the past month by 972,000 persons (0.4 percent) aged 12 or older in 2011. These estimates were lower than the estimates in 2010 (1.2 million or 0.5 percent). There were 6.1 million persons (2.4 percent) aged 12 or older who used prescription-type psychotherapeutic drugs nonmedically in the past month. The number of past-month methamphetamine users decreased between 2006 and 2011. Some other findings of the report include: • Among youths aged 12 to 17, the rate of current nonmedical use of prescrip-

tion-type drugs declined from 4.0 percent in 2002 to 2.8 percent in 2011. The rate of nonmedical pain reliever use declined during this period from 3.2 to 2.3 percent among youths. • 9.4 million (3.7 percent) of persons aged 12 or older reported driving under the influence of illicit drugs during the past year. • Among persons aged 12 or older who used pain relievers nonmedically in the past 12 months, 54.2 percent got the drug from a friend or relative for free. Another 18.1 percent reported they got the drug from one doctor. Only 3.9 percent got pain relievers from a drug dealer or other stranger, and 0.3 percent bought them on the Internet.

Alcohol Use • Slightly more than half (51.8 percent) of Americans aged 12 or older reported being current drinkers of alcohol in the 2011 survey. This translates to an estimated 133.4 million current drinkers. • In 2011, nearly one quarter (22.6 percent) of persons aged 12 or older participated in binge drinking. This translates to about 58.3 million people. • In 2011, heavy drinking was reported by 6.2 percent of the population aged 12 or older, or 15.9 million people. Heavy drinking is defined as binge drinking on at least 5 days in the past 30 days. • Among young adults aged 18 to 25 in 2011, the rate of binge drinking was 39.8 percent. The rate of heavy drinking was 12.1 percent. • An estimated 11.1 percent of persons aged 12 or older drove under the influence of alcohol at least once in the past year. • There were an estimated 9.7 million underage (aged 12 to 20) drinkers

856   Substance Abuse and Mental Health Services Administration (SAMHSA)

in 2011, including 6.1 million binge drinkers and 1.7 million heavy drinkers. • 57.0 percent of current underage drinkers reported that their last use of alcohol occurred in someone else’s home, and 28.2 percent reported that it had occurred in their own home. About one third (30.3 percent) paid for the alcohol the last time they drank, including 7.7 percent who purchased the alcohol themselves and 22.4 percent who gave money to someone else to purchase it. Among those who did not pay for the alcohol they last drank, 38.2 percent got it from an unrelated person aged 21 or older, 19.1 percent from another person younger than 21 years old, and 21.4 percent from a parent, guardian, or other adult family member.

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Tobacco Use • In 2011, an estimated 68.2 million Americans aged 12 or older were current (past-month) users of a tobacco product. This represents 26.5 percent of the population in that age range. Also, 56.8 million persons (22.1 percent of the population) were current cigarette smokers; 12.9 million (5.0 percent) smoked cigars; 8.2 million (3.2 percent) used smokeless tobacco; and 2.1 million (0.8 percent) smoked tobacco in pipes. • One in six pregnant women aged 15 to 44 smoked cigarettes in the past month during 2010–2011.

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Initiation of Substance Use (Incidence, or First-Time Use) within the Past 12 Months • In 2011, an estimated 3.1 million persons aged 12 or older used an illicit drug for the first time. This averages to about 8,400 initiates per day and was similar to the estimate for 2010

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(3.0 million). A majority of these pastyear illicit drug initiates reported that their first drug was marijuana (67.5 percent). More than one in five initiated with psychotherapeutics (22.0 percent, including 14.0 percent with pain relievers, 4.2 percent with tranquilizers, 2.6 percent with stimulants, and 1.2 percent with sedatives). In 2011, 7.5 percent of initiates reported inhalants as their first illicit drug, and 2.8 percent used hallucinogens as their first drug. In 2011, the illicit drug categories with the largest number of past-year initiates among persons aged 12 or older were marijuana use (2.6 million) and nonmedical use of pain relievers (1.9 million). In 2011, the average age of marijuana initiates among persons aged 12 to 49 was 17.5 years. The number of past-year initiates of methamphetamine among persons aged 12 or older was 133,000. In 2011, there were 178,000 persons aged 12 or older who used heroin for the first time. Most (82.9 percent) of the 4.7 million past-year alcohol initiates in 2011 were younger than 21 at the time of initiation. The number of persons aged 12 or older who smoked cigarettes for the first time was 2.4 million in 2011. Most new smokers were younger than 18 when they first smoked cigarettes (55.7 percent or 1.3 million). The number of persons aged 12 or older who used smokeless tobacco for the first time within the past year was 1.3 million.

Youth Prevention-Related Measures • The percentage of youths aged 12 to 17 perceiving great risk in smoking

Substance Abuse and Mental Health Services Administration (SAMHSA)  857

marijuana once or twice a week decreased from 54.6 percent in 2007 to 44.8 percent in 2011. • Almost half (47.7 percent) of youths aged 12 to 17 reported that it would be “fairly easy” or “very easy” for them to obtain marijuana if they wanted some. More than one in six reported it would be easy to get cocaine (17.5 percent). About one in eight (12.2 percent) indicated that LSD would be easily available, and 10.7 percent reported easy availability for heroin. • A majority of youths aged 12 to 17 (89.3 percent) reported that their parents would strongly disapprove of their trying marijuana once or twice. Current marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana once or twice than for those who did not (5.0 vs. 31.5 percent). • 75.1 percent of youths aged 12 to 17 reported having seen or heard drug or alcohol prevention messages from sources outside of school. The percentage of school-enrolled youths reporting that they had seen or heard prevention messages at school also declined during this period, from 78.8 to 74.6 percent.

Substance Dependence, Abuse, and Treatment • In 2011, an estimated 20.6 million persons (8.0 percent of the population) were classified with substance depen­ dence or abuse in the past year based on criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Of these, 2.6 million were classified with dependence or abuse of both alcohol and illicit drugs, 3.9 million had dependence or abuse of illicit drugs but not alcohol, and 14.1

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million had dependence or abuse of alcohol but not illicit drugs. The specific illicit drugs that had the highest levels of past year dependence or abuse were marijuana (4.2 million), pain relievers (1.8 million), and cocaine (0.8 million). In 2011, adults aged 21 or older who had first used alcohol at age 14 or younger were more than 7 times as likely to be classified with alcohol dependence or abuse than adults who had their first drink at age 21 or older (13.8 vs. 1.8 percent). Treatment need is defined as having substance dependence or abuse or receiving treatment at a specialty facility (hospital inpatient, drug or alcohol rehabilitation, or mental health centers). In 2011, 21.6 million persons aged 12 or older needed treatment for an illicit drug or alcohol use problem (8.4 percent of persons aged 12 or older). Of these, 2.3 million (0.9 percent of persons and 10.8 percent of those who needed treatment) received treatment at a specialty facility. Thus, 19.3 million persons (7.5 percent of the population) needed treatment for an illicit drug or alcohol use problem but did not receive treatment at a specialty facility. Of the 19.3 million persons who were classified as needing substance use treatment but did not receive treatment at a specialty facility in the past year, 912,000 persons (4.7 percent) reported that they felt they needed treatment for their illicit drug or alcohol use problem. Of these 912,000 persons who felt they needed treatment, 281,000 (30.8 percent) reported that they made an effort to get treatment, and 631,000 (69.2 percent) reported making no effort to get treatment.

858   Substance Abuse Services Amendments of 1986

More information on SAMHSA and its activities is available at its Web site: http:// www.samhsa.gov. Howard Padwa and Jacob A. Cunningham See also: National Institute on Alcohol Abuse and Alcoholism; National Institute on Drug Abuse

Further Reading National Institute of Mental Health. “Important Events in NIMH History.” http://www .nih.gov/about/almanac/archive/1998/org anization/nimh/history.html. Substance Abuse and Mental Health Services Administration. “About.” http://www.hhs .gov/samhsa/about/1336.html. Substance Abuse and Mental Health Services Administration. “About Us.” http://www .samhsa.gov/About/background.aspx. Substance Abuse and Mental Health Services Administration. 2012. Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration.

Substance Abuse Services Amendments of 1986 The Substance Abuse Services Amendments of 1986 were part of President Ronald Reagan’s Drug-Free America Act of 1986. These were a response to the increase in illegal drug use that was occurring at the time, and the resulting health threats that their use presented. The amendments continued the block grant programs through Fiscal Year 1992 under which states were provided federal funds to implement alcohol and drug abuse programs, along with mental health programs. The amendments also eliminated

some restrictions that were part of the thenexisting law that limited the state’s choices as to how the money would be spent. Under the new amendments, states could spend the funds where they were most needed rather than where the federal government regulated. The amendments were a group of initiatives that came to a total allocation of nearly $900 million in Fiscal Year 1987 in additional allocations that would be spent on programs aimed at halting drug use across America. The new allocations increased the total federal spending for the fight against drugs to over $3 billion. There were many separate budget amendments involved in the act, which was composed of six titles, or chapters, that sought increased authority for law enforcement personnel and enhanced penalties for selling illegal drugs, and established new programs to help schools prevent drug use among children and an executive order in which a drug-free federal work force was created. In turn, this served as an example for drug-free workplaces around the country. Through separate budget amendments President Reagan requested $100 million for state grants to enhance the country’s capacity to treat drug users. An additional $34 million was requested for supporting increased research into the most successful rehabilitation and treatment methods. This included a focus on better, more effective methods for intervening with high-risk children and adolescents. Funding for law enforcement and interdiction efforts was also increased as well. Nancy E. Marion See also: Drug-Free America Act; Reagan, Ronald, and Nancy Reagan

Further Reading “Congress Clears Massive Anti-Drug Measure.” 1987. In CQ Almanac 1986, 42nd ed., 92-106. Washington, DC: Congressional

Substance Addiction  Quarterly. http://library.cqpress.com/cqalma nac/cqal86–1149752. Reagan, Ronald. 1986. “Message to Congress Transmitting Proposed Legislation to Combat Drug Abuse and Trafficking.” September 15. http://www.reagan.utexas.edu/ archives/speeches/1986/091586b.htm.

Substance Addiction Substance addiction is characterized by the compulsive use of legal and illegal psychoactive drugs despite adverse consequences. It is defined by the National Institute on Drug Abuse (NIDA) as a disease of the brain in which the addict is unable to control consumption of the substance. With approximately 22.2 million drug addicts in the United States and 150,000 Americans dying from chemical addiction a year, addiction is a public health crisis (NIDA). Addicts come from all backgrounds, races, socioeconomic groups, and geographic areas, and nearly everyone, whether he or she knows it or not, is likely to be acquainted with at least one current or recovering addict. Only 10 to 15 percent of addicts get the proper treatment, partly because of cost and partly because of the stigmatization associated with the disease. Insurance companies are reluctant to insure addicts—properly administered treatment initially takes weeks, not days, and may involve expensive stays in a hospital, clinic, or rehabilitation center. Although some states have passed laws requiring insurers to treat addiction like any other chronic disease, coverage is shrinking despite statistics showing that investing in treatment saves $7 for every $1 spent. Since the destructive fallout from one addict’s disease is estimated to affect between 4 to 15 people—family, co-workers, friends—the impact can be devastating. Shame, fear, and

the mistaken belief that they cannot recover prevent many addicts from admitting their addiction to others and seeking treatment. In the midbrain, where critical functions of memory and learning take place, a pleasure center known as the mesolimbic reward pathway transmits feel-good messages via chemical neurotransmitters in response to natural stimuli such as food or sex. The principal neurotransmitters communicating pleasurable sensations are serotonin, endorphins, GABA, glutamate, acetylcholine, endocannabinoids, and, especially, dopamine. Each time an individual takes drugs, the reward pathway is overstimulated by an outpouring of dopamine, which produces a high that is characteristic of that particular drug. The brain tries to compensate for the overflow of neurotransmitters by reducing its output of dopamine and the number of receptors on the receiving cells that communicate the pleasurable sensations. As a result, in time, the addict must consume more of the drug to get the initial effect. Many experts believe that the more intense the high the user experiences, the more intensely the brain learns to respond to the drug. As part of this process, the people, settings, and paraphernalia—anything the addict associates with drug use—become triggers that stimulate craving and the desire to use again. Because the brain has learned at the cellular level to respond to the drug(s), it no longer reacts normally to natural triggers. In time, this muted response extends to the drugs themselves. At this point, the addict finds he or she must use the substance simply to feel normal. Without it, the brain’s struggle to rebalance its neurochemical equilibrium results in many of the extreme discomforts of withdrawal. Addictive substances fall into 1 of 5 categories: depressants, stimulants, hallucinogens, inhalants, or anabolic steroids. The

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first 4 categories of drugs have psychoactive effects; the fifth comprises anabolic steroids, which are not inherently mood altering but can be psychologically addicting because users who take them to enhance their perfor­ mance and physical stature may get high on the increased self-esteem. Inhalants, among the least addictive drugs, are nevertheless among the most dangerous; they are potent toxins that can trigger life-threatening irregularities in heart rhythm and suppress breathing, and long-term use causes serious organ damage. The aerosols inhaled can freeze up the user’s airway, killing almost instantly. Although their effects vary somewhat based on users’ personal characteristics and use patterns, all addictive drugs act similarly on the reward pathway. In descending order of their addictive potential, they are methamphetamine (and other amphetamines) and cocaine, nicotine, and opiates; second are alcohol, tranquilizers (benzodiazepines), and sedatives (barbiturates); third, marijuana and hashish; and fourth are hallucinogens and caffeine. There are also differences between the addictive potential of one drug over another within the same category. Among the benzodiazepines, for example, Xanax may have a higher addictive potential than Valium. In general, the longer someone is exposed to the drugs, the greater the likelihood that addiction will develop. There is one exception: opiates. When used medicinally to relieve pain, most opiates tend not to addict patients in the usual sense. Instead, patients may have a pseudoaddiction, in which they develop tolerance and actively engage in drug-seeking behavior. When the patient heals and the pain is reduced or eliminated, their need for the drug usually evaporates. In 2001, to clarify some of the confusion surrounding this phenomenon, the American Academy of Pain Medicine, the American Pain Society, and the American Society of

Addiction Medicine issued definitions to distinguish true addiction from pseudoaddiction, explaining that the former was characterized by impaired control over use.

Diagnosis The symptoms of drug abuse vary based in part on the class of substance in question. Depressants, so-called because of their suppressive effects on the central nervous system, produce slurred speech, loss of motor coordination, sedation, and, in overdose, coma and death. In therapeutic doses, stimulants increase alertness and energy; taken in large amounts, they produce dizziness, chest pain, high fever, convulsions, and cardiac arrest. Hallucinogens, a group that includes marijuana and hashish, are known for causing sensory changes in perceptions including visual or auditory hallucinations; often called psychedelics, these drugs include lysergic acid diethylamide (LSD) and phencyclidine (PCP). In the past, the diagnosis of drug addiction was complicated by the range of symptoms the drugs produced and cultural attitudes about their use. It was not until the 1970s that scientific evidence about the environmental and biological underpinnings of addiction allowed experts to reach consensus on specific diagnostic criteria. They were codified by the American Psychiatric Association (APA) in the 4th edition of its Diagnostic and Statistical Manual of Mental Disorders. Although critics who regard addiction as a behavioral issue reject the APA’s assessment of addiction as a disease, many nevertheless acknowledge the diagnostic value of the criteria in identifying addiction and distinguishing its characteristics from those of abuse. Causes Except for those who abuse anabolic steroids to improve their athletic performance and musculature, most people begin to use and

Substance Addiction 

abuse drugs for the same reason they abuse alcohol—they like the feeling. Their introduction to the drug may arise from a sampling opportunity at a party, social pressure from peers at school or work, or even by way of a medically prescribed drug initially written for therapeutic purposes. As part of the maturing process to develop identities independent of their families, teenagers have an increased capacity for risk taking and novelty-seeking behavior that encourages experimentation, often with drugs. Tragically, the younger a person is when he begins using drugs, the more likely he is to become addicted. Recent research shows that addictive drugs target the same area of the brain. Nevertheless, individuals respond to the drugs in different ways. Although there is no addiction gene, a number of gene variants have been identified that predispose certain individuals to addiction, but because environment can affect gene expression and thus biochemistry, determining the respective impact of the genes has thus far eluded science. Even though the likelihood of addiction can be predicted with a degree of accuracy based on genetics and patterns of use, the influence of other factors such as the method of administration (orally, through smoking or snorting, by injecting subcutaneously or into an artery, or inserting suppositories rectally), emotional vulnerabilities, stress, family dysfunction, and preexisting mental disorders cannot be weighed with precision. Increasing evidence is emerging that posttraumatic stress disorder seen in war veterans and victims of natural disasters, including their rescue personnel, are at particularly high risk for substance abuse and addiction.

Effects Depending on the substance in question, the short-term effects of drug use are slowed reflexes, lack of motor coordination, altered

perception, and cerebral disinhibition that can lead to dangerous behaviors such as unsafe sex or reckless driving. Withdrawal produces hangovers of varying intensity and severity, some of which may be life threatening, and include fatigue, depression, anxiety, even convulsions and delirium. When the user begins to use drugs compulsively, he may resort to criminal activity to obtain them or the money with which to purchase them. He might neglect school, work, family, and friends in an increasingly downward spiral into addiction. Additional dangers include needle sharing, which spreads AIDS and hepatitis, and the emergence of aggressive tendencies that lead to violence. Combining two or more drugs can have unpredictable and dangerous synergistic effects that are significantly more dangerous than the sum of the individual effects of the drugs. If the user is pregnant, the impact on the unborn child can be devastating and permanent. Drug addiction can produce serious ailments such as cardiovascular disease; trigger or exacerbate mental disorders in susceptible individuals; cause lung disease, cancer, infections, and viral diseases; and compromise the immune system to leave the user more vulnerable to opportunistic diseases. The use of hallucinogens such as LSD can cause flashbacks and other perceptual distortions years after drug use has stopped. Users risk social standing, jobs, family stability, and financial security. Although drugs are often taken to relieve the symptoms of mental disorders like anxiety, depression, and posttraumatic stress, their abuse invariably worsens the symptoms and creates other serious problems that threaten health and well-being. Drug addiction fosters dysfunctional dynamics within the family, such as enabling or codependence, and creates hostility and resentment that can take a long time to resolve, even with family counseling. The profound psycho-

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logical, physical, and medical consequences of addiction also spill over into society in terms of criminal behavior, lost productivity, spread of disease, and endangerment of others.

Prevention According to the NIDA, drug use peaks during the teen years, and children as young as 12 and 13 are already abusing drugs. For this reason, it is essential that even elementaryschool students be taught about their dangers. Evidence shows that if young people understand the potential harm, they abuse drugs to a lesser extent. Evidence also suggests that truthful, reliable information is more effective than scare tactics; otherwise, when youngsters and adolescents learn that they have been given inaccurate information, they tend to reject the entire message. Parents are the key to successful prevention by setting a good example, engaging their children in wholesome family activities, providing a nonaccusatory environment in which children can ask questions or discuss difficulties, and helping children learn to address life’s problems in a healthy fashion. Parents should also be alert to the warning signs of drug use and be aware that transitions in an adolescent’s life such as changing schools, puberty, and disruptions in family life present opportunities for them to experiment with drugs. Not all families can provide the stable and consistent oversight needed to protect their children from drug use, and to address this need local, state, and federal programs need to be reevaluated. Many experts suggest that if less money and effort were spent on punitive measures to incarcerate and punish users, and more were spent on treatment and rehabilitation such as that offered through drug courts, the benefits to individual drug users and thus to society as a whole could significantly reduce the public health crisis that drug addiction represents.

Treatment Treatment can take several forms based on the drugs that are abused and the addict’s personal circumstances. In general, it should include an assessment of the severity of the addiction and health status, followed by detoxification, or “getting clean.” This is the period in which drugs are eliminated from the body and withdrawal symptoms are managed to reduce excessive discomfort or risks to health. This stage may require specialized medical oversight. The next stage, rehabilitation, is the period during which the addict learns to manage any cravings, address symptoms of accompanying mental disorders, and confront some of the issues that helped feed the original addiction. Rehabilitation may occur in a residential setting for several days or weeks or it may be carried out in outpatient programs that offer counseling and group support to ensure abstinence and help addicts resume a more normal lifestyle. Medications to block craving or minimize the chance of relapse may be appropriate. The final stage is continuing care, a period of several months after treatment when addicts are most vulnerable to relapse. During this time community resources such as treatment centers, hospital groups, or local groups like AA help the addict adjust to reentry into a drug-free life with a measure of confidence and optimism. Support groups based on the 12-step AA model have provided substantial help to addicts for over 60 years, and many addicts, regardless of the nature of their addiction, view the organization as critical to their continued recovery. Although most treatment programs follow these general stages, there are wide variations depending on individual circumstances and availability of services. Specialists stress that specific treatment techniques are less important than the quality of the treatment and providers, and getting treatment as soon as possible. Particularly important are treat-

Substance Addiction 

ment matching, which addresses the severity of the addiction and the addict’s individual characteristics, and dealing with co-occurring disorders at the same time. Kathryn H. Hollen See also: Addiction; Hallucinogens; Johnson, Lyndon Baines; Marijuana; Opiates; Prevention; Treatment

Further Reading American Psychiatric Association. 2000. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., Text Revision. Washington, DC: American Psychiatric Association. Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Hanson, Glen R. 2007. Substance Abuse Disorders: Diseases of the Mind. Utah Addiction Center. http://uuhsc.utah.edu/uac. Johnston, L. D., Patrick O’Malley, Jerald Bachman, and John Schulenberg. 2007. Monitoring the Future. National Results on Adolescent Drug Use: Overview of Key Findings, 2006. NIH Publication No. 07-6202. Ketcham, Katherine, and Nicholas A. Pace. 2003. Teens Under the Influence: The Truth about Kids, Alcohol, and Other Drugs. New York: Ballantine Books. Kuhn, Cynthia, et al. 2008. Buzzed: The Straight Facts About the Most Used and Abused Drugs From Alcohol to Ecstasy. New York: Norton. Moyers, William Cope. 2006. Broken: The Story of Addiction and Redemption. New York: Penguin. Nutt, David. 2007. “Development of a Rational Scale to Assess the Harm of Drugs of Potential Misuse.” Lancet 369: 1047–53. Roffman, R. A., and Robert Stephens, eds. 2006. Cannabis Dependence: Its Nature, Consequences, and Treatment. New York: Cambridge University Press.

Thombs, Dennis L. 2006. Introduction to Addictive Behaviors. 3rd ed. New York: Guilford Press. U.S. Department of Health and Human Ser­ vices. 2007. Results from the 2006 National Survey on Drug Use and Health: National Findings. Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. DHHS Publication No. SMA 07-4293. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2001. Research Report Series: Hallucinogens and Dissociative Drugs. NIH Publication No. 01-4209. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2003. Preventing Drug Use Among Children and Adolescents, A Research-Based Guide for Parents, Educators, and Community Leaders. NIH Publication No. 04-4212(B). U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2004. Research Report Series: Cocaine Abuse and Addiction. NIH Publication No. 99-4342. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2005a. Research Report Series: Heroin Abuse and Addiction. NIH Publication No. 05-4165. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2005b. Research Report Series: Inhalant Abuse. NIH Publication No. 05-3818. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2005c. Research Report Series: Marijuana Abuse. NIH Publication No. 05-3859. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2005d. Research Report Series: Prescription Drugs Abuse and Addiction. NIH Publication No. 05-4881. U.S. Department of Health and Human Services, National Institute on Drug Abuse.

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864   Supply-Side Strategy 2006a. Research Report Series: Anabolic Steroid Abuse. NIH Publication No. 06-3721. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006b. Research Report Series: MDMA (Ecstasy) Abuse. NIH Publication No. 06-4728. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006c. Research Report Series: Methamphetamine Abuse and Addiction. NIH Publication No. 06-4210. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov. U.S. Department of Justice, Drug Enforcement Administration. http://www.usdoj.gov/dea.

Supply-Side Strategy In economics, a supply-side strategy is a method to control prices and availability by controlling the supply of a commodity. Also known as “supply-control strategy,” the method has been used in a wide variety of areas as a way to regulate controlled substances or objects. Two areas in which the supply side strategy has been particularly widely used are drug control and the control of illegal weapons. In particular, drug markets have been targeted by supply-side strategies internationally, and even more specifically by the U.S. government. Though the League of Nations hoped to develop international drug policy through the 1920s and early 1930s, the United States wished to lead efforts at international drug control, and because of the strained relations between the League and the United States, there was little headway made in terms of a narcotics control policy across borders. However, also in the early 1920s the United States advocated a policy dedicated to a strict supply-side approach. Specifi-

cally, international legislation advocated by House Foreign Affairs Committee chairman Stephen Porter sought to create an immediate and large reduction of the agricultural supply of drugs, particularly of opium and coca, outside of what would be required for medical purposes. This, in part, was spurred by the seeming lack of success at rehabilitation of addicts to drugs derived from those products. This proposal, however, was thought to be largely untenable by the League. Many of the countries involved had political or economic interests in maintaining the status quo in terms of drug production, with agricultural producers in Asia and Latin America relying on drug-related crops for income, and many of the governments where the crops were grown relying on the income for their respective communities. The stance by the United States had the effect of polarizing the debate between those countries who were concentrated on supply-side strategies and those who desired an anticontrol approach. This debate led to the United States pulling out of what became the 1925 International Opium Convention and strained the relationship between the United States and those supporting the convention for the next decade. This frustration of the U.S. efforts, in turn, led to domestic policy like the creation of the Federal Bureau of Narcotics. By 1931, with the passage of the new drug control treaty, which now included the United States as a signatory, the international drug control regime was in place with supply-side strategy as a key component of international drug control. According to McCallister, this approach focused on, not the prohibition of illicit substances, but rather their relegation to medical, scientific, and industrial needs, as the system had become enmeshed with commercial interests of the pharmaceutical industry. It also tended to

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focus “blame” for illicit drugs outside of the United States, onto countries that were producing “excess supply.” Over the course of the next two decades, particularly with the advent of the United Nations and its Commission on Narcotic Drugs in 1945, which had a heavy supplyside focus, the United States was able to maintain levels of international control but was unable to increase the stringency of international control efforts. Thus, the United States would be relegated to increasing domestic policies, particularly the enforcement efforts of the U.S. Customs Service and the FBN, and the development of new policies like the 1951 Boggs Act and the Narcotic Control Act of 1956. The 1960s and 1970s saw increasing levels of enforcement and regulatory control within the international context. However, the explosion of the demand of drugs domestically changed the way international drug control was carried out. Demand began to become more important in terms of control efforts, and efforts at prevention, intervention, and treatment became more salient with more of the public using drugs than ever before. Despite this, there was still a consistent emphasis in terms of the supply-side paradigm, and drug use was being consistently defined as a problem in the international community. The 1980s and 1990s maintained this “dualtrack” approach, though it remained focused on the supply-side rather than treatment and demand options. Supply-side strategies are focused on controlling a supply. While there are many ways to do this (e.g., restricting the legality of a commodity), the most common form of supply-side control in drug markets is interdiction. Indeed, in the 2007 National Drug Control Strategy, nearly half of the document is dedicated to “Disrupting the Market for Illegal Drugs.” In terms of actual resource al-

location, this means that the majority of drug control expenses happen on the supply side. Post-9/11, there has been an increased focus on run-on effects of drug trafficking. Specifically, the relationship between international criminal markets and terrorism has become one of the most salient focuses of supply-side control strategies. However, despite the focus on controlling supply, and the decades-long commitment to that strategy, it is difficult to measure the policy’s success. Not only is it difficult to determine how much potential supply is “deterred” through interdiction efforts, it is virtually impossible to judge the second- and third-order effects of disrupted trafficking. Supply-side strategies have come under significant criticism from their inception, but in recent years, after a 50-year War on Drugs with questionable effects, those criticisms have become more pointed. These criticisms tend to focus on the lack of effectiveness of a supply-side strategy, or an overemphasis on supply-side vs. demand-side strategies. For example, one of the frequent criticisms is that despite the decades of enforcement, the number of narcotics seized each year has tended to increase. While those who are operating in drug-interdiction capacities tend to emphasize this as one of the successes of interdiction, those who are critical point out that an equally plausible explanation is that there are simply more drugs being shipped. This is emphasized by the fact that U.S. intelligence supports the contention that the supply of drugs exiting Colombia has doubled over the past 20 years. The second major criticism, that the emphasis of supply-side strategies has either negated or taken away from demand-side approaches, has been explicitly recognized by the most recent National Drug Control Strategy in 2012. Additionally, the term “War on Drugs,” which had been in use for over

866   Surgeon General’s Reports on Tobacco

50 years, has been eliminated in official parlance by the director of the Office of National Drug Control Policy as of 2009. Despite this, well over half of the overall budget for combatting illicit drugs falls into the supply-side side of the overall drug-control strategy. In addition to the general complaints about supply-side drug control, specific efforts, recently the “Plan Colombia” effort, have also come under criticism, as they have not seemingly reduced the amount of drugs being cultivated, despite aggressive efforts at crop eradication. Additionally, while the funding has gone to train military personnel, much of the money spent is not directly related to controlling illicit drugs, but rather to dealing with a related, but significantly different issue. Supply-side control policies have developed over the past 100 years as the preferred method of dealing with illicit drugs and other illegal commodities. Focused on reducing the supply of drugs, the strategy has always been contentious, and in recent years has come under heavy criticism. There has been significant response to this criticism, particularly the lack of demand-side emphasis (e.g., drug treatment and prevention), but despite this tacit acknowledgement by drug control policy stakeholders, nearly two thirds of the annual drug-control budget still focuses on supply-side issues. Joshua B. Hill

Further Reading Carpenter, T. G. 2001. “Plan Colombia: Washington’s Latest Drug War Failure.” http:// www.cato.org/publications/commentary/ plan-colombia-washingtons-latest-drug -war-failure. Erlen, J., and J. F. Spillane, eds. 2004. Federal Drug Control: The Evolution of Policy and Practice. Binghamton, NY: Pharmaceutical Products Press.

McCallister, W. B. 2004. “Habitual Problems: The United States and International Drug Control.” In Federal Drug Control: The Evolution of Policy and Practice, ed. J. Erlen and J. F. Spillane. Binghamton, NY: Pharmaceutical Products Press. Miller, G. J. 2008. The Original Long War: Supply Side Strategy in the War on Drugs. U.S. Army War College. Sacco, L. N., and K. Finklea. 2013. Reauthorizing the Office of Drug Control Policy: Issues for Congress. CRS Report No. R41535. http://www.fas.org/sgp/crs/misc/ R41535.pdf. Storti, C. C., and P. De Drauwe, eds. 2012. Illicit Trade and the Global Economy. Cambridge, MA: MIT Press. White House. 2012. National Drug Control Strategy. http://www.whitehouse.gov/sites/ default/files/ondcp/2012_ndcs.pdf.

Surgeon General’s Reports on Tobacco Appearing on an almost annual basis after the inaugural report in 1964, the surgeon general’s reports on tobacco have scientifically established the many health hazards of smoking. The first surgeon general’s report on tobacco, which appeared when almost half of American adults smoked, was a groundbreaking document that culled years of research and concluded, among other things, that smoking was a cause of lung and laryngeal cancer. Similarly repercussive was the 1988 report on nicotine addiction, which concluded that cigarettes were addicting, nicotine was the drug that causes addiction, and the pharmacologic and behavioral processes at work in nicotine addiction were similar to those determining addiction to drugs like heroin or cocaine.

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The first surgeon general’s report on smoking was born out of a committee that started to come together in 1962. In that year, President Kennedy’s surgeon general, Luther Terry, announced that he would be forming a committee to investigate the impact of smoking upon health, and the group he judiciously convened consisted of five smokers and five nonsmokers. The committee was not opposed by the tobacco industry’s pseudo-scientific institution, the Tobacco Industry Research Committee (TIRC), thereby making it all the more difficult for the conclusions the committee eventually reached to be called into question by big tobacco. The committee’s groundbreaking findings, which were based upon a review of more than 7,000 articles about smoking, health, and disease, were published on January 11, 1964, under the title Smoking and Health. Cognizant of the potential impact of the committee’s findings, Terry scheduled the news conference surrounding the report’s release on a Saturday so as to avert any panic that might arise on Wall Street. Similarly, Terry made sure that information as potent as that contained in the report made its way into the hands of as few people as possible before the news conference. As such, the White House received a copy of Smoking and Health only two hours before its official release. The historic report constituted both the most authoritative and direst assessment of the health effects of tobacco use up that point. It concluded that cigarette smoking was a cause of both lung and laryngeal cancer in men; in the case of women, cigarette smoking was described as a probable cause. Chronic bronchitis and emphysema were found to be far more common in smokers than nonsmokers, and the report also determined that the rates of coronary artery disease were 70 percent higher among smokers. Additionally alarming to a nation

of some 70 million regular smokers was the report’s conclusion that the fatality rate from lung cancer was 1,000 percent higher among smoking men than nonsmoking men. In response to these findings, the committee stated that smoking represented a health hazard of such a degree as to warrant appropriate remedial action, though they left such an action undefined. These conclusions represented a tremendous blow to the tobacco industry, which had successfully weathered the first wave of reports linking cigarette smoking to cancer and other diseases in the early 1950s by hiring the public relations firm, Hill & Knowlton, which helped form the TIRC and was behind the publication, in hundreds of newspapers across the country in 1954, of “A Frank Statement to Cigarette Smokers.” That letter-form advertisement had alleviated growing concern over the health effects of smoking by claiming that there was no proof that cigarette smoke was a cause of lung cancer, but Smoking and Health made such a stance no longer scientifically tenable. The TIRC tried to regain some of the legitimacy it lost in the wake of the report by changing its name to the Council for Tobacco Research, but the superficiality of this move highlighted that the tobacco industry could have no significant answer to Smoking and Health. American smokers, too, were hit hard by the committee’s conclusions, and in January and February of 1964 many smokers tried to quit in what was called “The Great Forswearing.” In March, however, even the knowledge of smoking’s dangers was not enough to prevent what soon came to be known as “The Great Relapse.” The continued smoking of cigarettes surprised Terry, who believed that Smoking and Health would be enough to convince Americans to quit an extremely hazardous practice, and he

868  Synanon

suggested that the addictiveness of cigarettes was stronger than had been indicated in the conclusions of the first surgeon general’s report on smoking. Additional surgeon general’s reports on various aspects of smoking appeared almost annually after the groundbreaking Smoking and Health, and in 1988, the surgeon general released a report focusing on the addictiveness of smoking. The topic had been previously discussed, as the 1964 report committee’s pharmacology expert believed that smoking was habit-forming and that smokers could undergo withdrawal. He was, however, unwilling to go so far as to conclude that smoking was addictive by the standard definitions of the time. The surgeon general in the 1980s, C. Everett Koop, had no such reservations, and the report he released in May 1988 was based upon a significant amount of new research. The Health Consequences of Smoking—Nicotine Addiction: A Report of the Surgeon General concluded that cigarettes were addicting and that nicotine was the drug causing addiction. It additionally determined that the pharmacologic and behavioral processes at work in nicotine addiction were similar to those determining addiction to drugs like heroin or cocaine. Koop even explicitly explained that his document overturned the 1964 report’s conclusion that cigarette smoking was habituating instead of addicting. Koop’s report was yet another blow to the tobacco industry, which by then had been denying the addictiveness of cigarettes in important lawsuits such as Cipollone v. Liggett Group Inc. et al. Internal industry documents, however, revealed big tobacco’s longstanding knowledge of nicotine’s addictiveness, and whistleblower Jeffrey Wigand provided further confirmation of this. Food and Drug Administration (FDA) head David

Kessler would later utilize the conclusions reached by surgeon general’s reports like those from 1964 and 1988 when he declared, in 1996, that cigarettes were essentially nicotine-delivery devices and should thus be brought under the regulatory authority of the FDA. Howard Padwa and Jacob A. Cunningham See also: Cipollone v. Liggett Group, Inc. et al.; Food and Drug Administration; Nicotine; Tobacco; Tobacco Institute

Further Reading Brandt, Allan M. 2007. The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America. New York: Basic Books. Cordry, Harold V. 2001. Tobacco: A Reference Handbook. Santa Barbara, CA: ABC-CLIO. U.S. Public Health Services. Office of the Surgeon General. 1988. The Health Consequences of Smoking—Nicotine Addiction: A Report of the Surgeon General. http://prof iles.nlm.nih.gov/NN/B/B/Z/D/_/nnbbzd .pdf. U.S. Surgeon General’s Advisory Committee on Smoking and Health. 1964. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. http://profiles.nlm.nih.gov/ NN/B/B/M/Q/_/nnbbmq.pdf.

Synanon Founded by Charles Dederich (1913–1997) in 1958, a man believed to have coined the phrase, “Today is the first day of the rest of your life,” Synanon was once a promising drug rehabilitation program that evolved into a cult, eventually disbanding in 1989. Before the organization was overtaken by members with extremist tendencies, most of its then innovative principles based on behavioral

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modification proved to be so effective that many of them have survived to be incorporated into modern treatment approaches. Dederich’s father, an alcoholic, died in a car crash when Dederich was a young boy. Dederich also became a heavy drinker in college and received help from Alcoholics Anonymous (AA) to help him become sober. While in AA, he became a believer in the Twelve Step process. After an encounter with a drug addict during one of the AA meetings, he adapted the Twelve Step program to help the addict. There were very few forms of treatment for those addicted to narcotics at the time. Dederich found that the Twelve Step program worked as well for drug addicts as for alcoholics—even those addicts whom others said could not be helped. He combined the 12 steps with a series of lectures and therapy in which patients challenged each other to understand the reasons why they took drugs. His program used an environment that kept patients insulated from the outside world every day, all day. It was a new approach to drug treatment, and it seemed to work. Even though Dederich was an alcoholic, he formed Synanon to serve people addicted to other drugs because, at that time, AA members did not allow other addicts to join the organization. Based in California, Synanon was originally established as a two-year residential program, but, because Dederich felt addiction was a lifelong disorder with no graduates, it evolved into an alternative community that espoused a permanent commitment to its own utopian ideal. The program provided educational and vocational opportunities to its clients. Adopting abusive methods to confront others, the group became more abusive in time. Part of its treatment program involved the Synanon Game, initially a truth-telling therapeutic tool that later became a form of dogmatic

social control and manipulation. Reports of verbal abuse, humiliation, and even physical assault became common. As the organization became more rigid and cult-like, members’ personal and sexual lives fell under the domination of the group. By the 1970s, rumors spread about child abuse, illegal activities, and oppressive treatment of members within the organization. Dederich was involved with some problems with the Internal Revenue Service. When Synanon proclaimed itself a church (possibly to help Dederich’s tax status), religious and tax-status issues drew focused media attention that revealed some members were engaged in bizarre and occasionally violent criminal activity. Members lived in a commune and worked at different businesses to support the organization and Dederich. Law enforcement investigations increased, which ultimately culminated in charges of assault and murder conspiracies, one of which had to do with a rattlesnake being left in the mailbox of an attorney. In 1980, Dederich entered into a plea bargain on conspiracy charges. The court did not sentence him to jail time, but did force him to give up the leadership of the organization. By the 1990s, the organization had largely been dissolved, and both he and the group had lost most of their reputation. Dederich passed away in 1997. Initially, Synanon was a positive force in the field of addiction and recovery, encouraging recovered members to tour the country speaking to high school students. The program inspired television shows, a movie, and several books, and one branch of Synanon still exists today in Germany. Before the organization was corrupted by greed and extremism, positive behavior modification in a highly structured environment of cooperative peer interaction dominated Synanon’s approach and became, in part, a model

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for the therapeutic community approaches to treatment that are widespread today. Kathryn H. Hollen See also: Addiction; Alcoholics Anonymous; Recovery; Treatment

Further Reading Gerstel, David U. 1982. Paradise, Incorporated—Synanon: A Personal Account. Novato, CA: Presidio Press. Janzen, Rod A. 2001. The Rise and Fall of Synanon: A California Utopia. Baltimore: Johns Hopkins University Press. Mitchell, Dave, Cathy Mitchell and Richard Ofshe. 1980. The Light on Synanon: How a Country Weekly Exposed a Corporate Cult—and Won the Pulitzer Prize. New York: Seaview Books.

Synthetic Drugs “Synthetic drugs” is a term used to refer to nonorganic, chemically synthesized drugs that are created by scientists in a laboratory, either through an accident or planned research. Examples of synthetic drugs are amphetamine, Ecstasy (MDMA), LDD, methamphetamine (meth), Rohypnol, PCP, and OxyContin. Many times, these “designer drugs” were legal because they were not chemically identical to other drugs. Many laws have been changed so that any drug with a chemical structure that is similar to that of a controlled substance is also illegal. Laws were also passed that gave the U.S. Drug Enforcement Administration the power to place these drugs into a schedule under the Controlled Substances Act for one year, with an optional six-month extension. This would provide the time to gather evidence to permanently schedule the new drug.

There has been little research about the safety of these drugs. Certainly, the longterm effects of these drugs remain unknown. There is sometimes an added danger to synthetic drugs. They often contain impurities that can have unpredicted effects on a user. In the mid-1980s, some synthetic heroin made in the United States contained an impurity called MPTP that destroyed neurons in the midbrain. Many young people who used this drug could be susceptible to acquiring Parkinson’s disease. These drugs have many medicinal uses. Others can be abused for nonmedical or recreational reasons. They can cause hallucinations. However, when used in high doses, they can cause seizures, comas, and even death. Synthetic drugs are also called “club drugs,” “designer drugs,” or “rave drugs” because they are often used by young people attending raves and clubs. One person who carried out significant research in the area of synthetic drugs was Dr. Alexander Shulgin, who wrote about the effects of hundreds of substances in two books, PiHKAL (Phenethylamines I Have Known and Loved) and TiHKAL (Tryptamines I Have Known and Loved), which he wrote with his wife Ann Shulgin. Chemists have been able to successfully duplicate the medicinal compounds found in many plants and used to treat illnesses and ailments. For example, scientists have discovered how to re-create quinine (used to treat malaria); digoxin (used to treat heart problems); diacetylmorphine (called heroin; used for pain relief); aspirin (used for pain relief); and taxol (used as an antitumor drug). There are hundreds of synthetic drugs. Synthetic opiates include methadone, meperidine (Demerol), propoxyphene (Darvon, Darvocet), LAAM (Orlaam), tramadol (Ultram, Ultracet), and buprenorphine (Sub-

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utex, Suboxone). These were discovered by chemists as they were looking to develop drugs that would be effective pain relievers as natural opiates but without the same high potential for abuse. A new synthetic opiate discovered in the 1980s was derived from fentanyl, a prescription narcotic drug. Small chemical modifications to fentanyl make it 10 to a thousand times stronger than heroin. It is sold under the name “China White” and, because of its potency, has a high risk of overdose. A well-known synthetic drug is MDMA, or Ecstasy. It was developed to help psychiatrists who were using the drug for psychotherapy. But because so many patients suffered from serious side effects, the government put it into Schedule I of the Controlled Substances Act. This means it has no accepted medical purpose and a high level of abuse. In the 1990s, the drug became popular in clubs, especially at “raves.” The drug has stimulant qualities and hallucinogenic qualities. One effect is to raise the body temperature of the user, leading to dehydration. It can also produce confusion, sleep problems, and declines in memory. Some Ecstasy is tainted with other chemicals, making it an even more dangerous drug. Phencyclidine (PC) is a synthetic depressant, also known as “angel dust.” It was created in 1963, but soon after taken off the market because it caused delirium, disorientation, and hallucinations. It has been classified as a Schedule II drug under the CSA. It causes a feeling of being dissociated (or cut off) from one’s body. The drug is unpredictable and can cause violent behavior and amnesia. “Bath salts” are another example of a synthetic drug. The chemical compound of these drugs varies widely, but they have effects similar to amphetamines and cocaine. In general, they cause headaches, heart

palpitations, nausea, hallucinations, panic attacks, and violent behavior. Many critics of the current prohibitionist policy toward illegal drugs say that even if interdiction efforts were hugely successful in shutting down the production of coca and poppy plants, it would only result in an increase in synthetic drugs. Today, the consumption of Ecstasy and amphetamine exceeds that of cocaine and heroin in many European countries. Ron Chepesiuk See also: Amphetamine; Bath Salts and Synthetic Cannabis; Controlled Substances Act; Ecstasy; Methamphetamine; Shulgin, Alexander

Further Reading Abadinsky, Howard. 2007. Organized Crime. Belmont, CA: Thomson/Wadsworth. Abadinsky, Howard. 2008. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Thomson/Wadsworth. Abel, Ernst L. 1994. A Dictionary of Drug Abuse Terms and Terminology. Westport, CT: Greenwood Press.

Syrup “Syrup” refers to a recreational drug that is popular in the hip-hop community. The main ingredient in this concoction is prescriptionstrength cough syrup that contains codeine (a narcotic) and promethazine (an antihistamine), which is usually prescribed for pneumonia. The cough syrup is mixed with soda such as Sprite, 7Up, or Mountain Dew. It can also be mixed with a sport drink or even Kool-Aid. The mixture is also referred to as sizzurp, lean, drank, purple drank, barre, purple jelly, Texas tea, Memphis Mud, purple Sprite, and Tsikuni. The references to purple have to do with the color of the cough

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syrup, which has a purple color. Once taken, the effects last between three to six hours. A study carried out by the University of Texas in 2004 showed that 8.3 percent of secondary school students in Texas had taken codeine syrup to get high. When a large amount of codeine and promethazine is ingested, the drugs can cause sedation and altered levels of consciousness. Promethazine itself can cause a user to stop breathing, but when mixed with codeine can heighten the effects of the drug. Effects also include constricted pupils, raspy voice, slow and slurred speech, uncontrolled eye movement, slowed heart rate, sleepiness, loss of balance, and constipation. Syrup can also cause weight gain and tooth decay because of the high sugar content in the mixture. Syrup can also be made using prescription cough syrups that contain hydrocodone, but it is less effective and therefore less popular. Syrup can also be made with over-the-counter cough syrups such as Robitussin DM, because it contains dextromethorphan. Syrup or purple drank can be traced to the Houston area in the 1960s, when it became popular in the underground rap music scene. A music producer from Houston, DJ Screw, made the substance popular. Since then, it has become popular in other Southern states. The drug is often referenced in hip-hop song lyrics. Rap group Three 6 Mafia released two songs about syrup. The first, “Sippin’ on Some Syrup” featured UGK and the other was “Rainbow Colors” that featured Lil’ Flip. This song described the colors that occur to purple drank when a Jolly Rancher candy is added to the cough syrup. Those using syrup risk respiratory depression, a potentially serious (or even fatal) adverse drug reaction that is most often associated with the use of codeine. Users also face the danger of cardiac arrest due to the promethazine in the cough syrup. When

these two drugs are mixed with alcohol, it increases the risk of respiratory failure and other severe health complications. There have been many hip-hop artists and athletes who have had run-ins with Syrup. DJ Screw, who originally popularized the substance, died of an overdose of codeine, promethazine, and alcohol on November 16, 2000. Big Moe, a rapper who released two albums having syrup as the theme (City of Syrup and Purple World), died on October 14, 2007. At the age of 33, he suffered a heart attack that left him in a coma, ultimately leading to his death. There were rumors circulating that he used purple drank before his death. Pimp C, a popular rapper from Texas and a member of rap group UGK, was found dead at the Mondrian Hotel in California on December 4, 2007. Members from the Los Angeles County Coroner’s Office investigated the death and finally concluded he died from effects of using promethazine and codeine, aggravated by some other unknown factors. While he had the substance in his system, it was not enough to cause his death and label it an overdose. However, Pimp C’s medical record included sleep apnea, whereby a person will stop breathing for short periods while sleeping. It is thought that the sleep apnea mixed with cough medication probably caused him to stop breathing. There have been other events that indicate that rappers are using Syrup. Rapper 2 Chainz was arrested at the Los Angeles International Airport on June 11, 2013, just a few days after he was robbed at gunpoint in San Francisco. The arrest revolved around charges that he was in possession of marijuana, as well as promethazine and codeine. In October 2012, rapper Lil Wayne was hospitalized after suffering seizures while flying in his private jet. His attack was later

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attributed to a migraine and dehydration. On March 15, 2013, Lil Wayne was again hospitalized, this time after suffering from seizures after an alleged sizzurp binge. He was admitted to Cedars-Sinai Medical Center’s Intensive Care Unit in Los Angeles after being found unconscious and shaking uncontrollably. Doctors later reported that they had found codeine in Lil Wayne’s body and they were forced to pump his stomach three times in order to remove the drugs from his system. He was released from the hospital three days later. Lil Wayne has admitted to using purple drank, and references to the mixture appear in his song lyrics and in his videos. When asked about stopping his abuse of the drug, he talked about the symptoms of going through withdrawal, saying that it wasn’t easy to stop. There have been professional athletes who have had legal problems because of Syrup. In September 2006, Terrance Kiel, a player with the San Diego Chargers NFL team, was arrested during practice for possession of prescription cough syrup. Kiel was arrested as he attempted to send a case of cough syrup via FedEx to a friend. Kiel was eventually charged with two felony charges of transporting a controlled substance and three counts of possession for sale of a controlled substance. He pled guilty to the charges. He was released from the Chargers and died in a car accident two years later at the age of 27. In July 2008, another sports figure, Johnny Jolly, a member of the Green Bay Packers NFL team, was driving and was pulled over by police for excessively loud music. The police found a Dr. Pepper bottle in the drink holder. Next to it were two Styrofoam cups that contained only soda and ice. But the police officers reported a strong odor of codeine from the containers.

They also found 200 grams of codeine in the car. Jolly was charged with a second degree felony. The case against Jolly was initially dismissed but charges were later refiled in December 2009 after the Houston Police Department received equipment with which the police could retest the cup’s contents. Then the contents of the cup tested positive for codeine, the charges against Jolly were reinstated. In 2005, former Oakland Raiders quarterback JaMarcus Russell was arrested at his home in Mobile, Alabama, for possession of codeine syrup without a prescription. He had previously been released from the Raiders because he was “drowsy and weak” too often. The arrest came after an undercover narcotics investigation. In the past few years, companies have developed legal products based on purple drank. While these products do not contain any illegal substances, they are controversial because they are seen as popularizing the use of the medication. One of those is a drink called “Drank” that includes herbal ingredients to “Slow Your Roll.” It has been argued that these legitimate drinks can act as a gateway substance that is used by young people who then become comfortable in trying syrup. They may be more dangerous to those teens who follow hip-hop music. Nancy E. Marion See also: Codeine; Hip-Hop and Drugs

Further Reading “Effects of Purple Drank Abuse.” Narconon International. http://www.narconon.org/drug -abuse/purple-drank-effects.html. MJD. 2005. “JaMarcus Russell Arrested; Not Likely to Be Employed Soon.” Yahoo Sports, July 5. http://sports.yahoo.com/ nfl/blog/shutdown_corner/post/JaMarcus

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“Signs and Symptoms of Purple Drank Abuse.” Narconon International. http://www.narc onon.org/drug-abuse/purple-drank-signs -symptoms.html.

Reid, Shameem. 2008. “Lil Wayne on Syrup: ‘Everybody Wants Me to Stop . . . It Ain’t That Easy.’” MTV.com, February 28. http:// www.mtv.com/news/articles/1582520/ lil-wayne-on-syrup-everybody-wants-me -stop.jhtml.

Sullivan, Tim. 2008. “Kiel Left Little as Memorial to Himself.” Union Tribune, July 6. http://www.utsandiego.com/sports/sullivan/ 20080706–9999–1s6sullivan.html.

U.S. Department of Justice, National Drug Intelligence Center. 2011. “Drug Alert Watch.” http://www.justice.gov/archive/ndic/ pubs43/43924/sw0008p.pdf.

-Russell-arrested-not-likely-to-be-empl ?urn=nfl,253790.

T lemmas that find the main character committing murder, conspiring to form his version of a cartel, and employing corrupt lawyers and prison inmates to further his agenda, all under the umbrella of “doing it for his family.” The viewers, however appalled they are meant to feel at the sight of drug production and sales, engage with the main characters compassionately, and in a way that makes many in the audience uncomfortable with their own values as they root for him to succeed in his plots. The Wire provides an omniscient view into the lives of a drug-fueled society of gangsters, police officers, and political figures, all dealing with life on the streets of Baltimore. West Baltimore has a rich history of notable management of the “War on Drugs,” and as this show is written by a team of experienced participants, the viewer is assured that what they are watching is not far from the truth of these streets—in the slightest. David Simon, a former police reporter for a major newspaper, and Ed Burns, a former Baltimore police officer, combine their different perspectives to address the singular concern of how a city deals with an urban drug-fueled environment. These programs exist as two sincere examples of viewer participation with protagonists that use drug dealing to finance their seminoble ambitions. It causes the audience to digest the harsh reality that life on the streets, as well as in the suburbs, is not so black and white. Poetically just, The Wire is a commentary on the effects of a drug economy in a largely black population, and Breaking Bad is a journey through the complex, and morally bankrupt life of Walter White, a man no viewer would ever choose

Television and Drugs Drug use, and the War on Drugs, have been a major influence in U.S. television for years. Most recently, two specific shows have emerged that challenge the public policies meant to protect the citizenry from illicit drug use, as well as challenge the common perception of who the drug dealer is, and why they do what they do. Breaking Bad and The Wire have taken the issues and lifestyle of drug use from illicit conversation among academics and policymakers to the most popular programs on cable television. These shows, and many others, stand in stark contrast to romance and comedy commonly employed when developing popular entertainment. These programs deal with issues of murder and death, drug use/drug abuse, and illicit drug trafficking through a lens of ethics and morality. They bring the U.S. (and world) television viewer into the world of drugs by introducing compelling characters faced with complicated choices. This translates into enormous cult viewership, and award-winning dramas that have changed many popular opinions on the benefits of waging a “War on Drugs,” and have offered an alternative view that suggests a more humane approach to dealing with the protagonists of U.S. drug culture.

Art Imitating Lives Breaking Bad is the story of a high school chemistry teacher, recently diagnosed with cancer, who turns to methamphetamine production in order to finance his medical treatment. His saga is littered with moral di875

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Bryan Cranston starred in Breaking Bad, a television drama in which a high school chemistry teacher diagnosed with cancer makes methamphetamine before he dies. The show ended in September 2013. (AMC/Photofest)

to meet, yet one that all viewers tune in to witness.

Why Is This? The reason viewers decide to spend an hour a week with these characters (and most spend many hours at a time, as The Wire and Breaking Bad are among the most binge-watched online programming), and many others in programming that choose to highlight the monsters among us that fashion themselves as heroes, is because the audience has a universal sense of compassion for the drugaddicted. Ironically, many of these characters do not use drugs themselves, but they are equally addicted through their actions within the drug economy. The roles played by the protagonists’ side-characters, such as Walter White’s wife and Officer Shakima Greggs, have no interest in getting high on the drugs they see around them, but they do

come to find their existence as a means to an end that they find beneficial, and more importantly, acceptable. It is even in these audience relationships with side-characters that the individual viewer must decide on a moment-to-moment basis, what actions are right enough, and which atrocities aren’t as wrong as others. This interaction between the writers of these programs and the audience suggests that there is a larger conversation that needs to be had. For over 40 years, the “War on Drugs” has been a controversial issue that has driven political campaigns, enhanced the private prison industry, and inspired countless public policy choices that have seemingly gotten the “Drug Warriors” no closer to their desired outcome. Drugs still prevail on the streets of America, and now in the suburbs, and these two programs dig in to the life choices that actors in these challenged

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realms are forced to deal with. The question becomes, are they really forced to deal with these circumstances, and if so, who is forcing them to respond? What forces encroach upon them to make life/death decisions in, what seems like, an instant? Tragedy surrounds all of these characters as they walk their streets, motivated to succeed by a basic understanding that taking it one day at a time is the only way to operate. That is the trick that the writers of these two programs employ to remind the viewer that life in a drug-infested world is full of surprises. The Wire introduces characters like Omar, a gangster who “never points his gun at a citizen,” but thrives on the riches gained by robbing only drug dealers. Omar relates to the audience as a Robin Hood of sorts, though he does not spread the spoils of his capers with the needy around him, but rather uses the contraband to set up the next robbery. Breaking Bad spends an incredible amount of time following the confused, and cursed, life of Jessie Pinkman. Mr. White’s right hand man, most of the time, is an addict who goes through more emotional hurdles than anyone else presented within these two selected dramas. Jessie is forced to take lives, as well as forced into slavery, due to his inner hatred for both Mr. White’s manipulative demeanor, and his own desire to harness Mr. White as a father figure. His character never realizes the outcomes he works to achieve, but his growth as a “druggie with a conscience” does earn him a final release back into a world that still holds sway over his addictive and impressionable temptations. Though Walter releases him from the slavery of his personal manipulation, Jessie is still bound to be a victim within the world of meth, unless he can find his avenue out—and stay out. This is directly related to the way cities, states, and the United States at large have dealt with the nonviolent drug addict.

By choosing an approach of police power to suffocate the drug trade in urban centers around the nation, the outcome is overflowing prisons filled with simple possession offenders serving multiyear sentences. Where these people need recovery programs, U.S. society has chosen to allocate resources devoted to corralling drug-actors into criminal country clubs. No one in prison enjoys their stay, but inside the penitentiary small-time offenders grow into seasoned criminals. The Wire takes us into a Maryland prison with Avon Barksdale, the kingpin of the West Baltimore heroin crew. His sentence finds him making moves in the outside world just as easily as he did on the streets, and the idea of sentencing someone to a correctional facility to become a reformed offender is replaced with a masterful inmate that makes jail his proxy to lower his own sentence. He knows that a prison guard is bringing drugs into the prison for inmates to use and sell, and thus, to lower his own sentence, he conspires to have the prison guard’s contraband poisoned, and when five prisoners die of bad drugs on the inside of the jail, a police commander is forced to say to his lieutenants, “How are we going to win the war on drugs, if we can’t even win it in our prisons?” Barksdale provides the name of the guard, while having additional poisoned drugs planted in his car, the guard is arrested, and Barksdale is soon released. As we know the data on recidivism is staggering, and many of these offenders will be released and soon returned to the same cycle of criminal apprenticeship, the War on Drugs has grown so big that it cannot be contained, and the lunatics truly have taken over the asylum. Handling an economic occurrence such as the drug trade with punitive measures suggests that the policymakers have no concept of supply and demand. As officers are placed all along the border of Mexico, it is a known fact that millions of dollars are traversing our

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interstate highways at all times, and to approach such a problem with threatening manpower is a futile response to an asymmetrical situation. There are simply more drug users, drug dealers, drug traffickers, drug financiers—There is too large a drug economics for a measured response by law enforcement to successfully take it on. There are not enough tax dollars generated that are devoted to drug enforcement to compete with the immeasurable amount of drug money exchanged. Sadly enough, it is simple economics, and though many seem to profit by opening up new “maximum security” penitentiaries, approaching this problem as anything but an economic dilemma is a sincere mistake. The Wire perfectly represents this with Stringer Bell, Avon Barksdale’s partner “on the outside,” who attends night classes on entrepreneurship and economics, takes his education back to his crew on the streets, and breaks it down for them as simple, employable instruction. His understanding of how the political system reacts to campaign donations, as well as public humiliations, leads him to make decisions that appear more like interstate commerce policy than drug-fueled, fiendish impulsiveness. Understanding that almost everyone in power is corruptible, he devises plans as to how much it will take to turn the power players in his way of establishing an economic empire. Being considered a leader of some Section-8 housing exploitation ring is the first and most fatal mistake that the police force can make, because the modern approach to small business and circumventing regulations has replaced the “hanging by the corner store” drug trade. Walter White takes this understanding to a new level as he produces his product with a sound system of distribution that causes the audience to laugh when they see the police force staking out a “crack house,” hoping to make a simple bust, while Walter is five miles

down the road loading $8 million dollars of product out of the basement of a laundry factory. Breaking Bad embraces the idea of the business angle of drugs, while pivoting off of the futile and foolhardy efforts of law enforcement looking for the mysterious “Heisenberg.” Showing the high-minded efforts of using fumigated houses to turn into temporary meth labs is just one example that Walter embodies of the “work around” nature of understanding law enforcement’s tunnel-vision approach to combatting the drug problem. Ultimately, the issue that both The Wire and Breaking Bad aim to raise is that drug culture has matured and adapted to the failing approach that embodies the damagingly public policy known as the War on Drugs. As the police force raises a surveillance squad or puts a Drug Enforcement Administration detail specifically on the case, they consistently fail to understand that the economic engine of the drug trade is built upon diversion methods, being fully aware of law enforcement’s approach to shutting down their operations. Further, the War on Drugs leads law enforcement to focus on “hand-to-hand” buys, to boost up numbers of “stopped crime,” instead of investing in innovative approaches to capturing the ringleaders. New methods are seen as inferior to the established War on Drugs policies, and having more interest on “juking the stats” allows the true criminal activity to successfully take place. These choices are a reflection of an outdated policy that the intense viewership of these programs proves is not in touch with the pulse of the United States. As viewers side with Walter or Omar, they are accepting that the streets and cities these characters live in are a representation of someplace near them, someplace they may know well. The massive audience devoted to both these shows, and these dangerous, hypocritical protagonists, show that circumstances dic-

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tate how a public judges heroism. It suggests that our society has grown to adjust morality and legality, and now bases acceptable ethics on the environment one lives in, and what choices must be made when survival is constantly threatened. The War on Drugs seems to be breeding a smarter, savvier, and eversurviving drug economy, and without adjustments to the approach on this pervasive problem in America, viewers will continue to side with the actors that achieve highly questionable results, due to unbalanced and imprudent drug enforcement policy. People supporting these “heroes” as they plot and kill shows ultimately that the audience, which is a true reflection of popular culture and the court of public opinion, holds more disdain for the environments created by the ill-advised War on Drugs than on the actual offenders operating within it. The viewer understands that The Wire and Breaking Bad represent ensemble characters that would much rather be cast in safe, tolerant, and growing societies, and the fact that they find themselves in these complex situations allows the audience to give them “a pass” on the legality and morality of their day to day choices. The viewership of these programs reflects that the characters have the support of U.S. popular culture. As they struggle through lives complicated and corrupted by an economy that is sustained by many more offenders than the drug dealer on the corner, the viewer knows that the character did not create the world around them; they are just forced to live in it. These characters do seem to get their just deserts in the end, and from a law enforcement perspective, it is never considered their accomplishment; in the end, the War on Drugs is not credited with delivering any justice. Nancy E. Marion See also: Entertainers and Drug Use; White, Walter

Further Reading “Breaking Bad” AMC. Available at http:// www.amctv.com/shows/breaking-bad. “Breaking Bad” IMDB. Available at http:// www.imdb.com/title/tt0903747/. Chambers, Samuel Allen (2014, March 18). “Walter White is a Bad Teacher: Pedagogy, Partage, and Politics in Season 4 of Breaking Bad.” Theory and Event 17:1. n.p. Pierson, David P., 2014. Breaking Bad: Critical Essays on the Contexts, Politics, Style and Reception of the Television Series. Lanham : Lexington Books. Reed, Ryan. May 30, 2014. “Bryan Cranston Hints at Walter White’s Return” Rolling Stone. http://www.rollingstone.com/movies /videos/bryan-cranston-hints-at-walter-whi tes-return-20140530.

Temperance Movement In common usage, the term “temperance movement” refers to the movement to decrease or eliminate alcohol consumption among Americans through legal restriction and moral imperative that took place in the late 19th and early 20th century. Broadly speaking, the movement can be broken into three eras, culminating with the passage for the Eighteenth Amendment to the U.S. Constitution and the beginning of Prohibition in 1920. Temperance movements, however, are not unique to the United States, and they have occurred during many periods in a variety of nations. Temperance is also not limited to alcohol, with movements also encompassing drugs and other substances also emerging over time. The temperance movement in the United States was closely associated with the middle class, and was also likely fueled by issues with immigration and racism. It focused narrowly on the use of distilled spirits and orig-

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During Prohibition, many women, like Carrie Nation, destroyed kegs and bottles of alcohol with axes and hatchets as part of the temperance movement. (Bettmann/Corbis)

inally focused on the reduction of use, rather than complete abstinence. However, as the movement gained in popularity, and became more closely associated with U.S. Protestantism, it also increased in terms of its emphasis on complete abstinence. Further, the movement began to encompass abstinence from all forms of alcohol, rather than only liquor. The U.S. temperance movement migrated from England in the early years of the 19th century. Drinking and nondrinking had long been ways to define elements of culture, in the United States and elsewhere. Early temperance was a way for the social elite, which had been declining in importance relative to other groups (e.g., rural farmers, evangelical Protestants, etc.), to retain some of its power. During the early era of the temperance movement’s development, there was little focus on complete abstinence, but rather on temperance of use. The movement quickly developed into a

large and powerful force in terms of its moral authority. By the early 1830s, the temperance movement had taken hold in terms of U.S. society, and as a whole had become dedicated to total abstinence as the correct approach to the problem of alcohol. By 1840, there had been a complete shift in U.S. attitudes towards alcohol, from a society in which nearly every segment drank alcoholic beverages in a variety of contexts to a country in which alcohol was seen by many as the root cause of evil. During the middle phase of the temperance movement, the locus of control shifted from Evangelical Protestant clergy to middle- and lower-class individuals who viewed the movement as a “self-help” group, both in terms of drunkenness and as a solution for the social ills those individuals saw in others, in particular immigrant, groups. Additionally, the movement began to be more centralized in nature, with smaller regional and local temperance

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groups being organized into what became known as the Washington societies, which were dedicated to helping individuals with alcohol abuse problems reform. The first of these groups was established in 1849, and by the end of the next year, groups had been established widely in the northern United States. The groups that developed during this time were not cohesive, as they tended to cut across social classes and differed on the appropriate approach to temperance. The lower-class Washington societies tended to remain focused on the self-help elements of temperance, while the upper classes began to focus on legal coercion—or the legislation of abstinence from alcohol. An early example of this was the passage of the Maine Law of 1851, which limited the sale of alcohol to medicinal and industrial purposes. This represented a significant shift, as attempts at coercive reform can be considered attempts by the upper classes to control the lower classes through legislation. From about 1860, dramatic social changes, including rapid industrialization and urbanization, coupled with increases in immigration, had a large impact on the development of the temperance movement. Increases in the distillation and brewing of alcoholic beverages and the subsequent increase in their consumption led to the development of women’s groups focused on reforming drunken husbands and fathers. Several large national organizations developed during this time, the most influential of which was the Woman’s Christian Temperance Union (WCTU), which formed in 1874. By the late 1870s the movement had shifted, not only from a position of temperance to abstinence, but also from self-regulation to legal control of drinking—an approach known as coercive reform. At the turn of the century, the movement had gained significant political clout, particularly through the

work of the Anti-Saloon League of America (ASL), founded in 1896. The organization was nonpartisan in approach, focusing solely on the issue of abstinence, but worked with the major parties that supported their efforts. By the onset of World War I, prohibition was already on its way, with 33 state legislatures having already passed prohibition-style laws. The culmination of the movement was passage of the Eighteenth Amendment to the Constitution on January 16, 1919—which went into effect one year later. Temperance has influenced a variety of modern circumstances, in particular what has become known as “temperance culture.” This effect on societies that had large temperance movements, such as the United States, has impacted areas as varied as popular social movements and scientific inquiry. In particular, as temperance represented the first major attempt at drug control (of any kind) within the United States, the effects can be seen in our educations system, particularly in programs like “Just Say No” and the Drug Abuse Resistance Education programs in the 1990s. In regards to alcohol specifically, scholars have recognized a “New Temperance Movement.” Like the classical movement, this movement focuses on the legal restriction of alcohol and the health and social dangers of alcohol use. This New Temperance coincides with a larger “clean living movement,” which focuses not only on alcohol abuse, but mood-altering drug use, sexuality, diet, and physical fitness. Classical temperance has also had a strong effect on the modern case of illegal drugs. Currently, illegal drugs are regulated in a prohibition-style regimen, though it is stricter than Prohibition was regarding alcohol. However, recent studies have also indicated that the public’s perception of these types of restrictions is increasingly poor, and a focus on harm reduction rather than legal

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restriction is developing across a wide variety of circumstances. The temperance movement, particularly in the United States, is one of the largest and most significant social movements ever developed. The development of prohibition, from self-help to legal coercion, and the movement from local and regional groups to a full-fledged political movement is perhaps one of the most clear examples of a grassroots political success. Additionally, though prohibition was repealed in 1933, the framework that was set up to handle alcohol prohibition still functions in a variety of contexts, most notably when dealing with illegal drugs. Further, though the movement for complete prohibition has largely ended, several temperance organizations such as the WCTU still exist, and have incorporated drugs into their prohibitionist philosophy. Further, the temperance movement served as a springboard for the success of women’s rights, and had a significant effect on how Protestant churches viewed themselves in terms of their role in political issues, which became increasingly important with the advent of the civil rights movement in the 1950s. Modern temperance movements, though largely focusing on temperance rather than abstinence, have also developed. Their link with other, modern movements, and other issues such as drug use, have had a significant impact in areas like education and scientific inquiry. Joshua B. Hill See also: Eighteenth Amendment; Prohibition; Prohibition Party; Prohibition Unit; Woman’s Christian Temperance Union

Further Reading Crafts, Ms. Wilbur F., Mary Leitch, and Margaret W. Leitch. (1909). Intoxicat-

ing Drinks and Drugs in All Lands and Times. 10th ed. Washington, DC: Reform Bureau. Blocker, J. S. 1989. American Temperance Movements: Cycles of Reform. Boston: Twayne Publishers. Bruce, A. K., M. D. Maraun, G. A. Dawes, G. F. van de Wijngaart, and H. C. Ossebard. 1998. “The ‘Temperance Mentality’: A Comparison of University Students in Seven Countries.” Journal of Drug Issues 28: 265–82. Gusfield, R. 1986. Symbolic Crusade: Status Politics and the American Temperance Movement. 2nd ed. Urbana: University of Illinois Press. Heath, D. B. 1989. “The New Temperance Movement: Through the Looking Glass.” Journal of Substance Abuse 1: 109–15. Levine, H. G. 1992. “Temperance Cultures: Concern about Alcohol Problems in Nordic and English Speaking Countries.” In The Nature of Alcohol and Drug Related Problems, ed. M. Lader, G. Edwards, and D. Drummond, 15–36. Oxford: Oxford University Press. Nusbaumer, M. R., and D. M. Reiling. 2007. “Temperance Culture and the Repression of Scientific Inquiry into Illegal Drug-Altered States of Consciousness.” Contemporary Justice Review 10: 247–61. Tyrrell, I. R. 1982. “Women and Temperance in Antebellum America, 1830–1860.” Civil War History 28: 128–52. Woman’s Christian Temperance Union. 2013. “Issues.” http://www.wctu.org/issues.html.

Terrorism and Illicit Drugs The distribution of drugs goes hand-in-hand with terrorism. Terrorist organizations need money to operate, and for the most part their interests are fueled through illegal funding

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sources, particularly those related to the production and trafficking of illicit drugs, such as opium, heroin, and cocaine. Drugs are used as a monetary equivalent to pay for weapons and support of terrorist activity—in Afghanistan, the Bekaa Valley in Lebanon, as well as elsewhere throughout the world. Cultivators and tribal drug lords working with militias have built up a thriving business generating billions of dollars each year in illegal revenues. Initially, terror groups may reject the drug trade and drug use on ideological grounds; however, throughout history terrorist and guerrilla groups of many stripes have turned to crime to finance their activities. The production, refinement, and trafficking of drugs, directly or in partnership with criminal groups, has provided a major source of revenue for groups from South America to the Middle East and beyond. Perhaps the best example of the ties between terrorism and the drug trade can be found in the Revolutionary Armed Forces of Colombia (FARC). This group has traditionally relied on cocaine production and trafficking, allegedly trading the drug directly for arms in some cases. In areas under its control, FARC has allowed the cultivation of coca, which was more profitable for peasant farmers than other crops, and has then been able to exploit the trade to finance guerrilla and terrorist activities against the Colombian government. While FARC’s involvement in trafficking contributes to the flow of drugs into the United States, their terror activities are undertaken on a national scale. However, groups profiting from the illicit drug trade can have transnational aims, as is the case with al-Qaeda. During the 1990s, Afghanistan was the largest producer of illicit heroin in the world. In late 2000, the Taliban came under

pressure from the United Nations Office on Drugs and Crime (UNODC) and the international community to enforce an existing ban. In July of that year, a religious decree was issued on opium production, arguing that it went against Islamic tradition. This decree, or fatwa, along with strict enforcement gained the compliance of farmers. Public punishment was threatened, and destruction of the crop was closely monitored. This resulted in a 99 percent reduction of cultivation in country, and a 35 percent reduction worldwide. With the overthrow of the Taliban following the invasion of Afghanistan, and despite subsequent relief and construction efforts, Afghanistan and the region are again the number-one producers of opium and heroin in the world. In 2012, Afghanistan accounted for 64 percent of global cultivation; the net value of opiates exported from the country that year was about US$1.94 billion. In addition to this, poppy cultivation is linked to cannabis cultivation, with 71 percent of households growing the first and following with a later crop of the second. Many farmers lack market access for licit crops, suggesting that addressing this problem would remove them from the illicit drug trade, which continues to fund terrorism. Afghanistan’s Minister of Counternarcotics estimates that insurgent groups in that country receive as much as US$400 million annually from the drug trade. As of 2013, the United States has contributed over US$4 billion to counternarcotics programs through State Department and Department of Defense programs, including eradication efforts, yet it is estimated that only 10 percent of poppy fields are destroyed each year. Corruption among Afghan officials has frustrated antinarcotic efforts in that country; elites have been known to have rivals’ poppy crops destroyed

884   Terry, Luther (1911–1985)

while avoiding eradication efforts themselves through bribery. Other examples of past and present terrorist groups with suspected ties to the drug trade include Hezbollah and the now defunct al-Ittihad al-Islami, a predecessor to al-Shabaab. Because of the nature of terrorist groups and organized crime, both of which operate underground and tend to be highly security conscious, it can be difficult to establish the exact contribution of the drug trade to terrorist activities. However, because of the sheer magnitude of profit from illicit drugs in countries with active terror networks, even a small percentage of these funds would be sufficient to finance terrorist operations. Because of the reach of these organizations and their effects, concerted efforts between international organizations, law enforcement, and governments around the world will likely be necessary to disrupt the flow of funding and support between terrorist groups and criminal organizations. Richard E. Isralowitz See also: Drug Trafficking; War on Drugs

Further Reading Bewley-Taylor, David R. 2012. International Drug Control: Consensus Fractured. Cambridge: Cambridge University Press. “Drug Trafficking and the Financing of Terrorism.” 2007. United Nations Office on Drugs and Crime. McGraw, Steven C. 2003. “International Drug Trafficking and Terrorism.” Statement to the Senate Judiciary Committee, May 20. http://www.fbi.gov/news/testimony/intern ational-drug-trafficking-and-terrorism. Swarts, Phillip. 2013. “Terrorist Organizations Still Profit from Afghan Drug Trade.” Washington Times, September 20. http:// www.washingtontimes.com/news/2013/

sep/20/terrorist-organizations-still-profit -afghan-drug-t/. “Terrorism and Organized Crime.” 2013. European Parliament. February 26.

Terry, Luther (1911–1985) Luther Terry served as the ninth surgeon general of the United States. He worked to educate the U.S. public about the dangers of smoking. Luther Leonidas Terry was born to James Edward and Lula Maria Durham Terry in Red Level, Alabama, on September 15, 1911. He earned his bachelor’s from Birmingham-South College in 1931 and his MD from Tulane in 1935. At University Hospitals in Cleveland, Ohio, he worked as assistant intern and chief resident. It was in Cleveland where he met his wife, Beryl Janet Reynolds, whom he married in 1940. After working from fall 1940 to 1943 at the University of Texas in Galveston as associate professor of preventative medicine and public health for three years—where he also joined the Commissioned Corps of the U.S. Public Health Service—Terry joined the Public Health Service Hospital of Baltimore as chief of medical service until 1953. As chief of the Clinic of General Medicine and Experimental Therapeutics at the National Heart Institute and member of the cardiovascular study section of the National Institutes of Health, he earned great respect for his accomplishments in cardiovascular research. President Kennedy selected him as surgeon general of the Public Health Service in 1961. In 1962, the Royal College of Physicians in Britain published a report that made a link between smoking cigarettes with lung cancer, bronchitis, and other cardiovascular diseases. Shortly, after the report was released, Terry established the Surgeon

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General’s Advisory Committee on Smoking and Health that would produce a similar report for the United States. After a year of work by the 10-person advisory committee, “Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States” was released on January 11, 1964. Based on over 7,000 articles in the biomedical literature, the report concluded that cigarette smoking causes lung cancer and chronic bronchitis. The report also noted that there was suggestive evidence, if not definite proof, that smoking was linked to emphysema, cardiovascular disease, and various types of cancer. The committee concluded that cigarette smoking was a health hazard of sufficient importance to warrant appropriate remedial action. The landmark surgeon general’s report on smoking and health stimulated a greatly increased concern about tobacco on the part of the U.S. public and government policy makers. Also, it led to a broad-based anti­ smoking campaign. At the time, 46 percent of all Americans smoked; smoking was accepted in offices, airplanes, and elevators, and TV programs were sponsored by cigarette brands. Within three months of Terry’s report, cigarette consumption had dropped 20 percent but was soon to climb back. The report was also responsible for the passage of the Cigarette Labeling and Advertising Act of 1965 and the Public Health Cigarette Smoking Act of 1969, which mandated the surgeon general’s health warnings on cigarette packages, banned cigarette advertising in television and radio broadcasts, and called for an annual report on the consequences of cigarette smoking. After the end of his time as surgeon general in 1965, Terry continued to speak on the health effects of tobacco. He chaired the National Interagency Council on Smoking and Health from 1967 to 1969 and often

consulted for the American Cancer Society and other antismoking groups. From 1965 to 1975, Terry also taught as professor at the University of Pennsylvania, later becoming Corporate Vice President for Medical Affairs in 1982. Continuing to research into the 1980s, he died on April 25, 1985 in Philadelphia, Pennsylvania. Richard E. Isralowitz See also: Cigarettes; Nicotine; Secondhand Smoke; Tobacco

Further Reading Flannery, M. A. 2007. “Luther Terry.” Encyclopedia of Alabama. http://www.encyclopedia ofalabama.org/face/Article.jsp?id=h-1241. Hofer, Stephanie. 2012. “Biography for Luther Leonidas Terry.” Pennsylvania Center for the Book. October 25. https://secureapps .libraries.psu.edu/PACFTB/bios/biography .cfm?AuthorID=358. Koop, C. E. 1985. “An Enduring Memorial for Dr. Luther Terry.” Public Health Reports 100(4): 354–55. Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. 2006. “History of the Surgeon General’s Reports on Smoking and Health.” http://www.cdc.gov/tobacco/ data_statistics/sgr/history/.

“Texas Heroin Massacre” and Drug Use in the 1990s Just as cocaine reemerged and increased in popularity in the 1970s and 1980s, heroin was discovered by a new generation— Generation X—in the 1990s. As with the resurgence in cocaine use, unique socialcontextual factors and greater availability combined to drive the newfound popularity

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of heroin. Increasingly, the source countries for the heroin sold in the United States were Colombia and Mexico. Youth unfamiliar with the addicting potential of heroin started by snorting the drug before progressing to injection use. Countercultural analogs of the 1960s, grunge rock and heroin chic, romanticized heroin use in the 1990s before it took its predictable toll on the proselytizers. In 1999, Mikal Gilmore wrote an article in Rolling Stone magazine called “The Texas Heroin Massacre,” which described an improbable outbreak of heroin use in the wealthy Dallas suburb of Plano. Heroin use had become so extensive in Plano that local teens began referring to it as Heroinville. Before law enforcement identified and shut down the heroin traffickers, 18 teenagers died from overdoses and numerous others showed up in emergency rooms. Mini heroin epidemics in small town and suburban America continue through the present, exacerbated by more recent increases in the diversion and abuse of prescription opiates such as OxyContin and Vicodin.

Background In the first half of the 1990s, illegal drug use began increasing after a decade of decreases but remained well below the peak of use in 1979. Per the National Household Survey on Drug Abuse (NHSDA), 13 million Americans had used an illicit drug in the past month, whereas 25 million reported using any illicit drug in the past month in 1979. The large drop is mostly attributable to a steep decade-long decline in marijuana use. Whereas the panic over crack-cocaine was subsiding as street markets became established and the violence ebbed, a surprising turn (drug epidemics always seem to be surprising) led to heroin reemerging as a new, fashionable drug among U.S. youth. In 1993, the NHSDA survey estimated there

were 68,000 past-month heroin users. The comparable estimate was 216,000 by 1996 with the majority of new users under the age of 26. These numbers hardly register as a blip in national prevalence estimates (less than 1 percent) but they illustrate how even such a relatively small number of users can trigger concerns about and prominent media coverage of the next epidemic. As with the surge in cocaine use in the 1970s and 1980s, the uptick in heroin use was driven by the combination of increased availability and a welcoming cultural context within a small but still significant population of youth. Prior to the 1980s, most of the heroin in the United States came from poppies grown in the Golden Triangle in the Southeast Asian countries of Laos, Burma, and Thailand or from those grown in the Golden Crescent countries of Afghanistan, Iran, and Pakistan. This changed when Colombia began to get into the business of cultivating heroin-producing poppies in 1986. Pressure on the major cocaine-producing cartels in Medellín and Cali led to their diversification into the heroin market. Using established cocaine routes, Colombian traffickers began marketing pure, cheap heroin to U.S. markets in the 1990s. The low cost and high quality of the Colombian product drove out the heroin produced in Southeast and Southwest Asia. As Colombian traffickers increasingly used Mexico as a transshipment point for cocaine to avoid stepped-up interdiction efforts in Florida and the Caribbean, black tar heroin produced in Mexico began to be exported to the United States in greater quantities using the same newly established trafficking routes. In the years that followed, heroin produced in Colombia would dominate the Eastern Seaboard and southeastern states while Mexican-produced black tar heroin would predominate in the West,

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Southwest, and Midwest states. The predominance of Colombian and Mexican-produced heroin in the U.S. market is the reason why the ebbs and flows in poppy production in Afghanistan owing to the Taliban crackdown in 2000 and then the rapid resumption of poppy growing following the 2001 U.S. invasion had minimal effect on heroin availability in America. The purity of the heroin produced in Colombia and Mexico relative to the purity of the heroin produced by the Southeast and Southwest Asian countries had an important implication for the spread of heroin use in the 1990s. Whereas a typical bag of heroin confiscated and tested by the DEA in the 1970s would be between 5 percent to 10 percent pure, heroin confiscated and tested in the 1990s would be at least 30 percent to 40 percent pure (the current national average remains in this range at 35 percent purity) with some seized heroin as high as 98 percent pure. The higher purity was part of the Colombians’ aggressive marketing campaign to take over the heroin markets. It allowed beginners to snort or smoke heroin rather than inject it, a significant barrier for many who are averse to needles. Eventually, however, with the development of tolerance and addiction, many of those who began snorting heroin did end up as injection users. In the 1990s, as the disaffected generation of Gen-X youth were coming of age, they echoed the youthful, countercultural ambitions of their baby boomer parents. But there was a key difference: the countercultural inclinations of the Gen-Xers were devoid of the naïve proposition of the 1960s countercultural movement that drugs were a means of changing self and society for the better. In fact, the Gen-X counterculture was nihilistically devoid of any inclination toward positive change, period. Drugs were simply

a means of coping with a pessimistic assessment of life and the lack of any meaningful prospects for change. There is no agreement on the dates that bracket the start and end of Generation X. (How could there be? It is a categorical abstraction imposed on a continuous phenomenon, births.) A range of 1965 through 1984 provides as good an estimate as any. In a book devoted to describing the genesis and demise of Gen-X culture, Malcom Furek provides this characterization of Gen-Xers: As they were scapegoated, marginalized, and forgotten, the experience and expectation of Generation X were considerably different from that of Baby Boomers. X’ers had little of the optimism, expectation, and promise that embraced previous generations. . . . Their mission, in a hostile postmodern universe, was merely to survive. The music most associated with Generation X is grunge rock, an amalgamation of punk and metal that originated in Seattle and which represented a counterpoint and reaction to the glitzy, heavily commercialized rock of the 1980s. Reflecting the preoccupations of Gen-Xers, the subject matter of the music was often the acceptance and even celebration of alienation. Popular grunge bands included: the Melvins, Alice in Chains, Malfunkshun, and Pearl Jam. But the band that most defined grunge was Nirvana and its lead singer Kurt Cobain. Cobain used many drugs beginning with marijuana at age 13. He began taking heroin to relieve chronic gastrointestinal problems that were never diagnosed, and became addicted. His ongoing problems with drugs and depression and the difficulties of dealing with the fame achieved while playing with Nirvana led to his suicide in 1994. His death

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is seen as heralding the beginning of the end of grunge. As with jazz and rock musicians addicted to heroin, a number of grunge musicians would lose their lives through overdose, including Layne Staley and Mike Starr of Alice in Chains and Kristen Pfaff of the group Hole. Cobain’s wife Courtney Love would have her own battle with heroin addiction but survived it. One of the group’s most famous and popular songs, “Smells Like Teen Spirit” became an anthem of Gen-Xers in its celebration of apathy and self-loathing. Within the song’s inscrutable, stream-of-consciousness lyrics are moments of clarity as to the song’s meanings embodied in phrases such as “I feel stupid and contagious” and “I’m worst at what I do best.” For Cobain and other Gen-Xers, heroin was the perfect analog for the dark moods expressed in songs like “Smells Like Teen Spirit.” Whereas the stimulant cocaine was used in the 1980s to socialize and to celebrate the good times, the depressant heroin was used in the 1990s to retreat into a solipsistic cocoon, sheltered from a harsh and unwelcoming world seen as offering few real prospects for change or hope. Of course, not everyone was impressed with Gen-X’s taste in or Cobain’s style of music, personal philosophy, or choice of drugs. A scathing essay by Rich Lowry that appeared in the National Review (1996) brings to mind Norman Podhoretz’s similarly critical essay on the ethos of the Beat Poets in the 1950s (“I Saw the Best Minds of My Generation Destroyed by Madness”). Lowry’s short essay, entitled “Heroin, Our Hero” notes: Grunge shares some qualities with the old 1960s counter-culture. It is hostile to the bourgeois and consumer culture. It is at the same time, like 1960s activism, an outgrowth of wealth and leisure (it’s not

easy to be a tortured victim of ennui working on a factory floor). But there are important differences. Grunge is for the most part shorn of ideals and the impulse for political action. (Lowry 1996) Being driven into the arms of a dangerous drug by the conviction that life is a pointless bore never looked quite so good. If Kurt Cobain had it to do over again, no doubt he’d be careful to become addicted to something else. Oddly enough, the high fashion industry also got caught up in the same cultural crosscurrents as grunge rock, spawning what became known as heroin chic. As counterpoints to the glamorous look of 1980s models such as Christie Brinkley and Heidi Klum, heroin chic models such as Kate Moss were thin to the point of anorectic gauntness. Purposely made to look unhealthy, with dark circles under their eyes, pallid complexions, dark or black lipstick in the Goth style, heroin chic models posed staring vacantly into the distance; fashion’s embodiment of a druggedout disconnect. Adding to the mise-en-scène, models were photographed in decidedly unglamorous locations such as on a mattress on a floor in a squalid hotel room or in an alley with garbage strewn about nearby. Some images showed models snorting drugs near a chic piece of lingerie. The most infamous heroin chic ad campaign was for the Calvin Klein perfume “cK Be” that appeared in a 12-page spread in Harper’s Bazaar in 1996. Jim Inciardi writes in his book The War on Drugs IV that the advertisers sought out heroin addicts from the streets to lend authenticity to the campaign. The photographer best known for and one of the originators of heroin chic was Davide Sorrenti. Like Cobain, Sorrenti struggled with heroin addiction. He died at the age of 21 from a chronic kidney ailment that was

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likely exacerbated by his heroin use, but not before incurring President Clinton’s public denouncement of heroin chic as promoting drug use. As Cobain’s death marked the beginning of the end for grunge, Sorrenti’s death was seen as the beginning of the end of the heroin chic fashion trend. Were the teenagers that were part of the “heroin massacre” using the drug because they identified as alienated Gen-Xers following the self-pitying tenets espoused by grunge rock lyrics? There is no evidence these were direct influences. It is possible the cultural ethos of the time might have indirectly encouraged their experimentation with heroin. Then too, it could have been the case that heroin simply came along as they were experimenting with drugs and it was added to the mix as something new to try, no complex cultural explanation necessary. As the story indicates, they were naïve as to heroin’s potential for abuse, having had neither firsthand exposure to the drug nor exposure to an older generation of heroin users. The incident in Plano was not unique although the number of deaths and the use of heroin in the unlikely setting of a wealthy suburb attracted considerable media attention. The differential legal treatment of the Mexican immigrants compared with the American teens, as described in the article, again highlights how the war on drugs continued to be prosecuted disproportionately at the expense of minorities. The long sentences received by the Mexican traffickers can be contrasted with the relatively light sentence received by Laurie Hiett (and her husband), who used her status as the wife of a high-ranking military advisor to ship pounds of heroin and cocaine to the United States from Colombia. Things do not appear to have changed much in Texas since the 1997 incidents in Plano. On April 14, 2011, 12 individuals

from or living near Flower Mound, a relatively affluent suburb located near Dallas and Fort Worth, were indicted by a federal grand jury for conspiring to sell 100 grams of heroin. Most were between the ages of 18 and 21. The investigation that led to the indictments was spurred by the overdose deaths of three teenagers. A recent posting on a Flower Mound community forum in a thread entitled “Flower Mound’s new fad, heroine [sic]” by a teenaged local resident, seemingly unaware of the history of nearby Plano, describes the scope of the new problem: I’m sure y’all are aware that a lot of kids smoke weed and drink alcohol in Flower Mound. The network of these kids is huge and everybody seems to know or know of just about everybody in the social scene in Flower Mound. My point is, they are saying heroine [sic] is moving in on these kids like a wildfire, its the new marijuana, everybody’s hooked and everybody’s trying it. According to the DEA’s National Drug Threat Assessment report for 2011: “The availability of heroin in the United States— and the number of markets in which it is available—is increasing as a result of increased production in Mexico, even as Colombian production declines.” Mexico is now the second largest producer of heroin in the world, second only to (but far behind) Afghanistan. In an ironic twist, heroin is now marketed as a cheaper and more potent alternative to illegally obtained oxycodone, the semisynthetic opiate sold in a time-release formulation as OxyContin. Oxycodone users with a high tolerance may ingest as much as 400 milligrams of the drug each day costing about $400.00. In contrast, a comparable amount of heroin can cost less than half of that. Prescription drugs like oxycodone

890   THC (Tetrahydrocannabinol)

and hydrocodone (Vicodin) have become, in effect, gateway drugs for heroin. James A. Swartz See also: Black Tar Heroin; Cobain, Kurt; Heroin; Oxycodone/OxyContin

Further Reading Gilmore, Mikal. 1999. “Texas Heroin Massacre.” Rolling Stone, May 27. Lowry, Rich. 1996. “Heroin, Our Hero.” National Review, October 28, 75–76.

THC (Tetrahydrocannabinol) The primary active ingredient in marijuana, delta-9-tetrahydrocannabinol (THC) has psychoactive effects on human cognitive function. Potency of these effects depend on the concentration of THC in the product containing it. THC concentration, as expressed as percentage of THC per dry weight of material, has increased over the past 30 years. In the 1990s, the THC concentration averaged 1–5 percent for marijuana, 5–15 percent for hashish, and 20 percent for hashish oil. In 2012, THC concentrations averaged nearly 15 percent. It is unknown how users have adjusted to this increase in potency, so actual THC intake may be higher or the same. When a user smokes marijuana, the THC passes from the lungs to cannabinoid receptors on the surface of nerve cells in the part of the brain that influences memory, concentration, and coordination. THC is believed to interact with parts of the brain that play a role in pain sensation, memory, and sleep. The effect that marijuana has on these parts of the user’s brain is referred to as being “high.” Typical psychoactive effects include (but are not limited to) relaxation, euphoria, relaxed inhibitions, impaired motor coordination, lack of concentration, dulling of

attention, and altered perception of time, space, and senses. Higher intake of THC induces more severe effects including psychosis, paranoia, image distortion, learning and memory impairment, and mood swings. Effects on learning and memory are particularly persistent among those users who began using in adolescence. Absorption of THC depends on how the user chooses to use the chemical-containing drug. Marijuana can be smoked, ingested with food, or incorporated into beverages. THC passes more quickly into the bloodstream when the drug is smoked than when ingested through food or drink—absorption of the chemical through the lungs to the blood being a more direct channel than through the digestive system. The effects of smoked marijuana can last 1–3 hours, those for digested marijuana, up to four hours. A synthetic form of THC, dronabinol, is available in the United States and Canada under the brand name Marinol. Some patients claim that Marinol does not have the same effects as smoked marijuana, or that it takes longer to work. Other patients claim that Marinol gets them “high” and is therefore not effective as a treatment. When THC is absorbed into the blood, it overstimulates cannabinoid receptors in the brain. Cannabinoid receptors occur in areas of the brain that control memory, thinking, concentration, pleasure, coordination, and sense perception. Naturally occurring chemicals called endogenous cannabinoids help control these functions, but THC interferes with this control and so produces the high and other psychoactive effects associated with marijuana use. Continued drug use and consistent exposure to THC can alter cannabinoid receptor function, resulting in addiction and withdrawal symptoms. Such symptoms may include restlessness, irritability, decreased appetite, and anxiety.

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THC is categorized as a Schedule I drug in the Controlled Substances Act. Thus, according to the U.S. federal government, THC has no medicinal value and a high potential for abuse. However, some scientific studies have shown that THC has medicinal properties that can relieve the symptoms of some diseases and conditions, as well as the side effects of their treatment. Cancer patients have used marijuana medicinally to find relief from the pain, nausea, and loss of appetite that can be caused by treatment. Patients with AIDS have used THC to help with wasting syndrome, or cachexia (extreme weight loss). It helps to control seizures for those with epilepsy, and the interocular eye pressure that results from glaucoma. It helps people suffering from migraines, Tourette Syndrome, high blood pressure, and insomnia. The peak effect of smoking marijuana occurs in 20–30 minutes after use, and the duration is between 90 and 120 minutes after smoking one marijuana cigarette. Elevated levels of urinary metabolites are found within hours of exposure and remain detectable for 3–10 days after smoking. Many jobs require their employees remain drug-free and demand random drug testing to ensure this. The U.S. Substance Abuse and Mental Health Services Administration suggests that employers use the THC One Step Marijuana Test Strip to test for marijuana use. This is a rapid urine screening test that can be performed without the use of an instrument. The test can test for elevated levels of marijuana in the employee’s urine. The Test Strip yields a positive result when the concentration of marijuana in urine exceeds 50 ng/mL. THC is stored by the body in fatty lipid tissue. It is slowly released into the bloodstream for up to several weeks, depending on

the amount of the drug used, the frequency it is used, and the user’s level of physical activity. With users who smoke often and are physically inactive, the THC may accumulate in fatty tissues faster than it can be eliminated. This means that they will test positive for longer periods after use than other users. Also, users with a high percentage of body fat in relation to total body mass are more likely to test positive for longer periods of time after use. Nancy E. Marion See also: Cannabis; Medical Marijuana; Substance Abuse and Mental Health Services Administration

Further Reading Meyer, Robert J. 2014. “Potential Merits of Cannabinoids for Medical Uses.” U.S. Food and Drug Administration, U.S. Department of Health and Human Services. http://www.fda .gov/NewsEvents/Testimony/ucm114741 .htm. National Highway Traffic Safety Administration. 2013. “Drugs and Human Performance Fact Sheets: Cannabis/Marijuana (Δ9–Tetrahydrocannabinol, THC).” http:// www.nhtsa.gov/people/injury/research/job 185drugs/cannabis.htm. National Institute on Drug Abuse. 2012a. “DrugFacts: Marijuana.” http://www.drug abuse.gov/publications/drugfacts/marijuana. National Institute on Drug Abuse. 2012b. “Marijuana Abuse: How Does Marijuana Produce Its Effects?” http://www.drugab use.gov/publications/marijuana-abuse/ how-does-marijuana-produce-its-effects.

Theories of Drug Addiction Drug addiction results from a number of interrelated causes, which include natu-

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ral, biological, psychological, and possibly genetic factors. The nature theories to explain drug use revolve around the idea that drug additions result from an innate characteristic of human nature to alter one’s consciousness. Andrew Weil, a physician and proponent of alternative medicine, argues that the desire to get high is innate and natural, which he likens to hunger or the sexual drive. Some people choose to do this by using chemical agents, whereas others use other methods. He does not answer whether the drive is good or bad, just that it exists. The biological explanation for drug addiction relies on a disease metaphor to explain drug addiction. Addiction is a disease. Drugs are toxins that build up in the body and damage organs and functions. The goal is the detoxification of the body. Additional biological explanations arose in tandem with increased understanding of brain function. One theory posits that drugs interfere with the way chemical neurotransmitters attach to receptor cells in the brain. Some drugs, like marijuana and heroin, activate neurons directly because their chemical structure closely approximates the structure of naturally occurring neurotransmitters. Drugs like cocaine operate by causing nerve cells to emit abnormal quantities of neurotransmitters. Other drugs prevent normal recycling of brain chemicals. Drugs can induce the release of two to 10 times more dopamine than natural rewards, which means that drug use is perceived as immensely more pleasurable than natural rewards. As drug use becomes ongoing, the brain responds by lowering the levels of dopamine in the brain; the user uses evermore drugs in order to return dopamine levels to normal. The biological phenomena produce the psychological experience of addiction. The

euphoria induced by (and a positive reinforcement for) drug use motivates the user to use again in order to achieve the intense pleasure he first experienced. The user may (as a euphoria-seeker) consciously make efforts to achieve ever-more-pleasurable mental states through drug use or, once tolerant of the drug, to take higher quantities of the drug to reach the original high (as a maintainer). As the drug interferes more deeply with the normal functioning of the brain, the need to keep taking the drug to maintain brain chemistry appears. The user experiences this as an increase in cravings and a loss of interest and pleasure in other activities, negative reinforcement that induces the user to use to avoid pain. As possible secondary effects, the estrangement of family and pursuit of criminal activity to support the drug habit also cause negative reinforcement. There may be other factors from individual experience that influence addiction to drugs. For many years, predominant theories of drug used invoked some inadequacy in personality to explain drug use. They point to an abnormal personality development or adjustment as a child that causes addictive behaviors. The self-derogation perspective, for example, once held that drug use arose from a combination of inadequate coping mechanisms and low self-esteem and selfrejection brought on by peer and family rejection, social stigma, physical problems, or sex-identity confusion. This theory has declined as the broader self-esteem approach has fallen. Other explanations of drug addiction look toward personality defects such as inherent irresponsibility, immaturity, an inability to delay hedonistic gratification, an incapability to face up to life’s problems, or a proneness to risky behaviors or unconventionality. Some theorists believe that addicts have psychopathic or sociopathic personalities (now

Theories of Drug Addiction  893

more commonly called antisocial personality disorders). Jerome Jaffe, the “drug czar” under President Nixon, came up with three generalizations that help explain marijuana users. He found that marijuana users tend to score high on scales of nonconventionality. This includes a sense of alienation, critical beliefs about society as a whole, and lower rates of religiosity. Second, marijuana users are open to new experiences. They tend to be more spontaneous in nature and more receptive and accepting of change and uncertainty. Third, according to Jaffe, those who use marijuana have lower rates of conventional achievement value and achievement satisfaction. The concept of Operant Conditioning suggests that individuals model their behavior after significant other people whose opinions they value and admire. Psychologists explain drug use with primary and secondary reinforcers. Primary reinforcers are those actions that are directly pleasurable. Certain drugs provide a pleasurable experience. Secondary reinforcers, or those objects or situations that are pleasurable because of the associations that people make with them. This can include the social aspects of drug-taking—the people, the music, and the setting. Social structures also have sizable impacts on drug use. One of the earliest sociological explanations, Anomie Theory proposed that people take up deviant behavior—including drug use—when they fail to attain a societal ideal that is in fact achievable only by a few. Social and Self-Control theories posit that all would deviate and use if there existed no laws to restrain them. The former theory suggests that people’s attachments to and advantages drawn from conventional behavior motivate them to obey societal conventions against using drugs. The latter theory sug-

gests that people lack the control to abstain from immediately self-serving behavior; the law reins in this defect. There has also been much thought as to the effects of socialization and identity with a subculture on drug use. A social learning theory for drug use, called Differential Reinforcement, suggests that behavior is reinforced through reward and punishment. The individuals and groups with whom we interact influence our behavior. If people hang out with drug users, they will reinforce various drug use behaviors. Genetics, combined with other causes, may also have a role to play in predisposing some people to drug addiction. Genes can affect the level of intoxication experienced when taking a certain amount of drugs, how much one can take without becoming ill, and how well the user’s body metabolizes the drug. While most of the work in this area focuses on an addict’s use of alcohol, some additional research finds a link between genetics and tobacco use. Cultural Deviance theories originated from the University of Chicago in the early 20th century. Sociologists explained that drug use is a consequence of life in “transitional neighborhoods” that are characterized by high turnover by residents and a lack of a strong community that encourages conventional values. Children raised in these “transitional neighborhoods” are likely to lack adequate supervision and more likely to be influenced by delinquent gangs. According to Differential Labeling theory, individuals are labeled as drug addicts based on their race, socioeconomic status or other characteristics rather than their activities. Once a person is labeled, they take on that social identity. Conflict theory helps us to understand drug abuse by looking at societal divisions and divisions of power, and the larger

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structural forces that affect communities. Higher rates of crack and heroin use exist in urban areas because meaningful economic opportunities do not exist, and residents feel powerlessness and alienated. Thus, in order to reduce drug use, society must alter the economic and political conditions that now exist. While these theories all provide some understanding about drug abuse, it is still not clear why some people abuse illicit drugs. These theories are only a beginning to fully understanding this behavior. Nancy E. Marion See also: Addiction Liability; Dole, Vincent; Nyswander, Marie

Further Reading Akers, Ronald L. 1969. Deviant Behavior: A Social-Learning Approach. Belmont, CA: Wadsworth. Bandura, Albert. 1969. Principles of Behavior Modification. New York: Holt, Rinehart and Winston. Crowley, Thomas J. 1981. “The Reinforcers for Drug Abuse: Why People Take Drugs.” In Classic Contributions in the Addictions, ed. Howard Shaffer and Milton Earl Burglass, 367–81. New York: Brunner/Mazel. Currie, Elliott. 1985. Confronting Crime: An American Challenge. New York: Pantheon Books. Currie, Elliott. 1993. Reckkoning: Drugs, the Cities, and the American Future. New York: Farrar, Straus and Giroux. De Fiebre, Christopher M., and Allan C. Collins. 2002. “Exploring the Genetic Commonality of Alcohol and Tobacco Abuse.” Science Blog, June. http://www.sciencebog .com/community/older/2002/G/2002156 .html. Faupel, Charles E., Greg S. Weaver, and Jay Corzine. 2014. The Sociology of American

Drug Use. New York: Oxford University Press. Goode, E. 2007. Drugs in American Society. 7th ed. New York: McGraw-Hill. Jaffe, Jerome. 1979. “The Swinging Pendulum: The Treatment of Drug Abusers in America.” In Handbook on Drug Abuse, ed. R. I. Dupont, A. Goldstein, and J. O’Donnell, 3–16. Washington, DC: U.S. Government Printing Office. Mosher, Clayton J., and Scott Akins. 2007. Drugs and Drug Policy: The Control of Consciousness Alteration. Thousand Oaks, CA: Sage Publications. National Institutes of Health, National Institute on Drug Abuse. 2010. “Drugs and the Brain.” Drugs, Brains, and Behavior: the Science of Addiction. http:// www.drugabuse.gov/publications/drugs -brains-behavior-science-addiction/drugs -brain. Peterson, Ruth D. 1985. “Discriminatory Decision Making at the Legislative Level: An Analysis of the Comprehensive Drug Abuse Prevention and Control Act of 1970.” Law and Human Behavior 9: 243–69. Weil, Andrew. 1986. The Natural Mind: A New Way of Looking at Drugs and the Higher Consciousness. Boston: Houghton-Mifflin.

Tijuana Cartel Headed by the brothers Ramon and Benjamin Arellano Felix, this is one of Mexico’s most powerful, aggressive, and violent drug-trafficking organizations. Also known as the Arellano Felix Organization (AFO), the Tijuana Cartel mainly operates in the Mexican state of Sinaloa, where the Arellano Felix brothers were born, as well as the states of Jalisco, Chiapas, and Michoacán. Its U.S. base is the southern and northern regions of Baja California, from which the

Tijuana Cartel  895

organization ships multiton quantities of cocaine and marijuana, as well as heroin and methamphetamine. The Tijuana Cartel had its birth in the demise of the Guadalajara Cartel. After the incarceration of Miguel Felix Gallardo, head of the Guadalajara Cartel, in 1989 for his part in the torture-murder of Drug Enforcement Administration (DEA) special agent Enrique Camarena, the Arellano Felix family took control of their part of the organization; the Sinaloa Cartel, headed by Hector Luis Salma Salazar and Joaquin Guzman Lorea, also broke off of Gallardo’s group at this time. The Arellano Felix family, seven brothers and four sisters, control the cartel through a mixture of corruption and violence. The Tijuana Cartel is well organized and uses heavily armed and well-trained paramilitary security forces and a team of international mercenaries as advisors to train its members. The organization employs violent street gangs from towns in both Mexico and the United States to kill individuals who ship drugs through their territory without paying a special transportation tax demanded by the cartel. A sophisticated criminal organization, the Cartel uses radio scanners, cellular phones, and other technology to carry out espionage against law enforcement. The group reportedly spends a million dollars a week in bribes to gain the complicity of Mexican drug enforcement officials. The DEA and Federal Bureau of Investigation have set up a joint task force in San Diego to target the cartel for investigation. As DEA head Thomas A. Constantine described the cartel, “More than any other major trafficking organization from Mexico, it extends its tentacles directly from high-echelon figures in the law enforcement and judicial systems in Mexico, to street-level individuals in the United States” (U.S. Senate Committee on Foreign Relations 1997).

Once Mexico’s deadliest drug-trafficking organization, the now weakened Tijuana Cartel has deteriorated in recent years with the deaths or imprisonment of Arellano Felix family members. Benjamin Arrelano Felix, the leader and brains of the cartel, was arrested in March 2002 and extradited to the United States in 2011. Eduardo, second in command, was captured after a shootout with the Mexican Army on October 26, 2008. The violent muscle of the organization, Ramon died in a shootout with the police at Ma­ zatlán on February 10, 2002. Francisco Rafael, the eldest of the brothers and involved in money laundering, was captured in 1993 and extradited to the United States in 2006; released two years later for good behavior, he was shot dead at a party on October 18, 2013. Francisco Javier, the youngest, was captured by the U.S. Coast Guard in August 2006. Sisters Alicia and Enedina continue to hold power within the cartel, which is now run by Luis Fernando Sanchez Arellano, Enedina’s son. The Tijuana Cartel allied with the Gulf Cartel, led by Osiel Cardenas, in late 2004 to fend off usurpers. The Tijuana Cartel leaders continued to manage their organizations from prison. As another sign of intercartel cooperation, Mexican officials reported that Los Zetas, specially trained antinarcotics troops who were originally the Gulf Cartel’s enforcers, were believed to have acted as hired killers for the AFO. However, this alliance did not last, and the late 2000s would find the Tijuana Cartel split in two. The arrest of so many of the Arellano Felix family left a power vacuum for the leadership of the Tijuana Cartel. The arrest of Francisco Javier in 2006 and the deployment of Mexican troops into Tijuana in 2007 as part of an anticorruption effort forced tight constraints on the once powerful cartel and propagated a split within its ranks. The

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ensuing fight beginning in 2008 between Teodoro Garcia Simintal, who preferred kidnapping and extortion, and Luis Fernando Sanchez Arellano, who favored drug trafficking, was particularly bloody. Simental abducted white-collar workers and dissolved a number of his dead opponents’ bodies in acid. Along with the violence of a general war between the factions, this extreme behavior drew pressure from the Mexican military, who allied with local police to try to pacify Tijuana. Perhaps receiving the backing of these, Sanchez Arellano’s faction beat Simental’s forces. Badly depleted from the struggle, Sanchez Arellano managed to forge a truce with the head of the Sinaloa Cartel, Joaquin Guzman Lorea. The Sinaloa Cartel pays a fee to the Tijuana Cartel for passage of the former’s drugs over the latter’s territory. Involved with its own fights in the late 2000s, a simple takeover of the city of Tijuana by Sinaloa would have been costly—nonetheless, Sinaloa has superiority of power in the relationship, with Sanchez Arellano as a figurehead. Robert J. Kelly, Joseph D. Serio, and Jesse L. Maghan See also: Camarena Salazar, Enrique; Drug Cartels; Drug Enforcement Administration; Mexican Drug Trade

Further Reading Alexander, Harriet. 2013. “Francisco Rafael Arellano Felix: Head of Tijuana Cartel Shot Dead by Clown Gunmen.” The Telegraph, October 20. http://www.telegraph.co.uk/news/ worldnews/centralamericaandthecaribbean/ mexico/10392239/Francisco-Rafael-Arella no-Felix-Head-of-Tijuana-Cartel-shot-dead -by-clown-gunmen.html. Booth, William. 2012. “Mexico’s Two Major Crime Cartels Now at War.” Washington Post, May 24. http://www.washingtonpost .com/world/mexicos-two-major-crime

-cartels-now-at-war/2010/08/25/gJQAUhK lmU_story.html. Constantine, Thomas A. 1997. “Mexico and the Southwest Border Initiative.” Statement to the Senate Foreign Relations Committee, March 12. http://www.druglibrary.org/ schaffer/dea/pubs/cngrtest/ct970312.htm. Diaz, Lizbeth. 2011. “Tijuana Violence Slows as One Cartel Takes Control.” Reuters, September 5. http://www.reuters.com/art icle/2011/09/05/us-mexico-drugs-tijuana -idUSTRE7844EX20110905. Marosi, Richard. 2008. “A Tijuana Surgeon Whose Kidnapping Prompted a Civic Uproar Is in the Public Eye Again after Gunmen Seek Care at His Clinic.” Los Angeles Times, May 3. http://articles.latimes .com/2008/may/03/local/me-tijuana3. Marosi, Richard. 2013. “Capture of Mexican Mob Boss Began with a Fed-up Informant.” Los Angeles Times, July 20. http:// articles.latimes.com/2013/jul/20/local/ la-me-cartel-manhunt-20130721. “Mexican Drug Cartels.” 2010. NPR, May 19. http://www.npr.org/templates/story/story .php?storyId=126890893. “Mexican Drug Lord Gets Life in Prison.” 2007. CBS News, November 5. http://www .cbsnews.com/news/mexican-drug -lord-gets-life-in-prison/. “Mexico Seizes Top Drugs Suspect.” 2008. BBC News, October 27. http://news.bbc .co.uk/go/pr/fr/-/2/hi/americas/7692319 .stm. U.S. Department of Justice, Office of Public Affairs. 2012. “Eduardo Arellano-Felix Extradited from Mexico to the United States to Face Charges.” http://www.justice.gov/opa/ pr/2012/August/12-crm-1072.html. Vulliamy, Ed. 2008. “Tijuana Streets Flow with the Blood of Rival Drug Cartels.” The Guardian, November 1. http://www .theguardian.com/world/2008/nov/02/ mexico-drugs-trade-tijuana-cocaine.

Tobacco  897

Tobacco Tobacco is the collective name given to the harvested leaves of the plant genus Nicotiana. It contains nicotine and other compounds found in cigarettes, cigars, and smokeless tobacco products such as snuff. Ancient drawings depict smoking among Native American tribes dating back to 2000 BCE, although tobacco was unquestionably used well before. Historical evidence suggests that it was chewed, sniffed, dipped, and even concocted into mixtures used in enemas. Today, tobacco products are consumed in a variety of forms around the world, and their level of carcinogens and other harmful chemicals depends in part on the curing methods used after the tobacco harvest. In the West, tobacco use probably originated with Native Americans who chewed the leaves and smoked “Indian weed” in a peace pipe. Originally obtained from the Nicotiana rustica plant during colonial times, tobacco was subsequently harvested from a milder version, Nicotiana tabacum, John Rolfe imported from Bermuda. During the 1600s, his commercial cultivation of the plant in Virginia’s Jamestown Settlement made him a wealthy man and caused tobacco agriculture to become an economic mainstay of the Southern and Mid-Atlantic colonies. Tobacco agriculture also drove the African slave trade. With the growth of slavery in the United States, tobacco production skyrocketed to supply a growing worldwide market. Today, different varieties of tobacco are grown and harvested worldwide, then cured, sometimes for months. In the past, traditional tobacco barns were erected in which the leaves would hang for air curing or fire curing. For mass production purposes today, a bulk method is often used. The tobacco is aged to develop

its flavors and compounds, then processed into a number of different types of tobacco products that may be sold under different names in different countries. Tobacco can also be an effective pesticide when diluted in water and sprayed on plants. Most of the tobacco grown around the world was originally cultivated in Virginia, Kentucky, Louisiana, and the Carolinas, although other varieties came from Greece and the Middle East. Responsible for the deaths of nearly a half-million Americans every year, the consumption of both smoked and smokeless tobacco is the single most preventable cause of death in the United States. According to the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, there were an estimated 72.9 million Americans age 12 or older using tobacco products in 2006. Much of the fall has occurred in response to scientific findings regarding the hazards of tobacco and various efforts, public and private, to help people quit. The first statistical correlation between tobacco use and lung cancer occurred in 1900. After 1930, several studies noticed more clearly the links between tobacco use and mortality and disease incidence. The number of statistical studies continued to increase, and by the 1950s included notable studies by the British Medical Research Council, the cancer societies of numerous Scandinavian nations, the American Cancer Society, and the American Heart Society. In response to these studies, the tobacco industry created the Tobacco Industry Research Committee and the Tobacco Institute in 1953 to try and dispute their findings. Nonetheless, the surgeon general created a study group on the subject in June 1956, the first instance of U.S. Public Health Service study of tobacco effects.

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Tobacco plants in a field will later be processed and turned into cigarettes, cigars, or chewing tobacco. (Kayankid/Dreamstime.com)

In 1962, the Royal College of Physicians in Britain published a report linking cigarette smoking to lung cancer, bronchitis, and probably cardiovascular disease. Shortly, after the release of this report, U.S. surgeon general Luther Terry established the Surgeon General’s Advisory Committee on Smoking and Health to produce a similar report for the United States. After a year of work by the 10-person advisory committee, “Smoking and Health: Report of the Advisory Committee to the Surgeon General of the United States” was released on January 11, 1964. Based on over 7,000 articles in the biomedical literature, the report concluded that cigarette smoking causes lung cancer and chronic bronchitis. The report also noted that there was suggestive evidence, if not definite proof, that smoking was linked to emphysema, cardiovascular disease, and various other types of cancer. The committee concluded that cigarette smoking was a health hazard of suf-

ficient importance to warrant appropriate remedial action. The landmark surgeon general’s report on smoking and health stimulated a greatly increased concern about tobacco on the part of the U.S. public and government policy makers and also led to a broad-based antismoking campaign. The report contributed to the passage of the Cigarette Labeling and Advertising Act of 1965 and the Public Health Cigarette Smoking Act of 1969, which mandated the surgeon general’s health warnings on cigarette packages, banned cigarette advertising in television and radio broadcasts, and called for an annual report on the consequences of cigarette smoking. From then on, the surgeon general and the Centers for Disease Control would study the matter continuously. From this continuous research, the evidence regarding the cancerous and cardiovascular effects of tobacco smoke on smokers and nonsmokers became ever clearer. The report of the surgeon gen-

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eral of 1986, in particular, was the first to definitively determine that secondhand smoke posed dangers to nonsmokers. Antismoking efforts steadily gained important victories. By degrees, smoking was restricted to certain areas of public facilities, eliminated from flights and public transportation, and restricted in workplaces. Bans of tobacco use, either in certain facilities or in all public buildings, became a publicly discussed possibility by the late 1970s; several states and localities have since enacted such bans. Private lawsuits against the tobacco companies also were filed, though few were successful. The climax of the public struggle against tobacco use came in 1998. Numerous states’ attorneys general began suits in the mid1990s against the tobacco companies for increased Medicaid costs from smokingrelated disease. The result of this effort, the Tobacco Master Settlement Agreement, required the tobacco manufacturers to pay over $200 billion through 2025 to the settling states. It also eliminated tobacco lobbying, mandated that the manufacturers contribute to a National Public Education Fund that would run antismoking advertisements aimed at minors, created a national foundation to reduce teen smoking and substance abuse, opened industry documents to public inspection, and banned various advertising methods. Kathryn H. Hollen See also: Secondhand Smoke; Tobacco Institute

Further Reading Borio, Gene. 2010. “The Tobacco Timeline.” http://www.tobacco.org/resources/history/ Tobacco_History.html, 1993–2008. Centers for Disease Control. 2011. “Targeting the Nation’s Leading Killer: At a Glance.”

http://www.cdc.gov/chronicdisease/ resources/publications/aag/osh.htm. Centers for Disease Control, Morbidity and Mortality Weekly Report (MMWR). 2012. “Current Cigarette Smoking among Adults—United States, 2011.” http://www .cdc.gov/mmwr/preview/mmwrhtml/mm 6144a2.htm?s_cid=mm6144a2_w. Pennsylvania Attorney General. “Summary of Terms of the Tobacco Master Settlement Agreement.” http://www.attorneygeneral .gov/consumers.aspx?id=683. U.S. Department of Health and Human Services. 1986. The Health Consequences of Involuntary Smoking: A Report of the Surgeon General. http://profiles.nlm.nih.gov/ ps/access/NNBCPM.pdf. U.S. Department of Health and Human Ser­ vices, Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. 2012. “Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings.” http://www.samhsa.gov/data/ NSDUH/2012SummNatFindDetTables/ NationalFindings/NSDUHresults2012 .htm#ch4. U.S. Department of Health, Education, and Welfare, Public Health Service. 1964. Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. http://profiles. nlm.nih.gov/ps/access/NNBBMQ.pdf.

Tobacco Institute Following early reports in the 1940s that tobacco use might have a strong relation to lung cancer, various tobacco companies formed, at a meeting at the Plaza Hotel of New York City in December 1953, two industry-wide organizations: the Tobacco Institute Research Committee (later the Council for

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Tobacco Research) and the Tobacco Institute. While the former body published research studies contesting industry-adverse research findings about the effects of smoking, the latter was a public relations organization. In the course of its public relations efforts, the Tobacco Institute issued pamphlets, letters to newspaper editors, magazine articles, newsletters, advertisements, white papers, and much else. On occasion, it also paid scientists for favorable medical journal articles and letters to the press. In one instance, the Tobacco Institute paid $156,000 to 13 scientists to counter studies, including a 1993 Environmental Protection Agency report, that indicated that secondhand smoke related to increased rates of lung cancer. The institute also acted as an intelligencegathering service for the industry regarding public attitudes towards smoking. It then used that intelligence to formulate legislative strategies for its own lobbyists to use against efforts inimical to tobacco company interests. The pamphlets and internal research documents of the Tobacco Institute illustrate its public relations strategies. For most of its life, the institute tried to create the impression of a controversy and dispute among scientists regarding the evidence relating smoking to cancer. It often presented antismoking efforts as attacks on smokers themselves instead of tobacco company activities. Other major efforts were made to refute studies regarding the effects of secondhand smoke, with the institute claiming that harmful effects from smoking could not be distinguished with those from indoor air pollution—in fact, the industry set up the Center for Indoor Air Research to support this claim. The institute, in a public attitude study in 1978, identified growing public concern about secondhand smoke as “the most dangerous development to the viability of

the tobacco industry that has yet occurred.” The shift in focus from the smoker to nonsmoker health shifted the discussion from one of private choice to one of public health. The prime concern of the Institute was that separate facilities for smokers or nonsmokers might lead to a total ban in public places. The government lobbying strategy had many facets. One strategy was to pose restrictions on smoking as part of a slippery slope towards banning other potentially annoying activity. Another was to file an action with the Federal Trade Commission against any inimical nonprofit advertising, demanding that they issue “corrective” advertising. Against proposals for facility-wide smoking bans, the institute preferred to advocate for separate smoking facilities; in cases where separate facilities were proposed, the institute suggested that the proprietor have the choice to adopt whatever smoking policy he pleased. Although its influence waned as individual companies, principally Philip Morris, developed their own lobbying arms, the Tobacco Institute continued to function well into the 1990s. When numerous states’ attorneys general began suits in the mid-1990s against the tobacco companies for increased Medicaid costs from smoking-related disease, limitations on industry lobbying were included in settlement demands. Together with the Council for Tobacco Research and the Center for Indoor Air Research, the Tobacco Institute was discontinued as part of the Tobacco Master Settlement Agreement in 1998. Nancy E. Marion See also: Tobacco

Further Reading Greene, B. 2000. “The Tobacco Institute Has Blown Smoke for the Last Time.” Chicago

Tranquilizers  901 Tribune. http://articles.chicagotribune.com /2000–07–17/features/0007170003_1_tob acco-companies-williamson-tobacco-corp -big-tobacco. The Roper Organization. 1978. A Study of Public Attitudes toward Cigarette Smoking and the Tobacco Industry in 1978, vol. 1. Prepared for the Tobacco Institute. http:// legacy.library.ucsf.edu/tid/jdc70a00/pdf. “Tobacco Firms Paid Scientists to Deride AntiSmoking Studies.” 1998. Chicago Tribune, August 5. http://articles.chicagotribune. com/1998–08–05/news/9808050211_1_tob acco-industry-tobacco-institute-environm ental-protection-agency-report. Tobacco Institute. 1976. Status Report and Update: Public Relations Strategy of U.S. Tobacco Manufacturers re: Smoking & Health Controversy. http://legacy.library.ucsf.edu/ tid/agu91f00/pdf. Watkins, T. 2004. “Government Lays Out Fraud Case against Big Tobacco.” CNN. http://www.cnn.com/2004/LAW/09/21/tob acco.lawsuit.

Tranquilizers The term “tranquilizers” also refers to anti­ anxiety medication. “Tranquilizers” is a term introduced in 1953 to describe drugs that have a calming effect. Tranquilizers come in two varieties. Minor tranquilizers (anxiolytics) are used for sedation and to treat anxiety. Today, these drugs are called antianxiety medications. Major tranquilizers (neuroleptics) were developed to treat psychiatric disorders including schizophrenia. These drugs combat hallucinations and other delusions. Usually prescribed for long terms, major tranquilizers include phenothiazines, thioxanthines, butyrophenones, clozapine, and rauwolfia alkaloids.

These drugs work by stimulating GABAreleasing neurons or gamma aminobutyric acid in the brain. GABA is an important inhibitory neurotransmitter throughout the brain and tranquilizers, or antianxiety medications, stimulate them to provide a reduction in feelings of stress and fear. They make users feel peaceful. The first antianxiety drug that was developed was meprobamate, called Miltown, named after the location of the company that introduced it. This was the first drug marketed as an antianxiety drug. It was popular because the toxic dose was high (the amount needed before death occurred), and it seemed to work well. However, the drug made some people very drowsy, and affected their motor reflexes so they were unable to drive. It also was quickly addictive. In response, this drug was replaced by a class of antianxiety drugs called benzodiazepines. Benzodiazepines are the most prominent of the minor tranquilizers, and include alprazolam (Xanax), chlordiazepoxide (Librium), and diazepam (Valium). These drugs were introduced in the early 1960s and used to reduce anxiety caused by stressful living. Valium is stronger than Librium and takes effect more quickly. Side effects include drowsiness and reduced alertness, with physical dependency occasionally resulting from prolonged use beyond the short and medium term. The drugs can be taken orally through a pill form. In that case, it takes about a half hour to an hour to become effective. These are useful for sleeping medications. The drugs can also be injected if an immediate response is needed, for example to treat withdrawal symptoms from other drugs like alcohol or in the case of a seizure. Benzodiazepines are one of the most frequently prescribed drugs. They have been used successfully as medications, and have

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been shown to be a relatively safe drug and less likely to cause a fatal overdose. But they can also be misused. Medications used to treat anxiety or depression are typically in the top five most frequently reported drugs in cases of drug-related deaths. Often, these victims have ingested far more than the suggested dosage, or have been used in combination with other drugs such as alcohol. According to the National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration, about 2.1 million people aged 12 and older used tranquilizers for nonmedical reasons in 2012. About 4 percent of people in 2012 who used an illicit drug for the first time used a tranquilizer. Over half of the users obtained their drug from a friend or relative. Of the people seeking treatment for drug use in 2012, about 458,000 sought treatment for tranquilizer use. Nancy E. Marion See also: Depressants; United Nations Convention on Psychotropic Substances

Further Reading U.S. Department Health and Human Services, U.S. Public Health Service, Substance Abuse and Mental Health Services Administration. 2013. “Results from the 2012 National Survey on Drug Use and Health.” http://www.samhsa.gov/data/NSDUH/ 2012SummNatFindDetTables/Index.aspx.

Treatment Treatment for drug addiction occurs by any of a number of methods, including hospital management, outpatient therapy, social pressure, and community support. Problems arising from drug use pose serious difficulties for both the community and individuals, and treatment, though sorely needed,

is underused. According to the U.S. Substance Abuse and Mental Health Services Administration 2006 surveys of drug use and health, the number of persons aged 12 or older needing treatment for an illicit drug or alcohol use problem was 23.6 million (9.6 percent of the population aged 12 or older). Of that number, 4 million (1.6 percent of the population) received some kind of treatment for a problem related to the use of alcohol or illicit drugs in 2006. According to the National Institute for Drug Abuse (NIDA), there are more than 11,000 specialized drug treatment facilities in the United States providing a wide range of inpatient and outpatient services to people with substance abuse disorders. Successful treatment for both substance and behavioral addictions depends on a number of factors, including the nature and duration of the addiction, the addict’s level of cooperation, the drug(s) or behavior(s) involved, the level of family support, the availability of treatment and counseling services to help prevent relapse, and—what is especially important—whether medical or psychological co-occurring disorders are addressed. Ideally, all treatments should be client-matched—that is, tailored to the unique needs of the individual. For this reason, rehabilitation centers and counseling services are increasingly focusing on the addict’s personality, mental health history, genetic and neurological profiles, socioeconomic status, and other factors to design a treatment approach most likely to rehabilitate the whole person. Treatment generally follows three stages: biological, including detoxification (in the case of substance addictions) and the use of medications; rehabilitation, recovering from the emotional, physical, and psychological devastation that addiction brings, learning about the addiction, and developing

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coping strategies; and continuing care, support, and evaluation that occur during the critical weeks and months after initial rehabilitation to help the addict sustain sobriety. Significant barriers often inhibit executing these stages as part of a coherent strategy, however.

Biological Treatment Detoxification Detoxification is the process by which an individual chemically withdraws from an addictive substance. Depending on the nature and severity of the addiction, this often requires medical management in a hospital or residential facility where the patient can be monitored for adverse events and where appropriate drugs, such as tranquilizers or sedatives, can be administered to alleviate some of the symptoms. In other cases, increasingly smaller doses of the addictive drug are given to the addict under tightly controlled conditions to wean him or her off the substance until detoxification is complete and he or she is stable. Detoxification can take a few days, although very severe cases may take longer. While the addict undergoes detoxification, treatment specialists assess the disease. Assessment is a clinical evaluation; counselors or others interview the addict, obtain blood analyses or other data to determine the physiological impact of the addiction, and talk to family members or others close to the addict. Sometimes a very detailed medical history is required. Many professionals use a standardized Addiction Severity Index, a multidimensional interview to help determine the extent of substance use and other social or health problems. The assessment also evaluates the psychological issues underlying drug use and establishes whether the addict has any co-occurring disorders that need concurrent treatment.

Medication A medication regimen can be very helpful in addiction treatment, but may be constrained or altered by accompanying or precipitating mental disorders. If the addiction arose out of anxiety disorder, depression, posttraumatic stress disorder, learning disability, attention deficit hyperactivity disorder, or schizophrenia, treatment should address these to ensure that the addict has the psychological stability to adhere to a medical regimen. The kind of medication administered depends on the addiction. The addict might receive drug antagonists—pharmaceuticals that block the activity of the addictive drug to alleviate the motivation to use it—or agonists—drugs that mimic the action of the addictive drug but are safer, less addictive, and are administered under medical supervision. Agonists include naltrexone or acamprosate for alcoholics, and methadone or buprenorphine for opiate addicts. There are also a number of other medications to treat alcohol and nicotine addictions. Disulfiram (antabuse) makes alcoholics violently ill if they consume even a small amount of alcohol, thus deterring alcohol use. Varenicline (a partial agonist) eliminates the craving for nicotine, and also shows promise in reducing the desire for alcohol. Several over-the-counter and prescription nicotine substitutes are commercially available as well; these replace the nicotine found in cigarettes, cigars, pipes, and smokeless tobacco. Using these substitutes helps smokers and others break habits associated with usage: the act of lighting and smoking the cigarette, cigar, or pipe; savoring the taste; and being accustomed to using the substance at specific times, such as right after a meal. Although many of these substitutes are addictive in themselves, many former smokers do not obtain the same rush from a replacement and are thus motivated

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by cost and inconvenience to wean themselves off of it.

Rehabilitation Once the acute effects of withdrawal have subsided and the addict is feeling better emotionally and physically, rehabilitation can begin. Rehabilitation is the adjustment period during which the addict learns about the disease and how to manage triggers, temptations, and symptoms, and to confront emotional issues that contributed to their addiction. If residential treatment is required— when outpatient treatment fails, when accompanying medical or psychological problems require inpatient services, or when access to local treatment is unavailable—addicts may go into a short-term (3 to 6 weeks) rehabilitation facility. If more structured treatment and geographic relocation away from a harmful environment is required, a therapeutic community may be appropriate. Therapeutic community facilities provide 24-hour care for 6 to 12 months for addicts who have seriously impaired functioning and require highly focused educational, occupational, or social rehabilitation. Both types of facilities as well as outpatient services likely include a combination of the following treatment approaches. Cognitive Behavioral Therapy Cognitive Behavioral Therapy (CBT) attempts, by counseling and talk therapy, to change or redirect thinking patterns that underlie negative emotional reactions, teach coping skills so addicts can resist triggers and avoid relapse, and encourage individuals in recovery to stay in treatment through a series of psychological incentives or rewards. Adolescents tend to respond well to this form of treatment because it helps them develop skills in resisting triggering stimuli, cravings, and social pressure to use drugs.

Among this age group, CBT also commonly involves family counseling so that treatment perspectives and goals can be sustained at home.

Motivational Enhancement Therapy Motivational Enhancement Therapy fosters an addict’s motivation to commit to change and sustain abstinence by helping them resolve conflicts about drug use or behavior. The therapy may involve just a few counseling sessions that instill or heighten innately motivating instincts in the addict. For example, newly abstinent alcoholics discover powerful motivators for staying sober when they realize how well they are feeling in the mornings. 12-Step Programs Based on AA’s program and many of the principles that evolved out of the Minnesota model, 12-step programs focus on admitting one’s powerlessness over the addictive behavior, relying on spiritual help to achieve sobriety and maintain recovery, and adopting 12 steps of specific actions that foster personal growth. More secular programs that do not emphasize the spiritual aspects of addiction and recovery include Rational Recovery, Secular Organizations for Sobriety, and Self-Management and Recovery Training. Other Treatments Other forms of treatment such as psychotherapy, acupuncture, group therapies, hypnosis, and self-help (such as relaxation techniques) may be of some value, but they are seldom effective in completely removing the impulses or cravings associated with addiction. Psychotherapy, for example, can usefully treat some of the depression, shame, or anxiety associated with addictions, but it is unlikely to stop impulsive behaviors

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or drug abuse that arose from those issues. Hypnosis and deep relaxation can treat impulse disorders, but, without CBT, they have minimal effect on addictions. Some addictions specialists do not subscribe to the abstinence-only traditional view of recovery and tend to support more behavior-centered approaches and alternative addiction treatments. These alternative treatments may include harm reduction programs that help addicts reduce their use or mitigate the harmful consequences of their use. One program that rejects traditional abstinence programs in favor of strategies that attempt to help drinkers moderate their level of intake is Moderation Management. Specialists ascribing to this approach believe that strongly motivated individuals with adequate support systems in their families and communities can learn, through counseling of often relatively short duration, how to analyze and moderate their addiction or quit entirely without lifelong involvement in 12step programs such as AA. Other treatments may be used to supplement standard treatment or ease some of the symptoms addicts experience during early rehabilitation and recovery. Acupuncture, biofeedback, nutritional therapy, meditation, and massage can help many.

Continuing Care The final stage of treatment is continuing care, also known as sustained recovery management, which encompasses both the immediate weeks after rehabilitation and a longer-term plan for posttreatment moni­ toring and reevaluation, links to supportive services, crisis management, and, if necessary, reintervention. NIDA notes that addiction is “a relapsing disease.” Recovery is not a one-time process and is likely to involve at least one episode of relapse—and sometimes several. At least one episode of relapse

occurs in more than 50 percent of addicts after initial treatment. A comprehensive chronic-care model is evolving out of a greater understanding of addiction as a brain disease requiring lifelong management. Much like diabetes, hypertension, or depression, the disease does not disappear but goes into remission, and thus can become symptomatic and troublesome at other stages of life. Addicts must learn to identify and treat any signs that their disease is reemerging. After rehabilitation, addicts may periodically participate in counseling or support services provided in therapeutic settings— 12-step meetings, family and individual counseling sessions, even telephone contact with former or current therapists. These sessions provide tremendous help to an addict trying to reenter a former life. Adolescent programs often require multidimensional therapy, which involves the whole family, sometimes in community settings, and usually includes random drug testing to ensure abstinence. The adolescent meets with the therapist apart from family members to learn new behaviors, how to cope with stress, and how to solve problems in a productive way. The family meets to gain educational and psychological insights and develop new understanding about how to interact with the adolescent. Issues of trust, betrayal, and anger are a frequent focus in this therapy. Sometimes family counseling may take place in schools, juvenile justice centers, or churches, as well as clinics.

Barriers to Treatment Once appropriate treatment strategies are determined, figuring out how to pay for them can be daunting. Managed health care plans for the most part limit the time addicts can stay in residential treatment, and there is often a restriction on the amount they will pay

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for prescribed medications. With inpatient rehabilitation costing up to $50,000 a month, and some drugs used in treatment averaging nearly $200 a month, many people cannot afford treatment. For those with no health insurance or inadequate insurance, Medicaid, Medicare, or block grants may cover treatment, but coverage may be limited to certain preapproved facilities. Many communitybased programs are available in hospitals or clinics, but these are often overcrowded and have long waiting lists. Some states have passed laws requiring insurers to cover addiction treatment, and there are efforts in Congress at the federal level to require insurance companies to provide the same type of coverage for addiction that they do for other medical conditions. Many employers, persuaded by the significant savings treatment produces in terms of reduced health care costs and restored productivity, have established employee assistance programs that offer aftercare and insurance assistance to employees. The stigmatization associated with addiction prevents many addicts from admitting their problem, much less seeking treatment, and the misperception that treating addicts does not work compounds the problem. Gradually, however, attitudes toward addiction are changing, so that what was once viewed as a shameful character deficit is increasingly accepted as a public health issue. Kathryn H. Hollen See also: Addiction; Alcoholics Anonymous; Alternative Addiction Treatment; Twelve-Step Programs

Further Reading Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books.

Engs, Ruth C., ed. 1990. Controversies in the Addiction Field. Dubuque, IA: Kendall-Hunt. Halpern, John H. 2002. “Addiction Is a Disease.” Psychiatric Times 19(10): 54–55. Hoffman, John, and Susan Froemke, eds. 2007. Addiction: Why Can’t They Just Stop? New York: Rodale. Kaminer, Y., O. Bukstein, and R. Tarter. 1991. “The Teen Addiction Severity Index: Rationale and Reliability.” International Journal of the Addictions 26: 219–26. Ketcham, Katherine, and Asbury, William. 2000. Beyond the Influence: Understanding and Defeating Alcoholism. New York: Bantam Books. Lemanski, Michael. 2001. A History of Addiction and Recovery in the United States. Tucson, AZ: See Sharp Press. Miller, Shannon C. 2015. “Language and Addiction.” American Journal of Psychiatry 2006: 163. Peele, Stanton. 2004. 7 Tools to Beat Addiction. New York: Three Rivers Press. Potenza, Marc N. 2006. “Should Addictive Disorders Include Non-Substance-Related Conditions?” Addiction 101(s1): 142–51. Schaler, Jeffrey A. 2002. “Addiction Is a Choice.” Psychiatric Times 19(10): 54, 62. Thombs, Dennis L. 2006. Introduction to Addictive Behaviors. 3rd ed. New York: Guilford Press. U.S. Department of Health and Human Services, National Cancer Institute. http:// www.cancer.gov. U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research. http://www.nidcr .nih.gov. U.S. Department of Health and Human Services, National Institute of Mental Health. http://www.nimh.nih.gov.

Truman, Harry S. (1884–1972)  907 U.S. Department of Health and Human Services, National Institute on Alcohol Abuse and Alcoholism. http://www.niaaa.nih.gov. U.S. Department of Health and Human Ser­ vices, National Institute on Drug Abuse. http://www.nida.gov.

Truman, Harry S. (1884–1972) Harry S. Truman was the 33rd president of the United States, serving from 1945–1953. His presidency was notable for its focus on drug policy, and under the Truman administration some of the most significant and punitive drug legislation was passed. Important drug legislation passed during the Truman presidency included the 1951 Boggs Act, the Durham-Humphrey Amendment, and the creation of the Interdepartmental Committee on Narcotics in 1951. These pieces of legislation were to serve as the basis for the nation’s drug policy for decades, and many of the effects of these pieces of drug legislation are still being felt. Harry S. Truman was born in 1884, in Lamar, Missouri, and spent the majority of his childhood in Independence, Missouri. One of the future president’s first jobs was at a drug store, though later he prospered as a farmer. He served in World War I as a captain in the Field Artillery. After the war, he married Elizabeth Virginia Wallace and became a haberdasher in Kansas City. Truman’s political career began when he was elected to an administrative judgeship of the Jackson County Court in 1922. Truman initially ran as the vice presidential candidate to Franklin D. Roosevelt, in 1944, and succeeded to the presidency after the latter’s death in 1945. Prior to his vice presidency, Truman was a U.S. senator from Missouri from 1935 to 1945. The Truman administration oversaw the end of World

War II, and Truman is known for making the decision to drop the atomic bombs on Hiroshima and Nagasaki. Further, under the Truman administration, tensions with the Soviet Union increased, marking the beginning of the Cold War. Truman died on December 26, 1972, at age 88. In addition to the significant events mentioned above, the Truman administration was responsible for the renewal of interest in drug legislation. Under Truman, the legislation regulating the sale of narcotics and marijuana became more punitive, lines of demarcation between prescription and over-the-counter drugs were clarified, and importantly, judicial discretion regarding sentencing for drug offenses was reduced. Truman was part of many antidrug legislative acts. One of those was the Boggs Act of 1951. This was a piece of legislation designed to build upon the Marihuana Tax Act of 1937 and the Narcotic Drug Import and Export Act of 1922. The Boggs Act was designed to create additional penalties against those convicted of drug crimes. Additionally, it was the first piece of legislation that considered marijuana and narcotic drugs together, which it did by establishing uniform penalties under the Narcotic Drug Import Act and the Marihuana Tax Act. It also fixed penalties across usage of opiates, marijuana, and cocaine. First-time offenders would receive a penalty of two years’ imprisonment, those arrested a second time would receive five to 10 years, and third time offenders had a mandatory minimum sentence of 10 years (ranging to 20). All offenses also carried a heavy fine ($2000). The act was named for its sponsor, Congressman Thomas Boggs Sr. of Louisiana. The Boggs Act took advantage of earlier legislation beyond the Marihuana Tax Act of 1937. The National Drug Import and Export Act of 1922 laid the foundation of

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regulation for narcotics, and in particular limited the amount of drugs that could be imported. This, coupled with the increasing public outcry against marijuana, led Congress to support the new, punitive measures contained in the act. When he signed the Boggs Act, Truman became the first president to officially attack drugs. In doing so, he declared the “situation” with illegal drugs “of grave concern to me. Illicit narcotics peddling has recently risen sharply in volume. Moreover, drug addiction has reached serious proportions, particularly among some of the youth of our nation.” He believed the Boggs Act would be a useful antidrug measure. Another piece of legislation with which Truman was involved was the DurhamHumphrey Amendment. This built off of the previously passed Federal Drug and Cosmetic Act of 1930 by creating a differential system when it came to drugs. Overthe-counter drugs were designated under a different category than what were termed “Legend” drugs, or those medications requiring a prescription, and requirements were established for elements like refills over the phone. The FDA was the agency designated as responsible for determining whether a drug fell into the Legend category or not. The amendment also established limits in terms of what circumstances allowed for the sale of Legend drugs—namely only in circumstances where the drug was determined to be medically necessary by a physician. This restriction was not extended to over-the-counter medications. An additional provision of the DurhamHumphrey Amendment clarified what was specifically meant by a “prescription drug.” A drug required a prescription if it was habit forming, toxic enough to require administration from a practitioner, or any new drug that was approved under the 1938 legislation

requiring labeling for any pharmaceutical that was prescription only. Any drug meeting any of these requirements also must carry a label stating, “Caution: Federal law prohibits dispensing without prescription.” Truman decided to create the Interdepartmental Committee on Narcotics as a way to give more attention to the growing problem. Created by Executive Order No. 10302 in 1951, the Interdepartmental Committee on Narcotics was established with the purpose of creating a national database regarding the illegal sale and use of narcotics and marijuana as well as disseminating that information to state and local governments. It included representatives from several government agencies, including the departments of State, Treasury, Justice, Defense, and Agriculture, as well as the Federal Security Agency. In addition to the database, the committee was charged with determining the character and effects of drug use, examining problems with drug enforcement both nationally and internationally, study issues of drug addiction and treatment, and advise the president of the United States on drug policy. The lead member of the committee was Harry J. Anslinger, the commissioner of the Bureau of Narcotics for 21 years. One of the major effects, particularly of the Boggs Act of 1951, was to limit judicial discretion in terms of sentencing for drug use. President Truman was aware of concern about provisions related to this, as is evidenced in the signing statement attached to the legislation, which states, “I am aware of the fact that some objection has been expressed to this act because of the limitations which it imposes on Federal courts in sentencing offenders . . . the Interdepartmental Committee on Narcotics will keep this matter under review.” The increasing severity of punishment under the Boggs Act for succeeding drug convictions largely foreshadowed the “get tough”

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policies on drugs of the 1980s and 1990s—in particular, the three-strikes laws adopted by many states. In addition to the significant impact of the legislation on federal courts and subsequent drug policy, the Boggs Act served as a model for many individual states’ legislation. The adoption of the federal model was encouraged by the Federal Bureau of Narcotics, and many states copied the punitive punishment scheme in the original act. Several states actually took a harsher stance than the Boggs Act provided for, in some cases increasing mandatory minimum sentences or fines levied against individuals convicted under the laws. Just four years after the Boggs Act was passed, there was another increase in the penalties for drug offenses at the federal level. The death penalty was introduced in 1956 for the crime of selling narcotics to a minor, at the option of the jury hearing the case. Overall, Harry S. Truman’s administration marked one of the most punitive periods in the nation’s history of drug policy. Through establishing mandatory minimums, packaging marijuana with narcotics in legislation, and creating an oversight and coordination mechanism, the policies that President Truman signed signaled the direction of U.S. drug policy for decades to come and foreshadowed the direction of drug policy into the future. Joshua B. Hill See also: Anslinger, Harry J.; Boggs Act; Marijuana Tax Act; Narcotic Drugs Import and Export Act

Further Reading Franco, C. 2009. “Federal Domestic Illegal Drug Enforcement Efforts: Are They Working?” CRS Report No-R40732.

Miller, G. 1997. Drugs and the Law: Detection, Recognition & Investigation. Longwood, FL: Gould Publishers. Swann, J. P. 1994. FDA and the practice of pharmacy: Prescription drug regulation before the Druham-Humphrey Amendment of 1951. Pharmacy in History 36: 55–70. Truman, Harry S. 1951a. “Executive Order 10302—Interdepartmental Committee on Narcotics.” November 2. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www.presidency .ucsb.edu/ws/?pid=78436. Truman, Harry S. 1951b. “Statement by the President Upon Signing Bill Relating to Narcotics Law Violations.” November 2. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http:// www.presidency.ucsb.edu/ws/?/pid=13984. White House. “Harry S. Truman.” http://www .whitehouse.gov/about/presidents/harry struman.

Twelve-Step Programs Twelve-step programs use a set of principles commonly derived from the original program of Alcoholics Anonymous (AA). In 1939, AA produced its Twelve Steps to recovery based on a series of specific principles that Bill Wilson (1895–1971) and Bob Smith (1879–1950), the alcoholic founders, developed to help guide other drinkers through recovery. With membership requiring only a desire to quit drinking, the AA program transformed alcoholism treatment and helped millions of formerly hopeless alcoholics recover permanently. The focus of treatment is simple: in coming together in fellowship, members share their hope, strength, and experience to help others stop drinking and regain their physical, mental, and spiritual health.

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Rather than a prescription for recovery, the Twelve Steps are principles that guide members seeking to address their addiction. AA’s Twelve Steps, which other programs have adapted to their purposes, are as follows:   1. We admitted we were powerless over alcohol—that our lives had become unmanageable.   2. Came to believe that a Power greater than ourselves could restore us to sanity.   3. Made a decision to turn our will and our lives over to the care of God as we understood Him.   4. Made a searching and fearless moral inventory of ourselves.   5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.  6. Were entirely ready to have God remove all these defects of character.  7. Humbly asked Him to remove our shortcomings.  8. Made a list of all persons we had harmed, and became willing to make amends to them all.  9. Made direct amends to such people wherever possible, except when to do so would injure them or others. 10. Continued to take personal inventory and when we were wrong promptly admitted it. 11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His Will for us and the power to carry that out. 12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

There is usually a strong focus on spiritual growth that, for some, is a religious journey. For others, the experience is embodied in the program’s philosophy of reaching out to other addicts through fellowship and service, a healing and maturing process that takes place over a lifetime and is considered critical to recovery. Many Twelve-Step members who resist the religious perspective have found that their desire to be free of addiction can be a viable substitute for the higher power or deity to whom other members might direct their appeals and prayers. Exploring the Twelve Steps together and sharing common experiences have been shown to create a solid support structure on which millions of former and current members have been able to rebuild their lives. Recognizing that any organization, no matter how loosely structured, must have a central philosophy and a governing framework, AA developed a set of Twelve Traditions; these were designed to prevent the development of a hierarchical power structure among members or service personnel and to reinforce the unifying, egalitarian spirit of local AA groups. These too have been adapted by other 12-step programs, and state:  1. Our common welfare should come first; personal recovery depends upon AA unity.  2. For our group purpose there is but one ultimate authority—a loving God as He may express Himself in our group conscience. Our leaders are but trusted servants; they do not govern.   3. The only requirement for AA membership is a desire to stop drinking.  4. Each group should be autonomous except in matters affecting other groups or AA as a whole.

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  5. Each group has but one primary purpose—to carry its message to the alcoholic who still suffers.  6. An AA group ought never endorse, finance, or lend the AA name to any related facility or outside enterprise, lest problems of money, property, and prestige divert us from our primary purpose.   7. Every AA group ought to be fully selfsupporting, declining outside contributions.   8. AA should remain forever nonprofessional, but our service centers may employ special workers.  9. AA, as such, ought never be orga­ nized; but we may create service boards or committees directly responsible to those they serve. 10. AA has no opinion on outside issues; hence the AA name ought never be drawn into public controversy. 11. Our public relations policy is based on attraction rather than promotion; we need always maintain personal anonymity at the level of press, radio, and films. 12. Anonymity is the spiritual foundation of all our traditions, ever reminding us to place principles before personalities. The traditions ensure that the organizations can provide an accessible, safe, therapeutic environment in which addicts find accep­ tance, support, and fellowship, and thus they represent a form of group therapy that has saved millions from the ravages of addiction. Frequent meetings of AA generally consist of sharing experiences and wisdom as

well as readings from Alcoholics Anonymous (also called The Big Book), the organization’s basic text. Other groups operate similarly, with readings from the original Big Book along with group-centered literature. Although modern research into the neurobiology of addiction has shown that medications and other forms of counseling such as cognitive behavioral therapy also produce effective results, 12-step organizations have a very important—in some cases essential—role in helping addicts take critical steps toward recovery and maintenance of long-term sobriety. Kathryn H. Hollen See also: Addiction; Alcohol Use; Alcoholics Anonymous; Alternative Addiction Treatment; Recovery; Smith, Robert Holbrook; Treatment; Wilson, William G.

Further Reading Alcoholics Anonymous. http://www.alcoholi cs-anonymous.org. Carnes, Patrick. 1993. A Gentle Path Through the Twelve Steps. Center City, MN: Hazelden Foundation. Frequently Asked Questions of Clutterer’s Anonymous. https://sites.google.com/site/ clutterersanonymous/Home/frequently -asked-questions. “The Tools and Principles of Workaholics Anonymous.” http://www.workaholics-anonym ous.org/page.php?page=toolsandprincip les. “Tools of Recovery of Overeater’s Anonymous.” http://www.oa.org/newcomers/tools -of-recovery/#literature.

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U illegal immigrant would use this particular substance increases by 100 percent when compared to a U.S. citizen. Katz et al. do caution that the findings of their study are not necessarily applicable to illegal immigrants from countries other than Mexico. The findings, however, do counter the perception of a relationship between illegal immigrants and crime. Studies like this can help in the creation of more sound policies based on facts and not anecdotal evidence. Illegal or undocumented immigrants and drug trafficking are highly correlated because most of the illegal drugs in the United States originate outside the country. Thousands of undocumented immigrants from different countries work as couriers, smuggling narcotics and other banned drugs into the United States. There are many examples of how immigrants to the United States are used by drug traffickers as unwilling participants in the distribution of drugs. In one such case, illegal immigrants were part of a scheme to distribute methamphetamine. The immigrants (from Mexico, Honduras, or elsewhere) would pay a fee for assistance to get into the United States. “Coyotes” is the name given to these border-crossing specialists. The immigrants were then taken to Missouri where they were told they would find jobs to help pay for their families in their home country. Once they arrived in Missouri, the only job opportunities had low wages and poor living conditions. They were also in debt to the group that smuggled them into the United States. Many of the immigrants turn to helping the group distribute drugs in order to

Undocumented Immigrants and Drug Use In the ongoing immigration reform debate, policy makers often resort to the public perception that illegal immigration causes increases in crime rates. The Illegal Immigration Reform and Immigrant Responsibility Act of 1996 increased the standards for the deportation of illegal immigrants while California Proposition 187 declared that Californians were suffering from the ill effects of the criminality of illegal immigrants. A recent study by Charles M. Katz, Andrew M. Fox, and Michael D. White tests the perceived relationship between illegal immigrants, and drugs and crime. The study examines drug use patterns of 3,050 newly incarcerated offenders in the Maricopa County, Arizona, jail. The findings show that a small number of the subjects (12 percent) reported themselves as illegal immigrants while 4 percent were self-reported legal immigrants. Illegal immigrants tended to be younger, male Hispanics who were employed and less likely to earn income through illegal activities. This group also self-reported fewer prior arrests including arrests for violent acts. Katz et al. did find that more illegal immigrants were arrested for alcohol-related offenses: approximately four times more likely than either legal immigrants or U.S. citizens. When compared to legal immigrants and U.S. citizens, illegal immigrants use marijuana, methamphetamine, and other illicit drugs significantly less than U.S. citizens. This pattern does not hold true in regard to the use of powder cocaine. The odds that an 913

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pay off their debt. They then become “drug mules” in the transportation of illicit drugs. They are sometimes threatened with personal injury or injury to their families if they do not comply. The immigrants can then be sentenced to long prison terms, or asked to leave, or forced to leave, the United States. In 2012, law enforcement arrested 28 illegal immigrants in Virginia and charged them with smuggling cocaine from Honduras over the past six years. The immigrants would smuggle in several pounds of cocaine at a time in items such as shoes and wooden frames on air flights into the United States. They would then wire the money back to the suppliers in Honduras. A new way that Mexican drug cartels are using to bring drugs and illegal immigrants into the United States is via the sea, across the border, and into beachfront California communities such as Malibu, Ventura, and Santa Barbara. The boats leave from Northern Mexico and travel hundreds of miles before landing in California. There, they find remote beaches and easy access to highways that are easy getaway routes for the smugglers, who are typically armed. The remote areas also make it very difficult for law enforcement. Many politicians have had to deal with this problem. Jan Brewer, governor of Arizona, said that most illegal immigrants who come to that state are being used to transport drugs. She said while most immigrants seek legitimate work opportunities, some are forced into being drug “mules” for drug cartels. To solve this problem, Governor Brewer signed a state immigration enforcement law that became very controversial. The law requires police officers to question a person’s immigration status if there is reasonable suspicion that the person is in the country illegally. Nancy E. Marion

Further Reading Associated Press. 2012. “Illegal Immigrants Arrested, Accused of Smuggling Drugs from Honduras to US.” Fox News, May 10. http:// www.foxnews.com/world/2012/05/10/ illegal-immigrants-arrested-accused-smugg ling-drugs-from-honduras-to-us/. Davenport, Paul. 2010. “Arizona Governor: Most Illegal Immigrants Smuggling Drugs.” NBC News.com, June 26. http://www .nbcn ews.com/id/37940862/t/ariz-governor -most-illegal-immigrants-smuggling-drugs/. Fox News Insider. 2012. “Mexican Cartels Smuggling Illegal Immigrants, Drugs across the Border by Boat.” Fox News, February 9. http://foxnewsinsider.com/2012/02/09/ mexican-cartels-smuggling-illegal-immig rants-drugs-across-the-border-by-boat/. Katz, Charles M., Andrew M. Fox, and Michael D. White. 2011. “Assessing the Relationship between Immigration Status and Drug Use.” Justice Quarterly 28(4): 541–75. http://cvpcs.asu.edu/sites/default/ files/content/products/JQ%20Final%20pap er.pdf. Rollins, Jess. 2013. “In Missouri, Illegal Immigrants Used to Smuggle Drugs.” Springfield, Missouri News-Leader, February 10. http://www.usatoday.com/story/news/nat ion/2013/02/10/missouri-meth-smuggling -illegal-immigrants/1907003/.

United Nations Commission on Narcotic Drugs The United Nations Commission on Narcotic Drugs (CND) is the principal UN policymaking body for narcotic and psychotropic drug control. Established in 1946, the commission was originally charged with overseeing the implementation of international drug control treaties. Prior to this, the primary international policy-making body on drug-

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related issues was the Advisory Committee on the Traffic on Opium and Other Dangerous Drugs, within the League of Nations. The primary document that outlines the responsibilities of the CND is the Political Declaration and Plan of Action on International Cooperation Towards an Integrated and Balanced Strategy to Counter the World Drug Problem of 2009. It demonstrated that the CND is the prime agency with responsibility for drug control matters. In 1991, the commission’s charge was expanded so that it now serves as the governing body of the United Nations Office on Drugs and Crime (UNODC). The change also gave it permission to approve the budget of the Fund of the United Nations International Drug Control Program. At that time, the CND restructured its responsibilities into two units. One was a normative segment, during which the CND carries out its treatybased and normative functions. The second was an operational segment, during which the CND performs its role as the governing body of UNODC. Today, the commission is composed of 30 members that are chosen for membership by the UN’s Economic and Social Council. They serve four-year terms and represent different regions, including African, Asian, Latin American/Caribbean, Eastern European, and Western European states. The commission is part of the UN’s Economic and Social Council, and makes recommendations to the council on policies to control drugs. It also watches the global drug situation and makes recommendations on how to strengthen international drug control efforts. This can include efforts to reduce the demand for illicit drugs, promoting alternative development initiatives, and/or adopting supply reduction measures. One key power held by the commission members is to amend the schedules of controlled drugs

under the Single Convention on Narcotic Drugs and the Convention on Psychotropic Substances as needed. The CND meets annually to consider new policies and resolutions. As needed, meetings are held to provide guidance to the UNODC. At the end of each year, the CND meets to consider budgetary and administrative matters. In 2014, the CND has plans to conduct a thorough review of the Political Declaration and Plan of Action. Related bodies of the CND are the Subcommission on Illicit Drug Traffic and Related Matters in the Near and Middle East and the meetings of the Heads of National Drug Law Enforcement Agencies for Africa, Asia and the Pacific, Latin America and the Caribbean, and Europe respectively. The purpose of these meetings is to coordinate activities to counteract illicit drug trafficking and to monitor new trends within the respective regions. The recommendations of the subsidiary bodies are submitted to the sessions of the CND for its consideration and follow-up action. Nancy E. Marion See also: United Nations Convention on Psychotropic Substances; United Nations International Conference on Drug Abuse and Illicit Trafficking; United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances; United Nations Office on Drugs and Crime; United Nations Single Convention on Narcotic Drugs

Further Reading Osmanczyk, Edmund Jan. 1985. Encyclopedia of the United Nations and International Agreements. New York: Routledge. United Nations. “The Commission on Narcotic Drugs.” http://www.unodc.org/unodc/en/co mmissions/CND/index.html. United Nations Department of Public Information. 1995. Basic Facts about the U.N.

916   United Nations Convention Against Illicit Traffic in Narcotic Drugs United Nations, Office on Drugs and Crime. “Twenty Years of Narcotics Control Under the United Nations.” http://www.unodc.org/ unodc/en/data-and-analysis/bulletin/bullet in_1966–01–01_1_page002.html.

United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1988) The United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988 is one of three major drug control treaties currently in effect. This treaty provides the legal mechanisms for law enforcement to implement both the Single Convention on Narcotic Drugs and the Convention on Psychotropic Substances. The convention took effect on November 11, 1990, and has 188 member states participating. The convention was the result of increasing international drug trafficking by multiple crime groups, and the increasing inability of law enforcement to stop it. The treaty notes that these drug activities “undermine the legitimate economies and threaten the stability, security and sovereignty of States.” The intent of the convention is to deprive international drug traffickers of their freedom of movement and any profits from resulting from the drug trade. The treaty focuses on the relationship between organized crime and drug trafficking. It requires that states cooperate in investigating and seizing drug-related assets. Under Article 5, law enforcement is required to confiscate any proceeds that are gained as a result of drugrelated activity. It also requires that nations give their courts the power or authority to order that financial records be made available to law enforcement.

There are 34 articles in the treaty. They are: Article 1 Definitions Article 2 Scope of the Convention Article 3 Offences and sanctions Article 4 Jurisdiction Article 5 Confiscation Article 6 Extradition Article 7 Mutual legal assistance Article 8 Transfer of proceedings Article 9 Other forms of co-operation and training Article 10 International co-operation and assistance for transit States Article 11 Controlled delivery Article 12 Substances frequently used in the illicit manufacture of narcotic drugs or psychotropic substances Article 13 Materials and equipment Article 14 Measures to eradicate illicit cultivation of narcotic plants and to eliminate illicit demand for narcotic drugs and psychotropic substances Article 15 Commercial carriers Article 16 Commercial documents and labelling of exports Article 17 Illicit traffic by sea Article 18 Free trade zones and free ports Article 19 The use of the mails Article 20 Information to be furnished by Parties Article 21 Functions of the Commission Article 22 Functions of the Board Article 23 Reports of the Board Article 24 Application of stricter measures than those required by this Convention Article 25 Non-derogation from earlier treaty rights and obligations Article 26 Signature Article 27 Ratification, acceptance, approval or act of formal confirmation Article 28 Accession Article 29 Entry into force

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Article 30 Denunciation Article 31 Amendments Article 32 Settlement of disputes Article 33 Authentic texts Article 34 Depository In those cases where a participating country does not have extradition treaties with other nations, the treaty provides a legal basis for such. Moreover, the treaty requires that countries provide legal assistance to one another in order to carry out searches and seizures, if requested. Since many of the provisions in the treaty begin with the phrase, “Subject to its constitutional principles and the basic concepts of its legal system, each Party shall . . .” This means that individual countries can choose to implement the articles in light of their particular constitutions. This means that if an article violates a country’s constitution, the provision would not be binding on the law enforcement in that country. Nancy E. Marion See also: United Nations Convention on Psychotropic Substances; United Nations Single Convention on Narcotic Drugs

Further Reading United Nations. “United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988.” http://www .unodc.org/pdf/convention_1988_en.pdf. United Nations Department of Public Information. 1995. Basic Facts about the U.N.

United Nations Convention on Psychotropic Substances (1971) The UN Convention on Psychotropic Substances is an agreement to control the availability of psychoactive drugs including

amphetamines, barbiturates, benzodiazepines, and psychedelic drugs. The treaty, signed in Vienna, Austria, was the follow-up to the Single Convention on Narcotic Drugs, passed in 1961, which did not apply to many newly developed drugs that were becoming popular worldwide. It became effective in August 1976. There are currently about 185 states participating in the treaty. The UN Office of Legal Affairs published a Commentary to the Treaty that provides background and analysis, which is helpful for those participating states. Many states have passed new laws that allow for implementation of the treaty. In the United States, Congress passed the Controlled Substances Act that created drug schedules. Each drug could be placed in one of the categories based on its addictive properties and potential medical uses. The treaty was largely a response to the growing popularity of LSD and other hallucinogenic drugs that were popular in the 1960s. In 1968, the United Nations Economic and Social Council became concerned about the serious health problems being caused by these drugs. In response, they passed a resolution asking nations to limit the use of the drugs for scientific and medical reasons. That same year, the UN asked that the Commission on Narcotic Drugs address the problem. The then-existing treaty regulating illicit drugs was the Single Convention on Narcotic Drugs, established in 1961. This convention did not account for the newly developed drugs that were so popular, and did not allow for international regulation of them. They realized that a new convention was needed. Using the concepts of the Single Convention, the commission wrote a new convention, called the Convention on Psychotropic Substances. The treaty includes four schedules of controlled substances. Schedule I

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drugs are the most restrictive, and Schedule IV the least. Generally, a drug in Schedule I poses a serious risk to public health and has no acknowledged medical value. Examples of these drugs are hallucinogenic drugs such as LSD and Ecstasy. Schedule II drugs have limited medicinal value, and include amphetamines or painkillers such as morphine. Those drugs in Schedule III have fast-acting effects but can be abused by users. An example would be a barbiturate. Finally, Schedule IV drugs have medical uses and a weaker potential for abuse. These drugs can by hypnotics and weaker stimulants. Additional drugs can be added to the schedules as needed. The final decision about if a drug should be added, and to what category, will be made by the Commission on Narcotic Drugs. Nancy E. Marion See also: Amphetamines; Barbiturates; LSD; United Nations Convention against the Illicit Traffic in Narcotic Drugs and Psychotropic Substances; United Nations Single Convention on Narcotic Drugs

Further Reading Osmanczyk, Edmund Jan. 1985. Encyclopedia of the United Nations and International Agreements. New York: Routledge. United Nations Department of Public Information. 1986. Everyman’s United Nations. United Nations Office on Drugs and Crime. “Convention on Psychotropic Substances, 1971.” http://www.unodc.org/unodc/en/trea ties/psychotropics.html.

United Nations International Conference on Drug Abuse and Illicit Trafficking (1987)

on Drug Abuse and Illicit Trafficking at the ministerial level in Vienna. The goal was to create international action against illicit drug use, and ways to combat the drug problem in all forms. They examined demand reduction, crop eradication, extradition, and the treatment and rehabilitation of addicts. The first session was held in Vienna, June 21–26, 1987, and the second conference was held in Bolivia. In December 1987, the third session was held in Vienna with the mandate to generate a universal plan of action and to express the will of the nations represented to combat the problem of drugs on an international scale. The report from the December meeting sought to strengthen cooperation and action internationally to reach the goal of an international society that is free of drug abuse. The committee members adopted a Declaration and the Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control and urged governments to follow the framework provided when formulating future programs for drug control. They also decided to observe June 26 of every year as the International Day Against Drug Abuse and Illicit Trafficking. Committee members made an appeal to the member states to provide additional resources for the UN Fund for Drug Abuse Control, which helps to strengthen the international work with developing countries as they seek to implement drug control programs. Even the pope got involved (John Paul II 1987). Nancy E. Marion See also: Crop Eradication; Extradition; United Nations Commission on Narcotic Drugs

Further Reading In Resolution 40/122, the UN agreed to convene in 1987 an International Conference

John Paul II. 1987. “Message of the Holy Father John Paul II to the Representatives

United Nations International Day Against Drug Abuse and Illicit Trafficking  919 of the International Conference on ‘Drug Abuse and Illicit Trafficking.’” http://www .vatican.va/holy_father/john_paul_ii/mess ages/pont_messages/1987/documents/hf _jp-ii_mes_19870604_conferenza-vienna _en.html. Reagan, Ronald. 1987a. “Announcement of the United States Delegation to the International Conference on Drug Abuse and Illicit Trafficking.” June 11. Reagan, Ronald. 1987b. “Remarks at a White House Briefing on the United Nationals Interantional Conference on Drug Abuse and Illicit Trafficking.” United Nations General Assembly. December 7, 1987, A/Res/42/112, http://www.un.org/ documents/ga/res/42/a42r112.htm. United Nations General Assembly, A/Res/42 /126. http://www.un.org/en/ga/search/view _doc.asp?symbol=A/RES/42/126&Lang=E &Area=RESOLUTION.

United Nations International Day Against Drug Abuse and Illicit Trafficking In December 1987, the United Nations, in Resolution 42/112, chose to make June 26 of every year the International Day Against Drug Abuse and Illicit Trafficking as a way to raise awareness of the problems that illicit druse use causes in today’s society. This would be their way to express their goal of strengthening international cooperation and action toward an international society that is free from drug abuse. This was part of the International Conference on Drug Abuse and Illicit Trafficking. The World Drug Report is issued on this day. Based on the premise that illicit drugs pose a health threat to society, the UN underscores the awareness that drugs should remain controlled. The UN recognizes

that, unfortunately, the world drug problem continues to pose a serious health threat to young people. It also threatens the socioeconomic and political stability of international development. The drug trade generates billions of dollars each year, that only serves to support corruption and organized criminal groups. Because the drug problem is international in scope, it requires a great amount of cooperation among countries. Each year, the Day Against Drug Abuse has a different theme, as noted below. In 2013 the theme was “Make Health Your ‘New High’ in Life, Not Drugs.” The goal of the events this year was to inform the public, but young people specifically, about the potential harmful effects of new psychoactive substances (also known as “bath salts”) that are available via the Internet. The message that these new drugs can be even more dangerous than existing drugs was made clear through the day’s events. Use of these drugs have resulted in unpredictable effects, even death. The events of the day are supported by individuals and groups around the world every year. 2012: “Global Action for Healthy Communities Without Drugs” 2011: “Say No!” 2010: “Think Health—Not Drugs” 2009: “Do Drugs Control Your Life? Your Life. Your Community. No Place for Drugs.” 2008: “Do Drugs Control Your Life? Your Life. Your Community. No Place for Drugs.” 2007: “Do Drugs Control Your Life? Your Life. Your Community. No Place for Drugs.” 2006: “Value Yourself . . . Make Healthy Choices” 2005: “Drugs Is Not Child’s Play”

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2004: “Drugs: Treatment Works” 2003: “Let’s Talk About Drugs” 2002: “Substance Abuse and HIV/AIDS” 2001: “Sports Against Drugs” 2000: “Facing Reality: Denial, Corruption and Violence” Nancy E. Marion See also: Bath Salts and Synthetic Cannabis; United Nations International Conference on Drug Abuse and Illicit Trafficking

Further Reading Time and Date.com. “International Day Against Drug Abuse and Illicit Trafficking.” http://www.timeanddate.com/holidays /un/international-day-against-drug-abuse &sa=U&ei=vxZ4UaOVJoXN0wGur4CgD Q&ved=0CC4QFjAF&usg=AFQjCNGh6e 6AqapM2iMfsjO81BwhStV8Pw. United Nations. “International Day Against Drug Abuse and Illicit Trafficking: June 26.” http://www.un.org/en/events/drugabuseday/index.shtml.

United Nations Office on Drugs and Crime The United Nations Office on Drugs and Crime (UNODC) is the unit of the United Nations (UN) charged with combating illicit drugs, terrorism, and other criminal activity. It is headquartered in Vienna, Austria, and has 21 field offices and a liaison office in New York. The agency has approximately 500 members across the globe who develop and enforce drug control policies that are responsive to their individual needs. The UNODC’s work program consists of three major pillars. The first of these is research and analysis of substance abuse issues and the relationship of these concerns to

policy and operational decisions. The second is the promotion of treaties and legislation among member nations to develop programs to counter drug activity, crime, and terrorism. The last pillar is cooperation among member states through field-based projects. The work program also seeks to obtain a number of outcomes. Interventions to achieve these outcomes include the use of international treaties by governments of the member nations to improve judicial cooperation; the use of measures taken to thwart drug production, drug trafficking, human trafficking, money laundering, corruption, terrorism, and other forms of organized crime; the use of empirical evidence-based research to influence policy and decision making; and the use of greater understanding and knowledge of drug and crime issues to take action against these problems. The manufacture, distribution, and use of illicit substances have been determined by the UNODC as significant problems that result in increased personal health costs, lost wages, and family and community disorganization. An increase in violent activity has also been deemed a correlate of illegal drug activity. Drug cartels promote governmental and economic deviance as well as street violence, gang warfare, urban disorganization, and personal loss. The organization promotes economic and social policy strategies to member nations that will reduce the harmful effects of drug use and abuse. A number of programs have been formulated by the UNODC to address its goals. The agency’s Global Program for Trafficking in Human Beings was created to thwart the rapidly growing problems of the smuggling of migrants for labor purposes and the trafficking of people for prostitution, slave labor, and the sex industry. The Global Program against Transnational Crime attempts to supply member states with information,

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data, training, and policy formation strategies to combat organized transnational criminal activity. The Global Program against Corruption focuses on helping member nations establish procedures to reduce corruption in government by implementing watchdog strategies. The Global Program against Terrorism assists members in enacting legislative policies designed to prevent and suppress terrorist activity and works in tandem with the Counter-Terrorism Committee of the Security Council, the Office of Legal Affairs, and local organizations. The UNODC also operates a Legal Advisory Program that provides assistance to member nations in the development of legal and structural frameworks for the successful execution of programs designed to fight drug problems and the accompanying criminal issues of terrorism, money laundering, and others. The UNODC’s Global Assessment Program is directly involved with initiatives designed to reduce the spread of HIV through the prevention of drug use. This program is responsible for supplying accurate and upto-date statistical data on drug use as well as developing strategies to inhibit drug use through prevention and rehabilitation measures using grassroots organizations, businesses, and governments. Hua-Lun Huang See also: United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances; United Nations Single Convention on Narcotic Drugs

Further Reading Krasno, Jean E. The United Nations: Confronting the Challenges of a Global Society. Boulder, CO: Lynne Rienner, 2004. United Nations. Basic Facts about the United Nations. Lanham, MD: Bernan, 2004.

United Nations Office on Drugs and Crime. “United Nations Office on Drugs and Crime.” http://www.unodc.org/pdf/unodc_ brochure_2003.pdf.

United Nations Single Convention on Narcotic Drugs (1961) Created in 1961, the United Nations Single Convention on Narcotic Drugs was an international treaty designed to attack the illicit production and supply of narcotics and other drugs having similar effects on the user. The purpose was to simplify and make the international drug control policies more consistent. This new treaty filled a gap in previous conventions that only had control over opium, coca, and other drugs such as heroin, morphine, and cocaine. The Single Convention also included cannabis, which had been omitted from earlier treaties. The Single Convention was the first international treaty to prohibit cannabis. The Single Convention created four schedules of controlled substances, as contrasted with the two “groups” of drugs that existed in previous treaties. The new schedules had stricter regulations for categorizing internationally controlled drugs. However, it noted the importance of these drugs for medical uses. There was also a process for adding new substances to the schedules, which would be done by the Commission on Narcotic Drugs and the World Health Organization. The treaty went into effect on December 13, 1964. • Schedule I—The substance is liable to similar abuse and productive of similar ill effects as the drugs already in Schedule I or Schedule II, or is convertible into a drug.

922   United Nations Surveys on Crime Trends

• Schedule II—The substance is liable to similar abuse and productive of similar ill effects as the drugs already in Schedule I or Schedule II, or is convertible into a drug. • Schedule III—The preparation, because of the substances which it contains, is not liable to abuse and cannot produce ill effects; and the drug therein is not readily recoverable. • Schedule IV—The drug, which is already in Schedule I, is particularly liable to abuse and to produce ill effects, and such liability is not offset by substantial therapeutic advantages. In May 1971, the UN Economic and Social Council held a conference to consider amending the Single Convention. They met in Geneva in 1972, and wrote the Protocol Amending the Single Convention on Narcotic Drugs. This went into effect in 1975. The treaty was updated by the Convention on Psychotropic Substances in 1971, which limited psychoactive drugs such as LSD and Ecstasy. As of May 2013, about 184 countries have agreed to enforce the Single Convention. If they agree to abide by the treaty, they must agree to pass laws to allow the law enforcement community to enforce the provisions. For example, Article 36 requires countries to pass new laws that would outlaw the “cultivation, production, manufacture, extraction, preparation, possession, offering, offering for sale, distribution, purchase, sale, delivery on any terms whatsoever, brokerage, dispatch, dispatch in transit, transport, importation and exportation of drugs contrary to the provisions of this Convention.” According to the treaty, the UN Office on Drugs and Crime was given the responsibility of monitoring the drug situation across

the globe and ensuring that the treaty was being implemented fairly. In 1961, a conference of plenipotentiaries in New York adopted the Single Convention on Narcotic Drugs, which consolidated the existing drug control treaties into one document and added cannabis to the list of prohibited plants. In order to appease the pharmaceutical interests, the Single Convention’s scope was sharply limited to the list of drugs enumerated in the schedules annexed to the treaty and to those drugs determined to have similar effects. Nancy E. Marion See also: Hemp; Marijuana

Further Reading Osmanczck, Edmund Jan. 1985. The Encyclopedia of the United Nations and International Agreements. New York: Routledge. United Nations. “Single Convention on Narcotic Drugs, 1961.” https://www.unodc.org/ pdf/convention_1961_en.pdf. United Nations Department of Public Information. 1986. Everyman’s United Nations.

United Nations Surveys on Crime Trends and the Operations of Criminal Justice Systems (UN-CTS) To determine the scope and seriousness of the problem, the United Nations and its agencies have conducted regular surveys on crime trends and the operations of national criminal justice systems. The modern tracking of survey data began when the Economic and Social Council requested the secretary general to collect these statistics on May 25, 1984, in resolution 1984/48. The statistics reported to the UN for any particular country are incidents of victimization reported to

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the authorities of that country. Official crime data may not be easily comparable or may be inaccurate. The most recent survey, 2013 UN-CTS, is a questionnaire focused on four main components: police, prosecution, courts, and prisons. The police component is separated into subsections regarding data on numbers of police personnel; recorded offenses and victims of intentional homicide; recorded offenses of assault, sexual violence, rape, robbery, and kidnapping; theft, motor vehicle theft, and burglary; and the number suspected, arrested, or cautioned about all crimes, intentional homicide, or rape. The other subsections are less extensive. Prosecution focuses on the number of prosecutions for all crimes, for rape, and for intentional homicide. The subsection on courts counts the number of judges, persons brought before criminal courts, adult convictions, juvenile convictions, and convictions for rape or intentional homicide. The subsection on prisons requests the capacity of adult and juvenile prisons, the number of inmates of those prisons, and the numbers of staff at those prisons. In addition to questioning UN member states about relevant numbers, there are several questions devoted to whether the country uses a particular definition of certain crimes, how they count their statistics, and other useful metadata. Robert J. Kelly, Joseph D. Serio, and Jesse L. Maghan See also: Drug Smuggling; Drug Trafficking; Drug Trafficking and Organized Crime

Further Reading United Nations, Statistics and Surveys Section, Division for Policy Analysis and Public Affairs. 2013. “United Nations Survey of Crime Trends and Operations of Criminal Justice Systems (UN-CTS)-2013.” http://

www.unodc.org/unodc/en/data-and-analys is/statistics/crime/cts-data-collection.html. United Nations Office on Drugs and Crime. 2013. “United Nations Surveys on Crime Trends and the Operations of Criminal Just ice Systems (CTS).” http://www.unodc.org /unodc/en/data-and-analysis/United-Nat ions-Surveys-on-Crime-Trends-and-the -Operations-of-Criminal-Justice-Systems .html.

United States Bureau of Narcotics and Dangerous Drugs (BNDD) In 1968, U.S. president Lyndon Johnson implemented Reorganization Plan Number 1, which consolidated the Federal Bureau of Narcotics (FBN) from the Department of the Treasury and the Bureau of Drug Abuse Control (BDAC) from the Food and Drug Administration, to create a new drug enforcement unit called the Bureau of Narcotics and Dangerous Drugs (BNDD), to be housed in the Department of Justice. The BNDD had responsibility for controlling stimulants such as methamphetamines and various hallucinogens. By 1972 the BNDD’s budget had more than quadrupled, its agent force had increased to 1,361, and its domestic and foreign arrests had doubled. It had regulatory control over more than a half-million registrants licensed to distribute licit drugs. There were many doubts about the agency’s ability to handle the drug problem. They provided training to local police departments on how to enforce illicit drug laws. The head of the BNDD was John Ingersoll, a California police official. He served from 1968 until the agency was eliminated in 1973. Ingersoll addressed some of the corruption that was evident in the depart-

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ment. He discovered that many agents were arresting the small-time dealers, but leaving major dealers alone. Ingersoll changed the focus of the agency from arrests to focusing on seizure and illicit drugs, both home and abroad. The BNDD tended to focus on international trafficking and interstate violators, while local police focused on local drug dealers. Ingersoll worked for the Oakland, California, police department as a patrolman and then a sergeant. In 1961, he became the director of Field Services for the International Association of Chiefs of Police. After that, he became the chief of police for Charlotte, North Carolina. Despite the changes, the BNDD still received public criticism for the increase in drug use, especially among the young. In 1973, President Richard Nixon created a new federal agency—the Drug Enforcement Administration (DEA). The BNDD and six other agencies were abolished and their functions placed under the DEA. Ron Chepesiuk See also: Drug Enforcement Administration; Federal Bureau of Narcotics; Johnson, Lyndon Baines; Methamphetamines; Nixon, Richard M.; Office of Drug Abuse Law Enforcement

Further Reading Courtwright, David T. 1982. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Epstein, Edward J. “Agency of Fear: Opiates and Political Power in America.” Schaffer Library of Drug Policy. http://druglibrary .org/schaffer/history/aof/aof11.html. Frydl, Kathleen J. 2013. The Drug Wars in America, 1940–1973. Cambridge: Cambridge University Press Johnson, Lyndon B. 1968. “Special Message to the Congress Transmitting Reorganiza-

tion Plan 1 of 1968 Relating to Narcotics and Drug Abuse Control.” February 7. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=29249. “Narcotics Bureau Official John Finlator Dies.” 1990. Washington Post, August 19. http:// www.highbeam.com/doc/1P2–1143269 .html. Weir, William. 1994. In the Shadow of the Dope Fiend. New Haven, CT: Archon Books.

United States Coast Guard Located within the Department of Homeland Security, the Coast Guard is one of the five armed forces of the United States. Members of the Coast Guard protect the country’s maritime interests and the environment around the world. The agency has been given broad legal authority to oversee rivers, ports, and the high seas. In 2012, the agency had over 43,000 active duty members, along with over 8,000 reservists, 8,800 civilian employees, and over 30,000 volunteer auxilliarists. While it is a military force, the Coast Guard is also a federal law enforcement agency. They enforce laws to protect the environment and protect the United States from danger. The agency’s roots go back to August 4, 1790, when President George Washington signed a tariff act to authorize the construction of 10 vessels to enforce federal law and prevent smuggling. This makes the Coast Guard one of the oldest federal government organizations. It was also the only armed force afloat until the Congress established the Navy Department in 1798. Over the years, the agency has undergone many changes. In 1915, the agency underwent a reorganization that resulted

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U.S. Coast Guard seaman carries a bail of marijuana confiscated from drug dealers in Florida. The Coast Guard watches for boats used by drug traffickers to bring illicit narcotics into the United States. (Petty Officer 2nd Class Patrick Kelley/U.S. Coast Guard)

in a new agency called the Coast Guard. Then in 1939, President Franklin Roosevelt ordered that the Coast Guard also incorporate the Lighthouse Service. Then in 1946, the Bureau of Marine Inspection and Navigation (from the Commerce Department) was merged into the Coast Guard as well. Today, the Coast Guard’s responsibilities for national defense remain one of its most important functions. During times of peace, the Coast Guard operates as one element of the Department of Homeland Security. It is the country’s front-line agency for enforcing the nation’s maritime laws. It seeks to protect the nation’s coastline and ports, but also the marine environment. In times of war, or when ordered by the president, the Coast Guard serves as part of the Navy Department. According to the Coast Guard, agents accomplished the following tasks in 2012:

• Responded to 19,790 search and rescue cases, and saved 3,560 lives and more than $77 million in property; • Removed 107 metric tons of cocaine bound toward the United States via the Transit Zone; • Continued the deployment of six patrol boats and 400 personnel to protect Iraqi critical maritime oil infrastructure and train Iraqi naval forces; • Conducted 919 escorts and patrols to support 190 domestic U.S. military cargo out-loads; • Conducted 25,500 container inspections, 5,000 facility safety- and marine pollution–related inspections, and 1,195 cargo transfer monitors to ensure safety and environmental stewardship of the maritime domain; • Conducted 1,424 boardings of highinterest vessels designated as posing a

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•

• • •

greater-than-normal risk to the United States; Interdicted nearly 3,000 undocumented migrants attempting to illegally enter the United States; Investigated and responded to over 3,300 pollution incidents; Verified more than 70,000 Transportation Worker Identification Credentials; Screened over 436,000 vessels, including over 117,000 commercial vessels and 29.5 million crewmembers and passengers prior to arrival in U.S. ports. Nancy E. Marion

See also: Drug Trafficking

Further Reading National Archives and Records Service. Office of the Federal Registry. 1997–1998. The United States Government Manual, 1997–1998. United States Coast Guard. “About Us: Overview of the United States Coast Guard.” http://www.uscg.mil/.

United States Customs and Border Protection Customs and Border Protection (CBP) is one of the largest security-oriented components of the Department of Homeland Security (DHS) and formerly resided in DHS’s Directorate of Border and Transportation Security, though now the organization reports directly to the secretary of homeland security. It is tasked with the protection of the borders from intrusion by terrorists and weapons smuggling, inspections of goods coming into the United States, levying tariffs, as well as enabling trade and travel. It must do this at the same time as enforcing a large num-

ber of governmental regulations on border crossings, including immigration and drug trafficking. This, in turn, means that the CBP is constantly working with agencies like the Drug Enforcement Administration and Immigration and Customs Enforcement (ICE), to fulfill their homeland security mission. The history of U.S. Customs and Border Protection is long, considering two of the agencies that were eventually joined to create the CBP constitute some of the oldest enforcement agencies in the United States. The U.S. Customs Service (USCS) was established by Congress on July 31, 1789, and has historically been the agency in charge of trade facilitation and enforcement. The USCS was originally under the direction of the secretary of the treasury, and the primary function of the agency was to collect customs tariffs, one of the major sources of government revenue before the establishment of income tax in 1913. While the agency saw several expansions of their power over the years, and underwent two major reorganizations, the functions of USCS remained little changed until the attacks of September 11, 2001, which resulted in the creation of the DHS, and like 21 other federal agencies or departments, the USCS became part of the newly formed organization. One of the other major agencies that was rolled into CBP post-9/11 was the U.S. Border Patrol (USBP). The USBP, like the USCS, was one of the oldest enforcement agencies in the United States, originally formed in 1915 as “Mounted Guards” under the auspices of the U.S. Immigration Service. The organization gained its formal footing on May 28, 1924, when the USBP was officially established by Congress and charged with securing the borders between inspection stations on the U.S. border. In 1925 their powers expanded to include patrol of the seacoast. Over the years, the focus of

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USBP operations shifted, from illegal smuggling of alcohol during prohibition to illegal entry by immigrants in the 1990s, but the essential function of the USBP remains intact, even with its new location in the DHS. Elements of other agencies were rolled into the CBP within the DHS after its creation in 2003 as well, including elements of the U.S. Department of Agriculture, such as many of the inspection teams under the purview of the U.S. Agricultural Inspection Service. In 2005, a recommendation was made to merge the CBP and ICE, as the agencies require significant coordination, but in practice were competing rather than cooperating. After the DHS’s 2005 Bottomup Review, the decision was made to keep the organizations separate, but try to improve coordination and cooperation across the organizations. The CBP was formed as part of the newly created DHS in 2003 with the implementation of the Homeland Security Act of 2002. The organizational structure is straightforward, reflecting the CBP’s responsibility for customs control and border enforcement. The organization is headed by a commissioner and deputy commissioner. There are 14 offices, for each of the organizations areas of operations. These include: • Office of Field Operations • Office of Air and Marine • Office of Intelligence and Investigative Liaison • Office of International Affairs • Office of International Trade • Office of Border Patrol • Office of Human Resource Management • Office of Technology Innovation and Acquisition • Office of Information and Technology • Office of Training and Development

• • • •

Office of Public Affairs Office of Internal Affairs Office of Administration Office of Congressional Affairs

The CBP currently employs over 60,000 employees, most of whom are CBP officers or border patrol agents. In fiscal year 2012, the CBP inspected 350 million passengers and pedestrians across 329 ports of entry. They processed over $2.3 trillion in trade in 2012, and conducted almost 23,000 seizures of goods that violate intellectual property rights, seized more than 4.2 million pounds of narcotics, and confiscated more than $100 million in unreported currency. The CBP has five officer types: border patrol agents, CBP officers, agricultural specialists, air and marine interdiction agents, and import specialists. Border patrol agents focus on working in tandem with CBP officers to prevent entry of terrorists and illegal smuggling of weapons, and apprehend those at the border who attempt to cross illegally. CBP officers are armed law enforcement officers who are in charge of identifying highrisk individuals attempting to make entry into the United States illegally, smuggling of prohibited items, and other violations. Agricultural specialists are trained in identifying invasive species, dangerous toxins, and biohazards. Agriculture specialists are usually stationed at ports of entry to the United States and along the borders. Air and marine interdiction agents are focused on monitoring, intercepting, and tracking suspected illegal movement of people or goods. Import specialists examine shipments coming into the United Sates from a variety of international locations, searching for contraband. One of the major challenges the CBP faces is their need to work very closely with other organizations both within and outside of the DHS. In particular, the CBP has to

928   United States Customs and Border Protection

work closely with ICE, as there is significant overlap in their missions. Recognizing that the organizations were not working well together, in 2005 the ICE-CBP Coordination Council was established, in order to provide officials from both agencies a forum to address challenges to the agencies’ abilities to coordinate operations and share information. The CBP has several key programs that are identified as such by the agency. These include • Global Entry • Electronic System for Travel Authorization • Container Security Initiative • Customs Trade Partnership Against Terrorism • Automated Commercial Environment • Centers for Excellence and Expertise These programs focus on the protection of America’s borders from illegal smuggling of contraband, illegal entry of individuals, and the necessary partnership with private entities that the CBP’s mission requires. The CBP is the lead agency for preventing drug trafficking through our nation’s ports of entry, including airports, seaports, and land borders. The strategy behind the CBP’s prevention is supply reduction, or reducing the amount of drugs that flow into the country from other nations. This is accomplished through interdiction and deterrence of drug smuggling, specifically including efforts to develop high-impact investigations involving aggressive identification, seizure and forfeiture of narcotic proceeds, support for international drug control efforts by providing increased training and long-term assistance to foreign border control and enforcement agencies, and increasing the number of carriers that participate in cooperative training. In fiscal year 2012, the CBP interdicted and seized over 200,000 pounds of cocaine,

4,000 pounds of heroin, and almost 4 million pounds of marijuana. The National Targeting Center–Cargo (NTC-C) supports CBP cargo-related activities by helping to identify appropriate targets for high-risk investigations. The NTC-C also identifies drug trends, conducts tactical postseizure analyses, and disseminates information to the CBP and DHS. The NTC-C, in addition to targeting drugs like heroin and marijuana, also targets precursor chemicals used to manufacture drugs like methamphetamines, Ecstasy, and other designer drugs. The CBP is one of the most significant elements of the Homeland Security apparatus of the United States. Their focus on stopping terrorism and, in particular, their protection of the borders, are some of the most important protections offered. However, aside from the homeland security elements, the CBP is also responsible for combatting the illegal entry of drugs and other contraband across the nation’s borders, while still making sure that goods and services can flow freely into the country. Through participation with cooperating agencies like ICE, the CBP has been a significant component in the United States’ war on illegal drugs. Joshua B. Hill See also: Drug Enforcement Administration; Drug Trafficking; United States Immigration and Customs Enforcement

Further Reading Customs and Border Protection. “U.S. Border Patrol—Protecting Our Sovereign Borders.” www.cbp.gov/xp/cgov/about/history/ legacy/bp_historcut.xml. Customs and Border Protection. 2012. “2012 Performance Accountability Review.” http:// www.cbp.gov/linkhandler/cgov/newsroom/ publications/admin/perform_account_ rpt_2013.ctt/perform_account_rpt_2013.pdf.

United States Immigration and Customs Enforcement (ICE)  929 Customs and Border Protection. 2013a. “CBP Organizational Chart.” http://www.cbp.gov/ linkhandler/cgov/about/organization/orgch a1.ctt/orgcha1.pdf. Customs and Border Protection. 2013b. “Customs and Border Protection Shapshot.” http://www.cbp.gov/linkhandler/cgov/ about/accomplish/cbp_snapshot_2013.ctt/ cbp_snapshot_2013.pdf. Customs and Border Protection. 2013c. “How CBP Combats Narcotics.” https://help.c bp.gov/app/answers/detail/a_id/17/~/how -cbp-combats-narcotics. Customs and Border Protection. 2013d. “U.S. Department of Agriculture, Animal and Plant Health Inspection Service—Protecting America’s Agricultural Resources.” http://www.cbp.gov/xp/cgov/about/history/ legacy/aqi_history.xml. Customs and Border Protection. 2013e. “Who We Are.” http://www.cbp.gov/xp/cgov/care ers/customs_careers/we_are_cbp.xml. Department of Homeland Security Office of Inspector General. 2007. “DHS’ Progress in Addressing Coordination Challenges Between Customs and Border Protection and Immigration and Customs Enforcement.” OIG Report OIC-07-38. Office of the Director of National Intelligence. 2009. Overview of the Intelligence Community for the 111th Congress of the United States of America. http://cstsp.aaas.org/ files/overview.pdf. U.S. Customs Today. 2003. “The U.S. Customs Service: Always There . . . Ready to Serve.” http://www.cbp.gov/xp/Customs Today/2003/February/always.xml.

United States Immigration and Customs Enforcement (ICE) U.S. Immigration and Customs Enforcement (ICE) is the investigative arm of the Depart-

ment of Homeland Security and has primary responsibility for investigations into civil and criminal issues stemming from customs, trade, and immigration violations. ICE employs more than 20,000 individuals and has an annual budget of more than $5.7 billion dollars. ICE was formally established under the auspices of the Homeland Security Act of 2002 and began operations in 2003. Prior to 2002, elements of ICE operated under the U.S. Customs Service, the Federal Protective Service (until 2009, when that element was moved), the Animal and Plant Health Inspection Service, and the Immigration and Naturalization Service. The mission of the organization is to protect national security, public safety, and the integrity of U.S. borders through the criminal and civil enforcement of federal law. ICE is one of three department components charged with the enforcement of national immigration laws, the others being Customs and Border Protection and the Transportation Security Administration. In 2010 ICE released its most recent strategic plan, laying out priorities for 2010–2014. In it, ICE identifies three areas of primary concern to the organization: preventing terrorism and enhancing security, securing and managing our borders, and enforcing and administering our immigration laws. ICE is headed by a director, who is appointed by the president of the United States and is subject to congressional approval. The director reports directly to the secretary of homeland security, and is assisted by a deputy director and several associate directors. The current acting director of ICE is John Sandweg, who replaced John Morton in 2013. Morton was appointed by President Obama in 2009. ICE is composed of two primary operating components and five leadership offices. The two operating components are Homeland

930   United States Immigration and Customs Enforcement (ICE)

Security Investigations (HSI) and Enforcement and Removal Operations (ERO). The leadership offices, located in the Director’s Office, are the Office of Public Affairs, the Office of Congressional Relations, Office of the Principal Legal Advisor, the Office of Professional Responsibility, the Office of Detention Policy and Planning, and the Office of State, Local, and Tribal Coordination. The HSI directorate in ICE is essential to ICE’s mission of stopping terrorism and illegal activities stemming from smuggling. The HSI is responsible for the investigation of crimes involving human smuggling, immigration, narcotics smuggling, and the illegal import of weapons and other contraband. In particular, ICE focuses on investigations to ensure the safety of critical infrastructure. The HSI directorate also is responsible for the oversight of ICE’s international affairs operations and intelligence. The directorate has more than 10,000 employees, approximately 6,700 of whom are special agents, responsible for carrying out the investigations. These agents are spread across all 50 states, and outside of the United States in 47 foreign countries. The HSI is composed of six divisions: • • • • •

Domestic Operations Intelligence International Affairs Mission Support National Intellectual Property Rights Coordination Center • National Security Investigations Division

While these divisions compose the large components of the HSI section, several subdivisions are important in accomplishing ICE’s overall mission. For instance, under the National Security Investigations Division is housed the Counterterrorism and

Criminal Exploitation Unit, which is tasked with tracking and apprehending nonimmigrant visa holders who violate their immigration status. Specifically, the unit focuses on suspected terrorists and those visa holders who have affiliations with terrorists. The ERO is tasked with enforcement of U.S. immigration law, particularly in the interior of the country. They are responsible for identifying and apprehending illegal aliens, detentions of these individuals, and deportations. They prioritize the arrest and removal of convicted criminals and those who post a significant national security threat to the United Sates. The ERO has nearly 8,000 officers in its employ, and has 24 field offices with 12 overseas locations. The annual operations budget for ERO is approximately $3 billion. Under the Immigration and National Act 287(g) Program, the ERO partners with state and local entities such that those entities can perform immigration enforcement within their own jurisdictions. This is done through a combination of training officers and departmental oversight. Under the 287(g) program, over 1,300 officers have been trained, and there are 39 active memoranda of agreement in 19 states. Along with the delegation of Immigration Authority, 287(g) program, the ERO also has several other significant programs. These include: • • • •

Community Outreach Fugitive Operations The Law Enforcement Support Center Rapid Removal of Eligible Parolees Accepted for Transfer (Rapid REPAT)

In support of ERO operations, ICE also operates U.S. ICE detention facilities that are managed by the Detention Management Division of the ERO. The majority of detainees reside in state and local facilities (67

United States Immigration and Customs Enforcement (ICE)  931

percent), with the rest split between contract detention facilities (17 percent), ICE-owned facilities (13 percent), and Bureau of Prisons facilities (3 percent). One of the major challenges ICE faces is their need to work very closely with other organizations both within and outside of the DHS. In particular, ICE has to work closely with U.S. Customs and Border Protection (CBP), as there is significant overlap in their missions. Recognizing that the organizations were not working well together, in 2005 the ICE-CBP Coordination Council was established, in order to provide officials from both agencies a forum to address challenges to the agencies’ abilities to coordinate operations and share information. Also, in 2005, a recommendation was made to merge the CBP and ICE, as the agencies require significant coordination, but in practice were competing rather than cooperating. After the DHS’s 2005 Bottom-up Review, the decision was made to keep the organizations separate, but try to improve coordination and cooperation across the organizations. In addition to the work ICE does itself, and the organization’s direct relationship with state and local law enforcement entities, ICE also works with each of the 104 local Joint Terrorism Task Forces (JTTF), making it the largest federal contributor to the JTTF. This participation is managed in the National Security Investigations Division’s National Security Unit. The JTTF is focused on the investigation, detection, interdiction, and prosecution of the foreign terrorists and works to dismantle terrorist organizations. In 2009 and 2010, ICE agents initiated 1,133 criminal investigations related to terrorism, made 534 arrests, and engaged in thousands of seizures of money, arms, and other contraband related to national security threats.

In addition to the basic functions of the ERO and the HSI, ICE is also responsible for a number of related missions, including the protection and repatriation of artifacts illegally smuggled into the United States under the Cultural Property, Art and Antiquities Investigations Program. Other elements, such as the Bulk Cash Smuggling Center and Cyber Crimes Center, demonstrate the necessary breadth of investigations covered by ICE. In addition to these elements, ICE is one of the lead agencies in regards to narcotics investigations and enforcement in the United States. ICE participates in high-intensity drug-trafficking area task forces to bring together local and federal law enforcement to combat drug-trafficking crimes in specially designated areas. ICE participates in 30 of the 32 high-intensity drug task forces around the country and works in close conjunction with other agencies and the Office of National Drug Control Policy in these areas. Additionally, ICE participates in organized crime drug enforcement task forces, which were established in the early 1980s to help prevent trafficking by large drug-trafficking and money-laundering organizations. ICE remains one of the most significant elements of the Homeland Security apparatus of the United States. Working closely with organizations at the state, local, and federal levels, ICE is responsible for investigations dealing with customs and immigrations violations in the interior of the country. ICE’s two primary divisions, ERO and HSI, compose the bulk of the agency, with significant support from the elements dealing with immigrant detention and other programs. Further, ICE’s work with JTTFs around the country make them one of the most significant components of the information-sharing elements of the country’s defenses against terrorism and other threats to homeland security. Joshua B. Hill

932   United States International Drug Control Efforts See also: United States Customs and Border Protection

Further Reading Department of Homeland Security. 2013a. “John T. Morton.” http://www.dhs.gov/ john-t-morton. Department of Homeland Security. 2013b. “Who Joined DHS.” http://www.dhs.gov/ who-joined-dhs. Department of Homeland Security Office of Inspector General. 2007. “DHS’ Progress in Addressing Coordination Challenges Between Customs and Border Protection and Immigration and Customs Enforcement.” OIG-07-38. Immigration and Customs Enforcement. 2013a. “Counterterrorism and Criminal Exploitation Unit.” http://www.ice.gov/ counterterrorism-criminal-exploitation/. Immigration and Customs Enforcement. 2013b. “Cultural Property, Art and Antiquities Investigations.” http://www.ice.gov/ cultural-heritage-investigations/. Immigration and Customs Enforcement. 2013c. “Drug Enforcement Task Forces.” http://www.ice.gov/drug-task-force/. Immigration and Customs Enforcement. 2013d. “Enforcement and Removal Operations.” http://www.ice.gov/about/offices/ enforcement-removal-operations/. Immigration and Customs Enforcement. 2013e. “Fact Sheet: Detention Management.” http://www.ice.gov/news/library/ factsheets/detention-mgmt.htm. Immigration and Customs Enforcement. 2013f. “Fact Sheet: Updated Facts on ICE’s 287(g) Program.” http://www.ice.gov/news/ library/factsheets/287g-reform.htm. Immigration and Customs Enforcement. 2013g. “Joint Terrorism Task Force.” http:// www.ice.gov/jttf/#. Immigration and Customs Enforcement. 2013h. “Overview.” http://www.ice.gov/ about/overview.

United States International Drug Control Efforts To assist in its campaign to keep illicit drugs from reaching the United States, the Drug Enforcement Administration (DEA) has undertaken a rigorous campaign to eliminate the crops that are grown in order to produce illicit drugs, and to intercept drugs as they come into the United States in order to prevent them from reaching local drug dealers. These efforts, however, only capture a small amount of the drugs that come into the United States illegally, as the DEA estimates that it is able to capture just $1 billion of the $65 billion worth of drugs that are illegally imported into, and transferred within, the United States each year. Before the formation of the DEA in 1973, the Federal Bureau of Narcotics (FBN) and U.S. Customs worked to track and intercept illegal shipments of drugs coming into the country. After World War II, FBN agents were sent to Asia and Europe to work in tandem with criminal investigative branches attached to the U.S. military to assure that drug smuggling did not emerge in areas that had been under Japanese and German control. In subsequent decades, the FBN sent agents across the world, working with informants and pressuring local police and governments to do more to crack down on the drug traffic. To disrupt smuggling across U.S. borders, the government created Operation Intercept, which allowed for searches of all individuals crossing into the United States from Mexico. When the border searches came to an end, Operation Cooperation—which allowed for U.S. agents to be stationed in Mexico—began, thus further increasing American drug enforcement agents’ presence outside of the United States. In 1972, U.S. drug agents, together with French police, broke up the “French Connection,” an organized crime

United States International Drug Control Efforts  933

syndicate that had been smuggling large amounts of heroin into the United States—a success that showed how effective international efforts at drug control could be. With the formation of the DEA, American law enforcement became much more involved in international efforts to curtail the drug trade. In the 1970s and 1980s, the United States stepped up its international efforts to curtail illicit drug production and trafficking. In 1975, the Mexican government began Operation Condor, a crop eradication program in which authorities flew over and destroyed fields of poppies used to make heroin. In 1976, it began Operation Trizo, which allowed for Mexican nationals to fly U.S. State Department planes to spray herbicides over poppy fields, thereby destroying crops that were used to make some of the heroin that was smuggled into the United States. The large number of arrests that accompanied Operation Trizo caused an economic crisis in the poppy-growing regions of Mexico, so to reduce the potential for social upheaval, the Mexican government asked the United States to call off the operation in 1978. In 1975, another international operation, Operation Stopgap, was created to crack down on drug supplies coming to the United States from Colombia. The DEA flew up and down the Colombian coastline, and reported suspicious watercraft back to the United States; Coast Guard vessels were then put on alert, and Navy satellites were used to track the vessels as they moved towards the United States. This operation led to the seizure of over 1 million pounds of marijuana. In 1977, the DEA began working with the FBI, and achieved a major success in Operation Banco, which broke up a major drug smuggling ring based in Miami. In 1979, the DEA and Customs teamed up on Operation Boomer/Falcon, which focused on drug smuggling in the Turks and Caicos Islands,

and led to the seizure of record quantities of illicit drugs. In the 1980s, the DEA continued to carry out both domestic and international operations to cut illicit drug traffic. In the early 1980s, Operation Grouper and Operation Tiburon targeted marijuana being smuggled from Colombia; in 1980, Operation Swordfish cracked down on the drug trade in Miami, while operations in New York and Detroit led to the arrest of a smuggling operation that brought Asian heroin into the country via Italy; and in 1983, a National Narcotics Border Interdiction System (NNBIS) was created to coordinate the work of federal agencies assigned to cut off drug supplies by air, sea, and land. The NNBIS launched Operation Blue Lightning in the early 1980s to crack down on drug smuggling in the area around the Bahamas. The DEA also worked internationally to capture individuals responsible for harming DEA agents, as it did in 1985 with Operation Leyenda, which led the organization to step up activities in Mexico and Costa Rica. In the late 1980s, the DEA worked with the Colombian government to seize the assets of major traffickers, and at the end of the decade, Operation Snowcap led the DEA to carry out operations in 12 Latin American countries to suppress the growth and smuggling of cocaine into the United States. In 1988, the United States launched its first antidrug operation that was directed from overseas, with Operation Blast Furnace, which aimed to reduce drug-growing and -processing operations in Bolivia. Most notably, in 1989 the United States was able to convict former Panamanian leader Manuel Noriega for working with international drug cartels. In the 1980s, the United States also supported crop-eradication programs in Colombia, Belize, Myanmar, Thailand, and Jamaica.

934   United States National Narcotics Control Act (1956)

In the 1990s, the DEA continued its operations, seizing drug assets of major traffickers in Britain, arresting leaders of the Cali drug cartel from four countries in Operation Green Ice, and also carrying out major operations in Asia, Latin America, and Africa. In addition, the United States has supported programs that substitute other crops that can be harvested as alternatives to opium in Pakistan, Thailand, and Turkey, and similar programs to displace coca production in Peru and Bolivia. Since 1990, the United States has shifted its international drug control efforts away from crop eradication, and increased its focus on keeping drugs from coming into the country and targeting major trafficking organizations. U.S. agents’ high level of involvement in international affairs, while deemed necessary by some if the United States is to effectively suppress the global drug traffic, is seen by others as a troubling side effect of the U.S. War on Drugs. Costing large sums of money and affecting lives across the globe, the U.S. expansion of drug control beyond its own borders has, some critics would argue, escalated the War on Drugs while doing relatively little to actually cut down on the amount of illicit drugs that reaches American streets. Howard Padwa and Jacob A. Cunningham

Drug Enforcement Administration. 2008. “DEA History in Depth.” http://www.usdoj .gov/dea/history.htm.

See also: Drug Addiction and Public Policy; Drug Enforcement Administration; Drug Smuggling; Drug Trafficking; Federal Bureau of Narcotics

Bacon, Donald C., Roger H. Davidson, and Morton Keller. 1995. The Encyclopedia of the United States Congress. New York: Facts on File.

Huggins, Laura E., ed. 2005. Drug War Deadlock: The Policy Battle Continues. Stanford, CA: Hoover Institution Press. Nadelmann, Ethan. 1993. Cops across Borders: The Internationalization of U.S. Criminal Law Enforcement. University Park: Pennsylvania State University Press.

United States National Narcotics Control Act (1956) Passed by the U.S. Congress in July 1956, this act established minimum sentences for selling narcotics and prohibited probation as a sentencing option in those cases. It even allowed the death penalty in certain cases for narcotics offenders. The act put travel restrictions on drug addicts as a way to reduce drug trafficking and created a Division of Statistics and Records to gather and disseminate information on narcotics that could help law enforcement efforts in the drug control area. Ron Chepesiuk

Further Reading

Further Reading Carson-Dewitt, Rosalyn, ed. 2001. Encyclopedia of Drugs, Alcohol & Addictive Behavior. 2nd ed. New York: Macmillan Reference USA. Chepesiuk, Ron. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO.

United States. v. Doremus and Webb et al. v. United States United States v. Doremus and Webb et al. v. United States were two landmark 1919 Supreme Court cases that upheld the constitutionality of the 1914 Harrison Narcotics

United States. v. Doremus and Webb et al. v. United States  935

Act. These cases gave the federal government the latitude it needed to prosecute both doctors who dispensed narcotics for questionable medical purposes, and also addicts themselves. According to the Harrison Act, people needed to have a stamp issued by the government if they were going to have narcotics in their possession. One exception, however, was for patients who received the drugs after getting a prescription from their physician. The law stipulated that these medical professionals could only prescribe narcotics “in good faith” and “in the course of . . . professional practice”—wording that was designed to prevent them from giving out prescriptions to recreational users or addicts. In a 1916 Supreme Court ruling, United States. v. Jin Fuey Moy, however, the government suffered a setback in its efforts to enforce the law as the Court found that a doctor who had prescribed morphine to an addict was not in violation of the act’s provisions. In the years immediately following Jin Fuey Moy, however, attitudes towards narcotics and addiction became more severe. After the United States entered World War I, many began to fear that a number of soldiers coming home from the battlefields of Europe would return with drug addictions that began when they took morphine as a painkiller. In addition, the movement towards alcohol prohibition was gaining momentum, and there was concern that alcoholics, when denied access to liquor, would switch over to narcotics. Fear of communism, which gripped the United States in the aftermath of the Bolshevik Revolution in Russia, also played a role in increased anxiety over drugs, as alarmists feared that drug habits could lead to degeneration and make the United States more vulnerable to a communist conspiracy. The fact that rates of addiction among the wealthy and middle classes declined thanks

to the Pure Food and Drug Act of 1906 and the Harrison Act fed these fears, as the addict population shifted towards the social margins by the end of World War I. All of these factors converged to harden attitudes towards addiction and drug users. The consequences of these changes became clear in 1919, when the Supreme Court made two landmark decisions in the Doremus and Webb cases. United States v. Doremus involved the prosecution of Charles T. Doremus, a San Antonio physician who, in March 1915, provided 500 tablets of heroin to Ameris, an addict who was not suffering from any disease other than addiction, and Doremus did so without filling out the proper forms required by the Harrison Act. Beyond not keeping proper records and providing narcotics simply to feed addiction, Doremus could have been feeding the black market, since he provided Ameris with such a large amount of drugs that he could not only use them, but also sell them to others illegally. When Doremus was charged, the District Court found him innocent, claiming that the Harrison Act was unconstitutional since it was being used as more than just a revenue measure. According to the lower court, this use of the Harrison Act constituted an unjust encroachment of federal police powers into states’ jurisdictions, since Doremus’s actions did not significantly compromise the federal government’s ability to collect tax revenue. The Supreme Court, however, disagreed. In its ruling, issued in March 1919, the Court found that the Harrison Act indeed allowed the federal government to punish those who dispensed narcotics without a revenue stamp, and also that it could stipulate under what circumstances physicians could provide narcotics to patients. The Court supported the Treasury Department’s claim that physicians could only give out prescriptions

936   United States. v. Doremus and Webb et al. v. United States

for controlled drugs in the course of their “professional practice.” According to the ruling, providing narcotics to a patient without a prescription was illegal, and Doremus was found guilty. The constitutionality of the Harrison Act on these grounds, therefore, was upheld. Webb et al. v. United States involved the case of two individuals in Memphis—a doctor (Webb) and a druggist (Goldbaum). The government claimed that Webb prescribed morphine to addict patients too freely—not to alleviate pain from a disease or to provide them with small amounts of morphine so they could wean themselves off of the drug, but rather in amounts large enough that they could continue to use the drug as much as they pleased. Even though Webb was writing prescriptions as a physician, he was doing so in a manner that, according to authorities, facilitated addiction instead of curing it. Goldbaum, the druggist, filled prescriptions written by Webb, even though he knew that many of Webb’s scripts were being used to feed addicts’ drug habits. The issue for both Webb and Goldbaum was whether or not prescribing and dispensing narcotics to known addicts just to maintain their addiction was within the bounds of the law. Evidence that the two were knowingly giving drugs to addicts was convincing, as Webb wrote prescriptions for over 4,000 individuals to receive morphine, and Goldbaum filled 6,500 of them in an 11-month period. Even though Webb wrote prescriptions in accordance with the law, and Goldbaum possessed the revenue stamps required by the Harrison Act, the District Court found them guilty of conspiracy to violate the law since they were dispensing such a large amount of narcotics to such a large number of people. When Webb and Goldbaum took their case to Washington, D.C., the Supreme Court heard the case, and upheld the conviction. Some members of

the Court believed that Webb and Goldbaum should have been innocent because they followed the letter of the law. The majority, however, held that Webb and Goldbaum were not acting in good faith to cure addiction, but rather facilitating it by prescribing and dispensing narcotics so liberally. The majority opinion held that the actions of Webb and Goldbaum went not against the letter of the Harrison Act, but against its intention, which was to eliminate addiction and drug use—not legally facilitate it. After the Doremus and Webb decisions, many of the doctors who had prescribed narcotics to addicts became more prudent in their prescription habits, and many of the narcotic clinics that had sprung up after the Harrison Act took effect closed. In the 1920s, the Webb ruling was upheld in United States v. Behrman, and though the Supreme Court opened a window for a different understanding of the Harrison Act in Linder v. United States, the interpretation of the Harrison Act in the Webb decision remained the law of the land. Consequently, many addicts, now without any legal channels to obtain their drugs, turned to the black market for narcotics, which grew substantially in the 1920s. Howard Padwa and Jacob A. Cunningham See also: Harrison Narcotics Act; Linder v. United States; United States v. Jin Fuey Moy

Further Reading Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Cambridge, MA: Harvard University Press. Musto, David F. 1987. The American Disease Origins of Narcotics Control. New York: Oxford University Press. United States v. Doremus. 249 U.S. 86 (1919). Webb et al. v. United States. 249 U.S. 96 (1919).

United States v. Flores-Montano (2004)  937

United States v. Flores-Montano (2004) Flores-Montano was attempting to cross the border between the United States and Mexico in a 1987 Ford Taurus station wagon. When he approached the border in Southern California, the U.S. Customs inspectors noticed that he seemed unusually nervous and that his hands were shaking. He was asked to leave the vehicle, which was then taken to a secondary inspection site. One of the agents was examining the car when he tapped the gas tank with a screwdriver. The tapping made a noise that made the tank seem solid. A drug-sniffing dog also alerted to the vehicle, indicating the presence of drugs. A mechanic was called in, and within less than a half hour, a mechanic disassembled the fuel tank, finding 37 kilograms (a little over 81 pounds) of marijuana bricks inside. Flores-Montano was later indicted in federal district court in California for one count of unlawfully importing marijuana and another count of possession of marijuana with the intent to distribute. Flores-Montano filed a motion to suppress the marijuana evidence, citing the lack of reasonable suspicion to remove the gas tank. He claimed the marijuana seizure was an illegal search and seizure, a violation of the Fourth Amendment to the U.S. Constitution. He argued that the search in which the marijuana was discovered was intrusive and nonroutine, and therefore did not meet the required reasonable suspicion to remove the gas tank. His attorneys pointed to a previous case that had been decided in 2002 by the U.S. Ninth Circuit Court of Appeals. The case, U.S. v. Molina-Tarazon (279 F.3d 709 [2002]), involved similar circumstances. In this case, the district court justices decided that the search was nonroutine and thus required reasonable suspicion. In other words,

reasonable suspicion was needed when law enforcement agents seek to perform an “intrusive” search, which this was. The justices decided that the government failed to prove that there was reasonable suspicion to justify a search. On appeal, the Ninth Circuit Court of Appeals affirmed. The question of the current case was simply this: does the Fourth Amendment (reasonable search and seizure clause) require that Customs officers at the international border have reasonable suspicion in order to remove, disassemble, and search a vehicle’s gas tank for illegal material? Upon appeal to the U.S. Supreme Court, certiorari was granted in 2003. The Court rejected the logic of both the district and appellate courts and reversed the lower court decisions. They argued that “the reasons that might support a requirement of some level of suspicion in the case of highly intrusive searches of the person—dignity and privacy interests of the person being searched—simply do not carry over to vehicles.” In doing so, the Supreme Court found the Ninth Circuit’s decision to be inconsistent with the meaning of “reasonableness” under the Fourth Amendment. The decision in the case was written by Chief Justice Rehnquist. He wrote that the government has an interest in preventing unwanted people from entering the country at the international border. He wrote, “Time and again, we have stated that ‘searches made at the border, pursuant to the longstanding right of the sovereign to protect itself by stopping and examining persons and property crossing into this country, are reasonable simply by virtue of the fact that they occur at the border.’ United States v. Ramsey, 431 U.S. 606, 616 (1977).” Further, he made note that Congress “has granted the Executive plenary authority to conduct routine searches and seizures

938   United States v. Jin Fuey Moy (1916)

at the border, without probable cause or a warrant, in order to regulate the collection of duties and to prevent the introduction of contraband into this country.” In all, the government has the authority to protect its territory. Further, Rehnquist noted that “smugglers frequently attempt to penetrate our borders with contraband secreted in their automobiles’ fuel tank.” According to Rehnquist, the expectation of privacy is less at the border than it is in the interior. “It is difficult to imagine how the search of a gas tank, which should be solely a repository for fuel, could be more of an invasion of privacy than the search of the automobile’s passenger compartment.” In sum, the chief justice wrote, “For the reasons stated, we conclude that the Government’s authority to conduct suspicionless inspections at the border includes the authority to remove, disassemble, and reassemble a vehicle’s fuel tank. While it may be true that some searches of property are so destructive as to require a different result, this was not one of them. The judgment of the United States Court of Appeals for the Ninth Circuit is therefore reversed, and the case is remanded for further proceedings consistent with this opinion.” Nancy E. Marion

Further Reading United States v. Flores-Montano. Legal Information Institute, Cornell University Law School. http://www.law.cornell.edu/supct/ html/02–1794.ZO.html. United States v. Flores-Montano. Oyez, Chicago-Kent College of Law. http://www .oyez.org/cases/2000–2009/2003/2003 _02_1794/. United States v. Ramsey, 431 U.S. 606, 616 (1977). Justia, U.S. Supreme Court. http://supreme.justia.com/cases/federal/ us/431/606/case.html.

U.S. v. Molina-Tarazon (279 F.3d 709 [2002]). Legal Information Institute, Cornell University Law School. http://www.law.cornell .edu/supct/html/02–1794.ZO.html.

United States v. Jin Fuey Moy (1916) The 1915 Supreme Court case United States v. Jin Fuey Moy was the first test of the constitutionality of the 1914 Harrison Narcotics Act, which was the first sweeping federal legislation controlling the sale and traffic of narcotics in the United States. The case marked a setback for the Treasury Department, which was charged with enforcing the provisions of the Harrison Act. The act was titled “An act to provide for the registration of, with collectors of internal revenue, and to impose a special tax upon, all persons who produce, import, manufacture, compound, deal in, dispense, sell, distribute, or give away opium or coca leaves, their salts, derivatives, or preparations, and for other purposes.” According to the act, people needed to have a stamp issued by the government if they were going to have narcotics in their possession. One exception was made for those patients who received the drugs after getting a prescription from their physician. The law stipulated that these medical professionals could only prescribe narcotics “in good faith” and “in the course of . . . professional practice”—wording that was designed to prevent them from giving out prescriptions to recreational users or addicts. The law, however, was ambiguous on some key questions. There were many questions as to what “good faith” meant. For example, if a doctor believed that a person’s addiction was a disease, could that doctor provide the patient with narcotics? Could doctors, then, give drugs to addicts, or was that not

United States v. Jin Fuey Moy (1916)  939

a “legitimate” medical treatment? Law enforcement officials within the Treasury Department stated that the Harrison Act forbid physicians from prescribing narcotics for the purpose of treating an addiction. In the following months after the Harrison Act went into effect, the government charged many doctors and pharmacists (and addicts) for distributing narcotics illegally. They were charged on the grounds that they were acting against the law. In December 1915, a case involving Jin Fuey Moy, a doctor from Pittsburgh who prescribed morphine to an addict named Willie Martin, reached the Supreme Court. The government claimed the prescription was not for medical treatment and was not intended to treat the patient’s addiction problems. The legal question of the case was whether the possession fell within the prohibitions of the Harrison act. According to the government, the prescription was not issued in “good faith,” and also Martin did not have one of the required revenue stamps. The United States also argued that Martin illegally possessed drugs, making him guilty of violating the Harrison Act. The district judge had disagreed with the government’s arguments. The judge claimed that Martin only consumed drugs, and did not import, export, or sell them, he did not break the law and was innocent of the charges against him. Just possessing a drug was not convincing evidence enough to show he acted illegally. Yet, the federal government argued the act was passed with two orders to carry out the International Opium Convention (38 Stat. at L. 1929). Further, Congress had disguised it as a tax to mask its constitutionality. However, the act was truly a policing measure that strained Congressional powers. In the 1916 ruling, the Supreme Court agreed with the district judge. The majority

opinion stated that since it was a revenue act that was administered by the Treasury Department, the Harrison Act did not apply to possession. Justice Holmes, who wrote the majority opinion, argued that it could be assumed that the law has both moral and revenue ends, but the court was in agreement with the lower district court that those ends can only be reached through a revenue measure. Second, even if for a moment the scope and intent of the act were lost, the argument of the government would not be convincing to the Supreme Court. Third, the Supreme Court decided that if the act were interpreted literally, more citizens than originally intended would be subject to acting in violation of the law. Since the Harrison Act was strictly a revenue measure controlling drug transfers, the court concluded that the government could not charge Martin and Moy. There were two justices, Justice Hughes and Justice Pitney, who dissented from the majority opinion. The ruling outraged the Treasury Department, which complained that the ruling would make it difficult to monitor narcotics effectively because of difficulty in bringing cases against addicts, recreational drug users, and the doctors and physicians who supplied the drugs. The ruling invalidated the convictions of many people who had been found guilty of violating the Harrison Act, as well as federal officials who wanted to find a way to regulate the possession of narcotics with a government-issued stamp. In 1919, in Webb et al. v. United States and United States v. Doremus, the Treasury Department got its wish in allowing for a stricter interpretation of the Harrison Act. Jin Fuey Moy was charged with violating the Harrison Act again in 1920, and this time, because of the Webb decision, he was found guilty. Howard Padwa and Jacob A. Cunningham

940  Urinalysis See also: Harrison Narcotics Act; United States v. Doremus and Webb et al. v. United States

Further Reading Belenko, Steven R., ed. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press. Jin Fuey Moy v. United States. 241 U.S. 394 (1916). Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press.

Urinalysis Urinalysis is the process of testing a person’s urine to detect the use of drugs or their metabolites. The test can be as simple as using test strips that turn color if drugs are present. Or the process can be much more complex. One type of testing kit is called enzyme multiplied immunoassay technique. This is a commercial test that scans for major controlled substances. Another technique is the GC/MS method, which relies on vaporized urine to identify banned substances. Drug tests are reported as a pass/fail. Many employees are required, as part of their job, to undergo random drug testing. This may apply to bus drivers, school teachers, those who operate heavy machinery, those who work with sensitive material or who carry weapons as part of their tasks. Some employers are drug testing potential or new hires to determine if the person has used, or is currently using, drugs. Other employers require urinalysis if there is a reason to believe an employee has been abusing a drug, or after an accident occurs. If an employer requests a drug test from an employee, the employee must go to a particular lab or doctor’s office and provide a sample in a secure

cup with tamper-resistant tape. The sample must travel through a “chain of custody” to ensure there is no tampering with the sample. If a sample shows evidence of tampering, it may be rejected. It is then tested in a lab and screened for drugs. Some employers use on-site, instant drug testing for an initial screening. If an employee’s results are positive, then the employee is sent for a more complex lab analysis. Those offenders on probation and parole, depending on their offense, must undergo urine drug testing as part of their sentence. In the federal system, if an offender refuses to take a drug test, the probation or parole will be automatically revoked. A commonly used urine test is called a 10-Panel Urine Screen that instantly screens a person’s urine for 10 drugs: amphetamines (meth or methamphetamine), barbiturates, benzodiazepines, buprenorphine, marijuana (THC and synthetic THC), cocaine, methadone, methaqualone, opioids (including codeine, morphine, heroin, and oxycodone), PCP, and others. Drugs are excreted from the body in the urine after it is processed in the liver and kidneys. If the drugs are water soluble they are passed through the kidneys and excreted in urine. Generally, the larger the quantity of a drug, the more quickly the body will attempt to eliminate it. However, this is not true of alcohol, which is processed at a constant rate no matter how much alcohol is ingested. Urine tests for marijuana test for levels of THC, which is detectable in the urine after the smoker no longer feels high or is showing any effects of use. THC can remain in the body for several days after smoking even a small amount; and several weeks if there has been long-term use of the drug. Athletes are often drug tested by urinalysis to test for the presence of illegal substances. Since drugs are usually stable in

Urinalysis  941

frozen urine, the samples can be stored for long periods in case the results are appealed. The “detection window,” or the amount of time that a drug can be detected in urine, depends on many factors, including the amount of drug used, how often the drug is used, an individual’s metabolism, as well as their body mass, the size of the individual, age, and overall health. The chart below indicates the time for which a drug will be detected in urinalysis. Urine is considered to be abandoned property because it was expelled from the body and abandoned. The issue of urine testing was indirectly decided in Schmerber v. California (1966). This case involved a blood-alcohol test of a nonconsenting driver. While the court decided that simply taking blood of a person was an illegal search and seizure that violated the Fourth Amendment, such a test would be allowable if there was probable cause to conduct such a test. The decision from the Schmerber case was then applied to urine, so that the state has the right to obtain a person’s urine as part of its regulatory function.

The legality of urine drug tests were again tested in National Treasury Employees Union v. Von Raab (489 U.S. 656 [1989]). In this case, certain employees at the U.S. Customs Service were to be tested for drug use. Those employees who were to be tested included those who carried firearms, had access to classified material, or would be involved in the interdiction of drugs. The employees argued that drug urine tests violated the Fourth Amendment and was an illegal search (because there was no warrant). In their decision, the Court argued that drug use was a part of society, and any Customs agent who used drugs was in danger of being bribed or blackmailed. Moreover, the test would be held in a way that guaranteed an agent’s privacy. In sum, the Court agreed that those individuals who are employed in certain sensitive jobs, or those that could be considered to be high risk, could be legally drug tested as a way to maintain the integrity of the agency, as well as the safety of the employee and society. Analysis of hair is now being used in instead of, or to accompany, urine testing to determine a person’s possible drug use. This

Drug

Detection period

Alcohol

½ to 1 day

Amphetamines

1–7 days

Cocaine (occasional use)

6–12 hours

Cocaine (repeated use)

up to 48 hours

Ecstasy

3–4 days

LSD

2–24 Hours

Marijuana (casual use)

5–7 days

Marijuana (daily use)

10–15 days

Marijuana (heavy use)

1–2 months

Heroin

2–4 days

OTC cold medications

48–72 hours

Steroids

3–30 days

942  Urinalysis

is because testing hair shows evidence of drug use over a longer time span, up to a few months. Moreover, hair analysis is nonintrusive, it is more difficult to tamper with the sample, and there is a higher accuracy of results. Nancy E. Marion See also: Drug Abuse; National Treasury Employees’ Union v. Von Raab

Further Reading Inciardi, James A., Duane C. McBride, and James E. Rivers. 1996. Drug Control and

the Courts. Thousand Oaks, CA: Sage Publications. Levinthal, Charles F. 2012. Drugs, Behavior, and Modern Society. Boston: Allyn and Bacon. Psychemedics Corporation. “Advantages Over Urinalysis.” http://www.psychemedics.com /advantages-over-urinalysis/. “Urinalysis.” 2010. Black’s Medical Dic­ tionary, 42nd Edition. London: A&C Black. http://www.credoreference.com.ezproxy .library.ipfw.edu/entry.do?id=9629735.

V state, the director of the Bureau of Prisons or other officer must notify state and/or local law enforcement authorities (section 20417). Drug trafficking in rural areas was the topic of Title XVIII. The bill authorized appropriations for rural drug enforcement assistance. The attorney general was authorized to establish a Rural Drug Enforcement Task Force in specific areas. The director of the Federal Law Enforcement Training Center was required to develop training programs for law enforcement officers from rural agencies in the investigation of drug trafficking and related crimes. In other provisions of the bill:

Violent Crime Control and Law Enforcement Act (1994) The Violent Crime Control and Law Enforcement Act of 1994 was a far-reaching and comprehensive act that made a multitude of changes in the criminal justice system. The program authorized $30.2 billion for law enforcement and crime prevention programs, including programs geared toward community policing and violence against women. It funded an increase in correctional facilities, as well as more alternatives to prisons for nonviolent young offenders. The bill also included a “three strikes” provision and an assault weapons ban. Signed by President Clinton, the bill had many provisions related to drugs. One of the main provisions of the 1994 bill focused on drug courts. Title V devised a grant program to support state and local drug courts that provide special services to offenders suffering from drug addictions and who have been identified as having strong potential for rehabilitation. In 1995, the bill made $29 million available, with $971 million authorized in the period between 1996 and 2000. Drug treatment for inmates was also part of the bill. The law made $383 million available for prison drug treatment programs. In Section 20414 of the bill, the director of the Administrative Office of the U.S. Courts (Administrative Office) was required to establish a program of drug testing of federal offenders who were placed on postconviction release. If prisoners convicted of drug trafficking are released or relocated to a

• Grants to local governments for education and prevention programs related to the use and sale of illegal drugs by juveniles. • Imposition of the death penalty for specified drug-related offenses, particularly related to drug trafficking. • Enhanced penalties for inmates who trafficked drugs within a federal prison and for drug dealing in “drug-free” zones. • A yearly report of the effectiveness of the federal drug control strategy submitted by the director of the Drug Control Policy Office, or drug czar. The report would include an assessment of the reduction of drug use, drug availability, and the consequences of drug use. The director was also to examine addiction and rehabilitation research. 943

944   Vollmer, August (1876–1955)

• Increased penalties for using children to distribute drugs near school and playgrounds. Nancy E. Marion

Further Reading H.R. 3355 (103rd), Violent Crime Control and Law Enforcement Act of 1994. http://www .govtrack.us/congress/bills/103/hr3355. McCollum, Bill. 1995. “The Struggle for Effective Anti-Crime Legislation—An Analysis of the Violent Crime Control and Law Enforcement Act of 1994.” University of Dayton Law Review 20 (Winter).

Vollmer, August (1876–1955) August Vollmer was the police chief of the Berkeley (California) Police Department from 1905 to 1932. He served as the first professor of police administration at the University of Chicago from 1929 to 1930, and he was a professor of criminology at the University of California at Berkeley. He served for one year as the police chief of the Los Angeles Police Department (1923–1924) and he was the president of the International Association of Chiefs of Police from 1921 to 1922. A progressive-minded chief and a key advocate for the police professionalization movement, Vollmer often held viewpoints that ran counter to many of his contemporary police chiefs. He was against police brutality and their use of the “third degree”; he opposed the death penalty; and he did not believe that law enforcement was the proper response for illicit drugs in America. Vollmer’s career in law enforcement began in 1905 after gaining the notice of the publisher of a local newspaper in Berkeley. The publisher, Friend Richardson, told Vollmer of the corrupt town marshal. Policing at that time was not a credible profession

and despite being discouraged from running, Vollmer decided to challenge the incumbent and won by a landslide. Marshal Vollmer would be reelected in 1907 by another landslide, and then in 1909, Berkeley changed its charter and became a city with an appointed chief of police, to which Vollmer remained appointed until 1932, when he retired. Along the way, Vollmer was asked to conduct reviews of various police departments, for which he took leave. In 1923 he was asked to lead the Los Angeles Police Department for one year. Then in 1929, the University of Chicago hired him to be a professor of police administration in their public administration program. When he retired in 1932 as chief of police, he took a similar professorship at the University of California at Berkeley, a post in which he served until 1938. It was during Vollmer’s career as a police chief in which he earned his reputation as a progressive reform-minded chief, who moved policing from its old corrupt and brutal ways into the more professional model of the late 20th century. Vollmer spent much of his time working with his officers to perfect police procedures and adopting technology for police practices. He was an early proponent of deploying all of his police officers on bicycles, then motorcycles, then automobiles. He worked with his police officers to advance the use of communications systems, including an early red-light-recall system that let officers know to either call the station, or later, through Morse code, where to respond. He advanced the use of the polygraph in policing, two-way radios in the automobile, and he helped to create the first nondedicated crime lab in America at Berkeley (1917) and the first dedicated crime lab in America in Los Angeles (1924). He was also the first to apply the use of intelligence tests to screening for police officers, and he was a strong advocate for a Bureau of Iden-

Vollmer, August (1876–1955)  945

tification, first for California and later for the United States. In addition to technology, Vollmer was also a firm believer in police training and education. He began by creating weekly in-service training classes every Friday afternoon and implementing a police academy for training new recruits. In 1916, working with members of the University of California, he created the first criminology program that was aimed at providing his police officers with a degree in higher education, emphasizing police administration, and the application of scientific principles to policing. All of this led him to become the first professor of what would today be called criminal justice (it was called criminology at the time, but the focus was on police science). Vollmer was a firm believer that police officers, like doctors, dentists, and lawyers, should be well trained and well screened in order to secure their position and that, like those other professions, policing was a calling in life. As a Progressive, Vollmer also held some views that ran counter to his fellow police chiefs across the country. While many still advocated the use of the third degree—beatings in order to elicit confessions—Vollmer found this type of behavior reprehensible. In addition, while America was reaching its all-time high use of recorded executions through the death penalty, Vollmer came out against the death penalty as a sentence, favoring life in prison without parole. Chief Vollmer did not believe that vice was an appropriate police problem, another viewpoint that ran counter to many of his contemporaries. Vollmer felt that police should only focus on bona fide crime, deal with problems of disorder, and provide assistance when needed. He reluctantly agreed that the police should be involved in traffic enforcement, but only because there was no other appropriate agency. However, Vollmer be-

lieved that vice was a behavioral and moral issue that would better be dealt with by the religious organizations, social workers, and health care providers. He believed one of the most significant problems with police dealing with the societal ills of vice is that the police often became corrupt. Vollmer argued that vice needed to be overcome by education, not enforcement. He also argued that in order for a law to be enforced, it must be agreed upon by the entire community. Rape, robbery, and murder can be seen by all people as being unacceptable, but for many, prostitution, gambling, and drugs were not see as something socially or morally wrong. Hence, society was not unified in its opposition. He also found that those who did organize against vice, such as illegal narcotics, rarely saw things as they were; they were instead blinded by their attitude-based prejudices. He argued that it is difficult to solve any problem if people chose not to deal with facts. Vollmer did point out that people were actually in agreement over the “social menace” of narcotics, and most people wanted it outlawed. In his book, The Police in Modern Society, he noted that the very fact narcotics were taboo drove them underground into a black market making it a difficult crime to enforce. Vollmer went on to explain that this creates a game mentality among the drug dealers in how best to smuggle in the drugs and sell them on the street. This becomes a drain on police resources for an intractable problem. He concludes that to those in policing, “it is plain that the elimination of this vice is impossible, but by use of effective educational methods and by the reclamation of early users when this is possible, the number of those who practice it may be reduced” (Vollmer 1936, 116). He also acknowledges that the idea of hospitalizing all addicts would be the humane thing

946   Volstead, Andrew (1860–1947)

to do, but that the economy of scales prevents this from occurring. Vollmer articulates something that was just as true in his time period as it is today: “Stringent laws, spectacular police drives, vigorous prosecution, and imprisonment of addicts and peddlers have proved not only useless and enormously expensive as means of correcting this evil, but they are unjustifiably and unbelievably cruel in their application to the unfortunate drug victims” (Vollmer 1936, 117). Vollmer thus recommends something that was controversial in his time and would be just as controversial if argued today: “the establishment of federal control and dispensation—at cost—of habitforming drugs.” Professor Vollmer argued that with the profit motive gone, the pushers would disappear and the abusive users could be targeted for more selective treatment. Vollmer’s ultimate conclusion is this: “Drug addiction, like prostitution, and like liquor, is not a police problem; it never has been, and never can be solved by policemen. It is first and last a medical problem, and if there is a solution it will be discovered not by policemen, but by scientific and competently trained medical experts whose sole objective will be the reduction and possible eradication of this devastating appetite” (Vollmer 1936, 118). Vollmer, through his leadership as a police chief, his writings, and the many disciples he educated, influenced American policing for the rest of the 20th century. While many of his ideas were deemed radical at the time, they came to encapsulate what is today considered to be good quality and professional policing. Although Vollmer’s views on narcotics were, and still are, radical, it is curious to ponder if his views on illicit drugs were not prescient. Willard M. Oliver See also: Decriminalization; Legalization

Further Reading Carte, G. E., and E. H. Carte. 1975. Police Reform in the United States: The Era of August Vollmer, 1905–1932. Berkeley: University of California Press. Douthit, N. 1975. “August Vollmer, Berkeley’s First Chief of Police, and the Emergence of Police Professionalism.” California Historical Quarterly 54(Spring): 101–24. Oliver, W. M. 2008. “August Vollmer.” In Icons of Crime Fighting, ed. Jeffrey Bumgarner, 83–115. Westport, CT: Greenwood Publishing. Parker, A. E. 1961. Crime Fighter: August Vollmer. New York, NY: The MacMillan Company. Parker, A. E. 1972. The Berkeley Police Story. Springfield, IL: Charles C. Thomas Publisher. Vollmer, A. 1922. “Aims and Ideals of the Police.” Journal of the American Institute of Criminal Law and Criminology 13(2): 251–57. Vollmer, A. 1933. “Police Progress in the Past Twenty-Five Years.” Journal of Criminal Law and Criminology 24(1): 161–75. Vollmer, A. 1936. The Police and Modern Society. Berkeley: University of California Press. Vollmer, A., and A. Schneider. 1917. “The School for Police as Planned at Berkeley.” Journal of the American Institute of Criminal Law and Criminology 7(6): 877–98. Wilson, O. W. 1953. “August Vollmer.” Journal of Criminal Law, Criminology, and Police Science 44(1): 91–103.

Volstead, Andrew (1860–1947) Andrew Volstead was born to Norwegian immigrants on October 31, 1860, in Kenyon, Minnesota. He attended and graduated from local public schools, after which he enrolled in St. Olaf’s College in Northfield, Minnesota.

Volstead, Andrew (1860–1947)  947

Andrew Volstead, a member of the House of Representatives from Minnesota, is known for proposing the National Prohibition Act, or the Volstead Act. (Library of Congress)

He transferred to Decorah Institute in Iowa, from which he received his degree in 1881. Andrew Volstead became the county prosecuting attorney for Granite Falls, Minnesota, in 1886. He served in that position from 1887 to 1893 and then again from 1895 to 1903. In 1900 he was elected to serve as the town’s mayor, serving in that position until 1902. In addition to these tasks, Volstead served as the city attorney and as a member and president of the local Board of Education. Volstead was elected to the U.S. House of Representatives in 1903, where he served until 1923. While there, he was a strong supporter of civil rights and was one of the few politicians in Congress to argue for federal legislation against lynching. Andrew Volstead is most well known as being the author of the Volstead Act, officially known as the National Prohibition Act of 1919, which was the enforcement provi-

sion of the Eighteenth Amendment to the U.S. Constitution (the Prohibition amendment). The official title of the Volstead Act was “An act to prohibit intoxicating beverages, and to regulate the manufacture, production, use, and sale of high-proof spirits for other than beverage purposes, and to insure an ample supply of alcohol and promote its use in scientific research and in the development of fuel, dye, and other lawful industries.” The title specified three distinct purposes of the law: prohibiting intoxicating beverages; regulating the manufacture, production, use, and sale of high-proof spirits for other than beverage purposes; and ensuring an ample supply of alcohol for scientific research and in the development of fuel, dye, and other lawful industries. The Volstead Act was quite lengthy, over 25 pages long, and many of its provisions were confusing and complicated. Specifically, the Volstead Act established that “no person shall manufacture, sell, barter, transport, import, export, deliver, furnish or possess any intoxicating liquor except as authorized by this act.” It did not, as is sometimes popularly portrayed, prohibit the purchase or consumption of intoxicating liquors. This meant that those who had stockpiled large quantities of alcoholic beverages could legally consume them, even after Prohibition went into effect. Under the Volstead Act, people could ingest alcoholic beverages in their own homes or in the home of a friend. Alcohol could be purchased if a doctor wrote a medical prescription for it. Under this provision, a pint of alcohol could be purchased once every 10 days. Liquor could be stored in a home, as long as it was for the use of a family only, but it could not be given as a gift or received as a gift from another person. Volstead himself abstained from drinking alcohol, but he never made a temperance

948   Volstead Act (Eighteenth Amendment)

speech. He ran for reelection in 1922, but was defeated. He then returned to Granite Falls, where he briefly practiced law until 1924, when he was appointed to serve as legal adviser to the chief of the National Prohibition Enforcement Bureau. He did this until Prohibition was repealed in 1933. He then returned again to Granite Falls where he practiced law until the age of 83. Nancy E. Marion See also: Eighteenth Amendment; Prohibition; Prohibition Party; Prohibition Unit; Temperance; Volstead Act

Further Reading “Alcohol Problems and Solutions. The Volstead Act.” http://www2.potsdam.edu/hans ondj/Controversies/Volstead-Act.html# .Uu6YZq-A2M8. “Andrew Volstead (1860–1947): The Father of Prohibition.” Norwegian-American Hall of Fame. http://www.lawzone.com/half-nor/ volstead.htm. National Archives. 2014. “Teaching with Documents: The Volstead Act and Related Prohibition Documents.” http://www.archives .gov/education/lessons/volstead-act/. “Volstead, Andrew Joseph.” 2001. Columbia Encyclopedia, 6th ed. http://www.bartleby .com/65/vo/Volstead.html.

Volstead Act (Eighteenth Amendment) The Eighteenth Amendment to the U.S. Constitution ushered in national alcohol prohibition, but it was not until the 1920 passage of the Volstead Act that the new ban on the sale or commercial manufacture of alcoholic beverages was officially implemented as federal law. The Volstead Act was passed by Congress under the title of the National Pro-

hibition Act, but it was popularly known as the Volstead Act because of the support and sponsorship given to the bill in the House of Representatives by Congressman Andrew Volstead of Minnesota. The name of the act is a bit of a misnomer, however, as its chief author was not Volstead, but rather Wayne B. Wheeler, the general counsel and chief Washington lobbyist for the Anti-Saloon League of America (ASL). The ASL was a highly professional and organized lobby dedicated to the single issue of temperance, and the nonpartisan political pressure it applied translated into a broad base of power that extended to the point of being able to draft national prohibition legislation. The Volstead Act prohibited the sale or commercial manufacture of alcoholic beverages, and it enabled the enforcement of national prohibition, with the Bureau of Internal Revenue taking the lead. The law empowered the Bureau of Internal Revenue, which became the Internal Revenue Service in the 1950s, to fine brewers or distillers $1,000 for a first offense, or jail them for six months. Second offenses carried punishments of $10,000 and five years of jail time. The Volstead Act was not supported by President Woodrow Wilson who vetoed the bill when it first came to his desk in 1919. His veto was based upon a general opposition to altering the U.S. Constitution. If Americans were unhappy with alcohol, he believed, it should have been the responsibility of state and local authorities—not the federal government—to institute tighter controls over its sale and consumption. Wilson’s argument and opposition became a moot point, however, as Congress overrode his veto by a 176 to 55 vote, thus making the Volstead Act, and thereby national prohibition, federal law on January 20, 1920. However, with the passage of the Volstead Act, all alcohol did not instantly become illegal. The act permitted Americans to retain

Volstead Act (Eighteenth Amendment) 

all alcohol purchased before July 1, 1919, though these beverages could only be consumed in the home. As a result, many people rushed to purchase as much alcohol as they could before the summer of 1919, and hoard it so they could continue drinking after prohibition took effect. In addition, the Volstead Act also allowed men and women to manufacture their own wine and hard ciders, as long as these drinks were consumed in the home by members of the family. The law permitted an adult to produce 200 gallons of such drinks each year. So-called “near beer” (a brew that contained less than 0.5 percent, compared to 3 to 5 percent in regular beer) was also permissible under the law. Additionally, alcohol could still legally be produced by factories for medicinal purposes. Sacramental wines remained legal, too, with the Volstead Act authorizing, for example, each Jewish family to have one gallon of wine per year per adult. Some of these exceptions were seized upon by those who still enjoyed drinking alcohol. Since up to 200 gallons of wine or hard cider per year could be produced within the home, many Americans transformed their places of residence into houses of alcohol production. The Volstead Act thus had the unintended consequence of driving many Americans not to sobriety, but rather to drinking at home. In a more marked defiance of the Volstead Act, speakeasies offered the experience of drinking in a bar or club for those who illicitly wanted to imbibe alcohol outside of the home. By 1925, New York City alone had anywhere between 30,000 and 100,000 speakeasies. Despite these infractions, the Volstead Act was somewhat effective, as levels of alcohol consumption did decrease overall during Prohibition. However, the Volstead Act’s prohibitions on sales or commercial manufacturing of alcoholic beverages were transgressed so

often that the court system became jammed with cases. Reports from the time noted that 22,000 persons were convicted of violating the Volstead Act in the first 18 months after its passage. By 1926, the number of such cases increased to 37,000. In general, as Prohibition continued, there were growing rates of violation of the Volstead Act. Nationally, 44 percent of cases brought against U.S. citizens between 1920 and 1933 involved violations of the Eighteenth Amendment and the Volstead Act. In North Carolina, West Virginia, Minnesota, and Arkansas, the figure was 50 percent or greater. In southern Alabama, the center of moonshine production, the figure was as high as 90 percent. In 1928 and 1929, the Justice Department reported that Prohibition cases accounted for almost two-thirds of all federal district court criminal cases and over half of all civil suits against the government. In order to try and combat the growing lawlessness that Prohibition had generated, the Volstead Act was modified in 1929 by stiffening penalties for infractions against it, but this failed to increase the effectiveness of the law. The Volstead Act’s days were numbered when Franklin Delano Roosevelt became the Democratic Party’s candidate for president in 1932. The Association Against the Prohibition Amendment had by that point convinced the Democrats to make repealing the Eigh­ teenth Amendment a part of the party’s platform. Just over a week into his presidency, Roosevelt asked the Senate to modify the Volstead Act so as to allow the manufacture and sale of beer and light wines. Two days later, on March 16, 1933, the Senate followed through with Roosevelt’s request, effectively killing the Volstead Act. Prohibition was fully overturned with the final ratification of the Twenty-First Amendment on December 5, 1933, making legal once again the manufacture and sale of hard alcohol. Howard Padwa and Jacob A. Cunningham

949

950   Volstead Act (Eighteenth Amendment) See also: Anti-Saloon League; Association Against the Prohibition Amendment; McCoy, Bill; Prohibition; Prohibition Party; Prohibition Unit; Woman’s Christian Temperance Union

Further Reading Burns, Eric. 2004. The Spirits of America: A Social History of America. Philadelphia: Temple University Press.

Clark, Norman H. 1976. Deliver Us from Evil: An Interpretation of American Prohibition. New York: W. W. Norton. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee.

W production has increased dramatically on the domestic front, in Mexico, and especially in Canada, where Asian groups are reportedly beginning to dominate high-potency marijuana wholesale distribution systems. The drug war is estimated to cost the United States about $45 billion a year. However, many say this figure does not take into account hidden costs such as the disruption in lives that occurs when people are imprisoned for minor drug infractions, the diversion of police away from attending to more serious crimes, or the tensions and outright conflicts that arise with other nations over drug interdiction policies. Drugs are known to finance terrorism—especially the highly lucrative and productive poppy fields of Afghanistan—and the country’s resurgent Taliban, which U.S. intelligence officials acknowledge is connected to the al-Qaeda organization, takes full advantage of the lush crop whose production levels continue to rise. The DEA reported in 2001 that the Taliban built its financial base from heroin trafficking, using it as a major source of funding. In 2006, the Taliban increased opium production by 57 percent over the previous year despite the presence of 35,000 NATO troops in the country. The figures for 2007 were even worse. Critics cite these statistics, and many others that are equally disturbing, to support their contention that the War on Drugs has been lost. They suggest that the key to controlling rampant drug manufacture, distribution, and use is to reduce demand, and the way to do that is to legalize—or at least decriminalize—the drugs. They argue that this

War on Drugs In terms of official U.S. policy, the War on Drugs began in the late 1960s and early 1970s under the administration of Richard Nixon, who declared illicit drugs to be “public enemy number one in the United States.” The Controlled Substances Act (CSA) that was passed in 1970 as a result of this declaration of war categorized different classes of drugs according to their potential for abuse, prescribed penalties for distribution and use, and laid out the legal parameters of the drug war. In 1973, shortly after the passage of the CSA, the Drug Enforcement Administration (DEA) was created to combine previous federal drug-fighting organizations under the Department of Justice. The Anti–Drug Abuse Acts of 1986 and 1988 redefined mandatory sentencing laws for possessing, using, or selling drugs, and an Office of National Drug Control Policy was created under a national drug “czar” for coordinating federal drug policies. Many critics of the War on Drugs say it is nothing more than an attempt to infringe on personal rights by prohibiting people from using certain substances. In this respect, they say, it is no different from the Prohibition Act of the 1920s that banned alcohol and, just as that legislation proved to be a spectacular failure, so is the drug war. Statistics seem to support this allegation. Despite hundreds of billions of dollars spent on interdiction and law enforcement efforts, demand for drugs of abuse remains staggeringly high, especially in the United States, Europe, and the Far East, and it continues to grow. Marijuana 951

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would topple the profit structure that fuels international crime and ensure that the drugs that do get into users’ hands are untainted. It would also provide substantial tax revenues that could be diverted to treatment rather than to the incarceration of users who perpetrate victimless drug crimes. However, other experts and some members of the general public insist the War on Drugs must continue. They believe that decriminalization would lead to vastly increased rates of drug abuse and give tacit permission, especially to adolescents, that using psychoactive substances is acceptable. Few, if any, politicians have the courage to argue in favor of decriminalization for fear of being branded pro-drug, and others state that dismantling the huge bureaucracy that the DEA represents at home and abroad is too disruptive and daunting a process, despite what some say is the overall ineffectiveness of the agency’s efforts. In fall 2002, drug decriminalization or legalization initiatives were on the ballot in several states. Widespread passage was expected but because of a strong grassroots movement by parents, antidrug coalitions, and law enforcement, four of the six initiatives failed. The results were: Arizona: 57 percent of voters killed a plan that would have made state law enforcement the broker for medicinal marijuana. Nevada: 61 percent of voters opposed a proposal that would have allowed anyone to possess up to 3 ounces of marijuana. Ohio: 67 percent opposed a proposal that would have allowed nonviolent drug offenders to seek treatment instead of serve jail time. South Dakota: 62 percent of voters defeated an industrial hemp initiative. Washington, D.C.: 78 percent of voters approved an initiative that would offer drug

rehabilitation instead of prison for some nonviolent offenders. San Francisco: 63 percent approved a measure to have the city study growing and dispensing marijuana for medical purposes. Kathryn H. Hollen See also: Controlled Substances Act; Decriminalization; Drug Trafficking; Legalization; Medical Marijuana

Further Reading Bauder, Julia. 2008. Drug Trafficking. Detroit: Thomson Fisher, Gary L. Rethinking Our War on Drugs: Candid Talk about Controversial Issues. Westport, CT: Praeger, 2006.

Webb et al. v. United States (1919) Webb et al. v. United States was decided by the U.S Supreme Court in 1919, and involves provisions of the Harrison Narcotic Drug Act that gave physicians the right to prescribe narcotics to patients. The courts, however, interpreted this to mean that the prescriptions would be given within the course of normal treatment, not for the treatment of addiction. Webb was a practicing physician and Goldbaum was a retail druggist who were convicted and sentenced in the District Court of the United States for the Western District of Tennessee on the charge of conspiracy to violate the Harrison Narcotics Act. It was the regular custom of Webb to prescribe morphine for habitual users without considering the patients’ individual cases. The quantities Webb prescribed were sufficient to help the patient continue feeding their addiction rather than to end it. Goldbaum was familiar

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with Webb’s practice and regularly filled the prescriptions. Both men were duly registered as the act required: Webb paid the special tax while Goldbaum also paid the special tax and kept all records required by the law. Webb and Goldbaum reached an agreement by which the latter would legally procure a stock of morphine that would be available to Webb’s patients. It was the men’s intent that morphine be furnished to habitual users without any good faith attempt to cure the morphine addiction. The Court ruled that the Harrison Act prohibited the retail sales of morphine by druggists to persons without a prescription or to persons who could not obtain such prescriptions and that such prohibitions were not unconstitutional. Likewise, the act outlawed the prescribing of morphine by physicians for the purpose of maintaining a person’s customary use; such prescriptions were only allowed in cases of attempted cures. Nancy E. Marion See also: Harrison Narcotics Act; Morphine

Further Reading Webb v. U.S. 1919. Findlaw. http://caselaw.lp .findlaw.com/scripts/getcase.pl?court=US& vol=249&invol=96.

Webb-Kenyon Act (1913) The 1913 Webb-Kenyon Act was an important milestone in the early-20th-century antiliquor campaign that both secured prohibition laws previously passed at the local and state level, and also helped pave the way for national prohibition in 1920. The Webb-Kenyon Act’s passage in 1913 was presaged by decades of antiliquor activ-

ity and legislation. Perhaps most important in the lead-up to the passage of the WebbKenyon Act were the temperance activities of the Anti-Saloon League of America (ASL) and the Woman’s Christian Temperance Union, which resulted in the creation of many local-option ordinances across the country. The ASL, in particular, focused on pushing for local-option elections, by means of which voters could determine whether saloons in their districts should be granted or denied licenses to sell alcohol. Focusing on various local-option elections—as opposed to larger, all-or-nothing state and federal campaigns—gave temperance advocates the flexibility to concentrate their efforts on winnable elections, and in this way they were able to effectively extend prohibition, piece by piece, to parts of states that had, as a whole, resisted going dry. By additionally working to elect local and state politicians sympathetic to prohibition, they built a coalition of politicians and voters willing to extend local prohibition laws. As a result of these advances on the local and state level, antiliquor forces were successful in getting nine states to pass statewide prohibition laws by 1913. Despite these local-option successes, prohibition advocates were frustrated by the continued presence of alcohol in areas that, by law, should have been alcohol-free. Though prohibition was in place, liquor dealers in wet states found exporting their alcohol into dry states to be an extremely lucrative business. Dry states became prime target areas for expanding alcohol sales, thus jeopardizing prohibitionist gains that had been made via local-option elections. In order to prevent the influx of alcohol into dry states, the ASL went beyond their local- and state-level success and focused on federal law. Since the federal government regulated interstate commerce—the recently passed,

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antiprostitution Mann Act of 1910 clearly evidenced this—antiliquor advocates extended their fight against booze by attacking the transportation of intoxicating beverages on a federal level with the Webb-Kenyon Act. The act made it a federal crime with serious penalties to transport alcohol from wet states into states where booze was legally prohibited. Such a law was necessary to cement existing state prohibition laws because enforcement officers in dry states had no power over interstate commerce, and as such were essentially impotent when it came to stopping shipments of alcohol that were legally manufactured elsewhere across state lines. On a certain level, the Webb-Kenyon Act’s passage was a result of effectively casting it as a state’s rights bill. By stating that the bill would bar the entry of liquor into any state if the alcohol was to be used in a way that violated state law, the ASL presented the Webb-Kenyon Act in a manner palatable to wet states who resented federal control. This framing suggested that the nature of the bill was merely to allow state prohibition laws to operate without the interference of the federal government. As a result, Southern wets who were resentful of federal raids on moonshiners did not vehemently oppose the bill. The Webb-Kenyon Act thus figured simultaneously as agreeable federal legislation and an important strengthening of existing state prohibition laws. The primary architect of this adroitly framed act was Senator William Squire Kenyon of Iowa, who personally abstained from drink and believed that temperance legislation was in the nation’s best interests. The Webb-Kenyon Act’s other namesake sponsor was Edwin Webb, a dry congressman from North Carolina who pushed it through the U.S. House of Representatives. At first, the bill that the two men helped pass

was summarily vetoed upon reaching the desk of President William Howard Taft, who was a vocal opponent of legal prohibition. Senator Newell Sanders of Tennessee, however, promptly got enough members of both houses of Congress to override Taft’s veto, making the Webb-Kenyon Act federal law in 1913. The Webb-Kenyon Act’s status as federal law was not truly solidified, however, until Wayne Wheeler, the powerful national attorney of the ASL and true author behind the Volstead Act, successfully defended the constitutionality of the Webb-Kenyon Act in front of the Supreme Court in a 1917 test case. Emboldened and encouraged by the Webb-Kenyon Act, whose passage ultimately could not be stopped despite even a presidential veto, the ASL sponsored a “Jubilee Convention” later in 1913 in which the antiliquor movement declared that it would thereafter work towards a constitutional amendment for national prohibition. Five states passed state prohibition laws against alcohol in 1914, five more followed suit the next year, and four more states did the same in 1916. Twenty-six states had statewide prohibition laws by the time the nation began fighting in World War I. The Eighteenth Amendment was ratified in January 1919, and national prohibition became effective the following year. Howard Padwa and Jacob A. Cunningham See also: Anti-Saloon League; Eighteenth Amendment; Prohibition Party; State Drug and Alcohol Control Laws; Volstead Act; Woman’s Christian Temperance Union

Further Reading Lender, Mark Edward. 1984. Dictionary of American Temperance Biography: From Temperance Reform to Alcohol Research, the 1600s to the 1980s. Westport, CT: Greenwood Press.

Whiskey Rebellion  955 Mendelson, Jack. H., and Nancy K. Mello. 1985. Alcohol: Use and Abuse in America. Boston: Little, Brown and Company. Murdock, Catherine Gilbert. 1998. Domesticating Drink: Women, Men, and Alcohol in America, 1870–1940. Baltimore: Johns Hopkins University Press. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee. Rose, Kenneth D. 1996. American Women and the Repeal of Prohibition. New York: New York University Press.

Whiskey Rebellion The Whiskey Rebellion was a violent uprising that took place in 1794, primarily in Pennsylvania. Americans were angered by Secretary of the Treasury Alexander Hamilton’s 1791 decision to levy a federal tax on whiskey distillers. Only after President George Washington assembled a force of 15,000 militiamen to put down the rebellion was the tax reluctantly paid. The suppressed rebellion evidenced the authority of the federal government to tax whiskey production,

but it also marked the beginning of a tradition of underground whiskey production, often referred to as moonshining. The Whiskey Rebellion’s origins can be traced back to Congress’s 1791 decision to levy a seven-and-a-half-cent tax for each gallon of whiskey that was distilled from American grain. The tax soon increased to nine cents—and if the alcohol was produced from an imported product, such as molasses—the tax could reach 11 cents per gallon. Hamilton’s measure also included a fee of 60 cents per year for each gallon of capacity in a farmer’s still. It is likely that Hamilton viewed these taxes as a key component of the nation’s health, both fiscally and physically. Historians have argued that Hamilton’s measure may have been motivated by the need to finance the nation’s continuing conflict with Native Americans and by the desire to curb America’s level of alcohol consumption. At Hamilton’s request, the federal government had assumed the states’ debts from the Revolutionary War, and the federal government was also saddled with the costs of defending the country against attacks from Native Americans. Hamilton thought that a tax on spirit distillation would help the

During the Whiskey Rebellion of 1794 a government inspector is covered with tar as a protest against a new tax. (Bettmann/Corbis)

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United States cope with its debts and operating costs. Additionally, Hamilton, who drank infrequently, possibly envisioned the tax as having a positive impact on the nation’s well-being, as he believed that the extreme consumption of ardent spirits had a deleterious impact upon the physical, moral, and economic health of communities. Hamilton’s views were not universally held, however. Thomas Jefferson considered the tax a mistake, and farmers opposed its imposition on the grounds that it represented both an unfair financial burden on poor farmers and an unacceptable violation of their rights. With tax collectors effectively empowered by the federal government to inspect farms for hidden or untaxed spirits, farmers felt the federal government was overstepping its bounds. Farmers were also troubled by this new federal tax: farmers who wished to challenge a tax collector’s assessment would have to leave their farm and travel to a distant federal court. The popular resistance to the tax was most vociferous in southwestern Pennsylvania, where, it has been estimated, 25 percent of America’s stills were located. Farmers there announced that they had no intention of paying the tax, and that if tax collectors wanted to avoid a violent confrontation, government agents should stay away. When government revenue agents did try to enforce the law, they were often met with strong resistance. In Allegheny County, there were accounts of a federal marshal being attacked, and of a mob setting fire to a regional tax inspector’s home. Numerous other fires, beatings, and attacks took place in the region; tarring and feathering tax collectors was a very common tactic of the angry farmers. Attacks were not focused exclusively on outsiders who attempted to enforce the tax, however, as farmers who cooperated with federal authorities and paid taxes on their distilled spirits are

known to have been attacked by their rebel neighbors. Their crops and animals were stolen or slaughtered, and their homes and barns were broken into and damaged by mobs. In Washington County, one man was even attacked at knifepoint for allowing a building he owned to be used as a tax office. Though focused in Pennsylvania, acts of violence were not relegated to that state’s southwestern corner. Unhappiness with the tax extended west, as frontier farmers felt the tax was a challenge to their way of life, which, in many cases, involved using whiskey as a local currency for barter exchange. As a result, protesters from North and South Carolina, Virginia, and Kentucky joined Pennsylvanians in physically opposing the tax’s implementation, often invoking the analogy of the Stamp Act of 1765, a British tax viewed by colonial Americans as unreasonably harsh and which helped spark the Revolutionary War. By 1794, the Whiskey Rebellion had reached new heights of violence and organization. In July of that year, 500 to 700 members of the Mingo Creek, Pennsylvania, militia clashed with soldiers from Fort Pitt, who were headed by Major James Kirkpatrick. In the bloody fight, which took the lives of combatants from both sides, the most significant casualty was James McFarlane, the militia’s commander. Undeterred by his death, on August 2 some 7,000 rural protestors marched on Pittsburgh in a show of continued defiance to Hamilton’s tax. In response, President Washington amassed a force of 13,000 to 15,000 militiamen from eastern Pennsylvania, Maryland, Virginia, and New Jersey. Under the leadership of Revolutionary War general and Virginia governor Henry Lee, and with Washington and Hamilton accompanying, this immense army overwhelmed the insurgents. Washington dispatched three peace negotiators to meet with representatives of the rebellion, thus securing

White, Walter 

an end to the Whiskey Rebellion before the army reached Pittsburgh. The rebels scattered in advance of the army’s arrival, and the federal government contented itself with capturing 20 men for trial in Philadelphia. Two of them, John Mitchell and Philip Vigol, were convicted of treason and sentenced to death, though Washington eventually pardoned them both. By that point, the federal government had quashed resistance, enforced the unpopular tax, and effectively demonstrated its authority. The government’s power was not absolute, however, as moonshiners began to covertly produce whiskey in response. Thus, the failure of the Whiskey Rebellion marked the beginning of both federal control over, and a tradition of underground production of, whiskey. Howard Padwa and Jacob A. Cunningham See also: Alcohol Bootlegging and Smuggling; Eighteenth Amendment; Volstead Act

Further Reading Barr, Andrew. 1999. Drink: A Social History of America. New York: Carroll & Graf Publishers. Burns, Eric. 2004. The Spirits of America: A Social History of America. Philadelphia: Temple University Press. Rorabaugh, William J. 1979. The Alcoholic Republic: An American Tradition. New York: Oxford University Press.

White, Walter With 6 years on television, 5 seasons, 170 award nominations, and 51 awards won, Breaking Bad is nothing short of one of the most well-produced and well-received television shows ever created. The show revolved around a high school science teacher from Albuquerque, New Mexico, named

Walter White (played by Bryan Cranston) who, after being diagnosed with terminal cancer and looking for a way to help his family financially, begins to cook extremely high-quality crystal meth. Along with his former student and partner, Jesse Pinkman (played by Aaron Paul), White works his way through the drug underworld and eventually becomes notorious for his signature blue, high-quality meth. This draws him much unwanted attention from not only the law but also other criminals. Despite these adversaries, White is able to make millions of dollars by creating his product and becomes the most powerful meth cook around. Although the show had assistance from chemists from both the world of academia and the Drug Enforcement Administration, to ensure the accuracy of the chemistry in the show, the story is mostly fiction. While the idea that there is a mild-mannered high school science teacher who uses his knowledge of chemistry to create the purest and highest-quality meth around, who eventually is able to take down large, international drug cartels and remain free from the clutches of the law may appear to be fantasy, there is some truth behind it. Walter White, the real Walter White, is from Tuscaloosa County, Alabama. Since the late 1980s he has been cooking the highest-quality meth ever seen in the area, being called by some as being not only a meth cook, but a “meth chef.” He started the operation as a side venture to make some extra money along with the regular income that he was making in the construction business. After some time, he realized that the money that he was making from cooking meth outweighed the money from construction, so he quit his regular job to cook meth full time. Making thousands of dollars each day, White was able to spend money on things that he was never able to have before.

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“Looking back now,” White says, “it’s hard to believe that I could go through that much money in one day.” But for all the benefits, the meth business eventually drove a wedge between White and his family. Eventually he was arrested and was allowed to undergo treatment at the Foundry Rescue Mission & Recovery in Bessemer, Alabama, a faithbased, long-term recovery system. In 2014 White will go on trial and if convicted, will face a sentence that could put him in prison for the rest of his life. Although he may not be a “Heisenberg,” the real Walter White does share some qualities with the fictional one. He never had to kill international drug lords or use his wife’s car-washing business to launder millions of dollars, but he did make quite a living for himself and was eventually stopped by law enforcement after becoming the top name on the most wanted list. But for all the similarities, the real Walter White was in the meth business and the money business, but the fictional one was in neither. He was in the empire business. Jacob A. Marion See also: Drug Trafficking; Meth Labs; Methamphetamine; Television and Drugs

Further Reading “‘Breaking Bad’: Vince Gilligan on Meth and Morals.” 2011. NPR. September 29. http:// www.npr.org/2011/09/19/140111200/ breaking-bad-vince-gilligan-on-meth-and -morals. Dorn, Lori. 2013. “The Real Walter White: The True Story of the Best Meth Cook in Alabama.” Laughing Squid, December 18. http://laughingsquid.com/the-real-walter -white-the-true-story-of-the-best-meth -cook-in-alabama/. Gilligan, Vince. Breaking Bad. AMC. 2008 –2013.

Gordon, James. 2013. “Meet the REAL Walter White: Meth Dealer with the Same Name as Breaking Bad Character Managed to Dodge Police for Years to Become One of Most Wanted Figures in His Home State of Oklahoma.” Mail Online, November 28. http://www.dailymail.co.uk/news/articl e-2515380/Meet-real-life-Walter-White .html.

White House Conference for a Drug-Free America The White House Conference for a DrugFree America was a way to bring together many different people from the public and private sectors who were knowledgeable about issues relating to drug abuse education, prevention and treatment, and the production, trafficking, and distribution of illicit drugs. The conference had several goals, one of which was simply to share information and experiences that the actors have had in vigorously and directly attacking drug abuse at all levels—local, state, federal, and international. This way, the attendees were aware of what has been tried, what has worked, and help devise new ideas to fight drug abuse. The second goal of the conference was to increase public attention to different approaches to drug abuse education and prevention that have had much success in stopping the abuse of illegal and harmful drugs. Attention was also to be given to different treatment methods that have shown promise in enabling drug abusers to become drug free and remain that way. The third goal of the conference was to emphasize the dimensions and extent of the drug abuse crisis, and to examine the prog­ ress that has been made by all types of agencies in dealing with the crisis. This way, a

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new national strategy could be developed to halt the sale and solicitation of illicit drugs and to treat drug abuse. The fourth goal of the conference was to spend time examining the primary role that parents and other family members play in the basic causes of drug abuse and in successful treatment efforts. The final goal of the conferences was to focus public attention on the importance of fostering a widespread attitude of intolerance for illegal drugs and their use throughout all segments of the society. President Reagan designated the heads of the appropriate departments found within the executive branch, and the heads of military departments to participate in the conference. The president also invited the relevant federal, state, and local officials to take part, as well as private entities such as organizations, businesses, and individuals who were experts in some area of drug abuse. President Reagan asked the members of the conference to review many different aspects of the drug problem. He wanted the conference members to examine the effectiveness of local, state, and federal law enforcement officials in preventing the sale of illicit drugs and the need to establish greater coordination of such programs that might lead to fewer drug sales. The members of the conference were also to examine how drug abuse was affecting the education of students in the United States. Along those lines, the conference members were asked to examine the extent to which drug abuse education programs available on the federal, state, and local levels could be reorganized or modified so that they make better use of available resources and to ensure greater coordination among such programs. The impact of current laws related to efforts to control drug trafficking by international and domestic law enforcement was an

area for the committee to review, as was the extent to which the sanctions in the Foreign Assistance Act of 1961 either had been, or should have been, used as a way to encourage other countries to comply with their international agreements revolving around controlled substances. Other responsibilities of the committee were to review the circumstances that contributed to the onset of drug use by youth, and to review the available methods for creating drug-free segments of society, such as public transportation, public housing, media, business, workplace, and other areas identified by the conference. Finally, the conference was given the task of preparing a report for the president and Congress that would include the findings and some recommendations for making improvements in the areas listed above. They were to suggest possible legislative action that would be needed to implement their recommendations. For three years after that, the president was asked to make a report to the Congress on the status and implementation of the recommendations made by the conference members. Nancy E. Marion See also: Drug Abuse; Reagan, Ronald, and Nancy Reagan

Further Reading U.S. White House, Office of the President. 1987. “Executive Order 12595—White House Conference for a Drug Free America.” May 5. http://www.reagan.utexas.edu/ archives/speeches/1987/050587e.htm.

White House Conference on Narcotics and Drug Abuse Held in September 1962, this conference was the first ever to deal with the problem of

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narcotics and drug abuse. It lasted two days and was attended by an estimated 500 people who had a variety of backgrounds including police, psychiatrists, and government officials. The meeting showed how little the United States knew about narcotics and drug abuse. Seeking to make an initiative to deal with the problem, President John F. Kennedy appointed an official President’s Advisory Commission on Narcotics and Drug Abuse on 16 July 1963, which became known as the Prettyman Commission. Ron Chepesiuk See also: Drug Abuse; Kennedy, John F.

Further Reading Jonnes, Jill. 1996. Hep-Cats, Narcs and Pipe Dreams. New York: Scribner. President’s Commission on Organized Crime. 1986. America’s Habit: Drug Trafficking and Organized Crime.

Wilson, William G. (“Bill W.”) (1895–1971) So immediate were the euphoric effects of alcohol when he was introduced to the substance in the early 1900s that William Griffith Wilson, the founder of Alcoholics Anonymous (AA) who continues to be known affectionately within the organization as “Bill W.,” said he had “found the elixir of life.” Several years later, as a desperately ill alcoholic undergoing detoxification, he had a spiritual experience that convinced him God was showing him a path to healing; from that moment on, he wrote, his recovery from alcoholism began. Despite a family history of alcoholism and marriage to Lois Burnham, a young woman who had earlier been involved in the temperance movement, Wilson made drinking a part

of his life. As a soldier, then a businessman, he used alcohol to celebrate happy occasions or to alleviate his chronic depression, and he showed unmistakable signs of compulsive drinking very early in his drinking career. Although he managed to get through law school despite showing up drunk for his exams, he was too intoxicated to receive his diploma during commencement exercises and was not allowed to graduate. He went into business instead and initially did quite well, but gradually his alcoholism began to destroy his life. In less than 20 years, he went from being a healthy, successful young stock analyst to an unemployable alcoholic living on the charity of his in-laws. In 1934, during his fourth incarceration at Manhattan’s Towns Hospital where he was undergoing withdrawal from acute alcoholism, he was treated by William D. Silkworth (1873–1951), a neurologist regarded with great affection and esteem for his compassion and early support of the disease concept of alcoholism. After crying out in despair for help, Wilson claimed to have had a transcendent experience—a bright light and a feeling of great peace flooded through him. When Wilson expressed to Silkworth his worry that the experience might have been nothing more than a hallucination associated with the DTs, the doctor urged him to view the event as divine and to use it as a tool for healing. If he did not, Silkworth warned, Wilson would either die or be incarcerated forever with alcoholic psychosis. Newly determined, Wilson remained sober for months, but was badly tempted to drink again during a business trip to Akron, Ohio. Acting on his hunch that if he could talk to another alcoholic, perhaps they could remain sober together, he arranged to meet with a local Akron physician and struggling alcoholic named Robert Smith (1879–1950). Talking for hours, they discovered that

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bringing two or more alcoholics together could, indeed, help them both remain sober, and it was in this realization that the concept of AA was born. Wilson began hosting meetings with alcoholics in his home focused on extending mutual support, accepting their own powerlessness over alcohol, and recognizing the need to yield control of their lives to a higher power—conceived of, by most members, as God. By 1937, when Wilson and Smith had shown that their program had helped 40 alcoholics become sober, they decided to formalize their message. Two years later, both in an effort to raise operating funds and to publicize their successful program more widely, Wilson began writing the official text of their fledgling organization. Originally titled Alcoholics Anonymous, the book is more familiarly known as The Big Book and is widely read and discussed in AA meetings all over the world. It contains stories of recovering alcoholics, lists the 12 steps to recovery that Wilson and Smith developed, and affirms that the only requirement for membership in AA is the desire to quit drinking. Although Wilson has a well-deserved reputation as a social architect of great consequence for his contribution to public health, he is reported to have had an inflated ego and grandiose opinions that some found distasteful. However, the record also shows that he refused an honorary law degree from Yale University, and, named one of the 20th century’s 100 most important people by Time magazine, he maintained the anonymity principle of AA by refusing to allow his photograph to appear on the cover of the magazine. Unable to overcome an addiction to nicotine, Wilson died in 1971 of emphysema and pneumonia. He described himself as a man who, “because of his bitter experience, discovered, slowly and through a conver-

sion experience, a system of behavior and a series of actions that works for alcoholics who want to stop drinking.” Once Wilson left Towns Hospital in 1934, he never drank alcohol again. Kathryn H. Hollen See also: Addiction; Alcohol Use; Alcoholics Anonymous; Alcoholism; Recovery; Smith, Robert Holbrook (“Dr. Bob”); Treatment

Further Reading Alcoholics Anonymous. 1976. Alcoholics Anonymous (The Big Book), 3rd ed. New York: Alcoholics Anonymous World Services. Cheever, Susan. 2004. My Name Is Bill. Bill Wilson: His Life and the Creation of Alcoholics Anonymous. New York: Simon & Schuster. Wing, Nell. 1998. Grateful to Have Been There: My 42 Years with Bill and Lois, and the Evolution of Alcoholics Anonymous, rev. ed. Center City, MN: Hazelden Foundation.

Withdrawal from Drug Use Often cited as a symptom of addiction, many experts regard withdrawal as rebound hyperexcitability, a period during which the brain struggles to rebalance its normal level of neurotransmitters that had been disrupted by the artificial stimulus of drugs. Sometimes referred to in its early acute stages as detoxification, withdrawal varies depending on the nature of the drug. Symptoms are usually most pronounced during withdrawal from alcohol, opiates, sedatives, and anxiolytics, and less so during withdrawal from stimulants like amphetamines, cocaine, and nicotine. The classic signs— tremor, nausea, diarrhea, anxiety, and depression—can range from relatively mild, as

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in hangovers, to severe, as in seizures and hallucinations. In its early stages, withdrawal may require medical management in a hospital or residential facility where the patient can be monitored for adverse events and appropriate drugs such as tranquilizers or sedatives can be administered to alleviate some of the symptoms. In other cases, increasingly smaller doses of the addictive drug are given under tightly controlled conditions to wean the addict off the substance until he or she is stable. Detoxification can take a few days, although very severe cases may take longer. According to the American Psychiatric Association, the half-life of a substance—the time it takes to reduce the amount of a drug in the body by one-half—seems to predict the course of withdrawal; the longer the intoxicating effect of the substance persists, the longer it will take for withdrawal to be completed. Kathryn H. Hollen See also: Addiction; Hangovers

Further Reading Abadinsky, Howard. 2008. Drug Use and Abuse: A Comprehensive Introduction. Belmont, CA: Thomson/Wadsworth. Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton. Friedman, Lauri S. 2012. Drug Abuse. Detroit: Gale. Henderson, Harry. 2005. Drug Abuse. New York: Facts on File. Isralowitz, Richard E., and Peter L. Myers. 2011. Illicit Drugs. Santa Barbara, CA: Greenwood Press. Johnson, Bankole A. 2011. Addiction Medicine. New York: Springer. Karr, Justin. 2007. Drug Abuse. Detroit: Greenhaven Press.

Kerr, Ethan K. and Owen E. Gibson, 2009. Substance Abuse: New Research. New York: Nova Science Publishers. Klosterman, Lorrie. 2008. Drug Dependence. New York: Marshall Cavendish Benchmark. Miller, Peter G., and John Strang. 2010. Addiction Research Methods. Ames, IA: Wiley-Blackwell.

Woman’s Christian Temperance Union (WCTU) The Woman’s Christian Temperance Union (WCTU) was the 19th century’s most important temperance organization. In addition to its extensive anti-alcohol campaigns, the WCTU engaged in a variety of reform efforts, including women’s suffrage, making it the first mass movement of women in American history. The women’s crusade against alcohol began in the 1870s with somewhat spontaneous challenges by women to saloon keepers, initially in Hillsboro, Ohio, but also across the country. This loose movement of women gained greater organizational coherence with the founding of the WCTU in Fredonia, New York, in 1873. Under the leadership of its second president, Frances Elizabeth Willard (1829–1898), the WCTU played an important role in both the women’s suffrage and temperance movements. Willard’s stewardship, which began in 1879, transformed the WCTU from a fairly conservative group into a politically powerful organization with broad reform ambitions. Willard effectively expanded the WCTU’s initial mission of temperance into a multifaceted platform that attracted a much wider female membership base, with around 150,000 to 200,000 members and 10,000 local units at its height. Much of the WCTU’s success as a major union was the result of Willard’s leadership.

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A devout Methodist from Wisconsin, Willard rose to prominence as the first woman in the United States to become president of an institution of higher learning. After three years as dean of women at Northwestern University, Willard devoted herself full-time to temperance and suffrage work, helping put together the WCTU’s first national convention, which took place in Cleveland, Ohio, in 1874, and featured the union’s distinctive white ribbon emblem. In Willard’s WCTU, women labored hard on the local and state levels by sponsoring temperance speeches, organizing petitions, distributing prohibition ballots, and raising money for shelters. “Hatchetation,” the violent technique of physically attacking saloons carried out by more radical members like Carrie Nation, represented only a shortlived aberration from the union’s highly systematic and orderly reform efforts. One of Willard’s most significant actions was to advance a “Do Everything” policy for the WCTU in 1881. This mission effectively linked the temperance movement to a multitude of other causes, and the WCTU created between 35 and 45 separate “reform departments” to work on the various issues now a part of its expanded platform. The “Do Everything” WCTU featured departments that, among other things, pursued women’s suffrage, disseminated information on tobacco and narcotics, worked towards world peace, advocated prison reform, called for higher wages for workers, aided prostitutes, opposed gambling, worked to suppress the desecration of the Sabbath, called for grape juice to replace sacramental wine, fought against bigamy, and worked to assimilate immigrants, blacks, and Native Americans into mainstream society. Willard herself worked as the director of the Social Purity Department, which lobbied for laws against rape, prostitution, and sexual intercourse with women under the age of 18. With this much-

broadened platform, the WCTU attracted a far wider membership base than they might have been able to if they remained focused on the single issue of temperance. Perhaps the most important and successful reform department within the WCTU was the Department of Scientific Temperance Instruction, which promoted temperance education within the nation’s public school system. The literature that the WCTU produced for temperance curricula asserted that alcohol was a poison, and that people should never drink. Towards this end, the WCTU solicited the support, though it was sometimes only reluctantly given, of scientists. For instance, the prominent medical researcher Thomas D. Crothers developed Scientific Temperance Instruction materials for the WCTU to distribute in public schools. But his partnership with the WCTU was not exactly a perfect union, as Crothers was reluctant to accept a prohibitionist platform. Regardless, these efforts were successful in getting Congress to pass a law that made temperance education compulsory in all schools under federal control. Most of the WCTU’s efforts revolved around the notion of “home protection,” which stressed that alcohol was a women’s issue because liquor had a major impact upon domesticity. The WCTU argued that since the home was traditionally the woman’s domain, women should politically involve themselves in temperance activities; eliminating drunkenness would help improve family life. As a result of the theme of “home protection,” the WCTU was effectively able to link the temperance and women’s suffrage movements in a way that was highly attractive to thousands of women who were previously politically uninvolved. Despite significant political influence on the local and state levels, Willard was less effective in making the WCTU a national

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political power. Willard’s attempts to make the WCTU a political force for national prohibition revolved around the union’s 1884 endorsement of the Prohibition Party, which was founded in 1869 as a national temperance party by advocates who had grown frustrated with the ineffectual anti-alcohol efforts of the Republican and Democratic Parties. However, this temporary political alliance between the WCTU and the Prohibition Party led to the defection of many Republican women from the WCTU and the subsequent founding of a splinter, nonpartisan branch. The 1890s thus saw the diminution of the WCTU as a player in national politics. The WCTU fared even worse toward the turn of the century. Following Willard’s death in 1898, the WCTU would not find a leader as capable of mobilizing the group’s base. At the same time, financial woes for the WCTU compounded the difficulties generated by Willard’s passing. As a result, the AntiSaloon League of America (ASL) was primed to take over the lead of the temperance movement in the 20th century. Dominated by men, nonpartisan in its approach, and dedicated to the single political goal of national prohibition, the ASL effectively displaced the WCTU from the position of the nation’s most important temperance organization. The WCTU did not disappear: the union exists to this day. It became a charter member of the United Nation’s Non-Governmental Organizations, and the union’s chief publication, The Union Signal, lives on as a quarterly journal. The WCTU continues to oppose alcohol, tobacco, narcotics, and pornography, primarily through a variety of classroom education projects, including annual essay contests. Howard Padwa and Jacob A. Cunningham See also: Anti-Saloon League; Eighteenth Amendment; Prohibition; Prohibition Party;

Volstead Act; Women’s Organization for National Prohibition Reform

Further Reading Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Burns, Eric. 2004. The Spirits of America: A Social History of America. Philadelphia: Temple University Press. Lender, Mark Edward, and James Kirby Martin. 1982. Drinking in America: A History. New York: Free Press. Mendelson, Jack H., and Nancy K. Mello. 1985. Alcohol: Use and Abuse in America. Boston: Little, Brown and Company. Murdock, Catherine Gilbert. 1998. Domesticating Drink: Women, Men, and Alcohol in America, 1870–1940. Baltimore: Johns Hopkins University Press. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee. Szymanski, Ann-Marie E. 2003. Pathways to Prohibition: Radicals, Moderates, and Social Movement Outcomes. Durham, NC: Duke University Press. Woman’s Christian Temperance Union. 2008. “Issues of Concern.” http://www.wctu.org/ issues.html.

Women, Pregnancy, and Drugs Posing a substantial threat to a developing fetus, most addictive substances can cross the placental barrier uniting the mother and the unborn baby, resulting in a range of developmental or other problems such as fetal alcohol syndrome. If the mother repeatedly doses herself with addictive substances, the fetus is likely to become addicted as well and may suffer

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withdrawal symptoms after birth. Women should not drink if they are pregnant, planning to become pregnant, or could become pregnant (i.e., sexually active and not using an effective form of birth control). During pregnancy, the use of any drugs such as alcohol, nicotine, and other substances of abuse including prescription drugs can have very serious consequences depending on the drug in question and the degree to which the pregnant (or soon-to-be-pregnant) woman uses it. In the 1990s, the National Institute on Drug Abuse conducted a nationwide hospital survey to determine the extent of drug abuse among pregnant women in the United States. It showed that of the 4 million women who gave birth during the period, 757,000 (18.8 percent) women drank alcohol—among the most damaging drugs a pregnant woman can use—and 820,000 (20.4 percent) women smoked cigarettes during their pregnancies. The study also showed that 221,000 women (slightly over 5.5 percent) used illegal drugs while they were pregnant, most often marijuana and cocaine. An estimated 119,000 (2.9 percent) of the women reported using marijuana and 45,000 (1.1 percent) reported using cocaine. Rates of marijuana use were highest among women who were under 25 years of age, and the rates of cocaine use were higher among those who were 25 years and older. Generally, rates of any illegal drug use while pregnant were higher in women who were single, had less than 16 years of formal education, were unemployed, and relied on some public source of funding to pay for their hospital stay. The report also pointed to differences among ethnic groups in the use of drugs while pregnant. The estimated number of white women using illegal drugs during pregnancy was the largest at 113,000, with African American women at 75,000 and Hispanic women at 28,000; other groups composed the rest, about 5,000 women. As for legal drugs,

estimates of alcohol use were also highest among Caucasian women at about 588,000, compared to 105,000 among African American women and 54,000 among Hispanic women. Whites had the highest rates of cigarette use as well when compared to other groups: 632,000 for whites, 132,000 for African Americans, and 36,000 for Hispanics.

Alcohol Of the various drugs a pregnant woman might consume, alcohol is the most harmful to her fetus. Pregnant women are often told that whatever they drink, their fetuses drink as well, and babies undergoing critical organ and neurological development in the womb are exquisitely vulnerable to the damage alcohol causes. Ranging from mild to severe depending on the amount of alcohol the mother consumes and the stage of her pregnancy, the lifelong and often disabling effects are known collectively as fetal alcohol spectrum disorder or FASD. FASD represents a range of disorders from mild to extreme. Within this group are fetal alcohol syndrome, which affects babies the most severely and involves the worst birth defects and neurological problems, such as missing fingers or toes, facial deformities, small brains, and low IQ. Less severe forms of the FASD range of disorders are fetal alcohol effects, alcohol-related neurodevelopmental disorder, and alcohol-related birth defects. Alcohol use during pregnancy reduces blood flow to the fetus, causes chemical damage to fetal tissues, and produces toxic by-products during the breakdown of alcohol in the body. Although the highest risk is to babies whose mothers drink heavily, there is potential for harm even if pregnant women consume only a small amount of alcohol. Given the risks, and given that FASD— while 100 percent preventable—is the major cause of birth defects around the world,

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experts advise that abstinence is the safest policy. In 1981 and again in 2005, the U.S. surgeon general released advisories urging women who are pregnant or may become pregnant to avoid drinking entirely. The data on whether nursing mothers can drink is not entirely clear, although some evidence suggests that alcohol may reduce the quantity of breast milk.

Smoking and Nicotine Health experts are alarmed that the gap between the rate of women who smoke and that of men has narrowed. This is due, statistics show, to the fact that more men quit smoking than women. Even though women smoke fewer cigarettes per day and tend to smoke products with lower nicotine content, it appears that female teens are taking up smoking in greater numbers than their male counterparts. There is also some evidence that women’s rates of relapse are higher, which may be due in part to the fact that they do not seem to respond as well to nicotine replacement therapies. Other studies suggest that women’s fear of the weight gain that can accompany quitting reinforces their smoking habit and may influence decisions to reject drugs like Zyban that in themselves can promote weight gain. Many experts recommend that prevention messages should be expanded to address self-image concerns of teen girls and young women. In addition to information that stresses the health dangers of smoking, they suggest that these messages emphasize that smoking and the illnesses it causes are much less attractive than temporary weight gain. Women who smoke have a higher incidence of reproductive disorders and usually enter menopause earlier than nonsmokers. If they take birth control pills, their risks of side effects and complications from taking the pills increase significantly. If pregnant women smoke, the problems are com-

pounded. The nicotine in cigarettes crosses the placenta and can concentrate in the fetus, reaching levels 15 percent higher than those in the mother and causing the unborn child to become addicted and endure the distress of withdrawal, either after birth or when their smoking mothers stop breastfeeding. During gestation, the chemicals in cigarettes can deprive the fetus of oxygen and cause it to abort, a risk that is quadruple that of nonsmoking women. If the pregnancy continues to completion, the child may have a lower than normal birth weight, exhibit retarded development and learning difficulties later in life, or may even suffer from sudden death. In the last four decades, 94,000 infant deaths have been associated with mothers who smoked during pregnancy. Other studies suggest that the children of smoking mothers are more likely to develop conduct disorders and become smokers themselves. This raises the intriguing possibility that smoking during pregnancy and using other addictive drugs affect the child’s developing brain circuitry in ways that make him or her more vulnerable to addiction later in life.

Drugs Drug use during pregnancy can cause significant harm in addition to the baby’s small birth weight or the withdrawal he or she is likely to suffer. If the mother injects the drugs, there is a substantial risk of transmitting serious infections such as hepatitis or AIDS to the child. Babies born to mothers using cocaine seem to be at higher risk for various problems, which may be associated with prenatal neglect rather than damage specifically related to the drug. Specific drugs known to cause problems include:  1. Ecstasy, Rohypnol, ketamine, methamphetamine, and LSD may increase

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the chance of miscarriage and premature delivery.   2. Opiates can addict the fetus, leading to withdrawal symptoms from hours to days after birth, and may cause miscarriages or stillborn deliveries. Heroin is associated with small birth weight.   3. Amphetamines can produce heart defects. The use of marijuana during pregnancy does not appear to increase the risk of birth defects even though its active ingredient, THC, crosses the placental barrier. However, there is evidence that babies born to marijuana-using mothers showed signs of neurological problems. As preschool- and school-age children, they had a greater incidence of attention and memory deficits. Caffeine in any form—from coffee, tea, soft drinks, or chocolate—increases the risk of miscarriage. The data on the effects of addictive drugs other than alcohol and smoking-related chemicals on the developing fetus and the newborn baby during breastfeeding is incomplete. However, nursing mothers are advised not to take amphetamines, cocaine, heroin, or PCP, and must be informed of the many dangers of smoking or using alcohol. Antianxiety drugs, antidepressants, and antipsychotic medications, while safe for a pregnant or nursing mother if they are carefully administered under a physician’s supervision, remain in the fetal system for a longer period of time than other classes of drugs, and should be avoided if possible. Kathryn H. Hollen

ed. Whitehouse Station, NJ: Merck Research Laboratories. Califano, Joseph A., Jr. 2007. High Society: How Substance Abuse Ravages America and What to Do about It. New York: Perseus Books. Erickson, Carlton K. 2007. The Science of Addiction: From Neurobiology to Treatment. New York: Norton. Federal Trade Commission. 2007. “FTC Releases Reports on Cigarettes and Smokeless Tobacco.” http://www.ftc.gov/opa/2007/04/ cigaretterpt.shtm. Streissguth, Ann. Fetal Alcohol Syndrome: A Guide for Families and Communities. Baltimore: Paul H. Brookes, 1997. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. “Smoking and Tobacco Use.” http://apps.nccd.cdc.gov/osh_faq/topic.as px?TopicID=8. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2003. Targeting Tobacco Use: The Nation’s Leading Cause of Death. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General.

Further Reading

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. The Health Consequences of Smoking: A Report of the Surgeon General.

Beers, Mark H., Robert Porter, and Thomas Jones, eds. 2006. The Merck Manual, 18th

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention,

See also: Female Alcohol Use; Female Tobacco Use; Fetal Alcohol Syndrome

968   Women, Victimization,  and Substance Abuse National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 1988. Nicotine Addiction: A Report of the Surgeon General. U.S. Department of Health and Human Services, National Cancer Institute. http:// www.cancer.gov. U.S. Department of Health and Human Services, National Institute on Drug Abuse. 2006. Research Report Series: Tobacco Addiction. NIH Publication No. 06-4342, July. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Office of Applied Studies. 2007. Results from the 2006 National Survey on Drug Use and Health: National Findings. DHHS Publication No. SMA 07-4293. U.S. Environmental Protection Agency. 1992. Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders. Washington, DC: U.S. Environmental Protection Agency.

Women, Victimization,  and Substance Abuse There are many factors that contribute to the sexual victimization of women. One such factor is the role of alcohol and substance abuse. The effects that alcohol and substance abuse have on an individual can vary but most lead to feeling more comfortable in a given situation, less likely to notice risk, and more vulnerable because of an inability to respond to the environment or fight back physically. The goal is to understand the effects that alcohol and substance abuse can have on sexual victimization from the victim’s perspective. This does not mean that victims are responsible for the sexual assaults perpetrated against them. The 2005 Core Alcohol and Drug Survey found that 82 percent of victims of sexual as-

saults during one academic year were under the influence of drugs or alcohol. This is an incredibly high number of victims that were under the influence; however, what is even more startling was that 8.4 percent of women who experienced a rape were incapacitated due to alcohol or drugs (Krebs et al. 2009). This means that these victims had either passed out or were otherwise completely unable to respond in any way. Additionally, the frequency at which women reported getting drunk or using marijuana since entering college increased the odds of becoming an incapacitated sexual assault victim. When people are frequent drug users, they may find themselves in locations where an assault is more likely to occur. For example, Fisher, Sloan, Cullen, and Chunmeng (1998) found that students who regularly used recreational drugs increased their exposure to violent victimization. Drug and alcohol use create opportunities for violence since such use creates vulnerable targets and increases exposure to motivated offenders. Hence, someone who frequents bars or house parties and consumes alcohol would be at greater risk. Additionally, if a substance user entered a dangerous situation to obtain drugs or is involved in the sale of drugs, he or she would be at greater risk for sexual victimization. Alcohol and drug consumption can raise the risk of sexual assault through both physiological and learned effects. Physiological effects include decreased ability to process information and make judgments, impaired motor control, slurred speech, deterioration of reaction time, and loss of consciousness. Alcohol and drugs can affect a person’s decision making and risk perception, and can reduce stress. The stress reduction that occurs from drinking may inhibit someone from noticing risk cues that would have otherwise produced feelings of anxiety. This is referred to as “stress response dampening”

Women, Victimization,  and Substance Abuse  969

(Norris 2008). For example, if a woman were sober, she would be able to notice if she was given a drink that had significantly more alcohol than she was anticipating. This could lead that woman to feel uncomfortable or question the person who gave her the drink and avoid him. However, if this woman has become intoxicated, it may be more difficult to notice the increased alcohol in the next drink. She would not feel alarmed and would not try to avoid the situation. The effects of the alcohol and “stress response dampening” become more powerful as a person becomes more intoxicated. The same thing can happen if a woman is enjoying the company of a partner and does not recognize that he has become sexually aggressive. The fear that may initially motivate a woman to leave a situation may not occur because the alcohol stopped her from noticing the risk cues. Learned effects may also occur when someone is consuming alcohol based on the perception that culture has placed on drinking. A woman might expect that alcohol will make her more vulnerable or powerless; hence, if she wants others to perceive her as participating in drinking, she may act vulnerable. Similarly, she may also engage in uninhibited behaviors that she may not normally use to fit in with the others drinking around her. There is research that shows that the expected effects of drinking alcohol are important determinants of drinking and of the sexual outcomes that follow drinking (George and Stoner 2000). Such learned behaviors affect how a person will act even before he or she consumes any alcohol and can play a role in how that person might respond to unwanted sexual advances. It may also be difficult for a woman to resist an assault when she is under the influence of alcohol or drugs. If a woman recognizes that a man has become sexually

aggressive and makes her feel uncomfortable, her resistance is impacted by any alcohol or substances consumed. Alcohol can increase the feeling of being “paralyzed” or unable to move. It may also increase a woman’s “passive resistance” and make her feel as though she has to go along even if she does not want to. Women may become unconscious from alcohol or drug consumption, leaving them extremely vulnerable to being sexually assaulted. Women who do not usually consume large amounts of alcohol may be at even more risk because they do not have a high tolerance for alcohol and may experience side effects of alcohol rather quickly. The type of resistance that a woman responds with may also differ based on the level of alcohol she has consumed. She may respond with “polite resistance,” such as distraction or verbal response, instead of an “assertive resistance,” such as yelling, hitting, or kicking. The fact that her reaction to fear has been lowered by the alcohol can prevent a woman from using assertive resistance in a sexual assault. The more intoxicated a woman becomes, the more she may feel uncertain and embarrassed about the situation and may not be able to resist the attack. There is very little data about the specific effects that voluntary substance use of drugs other than alcohol have on a victim that would lead to a sexual assault. Many studies have found a link between them but have not examined the effects of the drugs that lead to being victimized. The most common drugs that were taken voluntarily before a sexual assault occurred were marijuana, cocaine, methamphetamine, and Ecstasy (Krebs et al. 2007). The majority of assaults that take place while a victim was under the influence of drugs happened because the victim was incapacitated and could not consent. The

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short-term effects of some of these drugs are similar to that of alcohol. For instance, the effects of marijuana include distorted perceptions, problems with memory, loss of coordination, and difficulty thinking or problem solving. One can see that the same myopia and stress dampening will take place in a victim who is high from marijuana as in one who is intoxicated by alcohol. The drugs mentioned above have different sets of short-term effects. For example, some of the short-term effects of cocaine are having a sense of euphoria, being energetic, and being talkative. While these may not be the same effects as alcohol, they can be just as dangerous and may also lead to erratic and violent behavior. There is evidence that a victim who becomes violent under the influence of drugs may incite violence in a male counterpart, who may use this as an opportunity to assault her (Martino, Collins, and Ellickson 2004). The feeling of euphoria is also present when using Ecstasy and methamphetamines. This can cause the same issue as when drinking alcohol if the individual is not aware that her surroundings have become dangerous. A potential victim would have no motivation to leave because she may be overcome with a feeling of peacefulness. Those under the influence of Ecstasy may experience strong sensations and a desire to touch others while being easily transfixed by light or sound. This could cause enough of a distraction that it would be difficult for someone under the influence to understand what is happening if an assault were to occur. While much of the research into the effects of drugs and alcohol on victimization focuses on the college-age population, there have been studies that accurately predicted the influence that substances have on adolescent populations that are engaging in sexual activities with each other. The research has

shown the same factors contributed to sexual assaults of high-school-age females. Brady Root See also: Alcohol-Facilitated Sexual Assault; Drug-Facilitated Rape; Date Rape Drugs

Further Reading Cass, A. 2007. “Routine Activities and Sexual Assault: An Analysis of Individual- and School-Level Factors.” Violence and Victims 22(3): 350–66. “The Effects of Methamphetamine.” 2011. About.com. http://alcoholism.about.com/od /meth/a/effects.-Lx6.htm. Fisher, B. S., F. T. Cullen, and M. G. Turner. 2000. “The Sexual Victimization of College Women.” National Institute of Justice. https: //www.ncjrs.gov/pdffiles1/nij/182369.pdf. Fisher, B. S., J. J. Sloan, F. T. Cullen, and L. Chunmeng. 1998. “Crime in the Ivory Tower: The Level of and Sources of Student Victimizations.” Criminology 36(3): 671–710. http://onlinelibrary.wiley.com/ doi/10.1111/j.1745–9125.1998.tb01262.x/ pdf. George, W. H., and S. A. Stoner. 2000. “Understanding Acute Alcohol Effects on Sexual Behavior.” Annual Review of Sex Research 11: 92–124. http://dionysus.psych.wisc.edu. Krebs, C. P., C. H. Lindquist, T. D. Warner, B. S. Fisher, and S. L. Martin. 2007. The Campus Sexual Assault Study. National Criminal Justice Reference Service. https://www .ncjrs.gov. Krebs, C. P., C. H. Lindquist, T. D. Warner, B. S. Fisher, and S. L. Martin. 2009. “College Women’s Experiences with Physically Forced, Alcohol- or Other Drug-Enabled, and Drug-Facilitated Sexual Assault Before and Since Entering College.” Journal of American College Health 57(6): 639–49. Martino, S. C., R. L. Collins, and P. L. Ellickson. 2004. “Substance Use and Vulnerability to Sexual and Physical Aggression: A

Women’s Organization for National Prohibition Reform (WONPR)  971 Longitudinal Study of Young Adults.” Violence and Victims 19(5): 521–40. National Institute on Drug Abuse. 2010. Cocaine: Abuse and Addiction. http://www .nida.nih.gov/researchreports/cocaine/effe cts.html. Norris, J. 2008. The Relationship Between Alcohol Consumption and Sexual Violence. VAWnet, a project of the National Resource Center on Domestic Violence/Pennsylvania Coalition against Domestic Violence. http:// www.vawnet.org. Partnership for Drug-Free Kids. 2011a. “Ecstasy.” http://www.drugfree.org/drug-guide/ ecstasy. Partnership for Drug-Free Kids. 2011b. “Marijuana.” http://www.drugfree.org/drug -guide/ marijuana.

Women’s Organization for National Prohibition Reform (WONPR) The Women’s Organization for National Prohibition Reform (WONPR) was a major national organization that worked towards repealing national prohibition. It was founded in 1929 and headed by Pauline Morton Sabin, a wealthy and politically connected socialite who initially supported prohibition but changed her stance as a result of what she saw as a lack of respect for the Constitution that an unpopular ban on alcohol produced. Sabin’s WONPR thus represented a marked departure from the Woman’s Christian Temperance Union (WCTU), and it challenged the widely held belief that American women were strong supporters of prohibition. Prior to the creation of the WONPR, women were generally considered to be strongly on the side of prohibition. The association of women with temperance activity was based upon prominent figures like

the WCTU’s Frances Willard and Carrie Nation, whose radical use of her characteristic hatchet to fight liquor made her the face of antiliquor crusading to millions of Americans. By emphasizing the notion of “home protection” the WCTU effectively cast prohibition as a women’s cause. The WONPR’s emergence challenged this notion and altered the prevailing view that women stood united behind prohibition. Many of the founding members of the WONPR were wealthy women whose husbands were active in the Association Against the Prohibition Amendment (AAPA), leading to the accusation that WONPR efforts were in reality the doings of the AAPA. Scholars have demonstrated, however, that the WONPR was a self-supporting and independent organization that truly represented the views of American women who were worried about the disregard for the Constitution that national prohibition seemed to be engendering. As such, the WONPR attracted more than 10,000 members across much of the United States within a year of its founding. The WONPR even claimed to have as many as 1.5 million members by 1939. Though the figure cannot be verified, scholars nonetheless believe that the WONPR constituted the country’s largest antiprohibition association by a large margin. And as WONPR founder Pauline Sabin put it, women joined the antiprohibition organization “because they don’t want their babies to grow up in the hip-flask, speakeasy atmosphere that has polluted their own youth” (Barr 1999, 152). Alcohol thus remained a women’s issue, though now it was prohibition that threatened the fabric of family and society. The WONPR was an important contributor to the success of the repeal movement in large part because of its symbolic, numerical, and political challenge to the WCTU as the organization that was most representative

972   World Federation Against Drugs

of women’s views on alcohol. The modern, sophisticated, and fashionable image of the WONPR’s largely middle- and upper-class members contrasted with the stereotypically staid and traditional WCTU member. Once it surpassed the WCTU in number of members, the rise of the WONPR began to signal that a changing of the guard had taken place. And since it had more members than the WCTU, the WONPR was able to place greater and more effective pressure on politicians. The WONPR was a presence at both national political conventions in 1932, with its leaders addressing both the Democratic and Republican Parties. The WONPR endorsed Franklin D. Roosevelt in his presidential bid after the Democratic Party included the repeal of prohibition in its party platform. Once he was elected, the WONPR wielded its lobbying power and applied political pressure on Congress to pass the amendment that repealed prohibition. Similarly, the WONPR was an important force in state contests that ratified the Twenty-First Amendment. The WONPR dissolved itself at a celebratory dinner two days after prohibition was repealed in 1933. Howard Padwa and Jacob A. Cunningham See also: Anti-Saloon League; Eighteenth Amendment; Prohibition; Prohibition Party; Prohibition Unit; Volstead Act; Woman’s Christian Temperance Union

Further Research Barr, Andrew. 1999. Drink: A Social History of America. New York: Carroll & Graf Publishers. Blocker, Jack S., Jr., David M. Fahey, and Ian R. Tyrrell, eds. 2003. Alcohol and Temperance in Modern History: An International Encyclopedia. Santa Barbara, CA: ABC-CLIO. Clark, Norman H. 1976. Deliver Us from Evil: An Interpretation of American Prohibition. New York: W. W. Norton.

Kyvig, David E. 2000. Repealing National Prohibition. 2nd ed. Kent, OH: Kent State University Press. Murdock, Catherine Gilbert. 1998. Domesticating Drink: Women, Men, and Alcohol in America, 1870–1940. Baltimore: Johns Hopkins University Press. Pegram, Thomas P. 1998. Battling Demon Rum: The Struggle for a Dry America, 1800–1933. Chicago: Ivan R. Dee. Rose, Kenneth D. 1996. American Women and the Repeal of Prohibition. New York: New York University Press.

World Federation Against Drugs Based in Stockholm, Sweden, the World Federation Against Drugs (WFAD) is a multilateral community made up of 89 nongovernmental organizations and individuals from around the world that is at the forefront of the fight against illicit drugs. Founded in 2009, with the support of then U.S. president George W. Bush, the aim of the WFAD is to create a drug-free world. The members of the WFAD share a common concern that illicit drug use is undercutting traditional values and threatening the existence of stable families, communities, and government institutions throughout the world. The work of the WFAD is built on the principles of universal fellowship and basic human and democratic rights. The WFAD believes that working for a drug-free world will promote peace and human development and dignity, democracy, tolerance, equality, freedom, and justice. The WFAD welcomes all individuals and organizations that are working to achieve a society free from the nonmedical or abusive use of narcotic drugs. One of WFAD’s tasks is to organize the biannual World Forum Against Drugs, a global conference that

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works as a meeting point for people from all continents who are working to prevent drug abuse at grassroots level, on a voluntary basis, professionally or as policy makers. The WFAD supports and is guided by the 1961, 1971, and 1988 UN narcotics conventions and the resolution resulting from the 1998 UNGASS meeting. The WFAD also supports the UN Convention on the Rights of the Child, which stipulates in Article 33 that children have the right to be protected from the abuse of illicit drugs. The WFAD regards the nonmedicinal use of narcotic substances as a severe public health problem that results in major problems for society. WFAD opposes the legalization of cannabis and recreational drugs, and activities such as injection rooms for heroin addicts, on evidence-based grounds and advocates that nations must adhere to the Single Convention of Narcotic Drugs of 1961. Nancy E. Marion

World Narcotics Conference

See also: Drug Abuse; United Nations Commission on Narcotic Drugs; United Nations Single Convention on Narcotic Drugs

Hamilton Wright was a physician who became one of the staunchest advocates of narcotics control in the early 20th century, and was considered by some to be the father of American narcotics control. Through personal stubbornness and political skill, he became one of the architects of both global and domestic drug policies when they first took shape in the years before World War I, and he remained one of the most outspoken leaders of the campaign against narcotics— opium in particular—until his death in 1917. Hamilton Kemp Wright was born in 1867, and began his career as a medical researcher specializing in the study of tropical diseases. In 1899, after marrying a woman from a family with strong political connections, he became involved in public health policy. Less than a decade later when the U.S. government began looking at the international opium problem more closely, President Theodore Roosevelt appointed Wright

Further Reading International Narcotics Control Board. “Single Convention on Narcotic Drugs, 1961.” http://www.incb.org/incb/en/narcotic-drugs /1961_Convention.html. International Narcotics Control Board. 2015. “INCB Encourages States to Consider the Abolition of the Death Penalty for DrugRelated Offenses.” http://www.incb.org/ documents/Publications/PressRelease/ PR2014/press_release_050314.pdf. World Federation Against Drugs. “Constitution of World Federation Against Drugs.” http://www.wfad.se/about-wfad/wfad-decl aration/35-wfad-declaration/51-constitut ion World Federation Against Drugs. “Aims.” http://www.wfad.se/about-wfad/aims.

Founded in 1926, this group was one of several antinarcotic organizations created in the early 1920s by crusader Richard P. Hobson. The conference and other antinarcotic organizations like it were given a boost by the passage of the 1919 constitutional amendment against alcohol. Ron Chepesiuk See also: Prohibition

Further Reading Bertram, Eva, Kenneth Sharpe, and Peter Anders. 1996. Drug War Politics: The Price of Denial. Berkeley: University of California Press.

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to a committee devoted to the study of the opium problem. Soon after his appointment to the opium committee, Wright enthusiastically worked to become a leading expert on the drug, its effects, and what steps should be taken to solve the opium problem both in Asia and at home. In addition to reading what others wrote about the opium problem abroad, Wright also conducted a national survey to estimate the prevalence of opium use in the United States, gathering information from prisons, police departments, local health and pharmacy authorities, and manufacturers. He also toured the country to see how the drug was used and controlled in U.S. cities. In the course of his research, Wright became alarmed by what he considered the widespread and problematic use of opium, its derivatives, and other drugs such as cocaine. Soon, he began pushing for the United States to institute a strict set of laws controlling access to these drugs and making them illegal except for medical use. As the first international conference to consider the opium problem prepared to meet at Shanghai in 1909, Wright pushed for national legislation that could be presented to the international meeting as an example of what good drug control legislation would look like. Together with Secretary of State Elihu Root, Wright advocated for new national laws, and in February of 1909, he succeeded with the passage of the Smoking Opium Exclusion Act. After serving as one of the U.S. delegates at Shanghai, Wright remained a key player in the development of both international and domestic drug policy. When officials from Britain, Germany, and Holland tried to delay the 1911 international drug control conference at The Hague, Wright pressured representatives from these countries to come together and meet sooner rather than later.

He then served as the chief U.S. delegate to that conference. At times, Wright’s insis­ tence and self-righteousness irritated the representatives of other nations: he came across as overly moralistic, irritating, and brazen in his demands that other nations adhere to the U.S. agenda for international drug control. At one point, others who were advocates of a tighter international control system asked Wright to quit the antinarcotics campaign because he tended to anger his opponents instead of convincing them to agree with his agenda. Steadfast in his belief that he was an essential part of the crusade against narcotics, however, Wright refused to quit and remained an influential leader in the move towards international narcotics control until the outbreak of World War I. Even more importantly, however, Wright continued to push for tight federal narcotics laws at home. When he returned from the Shanghai conference, Wright warned that the opium habit was more widespread in the United States than in any other industrialized country, drug habits were growing at an alarming rate, and addiction would become a grave social problem if the federal government did not take swift and decisive action. Many of Wright’s arguments had racist overtones. He tried to convince lawmakers that opium was particularly problematic because of its association with Chinese minorities and that cocaine was especially threatening because it made African Americans behave dangerously. According to Wright, even more disconcerting was that the opium habit was seemingly spreading beyond minority circles, and becoming a major epidemic among the white population as well. Beyond trying to scare lawmakers into taking action, Wright also furthered the cause of drug control by writing model laws that he wanted legislators to introduce in Congress. In 1909, he drafted a piece of

Wright, Hamilton (1867–1917)  975

legislation that would have controlled the sale and purchase of drugs through taxation, requiring sellers to register with the government, record all of their drug transactions, and most importantly, have a special stamp issued by the federal government. He also wanted heavy punishments for anyone who was caught in possession of narcotics without this government stamp. First, he tried to persuade Congressman James R. Mann of Illinois to introduce the bill, but Mann refused. Later, he convinced Congressman David Foster of Vermont to introduce a bill that would have put new controls over opiates, cocaine, chloral, and cannabis; the bill was eventually defeated in 1911 because of opposition from the pharmaceutical industry. A few years later he had greater success working with Democrat Francis Burton Harrison of New York to draft, and eventually get Congress to enact, the Harrison Narcotics Act in 1914.

After his death in 1917, Wright’s widow continued his work and served as an American assessor of the League of Nations Advisory Committee on Opium until 1925. Howard Padwa and Jacob A. Cunningham See also: Hague Convention; Harrison Narcotics Act

Further Reading Davenport-Hines, Richard. 2001. The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000. London: Weidenfeld & Nicolson. McAllister, William B. 2000. Drug Diplomacy in the Twentieth Century. London: Routledge. Musto, David F. 1987. The American Disease: Origins of Narcotics Control. Expanded Edition. New York: Oxford University Press.

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Y one day in the past 30 days) was reported by 4.0 percent of youths aged 12 to 17 who perceived great risk from “having five or more drinks of an alcoholic beverage once or twice a week,” which was lower than the rate (9.5 percent) for youths who saw moderate, slight, or no risk from having five or more drinks of an alcoholic beverage once or twice a week. Past-month marijuana use was reported by 1.0 percent of youths who saw great risk in smoking marijuana once a month compared with 9.6 percent of youths who saw moderate, slight, or no risk.

Youths and Illicit Drug Use in the United States The National Survey on Drug Use and Health (NSDUH) includes questions for youths between the ages of 12 and 17 as a way to track the risk and protective factors that may affect the likelihood that youth will engage in substance use. Many of the results are described below.

Perceptions of Risk According to the 2012 report, 65.7 percent of youths aged 12 to 17 perceived a great risk in smoking one or more packs of cigarettes per day; 63.9 percent perceived great risk in having four or five drinks of an alcoholic beverage nearly every day, and 39.7 percent perceived great risk in having five or more drinks once or twice a week. When it came to marijuana use, 43.6 percent of youths perceived great risk in smoking marijuana once or twice a week, and 26.5 percent perceived great risk in smoking marijuana once a month. The percentages of youths who perceived great risk in using other drugs once or twice a week were 80.0 percent for heroin, 78.9 percent for cocaine, and 70.6 percent for LSD. The percentages of youths reporting binge alcohol use and the use of cigarettes and marijuana in the past month were lower among those who perceived great risk in using these substances than among those who did not perceive great risk. For instance, in 2012, past-month binge drinking (consumption of five or more drinks of an alcoholic beverage on a single occasion on at least

Perceived Availability In 2012, about half (47.8 percent) of youths aged 12 to 17 reported that it would be “fairly easy” or “very easy” for them to obtain marijuana if they wanted some. About one in 10 (9.9 percent) indicated that heroin would be fairly or very easily available, and 11.5 percent reported so for LSD. Between 2002 and 2012, there were decreases in the perceived easy availability of marijuana (from 55.0 to 47.8 percent), cocaine (from 25.0 to 16.0 percent), crack (from 26.5 to 16.7 percent), LSD (from 19.4 to 11.5 percent), and heroin (from 15.8 to 9.9 percent). Youths aged 12 to 17 in 2012 who perceived that it was easy to obtain specific illicit drugs were more likely to be past-month users of those illicit drugs than were youths who perceived that obtaining specific illicit drugs would be fairly difficult, very difficult, or probably impossible. For example, 17.4 percent of youths who reported that marijuana would be easy to obtain were pastmonth illicit drug users, but only 2.9 percent 977

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of those who thought marijuana would be more difficult to obtain were past-month users. Similarly, 14.4 percent of youths who reported that marijuana would be easy to obtain were past-month marijuana users, but only 1.1 percent of those who thought marijuana would be more difficult to obtain were past-month users. The percentage of youths who reported that marijuana, cocaine, crack, heroin, and LSD would be easy to obtain increased with age in 2012. For instance, 19.5 percent of those aged 12 or 13 said it would be fairly or very easy to obtain marijuana compared with 50.1 percent of those aged 14 or 15 and 71.0 percent of those aged 16 or 17. In 2012, 13.2 percent of youths aged 12 to 17 indicated that they had been approached by someone selling drugs in the past month. This rate declined between 2002 (16.7 percent) and 2012, although the 2012 rate was similar to the 2011 rate (13.8 percent).

Perceived Parental Disapproval of Substance Use Most youths aged 12 to 17 believed their parents would “strongly disapprove” of their using substances. In 2012, 89.3 percent of youths reported that their parents would strongly disapprove of their trying marijuana or hashish once or twice, which also was the rate in 2011 and was similar to the 89.1 percent reported in 2002. Most youths in 2012 (90.5 percent) reported that their parents would strongly disapprove of their having one or two drinks of an alcoholic beverage nearly every day, which also was the rate in 2011, but was higher than the rate in 2002 (89.0 percent). In 2012, 93.1 percent of youths reported that their parents would strongly disapprove of their smoking one or more packs of cigarettes per day, which was similar to the rate reported in 2011 (93.2 per-

cent), but was higher than the 89.5 percent reported in 2002. Youths aged 12 to 17 who believed their parents would strongly disapprove of their using specific substances were less likely to use these substances than were youths who believed their parents would somewhat disapprove or neither approve nor disapprove. For instance, in 2012, past-month cigarette use was reported by 4.6 percent of youths who perceived strong parental disapproval if they were to smoke one or more packs of cigarettes per day compared with 31.9 percent of youths who believed their parents would not strongly disapprove. Also, pastmonth marijuana use was much less prevalent among youths who perceived strong parental disapproval for trying marijuana or hashish once or twice than among those who did not perceive this level of disapproval (4.3 vs. 31.0 percent, respectively).

Attitudes toward Peer Substance Abuse A majority of youths aged 12 to 17 reported that they disapproved of their peers using substances. In 2012, 91.4 percent of youths “strongly” or “somewhat” disapproved of their peers smoking one or more packs of cigarettes per day, which was similar to the rate of 91.0 percent in 2011, but was higher than the 87.1 percent in 2002. Also in 2012, 80.3 percent strongly or somewhat disapproved of peers using marijuana or hashish once a month or more, which also was the rate reported in 2011 and was similar to the 80.4 percent reported in 2002. In addition, 88.7 percent of youths strongly or somewhat disapproved of peers having one or two drinks of an alcoholic beverage nearly every day in 2012, which was similar to the rate of 88.1 percent in 2011, but was higher than the 84.7 percent reported in 2002. In 2012, youths aged 12 to 17 who strongly or somewhat disapproved of their

Youths and Illicit Drug Use in the United States  979

peers using marijuana once a month or more were less likely to be past-month marijuana users than those who neither approved nor disapproved of this behavior from their peers (2.0 vs. 28.3 percent).

Delinquent Behavior NSDUH includes questions for youths aged 12 to 17 about the number of times they had engaged in fighting or other delinquent behavior in the 12 months prior to the interview. In 2012, 18.3 percent of youths aged 12 to 17 reported that they had gotten into a serious fight at school or at work in the past year; 11.8 percent had taken part in a group-against-group fight; 5.6 percent attacked others in at least one instance with the intent to harm or seriously hurt them; 3.5 percent had carried a handgun at least once; 3.5 percent had, at least once, stolen or tried to steal something worth more than $50; and 2.7 percent sold illegal drugs in the past year. The 2012 rates for fighting or other delinquent behaviors among youths aged 12 to 17 were similar to the 2011 rates. Rates of the following behaviors in the past year among youths aged 12 to 17 were lower in 2012 than in 2002: getting into a serious fight at school or work (18.3 vs. 20.6 percent); taking part in a group-againstgroup fight (11.8 vs. 15.9 percent); attacking others with the intent to harm or seriously hurt them (5.6 vs. 7.8 percent); stealing or trying to steal something worth more than $50 (3.5 vs. 4.9 percent); and selling illegal drugs (2.7 vs. 4.4 percent). Percentages of youths who had carried a handgun in the past year were similar in 2012 and 2002 (3.5 and 3.3 percent). Youths aged 12 to 17 who had engaged in fighting or other delinquent behaviors were more likely than other youths to have used illicit drugs in the past month. In 2012, pastmonth illicit drug use was reported by 17.5

percent of youths who had gotten into a serious fight at school or work in the past year compared with 7.6 percent of those who had not engaged in fighting at school or work. An estimated 43.8 percent of youths who had stolen or tried to steal something worth over $50 in the past year used illicit drugs in the past month compared with 8.2 percent of those who had not attempted or engaged in such theft.

Religious Involvement and Beliefs In 2012, 30.4 percent of youths aged 12 to 17 reported that they had attended religious services 25 or more times in the past year; 74.4 percent agreed or strongly agreed with the statement that religious beliefs are a very important part of their lives; and 33.7 percent agreed or strongly agreed with the statement that it is important for their friends to share their religious beliefs. These rates were similar to corresponding rates in 2011. Percentages in 2012 for youths aged 12 to 17 were lower than in 2002 for attending religious services 25 or more times in the past year (30.4 vs. 33.0 percent); agreeing or strongly agreeing that religious beliefs are a very important part of their lives (74.4 vs. 78.2 percent); and agreeing or strongly agreeing that it is important for their friends to share their religious beliefs (33.7 vs. 35.8 percent). The rates of past-month use of illicit drugs and cigarettes and binge alcohol use were lower among youths aged 12 to 17 who agreed with statements about the importance of religious beliefs than among those who disagreed. In 2012, past-month illicit drug use was reported by 7.3 percent of those who agreed or strongly agreed that religious beliefs are a very important part of their lives compared with 15.6 percent of those who disagreed with that statement. Similar differences were found between those two

980   Youths and Illicit Drug Use in the United States

subgroups for the past-month use of cigarettes (5.0 vs. 10.9 percent) and past-month binge alcohol use (5.8 vs. 11.3 percent).

than among youths who were enrolled in school but reported having no such exposure (12.3 and 9.7 percent).

Exposure to Prevention Messages and Programs In 2012, approximately one in eight youths aged 12 to 17 (11.9 percent) reported that they had participated in drug, tobacco, or alcohol prevention programs outside of school in the past year. This rate was similar to the 11.7 percent reported in 2011, but was lower than the rate reported in 2002 (12.7 percent). In 2012, youths who did or did not participate in these programs had similar rates of past-month use for illicit drugs (9.5 percent for both groups), marijuana (6.7 and 7.3 percent), cigarettes (7.2 and 6.4 percent), and binge alcohol use (7.8 and 7.1 percent). In 2012, 75.9 percent of youths aged 12 to 17 reported having seen or heard drug or alcohol prevention messages in the past year from sources outside of school, such as from posters or pamphlets, on the radio, or on television. This rate in 2012 was similar to the 75.1 percent reported in 2011, but was lower than the 83.2 percent reported in 2002. In 2012, the prevalence of past-month use of illicit drugs among those who reported having such exposure (9.4 percent) was not significantly different from the prevalence among those who reported having no such exposure (10.0 percent). In 2012, 75.0 percent of youths aged 12 to 17 enrolled in school in the past year reported having seen or heard drug or alcohol prevention messages at school, which was similar to the 74.6 percent reported in 2011, but was lower than the 78.8 percent reported in 2002. In 2012, the prevalence of past-month use of illicit drugs or marijuana was lower among those who reported having such exposure in school (8.9 and 6.7 percent for illicit drugs and marijuana, respectively)

Parental Involvement Youths aged 12 to 17 were asked several questions related to the extent of support, oversight, and control that they perceived their parents provided or exercised over them in the year prior to the survey interview. In 2012, among youths aged 12 to 17 who were enrolled in school in the past year, 70.3 percent reported that their parents limited the amount of time that they spent out with friends on school nights. This rate in 2012 was similar to the rate reported in 2011 (69.9 percent) and also in 2002 (70.7 percent). In 2012, 81.3 percent reported that in the past year their parents always or sometimes checked on whether or not they had completed their homework, and 80.6 percent reported that their parents always or sometimes provided help with their homework. Both of these rates reported in 2012 were similar to the rates in 2011 (81.1 and 80.4 percent, respectively). The rate in 2012 for parents checking on whether youths had completed their homework was higher than in 2002 (78.4 percent). However, the rate for parents providing help with homework in 2012 was similar to the rate in 2002 (81.4 percent). In 2012, 88.5 percent of youths aged 12 to 17 reported that their parents always or sometimes made them do chores around the house in the past year, which was similar to the rate in 2011 (88.4 percent), but was slightly higher than the rate in 2002 (87.4 percent). In 2012, 85.6 percent of youths reported that their parents always or sometimes let them know that they had done a good job, and 85.8 percent reported that their parents always or sometimes let them know they were proud of something they had done.

Youths and Illicit Drug Use in the United States  981

These percentages in 2012 were similar to those reported in 2011 and 2002. In 2012, 41.0 percent of youths reported that their parents limited the amount of time that they watched television, which was similar to the rate in 2011 (40.5 percent), but was higher than the 36.9 percent reported in 2002. In 2012, past-month use of illicit drugs and cigarettes and binge alcohol use were lower among youths aged 12 to 17 who reported that their parents always or sometimes engaged in supportive or monitoring behaviors than among youths whose parents seldom or never engaged in such behaviors. For instance, the rate of past-month use of any illicit drug in 2012 was 7.6 percent for youths whose parents always or sometimes helped with homework compared with 18.1 percent among youths who indicated that

their parents seldom or never helped. Rates of current cigarette smoking and past-month binge alcohol use also were lower among youths whose parents always or sometimes helped with homework (5.1 and 5.9 percent, respectively) than among youths whose parents seldom or never helped (12.8 and 13.4 percent). Richard E. Isralowitz See also: Alcohol Use; Drug Abuse

Further Reading Substance Abuse and Mental Health Services Administration (SAMHSA). 2012. Results from the 2012 National Survey on Drug Use and Health: National Findings. Rockville, MD: United States Department of Health and Human Services.

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Z May 1998 incident, the U.S. Coast Guard seized a $2.5 million yacht after discovering a tenth of an ounce of marijuana onboard. The critics of Zero Tolerance Policy charged that the program was unfair because it made innocent people pay for the others’ behavior, over which they had no control. Within two months of initiating the program, the federal government began relenting to public pressure and started to relax the zero tolerance standard. Ron Chepesiuk

Zero Tolerance Policy Program (U.S.) The Zero Tolerance Policy Program was initiated by President Reagan and his administration on March 21, 1988. The program was geared toward reducing the supply of illegal drugs that were entering the United States each day by targeting the consumers as well as the suppliers. As part of the policy, law enforcement authorities were to investigate casual users as well as heavy users of drugs, including those who smoked marijuana. Federal officials were ordered to seize vessels within a 12-mile radius of the U.S. coastline if they found any trace of a banned substance on board. Several well-publicized incidents, however, caused controversy. For example, in a

See also: Reagan, Ronald, and Nancy Reagan

Further Reading Cooper, Mary H. 1990. The Business of Drugs. Washington, DC: Congressional Quarterly.

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Appendix: Documents Related to Drug Use in America

days nor more than six months, or by both such fine and imprisonment. Source: Statutes Relating to the City of Sacramento. Sacramento: Valley Press Printing House, 1881, p. 322.

The First Drug Law in America, 1875 The first drug law in the United States was passed in San Francisco in 1875. It outlawed visiting or supporting a opium den, a place where people would go to smoke opium. It defines the punishment for the offense as a fine of between $50 and 500, and a jail term of between 10 days and six months, or both. The first drug law in the United States is relatively short, as described below.

Pure Food and Drug Act (1906) The Pure Food and Drug Act was passed by Congress in 1906. It required vendors in the United States to place labels on food, medicines, and other consumable products that were sold to the general public. This had become necessary because of changes in technology that allowed for more synthetic medicines and processed foods. Some manufacturers learned how to use chemistry to adulterate their products and defraud customers. It was common for some companies to sell unlabeled products that may have contained poisons or habit-forming drugs. With this, many consumers often had no idea what they were actually buying and ingesting. They sometimes became sick.

San Francisco (CA) 1875, First Drug Law in America Ordinance Prohibiting Opium-Smoking Dens Section 1. No person shall in the city and county of San Francisco keep or maintain or become an inmate of or visit or shall in any way contribute to the support of any place, house, or room where opium is smoked or where persons assemble for the purpose of smoking opium or inhaling the fumes of opium. Any person who shall violate the provisions of this section shall be deemed guilty of a misdemeanor, and upon conviction thereof shall be punished by a fine of not less than fifty dollars and not exceeding five hundred dollars, or by imprisonment in the County Jail for a period of not less than ten

In 1905, President Theodore Roosevelt asked Congress to enact a bill to regulate the labeling of food and drugs. The law finally passed in June of 1906 as the Pure Food and Drug Act. The law made it a crime to transport adulterated or mislabeled foods 985

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or drugs across state lines. If someone chose to do that, they could have their products seized, or be fined or sent to jail. After the law was passed, drug manufacturers had to follow standards that were described in the U.S. pharmacopoeia. Further, if they made false or misleading claims about a food or drug, they could be charged with a crime. The act also gave officials with the Bureau of Chemistry—the federal agency that would later become the Food and Drug Administration—new regulatory powers.

Pure Food and Drug Act (1906) AN ACT CHAP. 3915—An Act for preventing the manufacture, sale, or transportation of adulterated or misbranded or poisonous or deleterious foods, drugs, medicines, and liquors, and for regulating traffic therein, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That it shall be unlawful for any person to manufacture within any Territory or the District of Columbia any article of food or drug which is adulterated or misbranded, within the meaning of this Act; and any person who shall violate any of the provisions of this section shall be guilty of a misdemeanor, and for each offense shall, upon conviction thereof, be fined not to exceed five hundred dollars, or shall be sentenced to one year’s imprisonment, for each subsequent offense and conviction thereof shall be fined not less than one thousand dollars or sentenced to one year’s imprisonment, or both such fine and imprisonment, in the discretion of the court. SEC. 2. That the introduction into any State or Territory or the District of Columbia from

any other State or Territory or the District of Columbia, from any other State or Territory or the District of Columbia, or form any foreign country, or shipment to any foreign country of any article of food or drugs which is adulterated or misbranded, within the meaning of this Act, is hereby prohibited; and any person who shall ship or deliver for shipment from any State or Territory or the District of Columbia to any other State or Territory or the District of Columbia, or to a foreign country, or who shall receive in any State or Territory or the District of Columbia, or foreign country, and having so received, shall deliver, in original unbroken packages, for pay or otherwise, or offer to deliver to any other person, any such article so adulterated or misbranded within the meaning of this Act, or any person who shall sell or offer for sale in the District of Columbia or the Territories of the United States any such adulterated or misbranded foods or drugs, or export or offer to export the same to any foreign country, shall be guilty of a misdemeanor, and for such offense be fined not exceeding two hundred dollars for the first offense, and upon conviction for each subsequent offense not exceeding three hundred dollars or be imprisoned not exceeding one year, or both, in the discretion of the court: Provided, That no article shall be deemed misbranded or adulterated within the provisions of this Act when intended for export to any foreign country and prepared or packed according to the specifications or directions of the foreign purchaser when no substance is used in the preparation or packing thereof in conflict with the laws of the foreign country to which said article is intended to be shipped; but if said article shall be in fact sold or offered for sale for domestic use or consumption, then this proviso shall not exempt said article from the operation of any of the other provisions of this Act.

Appendix  987

SEC. 3. That the Secretary of the Treasury, the Secretary of Agriculture, and the Secretary of Commerce and Labor shall make uniform rules and regulations for carrying out the provisions of this Act, including the collection and examination of specimens of foods and drugs manufactured or offered for sale in the District of Columbia, or in any Territory of the United States, or which shall be offered for sale in unbroken packages in any State other than that in which they shall have been respectively manufactured or produced, or which shall be received from any foreign country, or intended for shipment to any foreign country, which may be submitted for examination by the chief health, food, or drug officer of any State, Territory, or the District of Columbia, or at any domestic or foreign port through which such product is offered for interstate commerce, or for export or import between the United States and any foreign port or country. SEC. 4. That the examinations of specimens of foods and drugs shall be made in the Bureau of chemistry of the Department of Agriculture, or under the direction and supervision of such Bureau, for the purpose of determining from such examinations whether such articles are adulterated or misbranded within the meaning of this Act; and if it shall appear from any such examination that any of such specimens is adulterated or misbranded within the meaning of this Act, the Secretary of Agriculture shall cause notice thereof to be given to the party from whom such sample was obtained. Any party so notified shall be given an opportunity to be heard, under such rules and regulations as may be prescribed as aforesaid, and if it appears that any of the provisions of this Act have been violated by such party, then the Secretary of Agriculture shall at once certify the facts to the proper United States district

attorney, with a copy of the results of the analysis or the examination of such article duly authenticated by the analyst or officer making such examination, under the oath of such officer. After judgment of the court, notice shall be given by publication in such manner as may be prescribed by the rules and regulations aforesaid. SEC. 5. That it shall be the duty of each district attorney to whom the Secretary of Agriculture shall report any violation of this Act, or to whom any health or food or drug officer or agent of any State, Territory, or the District of Columbia shall present satisfactory evidence of any such violation, to cause appropriate proceedings to be commenced and prosecuted in the proper courts of the United States, without delay, for the enforcement of the penalties as in such case herein provided. SEC. 6. That the term “drug,” as used in this Act, shall include all medicines and preparations recognized in the United States Pharmacopoeia or National Formulary for internal or external use, and any substance or mixture of substances intended to be used for the cure, mitigation, or prevention of disease of either man or other animals. The term “food,” as used herein, shall include all articles used for food, drink, confectionery, or condiment by man or other animals, whether simple, mixed, or compound. SEC. 7. That for the purposes of this Act an article shall be deemed to be adulterated: In case of drugs: First. If, when a drug is sold under or by a name recognized in the United States Pharmacopoeia or National formulary, it differs from the standard of strength, quality, or purity, as determined by the test laid down in the United States Pharmacopoeia

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or National Formulary official at the time of investigation: Provided, That no drug defined in the United States Pharmacopoeia or National Formulary shall be deemed to be adulterated under this provision if the standard of strength, quality, or purity be plainly stated upon the bottle, box, or other container thereof although the standard may differ from that determined by the test laid down in the United States Pharmacopoeia or National Formulary. Second. If its strength or purity fall below the professed standard or quality under which it is sold. In the case of confectionery: If it contains terra alba, barites, talc, chrome yellow, or other mineral substance or poisonous color or flavor, or other ingredient deleterious or detrimental to health, or any vinous, malt or spirituous liquor or compound or narcotic drug. In the case of food: First. If any substance has been mixed and packed with it so as to reduce or lower or injuriously affect its quality or strength. Second. If any substance has been substituted wholly or in part for the article. Third. If any valuable constituent of the article has been wholly or in part abstracted. Fourth. If it be mixed, colored powdered, coated, or stained in a manner whereby damage or inferiority is concealed. Fifth. If it contain any added poisonous or other added deleterious ingredient which may render such article injurious to health: Provided, That when in the preparation of food products for shipment they are preserved by any external application applied in such manner that the preservative is necessarily removed mechanically, or by maceration in water, or otherwise, and directions for the removal of said preservative shall be printed on the covering or the package, the provisions of this Act shall be construed as

applying only when said products are ready for consumption. Sixth. If it consists in whole or in part of a filthy, decomposed, or putrid animal or vegetable substance, or any portion of an animal unfit for food, whether manufactured or not, or if it is the product of a diseased animal, or one that has died otherwise than by slaughter. SEC. 8. That the term “misbranded,” as used herein, shall apply to all drugs, or articles of food, or articles which enter into the composition of food, the package or label of which shall bear any statement, design, or device regarding such article, or the ingredients or substances contained therein which shall be false or misleading in any particular, and to any food or drug product which is falsely branded as the State, territory, or country in which it is manufactured or produced. That for the purposes of this Act an article shall also be deemed to be misbranded: In the case of Drugs: First. If it be an imitation of or offered for sale under the name of another article. Second. If the contents of the package as originally put up shall have been removed, in whole or in part, and other contents shall have been placed in such package, or if the package fail to bear a statement on the label of the quantity or proportion of any alcohol, morphine, opium, cocaine, heroin, alpha or beta eucaine, chloroform, cannabis indica, chloral hydrate, or acetanilide, or any derivative or preparation of any such substances contained therein. Third. If in package form, and the contents are stated in terms of weight or measure, they are not plainly and correctly stated on the outside of the package. Fourth. If the package containing it or its label shall bear any statement, design, or device regarding the ingredients or the sub-

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stances contained therein, which statement, design, or device shall be false or misleading in any particular: Provided, That an article of food which does not contain any added poisonous or deleterious ingredients shall not be deemed to be adulterated or misbranded in the following cases: First. In the case of mixtures or compounds which may be now or from time to time hereafter known as articles of food, under their own distinctive names, and not an imitation of or offered for sale under the distinctive name of another article, if the name be accompanied on the same label or brand with a statement of the place where said article has been manufactured or produced. Second. In the case of articles labeled, branded, or tagged so as to plainly indicate that they are compounds, imitations, or blends, and the word “compound,” “imitation,” or “blend,” as the case may be is plainly stated on the package in which it is offered for sale: Provided, That the term blend as used herein shall be construed to mean a mixture of like substances, not excluding harmless coloring or flavoring ingredients used for the purpose of coloring and flavoring only: And provided further, That nothing in this Act shall be construed as requiring or compelling proprietors or manufacturers of proprietary foods which contain no unwholesome added ingredients to disclose their trade formulas, except in so far as the provisions of this Act may require to secure freedom from adulteration or misbranding. SEC. 9. That no dealer shall be prosecuted under the provisions of this Act when he can establish a guaranty signed by the wholesaler, jobber, manufacturer, or other party residing in the united States, from whom he purchases such articles to the effect that the

same is not adulterated or misbranded within the meaning of this Act, designating it. Said guaranty, to afford protection, shall contain the name and address of the party or parties making the sale of such articles to such dealer, and such case said party or parties shall be amenable to the prosecutions, fines, and other penalties which would attach, in due course, to the dealer under the provisions of this Act. SEC. 10. That any article of food, drug, or liquor that is adulterated or misbranded within the meaning of this Act, and is being transported from one State, Territory, District, or insular possession to another for sale, or, having been transported, remains unloaded, unsold, or in original unbroken packages, or if it be sold or offered for sale in the District of Columbia or the Territories, or insular possessions of the United States, or if it be imported from a foreign country for sale, or if it is intended for export to a foreign country shall be liable to be proceeded against in any district court of the United States within the district where the same is found, and seized for confiscation by a process of libel for condemnation. And if such article is condemned as being adulterated or misbranded, or of a poisonous or deleterious character, within the meaning of this Act, the same shall be disposed of by destruction or sale, as the said court may direct, and the proceeds thereof, if sold, less the legal costs and charges shall be paid into the Treasury of the United States, but such goods shall not be sold in any jurisdiction contrary to the provisions of this Act or the laws of that jurisdiction: Provided, however, That upon the payment of the costs of such libel proceedings and the execution and delivery of a good and sufficient bond to the effect that such articles shall not be sold or otherwise disposed of contrary to the provisions of

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this Act, or the laws of any State, Territory, District, or insular possession, the court may by order direct that such articles be delivered to the owner thereof. The proceedings of such libel cases shall conform, as near as may be, to the proceedings in admiralty, except that either party may demand trial by jury of any issue of fact joined in any such case, and all such proceedings shall be at the suit of and in the name of the United States. SEC. 11. The Secretary of the Treasury shall deliver to the Secretary of Agriculture, upon his request from time to time, samples of foods and drugs which are being imported into the United States or offered for import, giving notice thereof to the owner or consignee, who may appear before the Secretary of Agriculture, and have the right to introduce testimony, and if it appear from the examination of such samples that any article of food or drug offered to be imported into the United States is adulterated or misbranded within the meaning of this Act, or is otherwise dangerous to the health of the people of the United States, or is of a kind forbidden entry into, or forbidden to be sold or restricted in sale in the country in which it is made or from which it is exported, or is otherwise falsely labeled in any respect, the said article shall be refused admission, and the Secretary of the Treasury shall refuse delivery to the consignee and shall cause the destruction of any goods refused delivery which shall not be exported by the consignee within three months from the date of notice of such refusal under such regulations as the Secretary of the Treasury may prescribe: Provided, That the Secretary of the Treasury may deliver to the consignee such goods pending examination and decision in the matter on execution of a penal bond for the amount of the full invoice value of such goods, together with the duty thereon, and

on refusal to return such goods for any cause to the custody of the Secretary of the Treasury, when demanded, for the purpose of excluding them from the country, or for any other purpose, said consignee shall forfeit the full amount of the bond: And provided further, That all charges for storage, cartage, and labor on goods which are refused admission or delivery shall be paid by the owner or consignee, and in default of such payment shall constitute a lien against any future importation made by such owner or consignee. SEC. 12. That the term “Territory” as used in this Act shall include the insular possessions of the United States. The word “person” as used in this Act shall be construed to import both the plural and the singular, as the case demands, and shall include corporations, companies, societies and associations. When construing and enforcing the provisions of this Act, the act, omission, or failure of any officer, agent, or other person acting for or employed by any corporation, company, society, or association, within the scope of his employment or office, shall in every case be also deemed to be the act, omission, or failure of such corporation, company, society, or association as well as that of the person. SEC. 13. That this Act shall be in force and effect from and after the first day of January, nineteen hundred and seven. Approved, June 30, 1906. Source: United States Statutes at Large (59th Cong., Sess. I, Chp. 3915, pp. 768–72; cited as 34 U.S. Stats. 768)

Harrison Narcotics Act (1915) The Harrison Narcotics Act was passed in 1914, taking effect in 1915. Before this law was passed, there were few federal laws that

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regulated the use and distribution of narcotics. The law was named after New York Democratic member of Congress and sponsor of the bill, Francis Burton Harris. The bill imposed strict rules concerning the transfer and sale of many dangerous drugs. Any person who purchased narcotics was required to keep records of their purchases for up to two years. This way, government officials could inspect them to make sure the drugs were obtained legally. Any pharmacist who sold medications containing opium, cocaine, or their derivatives could only sell to those individuals who had a prescription from a physician, dentist, or surgeon who had formally registered under the act. Patent medicines that contained anything more than a small amount of morphine, cocaine, opium, and heroin could no longer be sold through the mail or in general stores. Any pharmacist or physicians who dispensed certain drugs had to purchase a tax stamp in order to sell the drugs. Finally, everyone who sold narcotics had to be registered with the government. The act led to the creation of the Bureau of Narcotics. This law was the overarching federal antidrug legislation for many years, until the passage of the Comprehensive Drug Abuse Prevention and Control Act of 1970.

Harrison Narcotics Tax Act, 1914 Public Acts of the Sixty-Third Congress of the United States Woodrow Wilson, President; Thomas R. Marshall, Vice-President; James P. Clarke, President of the Senate pro tempore; Claude A. Swanson, Acting President of the Senate pro tempore, December 21 to 23, 29 to 31, 1914, and January 2, 1915; Nathan P. Bryan, Acting President of the Senate pro tempore,

January 22, 1915; Champ Clark, Speaker of the House of Representatives Chap 1.—An Act to provide for the registration of, with collectors of internal revenue, and to impose a special tax on all persons who produce, import, manufacture, compound, deal in, dispense, sell, distribute, or give away opium or coca leaves, their salts, derivatives, or preparations, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, that on and after the first day of March, nineteen hundred and fifteen, every person who produces, imports, manufactures, compounds, deals in, dispenses, distributes, or gives away opium or coca leaves or any compound, manufacture, salt, derivative, or preparation thereof, shall register with the collector of internal revenue of the district, his name or style, place of business, and place or places where such business is to be carried on: Provided, that the office, or if none, then the residence of any person shall be considered for purposes of this Act to be his place of business. At the time of such registry and on or before the first of July annually thereafter, every person who produces, imports, manufactures, compounds, deals in, dispenses, distributes, or gives away any of the aforesaid drugs shall pay to the said collector a special tax at the rate of $1 per annum: Provided, that no employee of any person who produces, imports, manufactures, compounds, deals in, dispenses, distributes, or gives away any of the aforesaid drugs, acting within the scope of his employment, shall be required to register or to pay the special tax provided by this section: Provided further, That officers of the United States Government who are lawfully engaged in making purchases of the abovenamed drugs for the various departments

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of the Army and Navy, the Public Health Service, and for Government hospitals and prisons, and officers of State governments or any municipality therein, who are lawfully engaged in making purchases of the abovenamed drugs for State, county, or municipal hospitals or prisons, and officials of any Territory or insular possession, or the District of Columbia or of the United States who are lawfully engaged in making purchases of the above-named drugs for hospitals or prisons therein shall not be required to register and pay the special tax as herein required. It shall be unlawful for any person required to register under the terms of this Act to produce, import, manufacture, compound, deal in, dispense, sell, distribute, any of the aforesaid drugs without having registered and paid the special tax provided for in this section. That the word “person” in this Act shall be construed to mean and include a partnership, association, company, or corporation, as well as a natural person; and all provisions of existing law relating to special taxes, so far as applicable, including the provisions of section thirty-two hundred and forty of the Revised Statutes of the United States are hereby extended to the special tax herein imposed. That the Commissioner of Internal Revenue, with the approval of the Secretary of the Treasury, shall make all needful rules and regulations for carrying the provisions of this Act into effect. Sec. 2 That it shall be unlawful for any person to sell, barter, exchange, or give away any of the aforesaid drugs except in pursuance of a written order of the person to whom such article is sold, bartered, exchanged, or given, on a form to be issued in blank for that purpose by the Commissioner of Internal Revenue. Every person who shall accept any

such order, and in pursuance thereof shall sell, barter, exchange, or give away any of the aforesaid drugs shall preserve such order for a period of two years in such a way as to be readily accessible to inspection by any officer, agent, or employee of the Treasury Department duly authorized for that purpose, and the State, Territorial, district, municipal and insular officials named in Section five of this Act. Every person who shall give an order as herein provided to any other person for any of the aforesaid drugs shall, at or before the time of giving of such order, make or cause to be made, a duplicate thereof on a form to be issued in blank for that purpose by the Commissioner of Internal Revenue, and in the case of the acceptance of such order, shall preserve such duplicate for said period of two years in such a way as to be readily accessible to inspection by the officers, agents, employees, and officials herein mentioned. Nothing contained in this section shall apply (a) To the dispensing or distribution of any of the aforesaid drugs to a patient by a physician, dentist, or veterinary surgeon registered under this Act in the course of his professional practice only: Provided, That such physician, dentist, or veterinary surgeon shall keep a record of all such drugs dispensed or distributed, showing the amount dispensed or distributed, the date, and the name and address of the person to whom such drugs are dispensed or distributed; except such as may be dispensed or distributed to a patient upon whom such physician, dentist, or veterinary surgeon shall personally attend; and such record shall be kept for a period of two years from the date of dispensing or distributing such drugs, subject to inspection, as provided in this Act. (b) To the sale, dispensing, or distributing of any of the aforesaid drugs by a dealer to a consumer under and in pursuance of a

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written prescription issued by a physician, dentist, or veterinary surgeon registered under this Act. Provided, however, That such prescription shall be dated as of the day on which signed and shall be signed by the physician, dentist, or veterinary surgeon who shall have issued the same: And provided further, That such dealer shall preserve such prescription for a period of two years from the day on which such prescription is filled in such a way as to be readily accessible by the officers, agents, employees, and officials hereinbefore mentioned. (c) To the sale, exportation, shipment, or delivery of any of the aforesaid drugs by any person within the United States or any Territory or the District of Columbia or any of the insular possessions of the United States to any person in any foreign country, regulating their entry in accordance with such regulations for importation thereof into such foreign country as are prescribed by said country, such regulations to be promulgated from time to time by the Secretary of State of the United States. (d) To the sale, barter, exchange, or giving away of any of the aforesaid drugs to any officer of the United States Government, or any State, territorial, district, county, or municipal or insular government lawfully engaged in making purchases thereof for various departments of the Army and Navy, the Public Health Service, and for Government, State, territorial, district, county, or municipal, or insular hospitals and prisons. The Commissioner of Internal Revenue, with the approval of the Secretary of the Treasury, shall cause suitable forms to be prepared for the purposes mentioned above, and shall cause the same to be distributed to collectors of internal revenue for sale by them to those persons who shall have registered and paid the special tax as required by section one of this Act, in their districts,

respectively; and no collector shall sell any of such forms to any persons other than a person who has registered and paid the special tax as required by section one of this Act in his district. The price at which said forms shall be sold by collectors shall be fixed by the Commissioner of Internal Revenue with the approval of the Secretary of the Treasury, but shall not exceed the sum of $1 per hundred. Every collector shall keep an account of the number of forms sold by him, the names of the purchasers, and the number of forms sold to each of such purchasers. Whenever any collector shall sell any of such forms, he shall cause the name of the purchaser thereof to be plainly stamped thereon before delivering the same; and no person other than such purchaser shall use any of said forms bearing the name of such purchaser for the purpose of procuring any of the aforesaid drugs, or furnish any of the forms bearing the name of such purchaser to any person with intent thereby to procure the shipment or delivery of any of the aforesaid drugs. It shall be unlawful for any person to obtain by means of said order forms any of the aforesaid drugs for any purpose other than the use, sale, or distribution thereof by him in the conduct of a lawful business in said drugs or in the legitimate practice of his profession. The provisions of this Act shall apply to the United States, the District of Columbia, the Territory of Alaska, the Territory of Hawaii, the insular possessions of the United States, and the Canal Zone. In Porto Rico and the Philippine Islands the administration of this Act, the collection of said special tax, and the issuance of the order forms specified in section two shall be performed by the appropriate internal revenue officers of these governments, and all revenues collected hereunder in Porto Rico and the Philippine Islands shall accrue intact to the governments thereof, respectively. The courts of

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first instance in the Philippine Islands shall possess and exercise jurisdiction in all cases arising under this Act in said islands. The President is authorized and directed to issue such executive orders as will carry into effect in the Canal Zone the intent and purpose of this Act by providing for the registration and the imposition of a special tax upon all persons in the Canal Zone who produce, import, compound, deal in, dispense, sell, distribute, or give away opium or coca leaves, their salts, derivatives, or preparations.

of any person who shall have registered and paid the special tax as required by section one of this Act, or to any person who shall deliver such drug which has been prescribed or dispensed by a physician, dentist, or veterinary surgeon required to register under the terms of this Act, who has been employed to prescribe for the particular patient receiving such drug, or to any United States, State, county, municipal, District, territorial, or insular officer or official acting within the scope of his official duties.

Sec. 3 That any person who shall be registered in any internal revenue district under the provisions of section one of this Act shall, whenever required to do so by the collector of the district, render to the said collector a true and correct statement or return, verified by affadavit, setting forth the quantity of aforesaid drugs received by him in said internal revenue district during such period immediately preceding the demand of the collector, not exceeding three months, as the said collector may fix and determine; the names of the persons from whom said drugs were received; the quantity in each instance of the quantity received from each of such persons, and the date received.

Sec. 5 That the duplicate-order forms and the prescriptions required to be preserved under the provisions of section two of this Act, and the statements or returns filed in the office of the collector of the district, under the provisions of section three of this Act, shall be open to inspection by officers, agents, and employees of the Treasury Department duly authorized for that purpose; and such officials of any State or Territory, or of any organized municipality therein, or of the District of Columbia, or any insular possession of the United States as shall be charged with the enforcement of any law or municipal ordinance regulating the sale, prescribing, dispensing, dealing in, or distribution of the aforesaid drugs. Each collector of internal revenue is hereby authorized to furnish, upon written request, certified copies of any of the said statements or returns filed in his office to any of such officials of any State or Territory, or organized municipality therein, or of the District of Columbia, or any insular possession of the United States, as shall be entitled to inspect said statements or returns filed in the office of the said collector, upon the payment of a fee of $1 for each one hundred words in the copy or copies so requested. Any person who shall disclose the information contained in the said statements or returns or in the said

Sec. 4 That it shall be unlawful for any person who shall not have registered and paid the special tax as required by section one of this Act to send, ship, carry, or deliver any of the aforesaid drugs from any State or Territory or the District of Columbia, or any insular possession of the United States, to any person in any other State or Territory or the District of Columbia or any insular possession of the United States: Provided, that nothing contained in this section shall apply to common carriers engaged in transporting the aforesaid drugs, or to any employee acting within the scope of his employment,

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duplicate-order forms, except as herein expressly provided, and except for the purpose of enforcing the provisions of this Act, or for the purpose of enforcing any law of any State or Territory, or the District of Columbia, or any insular possession of the United States, or ordinance of any organization or municipality therein, regulating the sale, prescribing, dispensing, dealing in, or distribution of the aforesaid drugs shall, on conviction, be fined or imprisoned as provided by section nine of this Act. And collectors of internal revenue are hereby authorized to furnish upon written request, to any person, a certified copy of the names of any and all persons who may be listed in their respective collection district as special tax-payers under the provisions of this Act, upon payment of a fee of $1 per hundred names or fraction thereof in the copy so requested. Sec. 6 That the provisions of this Act shall not be construed to apply to the sale, distribution, or giving away, dispensing, or possession of preparations and remedies which do not contain more than two grains of opium, or more than one-fourth of a grain of morphine, or more than one-eighth of grain of heroin, or more than one grain of codeine, or any salt or derivative of them in one fluid ounce, or, if a solid or semi-solid preparation, in one avoirdupois ounce, or to liniments, ointments, and other preparations which contain cocaine or any of its salts or alpha or beta eucaine or any of their salts or any synthetic substitute for them: Provided, that such remedies and preparations are sold, distributed, given away, dispensed, or possessed as medicines and not for the purpose of evading the intentions and provisions of this Act. The provisions of this Act shall not apply to decocainized coca leaves or preparations made therefrom, or to other preparations of coca leaves which do not contain cocaine.

Sec. 7 That all laws relating to the assessment, collection, remission, and refund of internal revenue taxes, including section thirty-two hundred and twenty-nine of the Revised Statutes of the United States, so far as applicable to and not inconsistent with the provisions of this Act, are hereby extended and made applicable to the special taxes imposed by this Act. Sec. 8 That it shall be unlawful for any person not registered under the provisions of this Act, and who has not paid the special tax provided for by this Act, to have in his possession or under his control any of the aforesaid drugs; and such possession or control shall be presumptive evidence of a violation of this section, and also a violation of the provisions of section one of this Act: Provided, That this section shall not apply to any employee of a registered person, or to a nurse under the supervision of a physician, dentist, or veterinary surgeon registered under this Act, having such possession or control by virtue of his employment or occupation and not on his own account; or to the possession of any of the aforesaid drugs which has or have been prescribed in good faith by a physician, dentist, or veterinary surgeon registered under this Act; or to any United States, State, county, municipal, district, Territorial or insular officer or official who has possession of any of said drugs, by reason of his official duties, or to a warehouseman holding possession for a person registered and who has paid taxes under this Act; or to common carriers engaged in transporting such drugs; Provided further, that it shall not be necessary to negative any of the aforesaid exemptions in any complaint, information, indictment or other writ or proceeding laid or brought under this Act; and the burden of proof of any such exemption shall be upon the defendant.

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Sec. 9 That any person who violates or fails to comply with any of the requirements of this Act shall, on conviction, be fined not more than $2,000 or be imprisoned not more than five years, or both, in the discretion of the court. Sec. 10 That the Commissioner of Internal Revenue, with the approval of the Secretary of the Treasury, is authorized to appoint such agents, deputy collectors, inspectors, chemists, assistant chemists, clerks, and messengers in the field and in the Bureau of Internal Revenue in the District of Columbia as may be necessary to enforce the provisions of this Act. Sec. 11 That the sum of $150,000, or so much thereof as may be necessary, be, and hereby is, appropriated, out of any moneys in the Treasury not otherwise appropriated, for the purpose of carrying into effect the provisions of this Act. Sec. 12 That nothing contained in this Act shall be construed to impair, alter, amend, or repeal any of the provisions of the Act of Congress approved June thirtieth, nineteen hundred and six entitled “An act for preventing the manufacture, sale, or transportation of adulterated, or misbranded, or poisonous, or deleterious foods, drugs, medicines, and liquors, and for regulating traffic therein, and for other purposes” and any amendment thereof, or of the Act approved February ninth, nineteen hundred and nine entitled, “An act to prohibit the importation and use of opium for other than medicinal purposes” and any amendment thereof. Approved, December 17, 1914 Source: Public Law No. 223, 63rd Cong. Available at Schaffer Library of Drug Policy. http://druglibrary.org/schaffer/ history/e1910/harrisonact.htm.

Eighteenth Amendment to the U.S. Constitution (1920–1933) The Eighteenth Amendment to the U.S. Constitution established Prohibition in the United States. This was a time when the sale, manufacture, and distribution of alcohol was illegal by federal law. Many states had made these events illegal prior to this, but this amendment made them illegal federally (nationwide). The amendment was passed by Congress on December 18, 1917, then was ratified by 36 states on January 16, 1919. The law had an effective date of one year after passage, which was January 16, 1920. Prohibition lasted for 13 years. It was repealed by the Twenty-First Amendment, which was passed in 1933. The legislation to end Prohibition was signed by President Franklin D. Roosevelt. The amendment consists of only three short sections. In Section 1 of the amendment, the manufacture, sale, or transportation of intoxicating liquor was made illegal, as was the importation and exportation of alcohol into and out of the United States and all of its territories. Section 2 mandated that Congress and the states both had the power (concurrent power) to enforce the law. The final section informed people that the amendment would become effective upon ratification by enough states within seven years.

Eighteenth Amendment Amendment XVIII Section 1 After one year from the ratification of this article the manufacture, sale, or transportation of intoxicating liquors within, the importation thereof into, or the exportation thereof from the United States and all

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territory subject to the jurisdiction thereof for beverage purposes is hereby prohibited. Section 2 The Congress and the several States shall have concurrent power to enforce this article by appropriate legislation. Section 3 This article shall be inoperative unless it shall have been ratified as an amendment to the Constitution by the legislatures of the several States, as provided in the Constitution, within seven years from the date of the submission hereof to the States by the Congress. Source: National Archives

the Addiction Research Center. Researchers were able to learn more about the nature of addiction and the psychopharmacology of drugs. However, there were many concerns about the quality of the research, and possible abuse, so in 1975 the prison farms were closed and became prisons once again. Below is the act that created the prison farms.

After the Harrison Act was passed in 1914, many prisons became severely overcrowded. The Porter Narcotic Farm Act created two prison-based hospitals for those in need of drug treatment. The first “narcotic farm” was opened in 1935 in Lexington, Kentucky. It was a 1,500-bed facility. The second one opened in 1938 in Fort Worth, Texas. These were prisons that were dedicated to holding only inmates with drug problems. Any federal prison inmates who were addicted to drugs could be assigned or transferred to one of these two facilities to serve out the term of their prison sentence. The prison farms had large grounds surrounding the facility on which crops were grown and cows and other farm animals were raised. In addition to working on the farm, inmates would receive drug treatment. The hope was that the inmates who received treatment would not use drugs once released. Unfortunately, this did not happen.

Porter Narcotic Farm Act (1929) An Act to establish two United States narcotic farms for the confinement and treatment of persons addicted to the use of habit-forming narcotic drugs who have been convicted of offenses against the United States, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, that when used in this Act— (a) The term “habit-forming narcotic drug” or “narcotic” means opium and coca leaves and the innumerable alkaloids derived there-from, the best known of these alkaloids being morphine, heroin, and codeine, obtained from opium, and cocaine derived from the coca plant; all compounds, salts, preparations, or other derivatives obtained either from the raw material or from the various alkaloids; Indian hemp and its various derivatives, compounds, and preparations, and peyote in its various forms. (b) The term “addict” means any person who habitually uses any habit-forming narcotic drug as defined in this Act so as to endanger the public morals, health, safety, or welfare, or who is or has been so far addicted to the use of such habit-forming narcotic drugs as to have lost the power of selfcontrol with reference to his addiction.

The narcotic farms were also research facilities. The Lexington farm became known as

SEC. 2. That the Attorney General, the Secretary of the Treasury, and the Secretary

Porter Narcotic Farm Act (1929)

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of War be and are hereby, authorized and directed to select sites for two institutions for the confinement and treatment of persons who have been or shall be convicted of offenses against the United States, including persons convicted by general courts-martial and consular courts, and who are addicted to the use of habit-forming narcotic drugs, and for the confinement and treatment of addicts who voluntarily submit themselves for treatment. Sec. 5. That the control and management of the United States narcotic farms shall be vested in the Secretary of the Treasury, who shall have power to appoint competent superintendents, assistant superintendents, physicians, pharmacists, psychologists, nurses, and all other officers and employees necessary or the safe keeping, care, protection, treatment, and discipline of the inmates. There is hereby created in the office of the Surgeon General of the Bureau of the Public Health Service, in the Department of the Treasury, a division to be known as the Narcotics Division, which shall be in charge of a physician trained in the treatment and care of narcotic addicts, and which division shall have charge of the management, discipline, and methods of treatment of said United States narcotic farms under the rules and regulations promulgated by the Secretary of the Treasury. Sec. 6. That the care, discipline, and treatment of the persons admitted to or confined in a United States narcotic farm shall be designed to rehabilitate them, restore them to health, and where necessary train them to be self-supporting and self-reliant. . . . Sec. 7. That the authority vested with the power to designate the place of confinement of a prisoner is hereby authorized and

directed to transfer to the United States narcotic farms, as accommodations become available, all addicts, as herein defined, who are now or shall hereafter be sentenced to confinement in or be confined in any penal, correctional, disciplinary, or reformatory institution of the United States, including those addicts convicted of offenses against the United States who are confined in State and Territorial prisons, penitentiaries, and reformatories: Provided, That no addict shall be transferred to a United States narcotic farm who, in the opinion of the officer authorized to direct the transfer, is not a proper subject for confinement in such an institution either because of the nature of the crime he has committed, or his apparent incorrigibility. . . . Sec. 11. That not later than one month prior to the expiration of the sentence of any addict confined in a United States narcotic farm, he shall be examined by the Surgeon General of the Bureau of the Public Health Service, or his authorized representative. If he believes the person to be discharged is still an addict within the meaning of this Act and that he may by further treatment in a United States narcotic farm be cured of his addiction. The addict shall be informed, under such rules and regulations as the Secretary of the Treasury may promulgate, of the advisability of his submitting himself to further treatment. The addict may then apply in writing to the Secretary of the Treasury for further treatment in a United States narcotic farm for a period not exceeding the maximum length of time considered necessary by the Surgeon General of the Bureau of the Public Health Service. Upon approval of the application by the Secretary of the Treasury or his authorized agent, the addict may be given such further treatment as is necessary to cure him of his addiction.

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Sec. 12. That any person, except a non convicted alien, addicted to the use of habitforming narcotic drugs, whether or not he shall have been convicted of an offense against the United States, may apply to the Secretary of the Treasury, or his authorized representative, for admission to a United States narcotic farm. Any such addict shall be examined by the Surgeon General of the Bureau of the Public Health Service or his authorized agent, who shall report to the Secretary of the Treasury whether the applicant is an addict within the meaning of this Act; whether he believes he may by treatment in a United States narcotic farm be cured of his addiction and the estimated length of time necessary to effect a cure, and any further pertinent information bearing on the addiction, habits, or character of the applicant. The Secretary of the Treasury may, in his discretion, admit the applicant to a United States narcotic farm. No such addict shall be admitted unless he voluntarily submits to treatment for the maximum amount of time estimated by the Surgeon General of the Bureau of the Public Health Service as necessary to effect a cure, and unless suitable accommodations are available after all eligible addicts convicted of offenses against the United States have been admitted. Source: P.L. 70-672, 45 Stat. 1085

Marihuana Tax Act (1937) The Marihuana Tax Act was a 1937 law that outlawed the recreational use of marijuana in the United States. Technically, the Marihuana Tax Act did not directly ban the use of marijuana, but rather increased the regulations around it so that its use was effectively made illegal. Before this, marijuana use was regulated by the 1906 Pure Food and Drug Act. This law required that any product

that contained marijuana had to be labeled as such if it was being sold to the public. Marijuana was not included as part of the Harrison Act, because it was not considered at the time to be addictive. The Marihuana Tax Act required that people who wanted to distribute the drug had to purchase a stamp from the Treasury Department. The exact price for the marijuana tax stamp varied, from $1 per year for producers of the drug and medical professionals, to $5 for individuals who were not medical professionals, and $24 for importers and manufacturers of the drug. In addition, all marijuana transfers were taxed $1 per ounce. The act also had provisions that anyone who grew, transported, prescribed, or sold the drug needed to register with the federal government to pay the tax. Anyone convicted of violating the law could be fined up to $2,000 and up to five years in prison. The act is printed below.

THE MARIHUANA TAX ACT OF 1937 Full Text of the Marihuana Tax Act as passed in 1937 U. S. TREASURY DEPARTMENT BUREAU OF NARCOTICS REGULATIONS No. 1 RELATING TO THE IMPORTATION, MANUFACTURE, PRODUCTION COMPOUNDING, SALE, DEALING IN, DISPENSING PRESCRIBING, ADMINISTERING, AND GIVING AWAY OF MARIHUANA UNDER THE

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ACT OF AUGUST 2, 1937 PUBLIC, No. 238, 75TH CONGRESS NARCOTIC-INTERNAL REVENUE REGULATIONS JOINT MARIHUANA REGULATIONS MADE BY THE COMMISSIONER OF NARCOTICS AND THE COMMISSIONER OF INTERNAL REVENUE WITH THE APPROVAL OF THE SECRETARY OF THE TREASURY EFFECTIVE DATE, OCTOBER 1, 1937 LAW AND REGULATIONS RELATING TO THE IMPORTATION, MANUFACTURE, PRODUCTION, COMPOUNDING, SALE, DEALING IN, DISPENSING, PRESCRIBING, ADMINISTERING, AND GIVING AWAY OF MARIHUANA THE LAW

every compound, manufacture, salt, derivative, mixture, or preparation of such plant, its seeds, or resin- but shall not include the mature stalks of such plant, fiber produced from such stalks, oil or cake made from the seeds of such plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such mature stalks (except the resin extracted therefrom), fiber, oil, or cake, or the sterilized seed of such plant which is incapable of germination. (c) The term “producer” means any person who (1) plants, cultivates, or in any way facilitates the natural growth of marihuana; or (2) harvests and transfers or makes use of marihuana. (d) The term “Secretary” means the Secretary of the Treasury and the term “collector” means collector of internal revenue. (e) The term “transfer” or “transferred” means any type of disposition resulting in a change of possession but shall not indue a transfer to a common carrier for the purpose of transporting marihuana.

(Act of Aug. 2, 1937, Public 238, 75th Congress) Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That when used in this Act, (a) The term “person” means an individual, a partnership, trust, association, company, or corporation and includes an officer or employee of a trust, association, company, or corporation, or a member or employee of a partnership, who, as such officer, employee, or member, is under a duty to perform any act in respect of which any violation of this Act occurs. (b) The term “marihuana” means all parts of the plant Cannabis sativa L., whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and

SEC. 2. (a) Every person who imports, manufactures, produces, compounds, sells, deals in, dispenses, prescribes, administers, or gives away marihuana shall (1) within fifteen days after the effective date of this Act, or (2) before engaging after the expiration of such fifteen-day period in any of the above mentioned activities, and (3) thereafter, on or before July 1 of each year, pay the following special taxes respectively: (1) Importers, manufacturers, and compounders of marihuana, $24 per year. (2) Producers of marihuana (except those included within subdivision (4) of this subsection), $1 per year, or fraction thereof, during which they engage in such activity. (3) Physicians, dentists, veterinary surgeons, and other practitioners who distribute, dispense, give away, administer, or

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prescribe marihuana to patients upon whom they in the course of their professional practice are in attendance, $1 per year or fraction thereof during which they engage in any of such activities. (4) Any person not registered as an importer, manufacturer, producer, or compounder who obtains and uses marihuana in a laboratory for the purpose of research, instruction, or analysis, or who produces marihuana for any such purpose, $1 per year, or fraction thereof, during which he engages in such activities. (5) Any person who is not a physician, dentist, veterinary surgeon, or other practitioner and who deals in, dispenses, or gives away marihuana, $3 per year: Provided, That any person who has registered and paid the special tax as an importer, manufacturer, compounder, or producer, as required by subdivisions (1) and (2) of this subsection, may deal in, dispense, or give away marihuana imported, manufactured, compounded, or produced by him without further payment of the tax imposed by this section. (b) Where a tax under subdivision (1) or (5) is payable on July 1 of any year it shall be computed for one year; where any such tax is payable on any other day it shall be computed proportionately from the first day of the month in which the liability for the tax accrued to the following July 1. (c) In the event that any person subject to a tax imposed by this section engages in any of the activities enumerated in subsection (a) of this section at more than one place, such person shall pay the tax with respect to each such place. (d) Except as otherwise provided, whenever more than one of the activities enumerated in subsection (a) of this section is carried on by the same person at the same time, such person shall pay the tax for each

such activity, according to the respective rates prescribed. (e) Any person subject to the tax imposed by this section shall, upon payment of such tax, register his name or style and his place or places of business with the collector of the district in which such place or places of business are located. (f) Collectors are authorized to furnish, upon written request, to any person a certified copy of the names of any or all persons who may be listed in their respective collection districts as special taxpayers under this section, upon payment of a fee of $1 for each one hundred of such names or fraction thereof upon such copy so requested. SEC. 3. (a) No employee of any person who has paid the special tax and registered, as required by section 2 of this Act, acting within the scope of his employment, shall be required to register and pay such special tax. (b) An officer or employee of the United States, any State, Territory, the District of Columbia, or insular possession, or political subdivision, who, in the exercise of his official duties, engages in any of the activities enumerated in section 2 of this Act, shall not be required to register or pay the special tax, but his right to this exemption shall be evidenced in such manner as the Secretary may by regulations prescribe. SEC. 4. (a) It shall be unlawful for any person required to register and pay the special tax under the provisions of section 2 to import, manufacture, produce, compound, sell, deal in, dispense, distribute, prescribe, administer, or give away marihuana without having so registered and paid such tax. (b) In any suit or proceeding to enforce the liability imposed by this section or section 2, if proof is made that marihuana was at any time growing upon land under the control of

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the defendant, such proof shall be presumptive evidence that at such time the defendant was a producer and liable under this section as well as under section 2. SEC. 5. It shall be unlawful for any person who shall not have paid the special tax and registered, as required by section 2, to send, ship, carry, transport, or deliver any marihuana within any Territory, the District of Columbia, or any insular possession, or from any State, Territory, the District of Columbia, any insular possession of the United States, or the Canal Zone, into any other State, Territory, the District of Columbia, or insular possession of the United States: Provided, That nothing contained in this section shall apply to any common carrier engaged in transporting marihuana; or to any employee of any person who shall have registered and paid the special tax as required by section 2 while acting within the scope of his employment; or to any person who shall deliver marihuana which has been prescribed or dispensed by a physician, dentist, veterinary surgeon, or other practitioner registered under section 2, who has been employed to prescribe for the particular patient receiving such marihuana; or to any United States, State, county, municipal, District, Territorial, or insular officer or official acting within the scope of his official duties. Sec. 6. (a) It shall be unlawful for any person, whether or not required to pay a special tax and register under section 2, to transfer marihuana, except in pursuance of a written order of the person to whom such marihuana is transferred, on a form to be issued in blank for that purpose by the Secretary. (b) Subject to such regulations as the Secretary may prescribe, nothing contained in this section shall apply:

(1) To a transfer of marihuana to a patient by a physician, dentist, veterinary surgeon, or other practitioner registered under section 2, in the course of his professional practice only: Provided, That such physician, dentist, veterinary surgeon, or other practitioner shall keep a record of all such marihuana transferred, showing the amount transferred and the name and address of the patient to whom such marihuana is transferred, and such record shall be kept for a period of two years from the date of the transfer of such marihuana, and subject to inspection as provided in section 11. (2) To a transfer of marihuana, made in good faith by a dealer to a consumer under and in pursuance of a written prescription issued by a physician, dentist, veterinary surgeon, or other practitioner registered under section 2: Provided, That such prescription shall be dated as of the day on which signed and shall be signed by the physician, dentist, veterinary surgeon, or other practitioner who issues the same; Provided further, That such dealer shall preserve such prescription for a period of two years from the day on which such prescription is filled so as to be readily accessible for inspection by the officers, agents, employees, and officials mentioned in section 11. (3) To the sale, exportation, shipment, or delivery of marihuana by any person within the United States, any Territory, the District of Columbia, or any of the insular possessions of the United States, to any person in any foreign country regulating the entry of marihuana, if such sale, shipment, or delivery of marihuana is made in accordance with such regulations for importation into such foreign country as are prescribed by such foreign country, such regulations to be promulgated from time to time by the Secretary of State of the United States.

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(4) To a transfer of marihuana to any officer or employee of the United States Government or of any State, Territorial, District, county, or municipal or insular government lawfully engaged in making purchases thereof for the various departments of the Army and Navy, the Public Health Service, and for Government, State, Territorial, District, county, or municipal or insular hospitals or prisons (S) To a transfer of any seeds of the plant Cannabis sativa L. to any person registered under section 2. (c) The Secretary shall cause suitable forms to be prepared for the purposes before mentioned and shall cause them to be distributed to collectors for sale. The price at which such forms shall be sold by said collectors shall be fixed by the Secretary but shall not exceed 2 cents each. Whenever any collector shall sell any of such forms he shall cause the date of sale, the name and address of the proposed vendor, the name and address of the purchaser, and the amount of marihuana ordered to be plainly written or stamped thereon before delivering the same. (d) Each such order form sold by a collector shall be prepared by him and shall include an original and two copies, any one of which shall be admissible in evidence as an original. The original and one copy shall be given by the collector to the purchaser thereof. The original shall in turn be given by the purchaser thereof to any person who shall, in pursuance thereof, transfer marihuana to him and shall be preserved by such person for a period of two years so as to be readily accessible for inspection by any officer, agent, or employee mentioned in section 11. The copy given to the purchaser by the collector shall be retained by the purchaser and preserved for a period of two years so as to be readily accessible to inspection by any officer, agent, or employee mentioned in

section 11. The second copy shall be preserved in the records of the collector. SEC. 7. (a) There shall be levied, collected, and paid upon all transfers of marihuana which are required by section 6 to be carried out in pursuance of written order forms taxes at the following rates: (1) Upon each transfer to any person who has paid the special tax and registered under section 2 of this Act, $1 per ounce of marihuana or fraction thereof. (2) Upon each transfer to any person who has not paid the special tax and registered under section 2 of this Act, $100 per ounce of marihuana or fraction thereof. (b) Such tax shall be paid by the transferee at the time of securing each order form and shall be in addition to the price of such form. Such transferee shall be liable for the tax imposed by this section but in the event that the transfer is made in violation of section 6 without an order form and without payment of the transfer tax imposed by this section, the transferor shall also be liable for such tax. (c) Payment of the tax herein provided shall be represented by appropriate stamps to be provided by the Secretary and said stamps shall be affixed by the collector or his representative to the original order form. (d) All provisions of law relating to the engraving, issuance, sale, accountability, cancelation, and destruction of tax-paid stamps provided for in the internal-revenue laws shall, insofar as applicable and not inconsistent with this Act, be extended and made to apply to stamps provided for in this section. (e) All provisions of law (including penalties) applicable in respect of the taxes imposed by the Act of December 17, 1914 (38 Stat. 785; U. S. C., 1934 ed., title 26, secs. 1040–1061, 1383–1391), as amended, shall,

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insofar as not inconsistent with this Act, be applicable in respect of the taxes imposed by this Act. SEC. 8. (a) It shall be unlawful for any person who is a transferee required to pay the transfer tax imposed by section 7 to acquire or otherwise obtain any marihuana without having paid such tax; and proof that any person shall have had in his possession any marihuana and shall have failed, after reasonable notice and demand by the collector, to produce the order form required by section 6 to be retained by him, shall be presumptive evidence of guilt under this section and of liability for the tax imposed by section 7. (b) No liability shall be imposed by virtue of this section upon any duly authorized officer of the Treasury Department engaged in the enforcement of this Act or upon any duly authorized officer of any State, or Territory, or of any political subdivision thereof, or the District of Columbia, or of any insular possession of the United States, who shall be engaged in the enforcement of any law or municipal ordinance dealing with the production, sale, prescribing, dispensing, dealing in, or distributing of marihuana. SEC. 9. (a) Any marihuana which has been imported, manufactured, compounded, transferred, or produced in violation of any of the provisions of this Act shall be subject to seizure and forfeiture and, except as inconsistent with the provisions of this Act, all the provisions of internal-revenue laws relating to searches, seizures, and forfeitures are extended to include marihuana. (b) Any marihuana which may be seized by the United States Government from any person or persons charged with any violation of this Act shall upon conviction of the person or persons from whom seized be confiscated by and forfeited to the United States.

(c) Any marihuana seized or coming into the possession of the United States in the enforcement of this Act, the owner or owners of which are unknown, shall be confiscated by and forfeited to the United States. (d) The Secretary is hereby directed to destroy any marihuana confiscated by and forfeited to the United States under this section or to deliver such marihuana to any department, bureau, or other agency of the United States Government, upon proper application therefor under such regulations as may be prescribed by the Secretary. SEC. 10. (a) Every person liable to any tax imposed by this Act shall keep such books and records, render under oath such statements, make such returns, and comply with such rules and regulations as the Secretary may from time to time prescribe. (b) Any person who shall be registered under the provisions of section 2 in any internalrevenue district shall, whenever required so to do by the collector of the district, render to the collector a true and correct statement or return, verified by affidavits, setting forth the quantity of marihuana received or harvested by him during such period immediately preceding the demand of the collector, not exceeding three months, as the said collector may fix and determine. If such person is not solely a producer, he shall set forth in such statement or return the names of the persons from which said marihuana was received, the quantity in each instance received from such persons, and the date when received. SEC. 11. The order forms and copies thereof and the prescriptions and records required to be preserved under the provisions of section 6, and the statements or returns filed in the office of the collector of the district under the provisions of section 10 (b) shall be open to inspection by officers, agents,

Appendix  1005

and employees of the Treasury Department duly authorized for that purpose, and such officers of any State, or Territory, or of any political subdivision thereof, or the District of Columbia, or of any insular possession of the United States as shall be charged with the enforcement of any law or municipal ordinance regulating the production, sale, prescribing, dispensing, dealing in, or distributing of marihuana. Each collector shall be authorized to furnish, upon written request, copies of any of the said statements or returns filed in his office to any of such officials of any State or Territory, or political subdivision thereof, or the District of Columbia, or any insular possession of the United States as shall be entitled to inspect the said statements or returns filed in the office of the said collector, upon the payment of a fee of $1 for each 100 words or fraction thereof in the copy or copies so requested. Sec. 12. Any person who is convicted of a violation of any provision of this Act shall be fined not more than $2,000 or imprisoned not more than five years, or both, in the discretion of the court. Sec. 13. It shall not be necessary to negative any exemptions set forth in this Act in any complaint, information, indictment, or other writ or proceeding laid or brought under this Act and the burden of proof of any such exemption shall be upon the defendant. In the absence of the production of evidence by the defendant that he has complied with the provisions of section 6 relating to order forms, he shall be presumed not to have complied with such provisions of such sections, as the case may be. Sec. 14. The Secretary is authorized to make, prescribe, and publish all necessary rules and regulations for carrying out the provisions of

this Act and to confer or impose any of the rights, privileges, powers, and duties conferred or imposed upon him by this Act upon such officers or employees of the Treasury Department as he shall designate or appoint. Sec. 15. The provisions of this Act shall apply to the several States, the District of Columbia, the Territory of Alaska, the Territory of Hawaii, and the insular possessions of the United States, except the Philippine Islands. In Puerto Rico the administration of this Act, the collection of the special taxes and transfer taxes, and the issuance of the order forms provided for in section 6 shall be performed by the appropriate internal revenue officers of that government, and all revenues collected under this Act in Puerto Rico shall accrue intact to the general government thereof. The President is hereby authorized and directed to issue such Executive orders as will carry into effect in the Virgin Islands the intent and purpose of this Act by providing for the registration with appropriate officers and the imposition of the special and transfer taxes upon all persons in the Virgin Islands who import, manufacture, produce, compound, sell, deal in, dispense, prescribe, administer, or give away marihuana. Sec. 16. If any provision of this Act or the application thereof to any person or circumstances is held invalid, the remainder of the Act and the application of such provision to other persons or circumstances shall not be affected thereby. Sec. 17. This Act shall take effect on the first day of the second month during which it is enacted. Sec. 18. This Act may be cited as the “Marihuana Tax Act of 1937.” (T. D. 28)

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Order of the Secretary of the Treasury Relating to the Enforcement of the Marihuana Tax Act of 1937 September 1, 1937 Section 14 of the Marihuana Tax Act of 1937 (act of Congress approved August 2, 1937, Public, No. 238), provides as follows: The Secretary is authorized to make, prescribe, and publish all necessary rules and regulations for carrying out the provisions of this Act and to confer or impose any of the rights, privileges, powers, and duties conferred or imposed upon him by this Act upon such officers or employees of the Treasury Department as he shall designate or appoint. In pursuance of the authority thus conferred upon the Secretary of the Treasury, it is hereby ordered: I. Rights, Privileges, Powers, and Duties Conferred and imposed Upon the Commissioner of Narcotics 1. There are hereby conferred and imposed upon the Commissioner of Narcotics, subject to the general supervision and direction of the Secretary of the Treasury, all the rights, privileges, powers, and duties conferred or imposed upon said Secretary by the Marihuana Tax Act of 1937, so far as such rights privileges, powers, and duties relate to: (a) Prescribing regulations, with the approval of the Secretary, as to the manner in which the right of public officers to exemption from registration and payment of special tax may be evidenced, in accordance with section 3 (b) of the Act. (b) Prescribing the form of written order required by section 6 (a) of the Act, said form to be prepared and issued in blank by the Commissioner of Internal Revenue as hereinafter provided. (c) Prescribing regulations, with the approval of the Secretary, giving effect to the exceptions, specified in subsection (b), from

the operation of subsection (a) of section 6 of the Act. (d) The destruction of marihuana confiscated by and forfeited to the United States, or delivery of such marihuana to any department, bureau, or other agency of the United States Government, and prescribing regulations, with the approval of the Secretary, governing the manner of application for, and delivery of such marihuana. (e) Prescribing rules and regulations, with the approval of the Secretary, as to books and records to be kept, and statements and information returns to be rendered under oath, as required by section 10 (a) of the Act. (f) The compromise of any criminal liability (except as relates to delinquency in registration and delinquency in payment of tax) arising under the Act, in accordance with section 3229 of the Revised Statutes of the United States (U. S. Code (1934 ed.) title 26, sec. 1661), and the recommendation for assessment of civil liability for internal-revenue taxes and ad valorem penalties under the Act. II. Rights, Privileges, Powers, and Duties Conferred and Imposed upon the Commissioner of Internal Revenue 1. There are hereby conferred and imposed upon the Commissioner of Internal Revenue, subject to the general supervision and direction of the Secretary of the Treasury, the rights, privileges, powers, and duties conferred or imposed upon said Secretary of the Marihuana Tax Act of 1937, not otherwise assigned herein, so far as such rights, privileges, powers, and duties relate to (a) Preparation and issuance in blank to collectors of internal revenue of the written orders, in the form prescribed by the Commissioner of Narcotics, required by section 6 (a) of the Act. The price of the order form, as sold by the collector under section 6 (c) of the Act shall be two cents for the original and one copy.

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(b) Providing appropriate stamps to represent payment of transfer tax levied by section 7, and prescribing and providing appropriate stamps for issuance of special tax payers registering under section 2 of the Act. (c) The compromise of any civil liability involving delinquency in registration, delinquency in payment of tax, and ad valorem penalties, and of any criminal liability incurred through delinquency in registration and delinquency in payment of tax, in connection with the Act and in accordance with Section 3229 of the Revised Statutes of the United States (U. S. Code (1934 ed.), title 26, sec. 1661)- the determination of liability for and the assessment and collection of special and transfer taxes imposed by the Act; the determination of liability for and the assessment and collection of the ad valorem penalties imposed by Section 3176 of the Revised Statutes, as modified by Section 406 of the Revenue Act of 1935 (U. S. Code (1934 ed.) title 26, secs. 1512–1525), for delinquency in registration; and the determination of liability for and the assertion of the specific penalty imposed by the Act, for delinquency in registration and payment of tax. General Provisions The investigation and the detection, and presentation to prosecuting officers of evidence, of violations of the Marihuana Tax Act of 1937, shall be the duty of the Commissioner of Narcotics and the assistants, agents, inspectors, or employees under his direction. Except as specifically inconsis­ tent with the terms of said Act and of this order, the Commissioner of Narcotics and the Commissioner of Internal Revenue and the assistants, agents, inspectors, or employees of the Bureau of Narcotics and the Bureau of Internal Revenue, respectively, shall have the same powers and duties in safeguarding the revenue thereunder as they now have

with respect to the enforcement of, and collection of the revenue under, the Act of December 17, 1914, as amended (U. S. Code (1934 ed.), title 26, sec. 1049). In any case where a general offer is made in compromise of civil and criminal liability ordinarily compromisable hereunder by the Commissioner of Internal Revenue and of criminal liability ordinarily compromisable hereunder by the Commissioner of Narcotics, the case may be jointly compromisable by those officers, in accordance with Section 3229 of the Revised Statutes of the United States (U.S. Code (1934 ed.), title 26, sec. 1661). Power is hereby conferred upon the Commissioner of Narcotics to prescribe such regulations as he may deem necessary for the execution of the functions imposed upon him or upon the officers or employees of the Bureau of Narcotics, but all regulations and changes in regulations shall be subject to the approval of the Secretary of the Treasury. The Commissioner of Internal Revenue and the Commissioner of Narcotics may, if they are of the opinion that the good of the service will be promoted thereby, prescribe regulations relating to internal revenue taxes where no violation of the Marihuana Tax Act of 1937 is involved, jointly, subject to the approval of the Secretary of the Treasury. The right to amend or supplement this order or any provision thereof from time to time, or to revoke this order or any provision thereof at any time, is hereby reserved. The effective date of this order shall be October 1, 1937, which is the effective date of the Marihuana Tax Act of 1937. STEPHEN B. GIBBONS, Acting Secretary of the Treasury. REGULATIONS Introductory The Marihuana Tax Act of 1937, imposes special (occupational) taxes upon persons

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engaging in activities involving articles or material within the definition of “marihuana” contained in the Act, and also taxes the transfer of such articles or material. These regulations deal with details as to tax computation, procedure, the forms of records and returns, and similar matters. These matters in some degree are controlled by certain sections of the United States Revised Statutes and other statutes of general application. Provisions of these statutes, as well as of the Marihuana Tax Act of 1937 are quoted, in whole or in part, as the immediate or general basis for the regulatory provisions set forth. The quoted provisions are from the Marihuana Tax Act of 1937 unless otherwise indicated. Provisions of the statutes upon which the various articles of the regulations are based generally have not been repeated in the articles. Therefore, the statutory excerpts preceding the several articles should be examined to obtain complete information. Chapter I Laws Applicable Sec. 7 (e) All provisions of law (including penalties) applicable in respect of the taxes imposed by the Act of December 17, 1914 (38 Stat. 785; U. S. C., 1934 ed., title 26, secs. 1040–1061, 1383–1391), as amended, shall, insofar as not inconsistent with this Act, be applicable in respect of the taxes imposed by this Act. ART. 1. Statutes applicable. All general provisions of the internal revenue laws, not inconsistent with the Marihuana Tax Act, are applicable in the enforcement of the latter. Chapter II Definitions Sec. 1. That when used in this Act:

(a) The term “person” means an individual, a partnership, trust, association, company, or corporation and includes an officer or employee of a trust, association, company, or corporation, or a member or employee of a partnership, who as such officer, employee, or member is under a duty to perform any act in respect of which any violation of this Act occurs. (b) The term “marihuana” means all parts of the plant Cannabis sativa L., whether growing or not; the seeds thereof; the resin extracted from any part of such plant; and every compound, manufacture, salt, derivative, mixture, or preparation of such plant, its seeds, or resins; but shall not include the mature stalks of such plant, fiber produced from such stalks, oil or cake made from the seeds of such plant, any other compound, manufacture, salt, derivative, mixture, or preparation of such mature stalks (except the resin extracted therefrom), fiber, oil, or cake, or the sterilized seed of such plant which is incapable of germination. (c) The term “producer” means any person who (1) plants, cultivates, or in any way facilitates the natural growth of marihuana; or (2) harvests and transfers or makes use of marihuana. (d) The term “Secretary” means the Secretary of the Treasury and the term “collector” means collector of internal revenue. (e) The term “transfer” or “transferred” means any type of disposition resulting in a change of possession but shall not include a transfer to a common carrier for the purpose of transporting marihuana. ART. 2. As used in these regulations: (a) The term “act” or “this act” shall mean the Marihuana Tax Act of 1937, unless otherwise indicated. (b) The term “United States” shall include the several States, the District of Colum-

Appendix  1009

bia, the Territory of Alaska, the Territory of Hawaii, and the insular possessions of the United States except Puerto Rico and the Virgin Islands. It does not include the Canal Zone or the Philippine Islands. (c) The terms “manufacturer” and “compounder” shall include any person who subjects marihuana to any process of separation, extraction, mixing, compounding, or other manufacturing operation. They shall not include one who merely gathers and destroys the plant, one who merely threshes out the seeds on the premises where produced, or one who in the conduct of a legitimate business merely subjects seeds to a cleaning process. (d) The term “producer” means any person who induces in any way the growth of marihuana, and any person who harvests it, either in a cultivated or wild state, from his own or any other land, and transfers or makes use of it, including one who subjects the marihuana which he harvests to any processes rendering him liable also as a manufacturer or compounder. Generally all persons are included who gather marihuana for any purpose other than to destroy it. The term does not include one who merely plows under or otherwise destroys marihuana with or without harvesting. It does not include one who grows marihuana for use in his own laboratory for the purpose of research, instruction, or analysis and who does not use it for any other purpose or transfer it. (e) The term “special tax” is used to include any of the taxes, pertaining to the several occupations or activities covered by the act, imposed upon persons who import, manufacture, produce, compound, sell, deal in, dispense, prescribe, administer, or give away marihuana. (f) The term “person” occurring in these regulations is used to include individual, partnership, trust, association, company,

or corporation; also a hospital, college of pharmacy, medical or dental clinic, sanatorium, or other institution or entity. (g) Words importing the singular may include the plural; words importing the masculine gender may be applied to the feminine or the neuter. 1. The definitions contained herein shall not be deemed exclusive. Source: Pub. 238, 75th Congress, 50 Stat. 551 (Aug. 2, 1937)

Richard Nixon’s Special Message to the Congress on Drug Abuse Prevention and Control (1971) In 1971, drug use was becoming more prevalent across America. Drugs like marijuana and LSD were being used more commonly by middle-class youth. President Nixon, as a candidate for office, understood the concern that many people had about the increase in drug use, and supported a more conservative approach to crime in general, and specifically for fighting drug abuse. Because of his strong stance, Nixon became known as the “law and order” president. In this speech, Nixon was speaking directly to the American public about his administration’s plans to fight drug abuse. There were many facets to Nixon’s plans to address illicit drug use. One was a focus on enforcement. He proposed more money and support for law enforcement effort to attack the supply side of drug use, as well as a plan to work with other countries to reduce the amount of drugs being produced there and smuggled into the United States. Along with a focus on enforcement, Nixon also sought to address the demand problem in the United States. He wanted to increase rehabilitation

1010  Appendix

efforts by increasing federal allocations for treatment programs. One of the most important parts of this speech was that Nixon announced the creation of the Special Action Office of Drug Abuse Prevention that would be located within the Executive Office of the President. The office would consolidate and coordinate the attack on drug use across the country. It would set goals for programs, provide training, and assist state and local governments in fighting drugs. Some people argue that this office was the precursor to the Office of National Drug Control Policy (the “drug czar”) that exists today.

Richard Nixon, Special Message to the Congress on Drug Abuse Prevention and Control June 17, 1971 To the Congress of the United States: In New York City more people between the ages of fifteen and thirty-five years die as a result of narcotics than from any other single cause. In 1960, less than 200 narcotic deaths were recorded in New York City. In 1970, the figure had risen to over 1,000. These statistics do not reflect a problem indigenous to New York City. Although New York is the one major city in the Nation which has kept good statistics on drug addiction, the problem is national and international. We are moving to deal with it on both levels. As part of this administration’s ongoing efforts to stem the tide of drug abuse which has swept America in the last decade, we submitted legislation in July of 1969 for a comprehensive reform of Federal drug enforcement laws. Fifteen months later, in October, 1970, the Congress passed this vitally-needed legislation, and it is now

producing excellent results. Nevertheless, in the fifteen months between the submission of that legislation and its passage, much valuable time was lost. We must now candidly recognize that the deliberate procedures embodied in present efforts to control drug abuse are not sufficient in themselves. The problem has assumed the dimensions of a national emergency. I intend to take every step necessary to deal with this emergency, including asking the Congress for an amendment to my 1972 budget to provide an additional $155 million to carry out these steps. This will provide a total of $371 million for programs to control drug abuse in America. A New Approach To Rehabilitation While experience thus far indicates that the enforcement provisions of the Comprehensive Drug Abuse Prevention and Control Act of 1970 are effective, they are not sufficient in themselves to. eliminate drug abuse. Enforcement must be coupled with a rational approach to the reclamation of the drug user himself. The laws of supply and demand function in the illegal drug business as in any other. We are taking steps under the Comprehensive Drug Act to deal with the supply side of the equation and I am recommending additional steps to be taken now. But we must also deal with demand. We must rehabilitate the drug user if we are to eliminate drug abuse and all the antisocial activities that flow from drug abuse. Narcotic addiction is a major contributor to crime. The cost of supplying a narcotic habit can run from $30 a day to $100 a day. This is $210 to $700 a week, or $10,000 a year to over $36,000 a year. Untreated narcotic addicts do not ordinarily hold jobs. Instead, they often turn to shoplifting, mugging, burglary, armed robbery, and so on. They also support themselves by starting

Appendix  1011

other people—young people—on drugs. The financial costs of addiction are more than $2 billion every year, but these costs can at least be measured. The human costs cannot. American society should not be required to bear either cost. Despite the fact that drug addiction destroys lives, destroys families, and destroys communities, we are still not moving fast enough to meet the problem in an effective way. Our efforts are strained through the Federal bureaucracy. Of those we can reach at all under the present Federal system—and the number is relatively small—of those we try to help and who want help, we cure only a tragically small percentage. Despite the magnitude of the problem, despite our very limited success in meeting it, and despite the common recognition of both circumstances, we nevertheless have thus far failed to develop a concerted effort to find a better solution to this increasingly grave threat. At present, there are nine Federal agencies involved in one fashion or another with the problem of drug addiction. There are anti-drug abuse efforts in Federal programs ranging from vocational rehabilitation to highway safety. In this manner our efforts have been fragmented through competing priorities, lack of communication, multiple authority, and limited and dispersed resources. The magnitude and the severity of the present threat will no longer permit this piecemeal and bureaucratically-dispersed effort at drug control. If we cannot destroy the drug menace in America, then it will surely in time destroy us. I am not prepared to accept this alternative. Therefore, I am transmitting legislation to the Congress to consolidate at the highest level a full-scale attack on the problem of drug abuse in America. I am proposing the appropriation of additional funds to meet the cost of rehabilitating drug users, and I

will ask for additional funds to increase our enforcement efforts to further tighten the noose around the necks of drug peddlers, and thereby loosen the noose around the necks of drug users. At the same time I am proposing additional steps to strike at the “supply” side of the drug equation—to halt the drug traffic by striking at the illegal producers of drugs, the growing of those plants from which drugs are derived, and trafficking in these drugs beyond our borders. America has the largest number of heroin addicts of any nation in the world. And yet, America does not grow opium—of which heroin is a derivative—nor does it manufacture heroin, which is a laboratory process carried out abroad. This deadly poison in the American life stream is, in other words, a foreign import. In the last year, heroin seizures by Federal agencies surpassed the total seized in the previous ten years. Nevertheless, it is estimated that we are stopping less than 20 percent of the drugs aimed at this Nation. No serious attack on our national drug problem can ignore the international implications of such an effort, nor can the domestic effort succeed without attacking the problem on an international plane. I intend to do that. A Coordinated Federal Response Not very long ago, it was possible for Americans to persuade themselves, with some justification, that narcotic addiction was a class problem. Whether or not this was an accurate picture is irrelevant today, because now the problem is universal. But despite the increasing dimensions of the problem, and despite increasing consciousness of the problem, we have made little headway in understanding what is involved in drug abuse or how to deal with it. The very nature of the drug abuse problem has meant that its extent and seriousness

1012  Appendix

have been shrouded in secrecy, not only by the criminal elements who profit from drug use, but by the drug users themselves—the people whom society is attempting to reach and help. This fact has added immeasurably to the difficulties of medical assistance, rehabilitation, and government action to counter drug abuse, and to find basic and permanent methods to stop it. Even now, there are no precise national statistics as to the number of drug-dependent citizens in the United States, the rate at which drug abuse is increasing, or where and how this increase is taking place. Most of what we think we know is extrapolated from those few States and cities where the dimensions of the problem have forced closer attention, including the maintenance of statistics. A large number of Federal Government agencies are involved in efforts to fight the drug problem either with new programs or by expanding existing programs. Many of these programs are still experimental in nature. This is appropriate. The problems of drug abuse must be faced on many fronts at the same time, and we do not yet know which efforts will be most successful. But we must recognize that piecemeal efforts, even where individually successful, cannot have a major impact on the drug abuse problem unless and until they are forged together into a broader and more integrated program involving all levels of government and private effort. We need a coordinated effort if we are to move effectively against drug abuse. The magnitude of the problem, the national and international implications of the problem, and the limited capacities of States and cities to deal with the problem all reinforce the conclusion that coordination of this effort must take place at the highest levels of the Federal Government. Therefore, I propose the establishment of a central authority with overall responsibility

for all major Federal drug abuse prevention, education, treatment, rehabilitation, training, and research programs in all Federal agencies. This authority would be known as the Special Action Office of Drug Abuse Prevention. It would be located within the Executive Office of the President and would be headed by a Director accountable to the President. Because this is an emergency response to a national problem which we intend to bring under control, the Office would be established to operate only for a period of three years from its date of enactment, and the President would have the option of extending its life for an additional two years if desirable. This Office would provide strengthened Federal leadership in finding solutions to drug abuse problems. It would establish priorities and instill a sense of urgency in Federal and federally-supported drug abuse programs, and it would increase coordination between Federal, State, and local rehabilitation efforts. More specifically, the Special Action Office would develop overall Federal strategy for drug abuse prevention programs, set program goals, objectives and priorities, carry out programs through other Federal agencies, develop guidance and standards for operating agencies, and evaluate performance of all programs to determine where success is being achieved. It would extend its efforts into research, prevention, training, education, treatment, rehabilitation, and the development of necessary reports, statistics, and social indicators for use by all public and private groups. It would not be directly concerned with the problems of reducing drug supply, or with the law enforcement aspects of drug abuse control. It would concentrate on the “demand” side of the drug equation—the use and the user of drugs.

Appendix  1013

The program authority of the Director would be exercised through working agreements with other Federal agencies. In this fashion, full advantage would be taken of the skills and resources these agencies can bring to bear on solving drug abuse problems by linking them with a highly goal-oriented authority capable of functioning across departmental lines. By eliminating bureaucratic red tape, and jurisdictional disputes between agencies, the Special Action Office would do what cannot be done presently: it would mount a wholly coordinated national attack on a national problem. It would use all available resources of the Federal Government to identify the problems precisely, and it would allocate resources to attack those problems. In practice, implementing departments and agencies would be bound to meet specific terms and standards for performance. These terms and standards would be set forth under inter-agency agreement through a Program Plan defining objectives, costs, schedule, performance requirements, technical limits, and other factors essential to program success. With the authority of the Program Plan, the Director of the Special Action Office could demand performance instead of hoping for it. Agencies would receive money based on performance and their retention of funding and program authority would depend upon periodic appraisal of their performance. In order to meet the need for realistic central program appraisal, the Office would develop special program monitoring and evaluation capabilities so that it could realistically determine which activities and techniques were producing results. This evaluation would be tied to the planning process so that knowledge about success/ failure results could guide the selection of future plans and priorities.

In addition to the inter-agency agreement and Program Plan approach described above, the Office would have direct authority to let grants or make contracts with industrial, commercial, or nonprofit organizations. This authority would be used in specific instances where there is no appropriate Federal agency prepared to undertake a program, or where for some other reason it would be faster, cheaper, or more effective to grant or contract directly. Within the broad mission of the Special Action Office, the Director would set specific objectives for accomplishment during the first three years of Office activity. These objectives would target such areas as reduction in the overall national rate of drug addiction, reduction in drug-related deaths, reduction of drug use in schools, impact on the number of men rejected for military duty because of drug abuse, and so forth. A primary objective of the Office would be the development of a reliable set of social indicators which accurately show the nature, extent, and trends in the drug abuse problem. These specific targets for accomplishment would act to focus the efforts of the drug abuse prevention program, not on intermediate achievements such as numbers of treatments given or educational programs conducted, but rather on ultimate “payoff” accomplishments in the reduction of the human and social costs of drug abuse. Our programs cannot be judged on the fulfillment of quotas and other bureaucratic indexes of accomplishment. They must be judged by the number of human beings who are brought out of the hell of addiction, and by the number of human beings who are dissuaded from entering that hell. I urge the Congress to give this proposal the highest priority, and I trust it will do so. Nevertheless, due to the need for immediate action, I am issuing today, June 17, an Exec-

1014  Appendix

utive Order [11599] establishing within the Executive Office of the President a Special Action Office for Drug Abuse Prevention. Until the Congress passes the legislation giving full authority to this Office, a Special Consultant to the President for Narcotics and Dangerous Drugs will institute to the extent legally possible the functions of the Special Action Office. Rehabilitation: A New Priority When traffic in narcotics is no longer profitable, then that traffic will cease. Increased enforcement and vigorous application of the fullest penalties provided by law are two of the steps in rendering narcotics trade unprofitable. But as long as there is a demand, there will be those willing to take the risks of meeting the demand. So we must also act to destroy the market for drugs, and this means the prevention of new addicts, and the rehabilitation of those who are addicted. To do this, I am asking the Congress for a total of $105 million in addition to funds already contained in my 1972 budget to be used solely for the treatment and rehabilitation of drug-addicted individuals. I will also ask the Congress to provide an additional $10 million in funds to increase and improve education and training in the field of dangerous drugs. This will increase the money available for education and training to more than $24 million. It has become fashionable to suppose that no drugs are as dangerous as they are commonly thought to be, and that the use of some drugs entails no risk at all. These are misconceptions, and every day we reap the tragic results of these misconceptions when young people are “turned on” to drugs believing that narcotics addiction is something that happens to other people. We need an expanded effort to show that addiction is all too often a one-way street beginning with “innocent” experimen-

tation and ending in death. Between these extremes is the degradation that addiction inflicts on those who believed that it could not happen to them. While by no means a major part of the American narcotics problem, an especially disheartening aspect of that problem involves those of our men in Vietnam who have used drugs. Peer pressures combine with easy availability to foster drug use. We are taking steps to end the availability of drugs in South Vietnam but, in addition, the nature of drug addiction, and the peculiar aspects of the present problem as it involves veterans, make it imperative that rehabilitation procedures be undertaken immediately. In Vietnam, for example, heroin is cheap and 95 percent pure, and its effects are commonly achieved through smoking or “snorting” the drug. In the United States, the drug is impure, consisting of only about 5 percent heroin, and it must be “mainlined” or injected into the bloodstream to achieve an effect comparable to that which may have been experienced in Vietnam. Further, a habit which costs $5 a day to maintain in Vietnam can cost $100 a day to maintain in the United States, and those who continue to use heroin slip into the twilight world of crime, bad drugs, and all too often a premature death. In order to expedite the rehabilitation process of Vietnam veterans, I have ordered the immediate establishment of testing procedures and initial rehabilitation efforts to be taken in Vietnam. This procedure is under way and testing will commence in a matter of days. The Department of Defense will provide rehabilitation programs to all servicemen being returned for discharge who want this help, and we will be requesting legislation to permit the military services to retain for treatment any individual due for discharge who is a narcotic addict. All of

Appendix  1015

our servicemen must be accorded the right to rehabilitation. Rehabilitation procedures, which are required subsequent to discharge, will be effected under the aegis of the Director of the Special Action Office who will have the authority to refer patients to private hospitals as well as VA hospitals as circumstances require. The Veterans Administration medical facilities are a great national resource which can be of immeasurable assistance in the effort against this grave national problem. Restrictive and exclusionary use of these facilities under present statutes means that we are wasting a critically needed national resource. We are commonly closing the doors to those who need help the most. This is a luxury we cannot afford. Authority will be sought by the new Office to make the facilities of the Veterans Administration available to all former servicemen in need of drug rehabilitation, regardless of the nature of their discharge from the service. I am asking the Congress to increase the present budget of the Veterans Administration by $14 million to permit the immediate initiation of this program. This money would be used to assist in the immediate development and emplacement of VA rehabilitation centers which will permit both inpatient and outpatient care of addicts in a community setting. I am also asking that the Congress amend the Narcotic Addict Rehabilitation Act of 1966 to broaden the authority under this Act for the use of methadone maintenance programs. These programs would be carried out under the most rigid standards and would be subjected to constant and painstaking reevaluation of their effectiveness. At this time, the evidence indicates that methadone is a useful tool in the work of rehabilitating heroin

addicts, and that tool ought to be available to those who must do this work. Finally, I will instruct the Special Consultant for Narcotics and Dangerous Drugs to review immediately all Federal laws pertaining to rehabilitation and I will submit any legislation needed to expedite the Federal rehabilitative role, and to correct overlapping authorities and other shortcomings. Additional Enforcement Needs The Comprehensive Drug Abuse Prevention and Control Act of 1970 provides a sound base for the attack on the problem of the availability of narcotics in America. In addition to tighter and more enforceable regulatory controls, the measure provides law enforcement with stronger and better tools. Equally important, the Act contains credible and proper penalties against violators of the drug law. Severe punishments are invoked against the drug pushers and peddlers while more lenient and flexible sanctions are provided for the users. A seller can receive fifteen years for a first offense involving hard narcotics, thirty years if the sale is to a minor, and up to life in prison if the transaction is part of a continuing criminal enterprise. These new penalties allow judges more discretion, which we feel will restore credibility to the drug control laws and eliminate some of the difficulties prosecutors and judges have had in the past arising out of minimum mandatory penalties for all violators. The penalty structure in the 1970 Drug Act became effective on May 1 of this year. While it is too soon to assess its effect, I expect it to help enable us to deter or remove from our midst those who traffic in narcotics and other dangerous drugs. To complement the new Federal drug law, a uniform State drug control law has been

1016  Appendix

drafted and recommended to the States. Nineteen States have already adopted it and others have it under active consideration. Adoption of this uniform law will facilitate joint and effective action by all levels of government. Although I do not presently anticipate a necessity for alteration of the purposes or principles of existing enforcement statutes, there is a clear need for some additional enforcement legislation. To help expedite the prosecution of narcotic trafficking cases, we are asking the Congress to provide legislation which would permit the United States Government to utilize information obtained by foreign police, provided that such information was obtained in compliance with the laws of that country. We are also asking that the Congress provide legislation which would permit a chemist to submit written findings of his analysis in drug cases. This would speed the process of criminal justice. The problems of addict identification are equalled and surpassed by the problem of drug identification. To expedite work in this area of narcotics enforcement, I am asking the Congress to provide $2 million to be allotted to the research and development of equipment and techniques for the detection of illegal drugs and drug traffic. I am asking the Congress to provide $2 million to the Department of Agriculture for research and development of herbicides which can be used to destroy growths of narcotics-producing plants without adverse ecological effects. I am asking the Congress to authorize and fund 325 additional positions within the Bureau of Narcotics and Dangerous Drugs to increase their capacity for apprehending those engaged in narcotics trafficking here and abroad and to investigate domestic industrial producers of drugs.

Finally, I am asking the Congress to provide a supplemental appropriation of $25.6 million for the Treasury Department. This will increase funds available to this Department for drug abuse control to nearly $45 million. Of this sum, $18.1 million would be used to enable the Bureau of Customs to develop the technical capacity to deal with smuggling by air and sea, to increase the investigative staff charged with pursuit and apprehension of smugglers, and to increase inspection personnel who search persons, baggage, and cargo entering the country. The remaining $7.5 million would permit the Internal Revenue Service to intensify investigation of persons involved in large-scale narcotics trafficking. These steps would strengthen our efforts to root out the cancerous growth of narcotics addiction in America. It is impossible to say that the enforcement legislation I have asked for here will be conclusive—that we will not need further legislation. We cannot fully know at this time what further steps will be necessary. As those steps define themselves, we will be prepared to seek further legislation to take any action and every action necessary to wipe out the menace of drug addiction in America. But domestic enforcement alone cannot do the job. If we are to stop the flow of narcotics into the lifeblood of this country, I believe we must stop it at the source. International There are several broad categories of drugs: those of the cannabis family-such as marihuana and hashish; those which are used as sedatives, such as the barbiturates and certain tranquilizers; those which elevate mood and suppress appetite, such as the amphetamines; and, drugs such as LSD and mescaline, which are commonly called hallucinogens. Finally, there are the narcotic

Appendix  1017

analgesics, including opium and its derivatives—morphine and codeine. Heroin is made from morphine. Heroin addiction is the most difficult to control and the most socially destructive form of addiction in America today. Heroin is a fact of life and a cause of death among an increasing number of citizens in America, and it is heroin addiction that must command priority in the struggle against drugs. To wage an effective war against heroin addiction, we must have international cooperation. In order to secure such cooperation, I am initiating a worldwide escalation in our existing programs for the control of narcotics traffic, and I am proposing a number of new steps for this purpose. First, on Monday, June 14, I recalled the United States Ambassadors to Turkey, France, Mexico, Luxembourg, Thailand, the Republic of Vietnam, and the United Nations for consultations on how we can better cooperate with other nations in the effort to regulate the present substantial world opium output and narcotics trafficking. I sought to make it equally clear that I consider the heroin addiction of American citizens an international problem of grave concern to this Nation, and I instructed our Ambassadors to make this clear to their host governments. We want good relations with other countries, but we cannot buy good relations at the expense of temporizing on this problem. Second, United States Ambassadors to all East Asian governments will meet in Bangkok, Thailand, tomorrow, June 18, to review the increasing problem in that area, with particular concern for the effects of this problem on American servicemen in Southeast Asia. Third, it is clear that the only really effective way to end heroin production is to end opium production and the growing of poppies. I will propose that as an international goal. It is essential to recognize that opium

is, at present, a legitimate source of income to many of those nations which produce it. Morphine and codeine both have legitimate medical applications. It is the production of morphine and codeine for medical purposes which justifies the maintenance of opium production, and it is this production which in turn contributes to the world’s heroin supply. The development of effective substitutes for these derivatives would eliminate any valid reason for opium production. While modern medicine has developed effective and broadlyused substitutes for morphine, it has yet to provide a fully acceptable substitute for codeine. Therefore, I am directing that Federal research efforts in the United States be intensified with the aim of developing at the earliest possible date synthetic substitutes for all opium derivatives. At the same time I am requesting the Director General of the World Health Organization to appoint a study panel of experts to make periodic technical assessments of any synthetics which might replace opiates with the aim of effecting substitutions as soon as possible. Fourth, I am requesting $I million to be used by the Bureau of Narcotics and Dangerous Drugs for training of foreign narcotics enforcement officers. Additional personnel within the Bureau of Narcotics and Dangerous Drugs would permit the strengthening of the investigative capacities of BNDD offices in the U.S., as well as their ability to assist host governments in the hiring, training, and deployment of personnel and the procurement of necessary equipment for drug abuse control. Fifth, I am asking the Congress to amend and approve the International Security Assistance Act of 1971 and the International Development and Humanitarian Assistance Act of 1971 to permit assistance to presently proscribed nations in their efforts to end

1018  Appendix

drug trafficking. The drug problem crosses ideological boundaries and surmounts national differences. If we are barred in any way in our effort to deal with this matter, our efforts will be crippled, and our will subject to question. I intend to leave no room for other nations to question our commitment to this matter. Sixth, we must recognize that cooperation in control of dangerous drugs works both ways. While the sources of our chief narcotics problem are foreign, the United States is a source of illegal psychotropic drugs which afflict other nations. If we expect other governments to help stop the flow of heroin to our shores, we must act with equal vigor to prevent equally dangerous substances from going into their nations from our own. Accordingly, I am submitting to the Senate for its advice and consent the Convention on Psychotropic Substances which was recently signed by the United States and 22 other nations. In addition, I will submit to the Congress any legislation made necessary by the Convention including the complete licensing, inspection, and control of the manufacture, distribution, and trade in dangerous synthetic drugs. Seventh, the United States has already pledged $2 million to a Special Fund created on April 1 of this year by the Secretary General of the United Nations and aimed at planning and executing a concerted UN effort against the world drug problem. We will continue our strong backing of UN drug-control efforts by encouraging other countries to contribute and by requesting the Congress to make additional contributions to this fund as their need is demonstrated. Finally, we have proposed, and we are strongly urging multilateral support for, amendments to the Single Convention on Narcotics which would enable the International Narcotics Control Board to:

—require from signatories details about opium poppy cultivation and opium production-thus permitting the Board access to essential information about narcotics raw materials from which illicit diversion occurs; —base its decisions about the various nations’ activities with narcotic drugs not only as at present on information officially submitted by the governments, but also on information which the Board obtains through public or private sources—thus enhancing data available to the Board in regard to illicit traffic; —carry out, with the consent of the nation concerned, on-the-spot inquiries on drug related activities; —modify signatories’ annual estimates of intended poppy acreage and opium production with a view to reducing acreage or production; and —in extreme cases, require signatories to embargo the export and/or import of drugs to or from a particular country that has failed to meet its obligations under the Convention. I believe the foregoing proposals establish a new and needed dimension in the international effort to halt drug production, drug traffic, and drug abuse. These proposals put the problems and the search for solutions in proper perspective, and will give this Nation its best opportunity to end the flow of drugs, and most particularly heroin, into America, by literally cutting it off root and branch at the source. Conclusion Narcotics addiction is a problem which afflicts both the body and the soul of America. It is a problem which baffles many Americans. In our history we have faced great difficulties again and again, wars and depressions and divisions among our people have tested our will as a people—and we have prevailed. We have fought together in war, we have worked together in hard times, and we have

Appendix  1019

reached out to each other in division—to close the gaps between our people and keep America whole. The threat of narcotics among our people is one which properly frightens many Americans. It comes quietly into homes and destroys children, it moves into neighborhoods and breaks the fiber of community which makes neighbors. It is a problem which demands compassion, and not simply condemnation, for those who become the victims of narcotics and dangerous drugs. We must try to better understand the confusion and disillusion and despair that bring people, particularly young people, to the use of narcotics and dangerous drugs. We are not without some understanding in this matter, however. And we are not without the will to deal with this matter. We have the moral resources to do the job. Now we need the authority and the funds to match our moral resources. I am confident that we will prevail in this struggle as we have in many others. But time is critical. Every day we lose compounds the tragedy which drugs inflict on individual Americans. The final issue is not whether we will conquer drug abuse, but how soon. Part of this answer lies with the Congress now and the speed with which it moves to support the struggle against drug abuse. Richard Nixon The White House June 17, 1971 Source: Online by Gerhard Peters and John T. Woolley, The American Presidency Project. http://www.presidency.ucsb.edu/ ws/?pid=3048.

“Just Say No” Speech by Ronald and Nancy Reagan (1986) In 1986, President Reagan was in the midst of his War on Drugs. Despite his war, drug

use (especially cocaine and heroin) was rising. One approach to reducing drug use was to attack the demand for drugs, especially by young people who could be permanently harmed by drug use. In this speech given by President Reagan to the U.S. public, his wife Nancy gave her perspective on how to stop young people from trying drugs. She told children that they should “just say no” when others asked if they wanted to use drugs. This became the name of a club that students could join. It also because a catchphrase for years to come.

“Just Say No” Speech President Ronald and Nancy Reagan, Address to the Nation September 14, 1986 The President: Good evening. Usually, I talk with you from my office in the West Wing of the White House. But tonight there’s something special to talk about, and I’ve asked someone very special to join me. Nancy and I are here in the West Hall of the White House, and around us are the rooms in which we live. It’s the home you’ve provided for us, of which we merely have temporary custody. Nancy’s joining me because the message this evening is not my message but ours. And we speak to you not simply as fellow citizens but as fellow parents and grandparents and as concerned neighbors. It’s backto-school time for America’s children. And while drug and alcohol abuse cuts across all generations, it’s especially damaging to the young people on whom our future depends. So tonight, from our family to yours, from our home to yours, thank you for joining us. America has accomplished so much in these last few years, whether it’s been rebuilding our economy or serving the cause of

1020  Appendix

freedom in the world. What we’ve been able to achieve has been done with your help— with us working together as a nation united. Now, we need your support again Drugs are menacing our society. They’re threatening our values and undercutting our institutions. They’re killing our children. From the beginning of our administration, we’ve taken strong steps to do something about this horror. Tonight I can report to you that we’ve made much progress. Thirtyseven Federal agencies are working together in a vigorous national effort, and by next year our spending for drug law enforcement will have more than tripled from its 1981 levels. We have increased seizures of illegal drugs. Shortages of marijuana are now being reported. Last year alone over 10,000 drug criminals were convicted and nearly $250 million of their assets were seized by the DEA, the Drug Enforcement Administration. And in the most important area, individual use, we see progress. In 4 years the number of high school seniors using marijuana on a daily basis has dropped from 1 in 14 to 1 in 20. The U.S. military has cut the use of illegal drugs among its personnel by 67 percent since 1980. These are a measure of our commitment and emerging signs that we can defeat this enemy. But we still have much to do. Despite our best efforts, illegal cocaine is coming into our country at alarming levels and 4 to 5 million people regularly use it. Five hundred thousand Americans are hooked on heroin. One in twelve persons smokes marijuana regularly. Regular drug use is even higher among the age group 18 to 25—most likely just entering the work force. Today there’s a new epidemic: smokable cocaine, otherwise known as crack. It is an explosively destructive and often lethal substance which is crushing its users. It is an uncontrolled fire.

And drug abuse is not a so-called victimless crime. Everyone’s safety is at stake when drugs and excessive alcohol are used by people on the highways or by those transporting our citizens or operating industrial equipment. Drug abuse costs you and your fellow Americans at least $60 billion a year. From the early days of our administration, Nancy has been intensely involved in the effort to fight drug abuse. She has since traveled over 100,000 miles to 55 cities in 28 States and 6 foreign countries to fight school-age drug and alcohol abuse. She’s given dozens of speeches and scores of interviews and has participated in 24 special radio and TV tapings to create greater awareness of this crisis. Her personal observations and efforts have given her such dramatic insights that I wanted her to share them with you this evening. Nancy. Mrs. Reagan: Thank you. As a mother, I’ve always thought of September as a special month, a time when we bundled our children off to school, to the warmth of an environment in which they could fulfill the promise and hope in those restless minds. But so much has happened over these last years, so much to shake the foundations of all that we know and all that we believe in. Today there’s a drug and alcohol abuse epidemic in this country, and no one is safe from it—not you, not me, and certainly not our children, because this epidemic has their names written on it. Many of you may be thinking: “Well, drugs don’t concern me.” But it does concern you. It concerns us all because of the way it tears at our lives and because it’s aimed at destroying the brightness and life of the sons and daughters of the United States. For 5 years I’ve been traveling across the country—learning and listening. And one of the most hopeful signs I’ve seen is the

Appendix  1021

building of an essential, new awareness of how terrible and threatening drug abuse is to our society. This was one of the main purposes when I started, so of course it makes me happy that that’s been accomplished. But each time I meet with someone new or receive another letter from a troubled person on drugs, I yearn to find a way to help share the message that cries out from them. As a parent, I’m especially concerned about what drugs are doing to young mothers and their newborn children. Listen to this news account from a hospital in Florida of a child born to a mother with a cocaine habit: “Nearby, a baby named Paul lies motionless in an incubator, feeding tubes riddling his tiny body. He needs a respirator to breathe and a daily spinal tap to relieve fluid buildup on his brain. Only 1 month old, he’s already suffered 2 strokes.” Now you can see why drug abuse concerns every one of us—all the American family. Drugs steal away so much. They take and take, until finally every time a drug goes into a child, something else is forced out—like love and hope and trust and confidence. Drugs take away the dream from every child’s heart and replace it with a nightmare, and it’s time we in America stand up and replace those dreams. Each of us has to put our principles and consciences on the line, whether in social settings or in the workplace, to set forth solid standards and stick to them. There’s no moral middle ground. Indifference is not an option. We want you to help us create an outspoken intolerance for drug use. For the sake of our children, I implore each of you to be unyielding and inflexible in your opposition to drugs. Our young people are helping us lead the way. Not long ago, in Oakland, California, I was asked by a group of children what to do if they were offered drugs, and I answered,

“Just say no.” Soon after that, those children in Oakland formed a Just Say No club, and now there are over 10,000 such clubs all over the country. Well, their participation and their courage in saying no needs our encouragement. We can help by using every opportunity to force the issue of not using drugs to the point of making others uncomfortable, even if it means making ourselves unpopular. Our job is never easy because drug criminals are ingenious. They work everyday to plot a new and better way to steal our children’s lives, just as they’ve done by developing this new drug, crack. For every door that we close, they open a new door to death. They prosper on our unwillingness to act. So, we must be smarter and stronger and tougher than they are. It’s up to us to change attitudes and just simply dry up their markets. And finally, to young people watching or listening, I have a very personal message for you: There’s a big, wonderful world out there for you. It belongs to you. It’s exciting and stimulating and rewarding. Don’t cheat yourselves out of this promise. Our country needs you, but it needs you to be clear-eyed and clear-minded. I recently read one teenager’s story. She’s now determined to stay clean but was once strung out on several drugs. What she remembered most clearly about her recovery was that during the time she was on drugs everything appeared to her in shades of black and gray and after her treatment she was able to see colors again. So, to my young friends out there: Life can be great, but not when you can’t see it. So, open your eyes to life: to see it in the vivid colors that God gave us as a precious gift to His children, to enjoy life to the fullest, and to make it count. Say yes to your life. And when it comes to drugs and alcohol just say no.

1022  Appendix

The President: I think you can see why Nancy has been such a positive influence on all that we’re trying to do. The job ahead of us is very clear. Nancy’s personal crusade, like that of so many other wonderful individuals, should become our national crusade. It must include a combination of government and private efforts which complement one another. Last month I announced six initiatives which we believe will do just that. First, we seek a drug-free workplace at all levels of government and in the private sector. Second, we’ll work toward drugfree schools. Third, we want to ensure that the public is protected and that treatment is available to substance abusers and the chemically dependent. Our fourth goal is to expand international cooperation while treating drug trafficking as a threat to our national security. In October I will be meeting with key U.S. Ambassadors to discuss what can be done to support our friends abroad. Fifth, we must move to strengthen law enforcement activities such as those initiated by Vice President Bush and Attorney General Meese. And finally, we seek to expand public awareness and prevention. In order to further implement these six goals, I will announce tomorrow a series of new proposals for a drug-free America. Taken as a whole, these proposals will toughen our laws against drug criminals, encourage more research and treatment and ensure that illegal drugs will not be tolerated in our schools or in our workplaces. Together with our ongoing efforts, these proposals will bring the Federal commitment to fighting drugs to $3 billion. As much financing as we commit, however, we would be fooling ourselves if we thought that massive new amounts of money alone will provide the solution. Let us not forget that in America people solve problems and no national crusade has ever succeeded without human in-

vestment. Winning the crusade against drugs will not be achieved by just throwing money at the problem. Your government will continue to act aggressively, but nothing would be more effective than for Americans simply to quit using illegal drugs. We seek to create a massive change in national attitudes which ultimately will separate the drugs from the customer, to take the user away from the supply. I believe, quite simply, that we can help them quit. and that’s where you come in. My generation will remember how America swung into action when we were attacked in World War II. The war was not just fought by the fellows flying the planes or driving the tanks. It was fought at home by a mobilized nation—men and women alike—building planes and ships, clothing sailors and soldiers, feeding marines and airmen; and it was fought by children planting victory gardens and collecting cans. Well, now we’re in another war for our freedom, and it’s time for all of us to pull together again. So for example, if your friend or neighbor or a family member has a drug or alcohol problem, don’t turn the other way. Go to his help or to hers. Get others involved with you—clubs, service groups, and community organizations-and provide support and strength. And, of course, many of you’ve been cured through treatment and self-help. Well, you’re the combat veterans, and you have a critical role to play. you can help others by telling your story and providing a willing hand to those in need. Being friends to others is the best way of being friends to ourselves. It’s time, as Nancy said, for America to Just Say No to drugs. Those of you in union halls and workplaces everywhere: Please make this challenge a part of your job every day. Help us preserve the health and dignity of all

Appendix  1023

workers. To businesses large and small: we need the creativity of your enterprise applied directly to this national problem. Help us. And those of you who are educators: Your wisdom and leadership are indispensable to this cause. From the pulpits of this spiritfilled land: we would welcome your reassuring message of redemption and forgiveness and of helping one another. On the athletic fields: You men and women are among the most beloved citizens of our country. A child’s eyes fill with your heroic achievements. Few of us can give youngsters something as special and strong to look up to as you. Please don’t let them down. And this camera in front of us: It’s a reminder that in Nancy’s and my former profession and in the newsrooms and production rooms of our media centers—you have a special opportunity with your enormous influence to send alarm signals across the Nation. To our friends in foreign countries: We know many of you are involved in this battle with us. We need your success as well as ours. When we all come together, united, striving for this cause, then those who are killing America and terrorizing it with slow but sure chemical destruction will see that they are up against the mightiest force for good that we know. Then they will have no dark alleyways to hide in. In this crusade, let us not forget who we are. Drug abuse is a repudiation of everything America is. The destructiveness and human wreckage mock our heritage. Think for a moment how special it is to be an American. Can we doubt that only a divine providence placed this land, this island of freedom, here as a refuge for all those people on the world who yearn to breathe free? The revolution out of which our liberty was conceived signaled an historical call to an entire world seeking hope. Each new arrival of immigrants rode the crest of that

hope. They came, millions seeking a safe harbor from the oppression of cruel regimes. They came, to escape starvation and disease. They came, those surviving the Holocaust and the Soviet gulags. They came, the boat people, chancing death for even a glimmer of hope that they could have a new life. They all came to taste the air redolent and rich with the freedom that is ours. What an insult it will be to what we are and whence we came if we do not rise up together in defiance against this cancer of drugs. And there’s one more thing. The freedom that so many seek in our land has not been preserved without a price. Nancy and I shared that remembrance 2 years ago at the Normandy American Cemetery in France. In the still of that June afternoon, we walked together among the soldiers of freedom, past the hundreds of white markers which are monuments to courage and memorials to sacrifice. Too many of these and other such graves are the final resting places of teenagers who became men in the roar of battle. Look what they gave to us who live. Never would they see another sunlit day glistening off a lake or river back home or miles of corn pushing up against the open sky of our plains. The pristine air of our mountains and the driving energy of our cities are theirs no more. Nor would they ever again be a son to their parents or a father to their own children. They did this for you, for me, for a new generation to carry our democratic experiment proudly forward. Well, that’s something I think we’re obliged to honor, because what they did for us means that we owe as a simple act of civic stewardship to use our freedom wisely for the common good. As we mobilize for this national crusade, I’m mindful that drugs are a constant temptation for millions. Please remember this when your courage is tested: You are Americans. You’re the product of the freest society

1024  Appendix

mankind has ever known. No one, ever, has the right to destroy your dreams and shatter your life. Right down the end of this hall is the Lincoln Bedroom. But in the Civil War that room was the one President Lincoln used as his office. Memory fills that room, and more than anything that memory drives us to see vividly what President Lincoln sought to save. Above all, it is that America must stand for something and that our heritage lets us stand with a strength of character made more steely by each layer of challenge pressed upon the Nation. We Americans have never been normally neutral against any form of tyranny. Tonight we’re asking no more than that we honor what we have been and what we are by standing together. Mrs. Reagan: Now we go on to the next stop: making a final commitment not to tolerate drugs by anyone, anytime, anyplace. So, won’t you join us in this great, new national crusade? The President: God bless you, and good night. Source: Ronald Reagan: “Address to the Nation on the Campaign Against Drug Abuse,” September 14, 1986. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=36414

Executive Order 12564: Drug-Free Federal Workplace (1986) (Ronald Reagan) As part of his “War against Drugs,” President Reagan created a drug-free workplace for all federal agencies through Executive Order 12564. This was important because a drug-free environment would not only

be safer, but it would also be more productive and more creative. According to President Reagan, a drug-free workplace is one in which employees refrain from using drugs. But the agency also plays a role. Each agency must have a plan for achieving a drug-free workplace. That may involve employee assistance programs, or training programs for supervisors so they are able to identify those employees who may be using drugs, and how to help them. As part of the plan, employees can be drug tested, if given enough warning that the test would be carried out. Any employee who was found to be using drugs could be referred for counseling or treatment. If it was discovered that they continued to use drugs, or refused to attend treatment, they could be released from their position. Reagan encouraged state and private agencies to follow suit and also become drug-free organizations as well.

Ronald Reagan Executive Order 12564—Drug-Free Federal Workplace September 15, 1986 I, Ronald Reagan, President of the United States of America, find that: Drug use is having serious adverse effects upon a significant proportion of the national work force and results in billions of dollars of lost productivity each year; The Federal government, as an employer, is concerned with the well-being of its employees, the successful accomplishment of agency missions, and the need to maintain employee productivity; The Federal government, as the largest employer in the Nation, can and should show the way towards achieving drug-free workplaces through a program designed to offer

Appendix  1025

drug users a helping hand and, at the same time, demonstrating to drug users and potential drug users that drugs will not be tolerated in the Federal workplace; The profits from illegal drugs provide the single greatest source of income for orga­ nized crime, fuel violent street crime, and otherwise contribute to the breakdown of our society; The use of illegal drugs, on or off duty, by Federal employees is inconsistent not only with the law-abiding behavior expected of all citizens, but also with the special trust placed in such employees as servants of the public; Federal employees who use illegal drugs, on or off duty, tend to be less productive, less reliable, and prone to greater absenteeism than their fellow employees who do not use illegal drugs; The use of illegal drugs, on or off duty, by Federal employees impairs the efficiency of Federal departments and agencies, undermines public confidence in them, and makes it more difficult for other employees who do not use illegal drugs to perform their jobs effectively. The use of illegal drugs, on or off duty, by Federal employees also can pose a serious health and safety threat to members of the public and to other Federal employees; The use of illegal drugs, on or off duty, by Federal employees in certain positions evidences less than the complete reliability, stability, and good judgment that is consis­ tent with access to sensitive information and creates the possibility of coercion, influence, and irresponsible action under pressure that may pose a serious risk to national security, the public safety, and the effective enforcement of the law; and

Federal employees who use illegal drugs must themselves be primarily responsible for changing their behavior and, if necessary, begin the process of rehabilitating themselves. By the authority vested in me as President by the Constitution and laws of the United States of America, including section 3301(2) of Title 5 of the United States Code, section 7301 of Title 5 of the United States Code, section 290ee-1 of Title 42 of the United States Code, deeming such action in the best interests of national security, public health and safety, law enforcement and the efficiency of the Federal service, and in order to establish standards and procedures to ensure fairness in achieving a drug-free Federal workplace and to protect the privacy of Federal employees, it is hereby ordered as follows: Section 1. Drug-Free Workplace. (a) Federal employees are required to refrain from the use of illegal drugs. (b) The use of illegal drugs by Federal employees, whether on duty or off duty, is contrary to the efficiency of the service. (c) Persons who use illegal drugs are not suitable for Federal employment. Sec. 2. Agency Responsibilities. a) The head of each Executive agency shall develop a plan for achieving the objective of a drug-free workplace with due consideration of the rights of the government, the employee, and the general public. (b) Each agency plan shall include: (1) A statement of policy setting forth the agency’s expectations regarding drug use and the action to be anticipated in response to identified drug use;

1026  Appendix

(2) Employee Assistance Programs emphasizing high level direction, education, counseling, referral to rehabilitation, and coordination with available community resources; (3) Supervisory training to assist in identifying and addressing illegal drug use by agency employees; (4) Provision for self-referrals as well as supervisory referrals to treatment with maximum respect for individual confidentiality consistent with safety and security issues; and (5) Provision for identifying illegal drug users, including testing on a controlled and carefully monitored basis in accordance with this Order. Sec. 3. Drug Testing Programs. (a) The head of each Executive agency shall establish a program to test for the use of illegal drugs by employees in sensitive positions. The extent to which such employees are tested and the criteria for such testing shall be determined by the head of each agency, based upon the nature of the agency’s mission and its employees’ duties, the efficient use of agency resources, and the danger to the public health and safety or national security that could result from the failure of an employee adequately to discharge his or her position. (b) The head of each Executive agency shall establish a program for voluntary employee drug testing. (c) In addition to the testing authorized in subsections (a) and (b) of this section, the head of each Executive agency is authorized to test an employee for illegal drug use under the following circumstances: (1) When there is a reasonable suspicion that any employee uses illegal drugs;

(2) In an examination authorized by the agency regarding an accident or unsafe practice; or (3) As part of or as a follow-up to counseling or rehabilitation for illegal drug use through an Employee Assistance Program. (d) The head of each Executive agency is authorized to test any applicant for illegal drug use. Sec. 4. Drug Testing Procedures. (a) Sixty days prior to the implementation of a drug testing program pursuant to this Order, agencies shall notify employees that testing for use of illegal drugs is to be conducted and that they may seek counseling and rehabilitation and inform them of the procedures for obtaining such assistance through the agency’s Employee Assistance Program. Agency drug testing programs already ongoing are exempted from the 60-day notice requirement. Agencies may take action under section 3(c) of this Order without reference to the 60-day notice eriod. (b) Before conducting a drug test, the agency shall inform the employee to be tested of the opportunity to submit medical documentation that may support a legitimate use for a specific drug. (c) Drug testing programs shall contain procedures for timely submission of requests for retention of records and specimens; procedures for retesting; and procedures, consistent with applicable law, to protect the confidentiality of test results and related medical and rehabilitation records. Procedures for providing urine specimens must allow individual privacy, unless the agency has reason to believe that a particular individual may alter or substitute the specimen to be provided.

Appendix  1027

(d) The Secretary of Health and Human Services is authorized to promulgate scientific and technical guidelines for drug testing programs, and agencies shall conduct their drug testing programs in accordance with these guidelines once promulgated. Sec. 5. Personnel Actions. (a) Agencies shall, in addition to any appropriate personnel actions, refer any employee who is found to use illegal drugs to an Employee Assistance Program for assessment, counseling, and referral for treatment or rehabilitation as appropriate. (b) Agencies shall initiate action to discipline any employee who is found to use illegal drugs, provided that such action is not required for an employee who: (1) Voluntarily identifies himself as a user of illegal drugs or who volunteers for drug testing pursuant to section 3(b) of this Order, prior to being identified through other means; (2) Obtains counseling or rehabilitation through an Employee Assistance Program; and (3) Thereafter refrains from using illegal drugs. (c) Agencies shall not allow any employee to remain on duty in a sensitive position who is found to use illegal drugs, prior to successful completion of rehabilitation through an Employee Assistance Program. However, as part of a rehabilitation or counseling program, the head of an Executive agency may, in his or her discretion, allow an employee to return to duty in a sensitive position if it is determined that this action would not pose a danger to public health or safety or the national security. (d) Agencies shall initiate action to remove from the service any employee who is found to use illegal drugs and:

(1) Refuses to obtain counseling or rehabilitation through an Employee Assistance Program; or (2) Does not thereafter refrain from using illegal drugs. (e) The results of a drug test and information developed by the agency in the course of the drug testing of the employee may be considered in processing any adverse action against the employee or for other administrative purposes. Preliminary test results may not be used in an administrative proceeding unless they are confirmed by a second analysis of the same sample or unless the employee confirms the accuracy of the initial test by admitting the use of illegal drugs. (f) The determination of an agency that an employee uses illegal drugs can be made on the basis of any appropriate evidence, including direct observation, a criminal conviction, administrative inquiry, or the results of an authorized testing program. Positive drug test results may be rebutted by other evidence that an employee has not used illegal drugs. (g) Any action to discipline an employee who is using illegal drugs (including removal from the service, if appropriate) shall be taken in compliance with otherwise applicable procedures, including the Civil Service Reform Act. (h) Drug testing shall not be conducted pursuant to this Order for the purpose of gathering evidence for use in criminal proceedings. Agencies are not required to report to the Attorney General for investigation or prosecution any information, allegation, or evidence relating to violations of Title 21 of the United States Code received as a result of the operation of drug testing programs established pursuant to this Order.

1028  Appendix

Sec. 6. Coordination of Agency Programs. (a) The Director of the Office of Personnel Management shall: (1) Issue government-wide guidance to agencies on the implementation of the terms of this Order; (2) Ensure that appropriate coverage for drug abuse is maintained for employees and their families under the Federal Employees Health Benefits Program; (3) Develop a model Employee Assistance Program for Federal agencies and assist the agencies in putting programs in place; (4) In consultation with the Secretary of Health and Human Services, develop and improve training programs for Federal supervisors and managers on illegal drug use; and (5) In cooperation with the Secretary of Health and Human Services and heads of Executive agencies, mount an intensive drug awareness campaign throughout the Federal work force. (b) The Attorney General shall render legal advice regarding the implementation of this Order and shall be consulted with regard to all guidelines, regulations, and policies proposed to be adopted pursuant to this Order. (c) Nothing in this Order shall be deemed to limit the authorities of the Director of Central Intelligence under the National Security Act of 1947, as amended, or the statutory authorities of the National Security Agency or the Defense Intelligence Agency. Implementation of this Order within the Intelligence Community, as defined in Executive Order No. 12333, shall be subject to the approval of the head of the affected agency. Sec. 7. Definitions. (a) This Order applies to all agencies of the Executive Branch.

(b) For purposes of this Order, the term “agency” means an Executive agency, as defined in 5 U.S.C. 105; the Uniformed Services, as defined in 5 U.S.C. 2101(3) (but excluding the armed forces as defined by 5 U.S.C. 2101(2)); or any other employing unit or authority of the Federal government, except the United States Postal Service, the Postal Rate Commission, and employing units or authorities in the Judicial and Legislative Branches. (c) For purposes of this Order, the term “illegal drugs” means a controlled substance included in Schedule I or II, as defined by section 802(6) of Title 21 of the United States Code, the possession of which is unlawful under chapter 13 of that Title. The term “illegal drugs” does not mean the use of a controlled substance pursuant to a valid prescription or other uses authorized by law. (d) For purposes of this Order, the term “employee in a sensitive position” refers to: (1) An employee in a position that an agency head designates Special Sensitive, Critical-Sensitive, or Noncritical-Sensitive under Chapter 731 of the Federal Personnel Manual or an employee in a position that an agency head designates as sensitive in accordance with Executive Order No. 10450, as amended; (2) An employee who has been granted access to classified information or may be granted access to classified information pursuant to a determination of trustworthiness by an agency head under Section 4 of Executive Order No. 12356; (3) Individuals serving under Presidential appointments; (4) Law enforcement officers as defined in 5 U.S.C. 8331 (20); and (5) Other positions that the agency head determines involve law enforcement, national security, the protection of life and

Appendix  1029

property, public health or safety, or other functions requiring a high degree of trust and confidence. (e) For purposes of this Order, the term “employee” means all persons appointed in the Civil Service as described in 5 U.S.C. 2105 (but excluding persons appointed in the armed services as defined in 5 U.S.C. 2102(2)). (f) For purposes of this Order, the term “Employee Assistance Program” means agencybased counseling programs that offer assessment, short-term counseling, and referral services to employees for a wide range of drug, alcohol, and mental health programs that affect employee job performance. Employee Assistance Programs are responsible for referring drug-using employees for rehabilitation and for monitoring employees’ progress while in treatment. Sec. 8. Effective Date. This Order is effective immediately. RONALD REAGAN The White House, September 15, 1986. [Filed with the Office of the Federal Register, 3:47 p.m., September 15, 1986] Source: 51 Federal Register 32889, 3 CFR, 1986 Comp., p. 224

Anti–Drug Abuse Act (1986) During the 1980s, drug abuse became a major problem in the United States. One drug that was receiving a lot of attention at the time was cocaine, especially crack cocaine. There were many calls for the government to take some action against this new harmful substance, especially after the death of basketball star Len Bias. The problem of drugs also became an issue in the congressional

elections that year. Many candidates ran on platforms that included tougher measures against drugs. When Congress reconvened in 1986, Congress passed this new piece of legislation. By passing the new law, Congress sought to increase foreign cooperation in eradicating drug crops, put an end to international drug smuggling, provide more support for enforcing federal drug laws, establish drug abuse prevention and education programs in schools, and expand federal support for drug treatment and rehabilitation centers. At the same time, the law sent new minimum sentences for different offenses. For example, the law set minimum sentences for selling or possessing large amounts of drugs (a kilogram or more of heroin, 1,000 kilograms of marijuana, five kilograms of cocaine) at 10 years in prison with no maximum. Now, major drug traffickers would face a possible life sentence for their actions. Further sentences were imposed if anyone suffered injury or death as a result of the sale of illicit narcotics. If this happened, the minimum penalty was set at a minimum of twenty years in prison. The fines for these crimes were also raised. Those who violated federal drug laws could be fined up to $4 million, and if a dealer was part of a drug ring, the fine could be up to $10 million. If the offense was a repeat offense, the penalties were doubled. The penalties for those who used minors to sell or distribute drugs were doubled. The law did not increase penalties as much for those who were in possession of only small amounts of drugs for personal use. For these offenders, the maximum prison sentence was set at one year in prison and a $5,000 fine, which doubled for repeat offenders. Or they could be placed on probation.

1030  Appendix

Congress also established a grant program in the law, to assist states in creating law enforcement programs that had the intent of disrupting drug trafficking. Congress also allocated money for programs that would focus on international drug smuggling. Attention was also given to programs geared to reducing the demand for illicit drugs. The law established a presidential media commission on alcohol and drug abuse that would create a media campaign about the dangers of drug abuse. The law also required a White House Conference for a Drug-Free America.

Anti–Drug Abuse Act of 1986 Title I: Anti-Drug Enforcement—Subtitle A: Narcotics Penalties and Enforcement Act of 1986—Narcotics Penalties and Enforcement Act of 1986—Amends the Controlled Substances Act to modify the threshold quantities and kinds of controlled substances which trigger revised enhanced penalties. Grants Federal courts limited authority to impose a sentence below a statutory minimum. Subtitle B: Drug Possession Penalty Act of 1986—Drug Possession Penalty Act of 1986—Establishes criminal penalties for simple possession of a controlled substance. Subtitle C: Juvenile Drug Trafficking Act of 1986—Juvenile Drug Trafficking Act of 1986—Establishes increased criminal penalties for employing persons under 18 years of age in drug operations. Establishes increased criminal penalties for the manufacture or distribution of a controlled substance in or near an elementary school, vocational school, secondary school, or college. (Current law establishes such enhanced penalties only for the distribution of a controlled substance in or near an elementary or secondary school.)

Subtitle D: Assets Forfeiture Amendments Act of 1986—Department of Justice Assets Forfeiture Fund Amendments Act of 1986— Permits the use of funds in the Department of Justice Assets Forfeiture Fund for certain necessary program-related expenses and for equipping vessels, vehicles, and aircraft for official use by certain Government agencies. Subtitle E: Controlled Substance Analogue Enforcement Act of 1986—Controlled Substance Analogue Enforcement Act of 1986—Amends the Controlled Substances Act to provide that controlled substance analogues shall be treated as a schedule I substance. Subtitle F: Continuing Drug Enterprise Act of 1986—Continuing Drug Enterprises Act of 1986—Amends the Controlled Substances Act to increase the criminal penalties for continuing criminal enterprise activities. Subtitle G: Controlled Substances Import and Export Act Penalties Enhancement Act of 1986—Controlled Substances Import and Export Act Penalties Enhancement Act of 1986—Amends the Controlled Substances Import and Export Act to modify the quantity and kinds of controlled substances which trigger revised enhanced penalties. Subtitle H: Money Laundering Control Act of 1986—Money Laundering Control Act of 1986—Amends the Federal criminal code to establish money laundering as a Federal offense. Establishes criminal and civil penalties for such violations. Establishes forfeiture procedures for the offense of money laundering. Makes certain changes regarding recordkeeping and reporting requirements and the disclosure of information by financial institutions. Subtitle I: Armed Career Criminals— Career Criminals Amendment Act of 1986—

Appendix  1031

Amends the Federal criminal code to provide increased criminal penalties for any person who transports firearms or ammunition in interstate or foreign commerce if such person has multiple convictions for serious drug offenses and/or violent felonies. (Current law provides increased penalties where such person had multiple convictions for robbery and burglary.) Subtitle J: Authorization of Appropriations for Drug Law Enforcement—Authorizes additional appropriations for FY 1987 for the Department of Justice for drug law enforcement activities. Subtitle K: State and Local Narcotics Control Assistance—State and Local Law Enforcement Assistance Act of 1986— Amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Director of the Federal Bureau of Investigation (FBI) to make grants to State and local law enforcement agencies for narcotics assistance. Subtitle L: Study on the Use of Existing Federal Buildings as Prisons—Requires the Secretary of Defense to provide the Attorney General with a list identifying Federal buildings under the jurisdiction of the Department of Defense which could be used as detention facilties. Subtitle M: Narcotics Traffickers Deportation Act—Amends the Immigration and Nationality Act to provide for the exclusion or deportation of any alien for violating any law or regulation relating to a controlled substance. Subtitle N: Freedom of Information Act— Freedom of Information Reform Act of 1986—Amends the Freedom of Information Act with respect to access to law enforcement information and fees.

Subtitle O: Prohibition on the Interstate Sale and Transportation of Drug Paraphernalia—Mail Order Drug Paraphernalia Control Act—Makes it a Federal criminal offense for any person to: (1) use the U.S. Postal Service or any private parcel service as part of a scheme to sell drug paraphernalia; (2) offer for sale and transportation in interstate or foreign commerce drug paraphernalia; or (3) import or export drug paraphernalia. Subtitle P: Manufacturing Operations— Amends the Controlled Substances Act to make it illegal to knowingly open, maintain, manage, or control a place for manufacturing, distributing, or using controlled substance. Subtitle Q: Controlled Substances Technical Amendments—Drug and Alcohol Dependent Offenders Treatment Act of 1986—Grants the Director of the Administrative Office of the United States Court authority to contract with public and private agencies for the detection and treatment of alcohol-dependent and drug-dependent offenders. Amends the Contract Services for Drug Dependent Federal Offenders Authorization Act to authorize appropriations for contracts for the supervision of released drug offenders. Makes technical changes to the Tariff Act of 1930, the Controlled Substance Act, and the Comprehensive Drug Abuse Prevention and Control Act of 1970. Subtitle R: Precursor and Essential Chemical Review—Directs the Attorney General to study and recommend methods to control the diversion of legitimate precursor and essential chemicals to the production of illegal drugs. Requires the Attorney General to report all findings to the Congress.

1032  Appendix

Subtitle S: White House Conference for a Drug Free America—White House Conference for a Drug Free America—Establishes the White House Conference for a Drug Free America. Subtitle T: Common Carrier Operation Under the Influence of Alcohol and Drugs—Amends the Federal criminal code to provide criminal penalties for operating a common carrier under the influence of alcohol or drugs. Subtitle U: Federal Drug Law Enforcement Agent Protection Act of 1986— Federal Drug Law Enforcement Agent Protection Act of 1986—Allows the Attorney General to pay for information concerning the killing or kidnapping of a Federal drug law enforcement agent. Subtitle V: Death Penalty for Certain Offenses—Amends the Controlled Substances Act to establish procedures for the imposition of the death penalty for certain continuing criminal enterprise drug offenses. Title II: International Narcotics Control—International Narcotics Control Act of 1986—Amends the Foreign Assistance Act of 1961 to increase the FY 1987 authorization for assistance for international narcotics control. Provides that any aircraft made available to foreign countries for narcotics-related purposes shall be provided only on a lease or loan basis. Requires the Secretary of State to maintain detailed records on the use of such aircraft. Earmarks a specified amount of the FY 1987 international narcotics control assistance for pilot and aircraft maintenance training for narcotics control activities.

Imposes certain restrictions on the provision of U.S. assistance to illicit drug producing countries and drug-transit countries. Earmarks a specified amount of the FY 1987 international narcotics control assistance for research, development, and testing of safe and effective herbicides for use in the aerial eradication of coca. Requires the Comptroller General to investigate and report to the Congress on the effectiveness of the international narcotics control assistance program. Requires the President’s annual report to the Congress on the international strategy to prevent cultivation and trafficking in narcotics to include a discussion of the extent to which each source country has cooperated with U.S. narcotics control efforts through the extradition or prosecution of drug traffickers and a description of the state of negotiations on updated extradition treaties. Amends the Foreign Assistance Act of 1961 to prohibit participation by any U.S. officer or employee in direct narcotics arrests in foreign countries. Provides exceptions to such prohibition. Commends the decision of the Secretary of State to issue diplomatic passports to officials and employees of the Drug Enforcement Administration. Requires the Secretary to report to the Congress before changing such policy. Requires the executive branch to establish expeditiously the information sharing system that will list all drug arrests of foreign nationals in the United States as required by the Foreign Relations Authorization Act, Fiscal Years 1986 and 1987. Requires the executive branch to report to the Congress when the system is established.

Appendix  1033

Amends the International Security and Development Cooperation Act of 1985 to place conditions on assistance for Bolivia. Requires the President to transmit biannual reports to the Congress on major illicit drug producing countries and major drug-transit countries. Requires restrictions on U.S. assistance to such countries. Earmarks a specified amount of the FY 1987 administration of justice program authorization to be used to provide Colombia (and other countries in the region) assistance to protect officials who are targets of narcoterrorism attacks. Expresses the sense of the Congress that a reward should be established for information leading to the arrest or conviction of Jorge Luis Ochoa Vasquez. Urges the Secretary of State to increase efforts to negotiate with relevant countries to facilitiate the interdiction of vessels suspected of carrying illicit narcotics. Directs the President to take appropriate actions against countries which refuse to negotiate. Requires the Secretary to submit semiannual reports to the Congress identifying such countries. Requires the President to direct that an updated threat assessment of narcotics trafficking from Africa be prepared. Requires the Secretary of the Treasury to promote the development and implementation of a drug eradication program through multinational development bank assistance. Urges the President to explore the possibility of engaging security-oriented organizations (such as the North Atlantic Treaty Organization) in cooperative drug programs. Declares congressional support for the United Nations General Assembly decision

to convene an International Conference on Drug Abuse and Illicit Trafficking. Calls for the conduct of a study of the effectiveness of the United Nations drug-related declarations, conventions, and entities. Requires the President to report any recommendations which result from such study to the Congress. Urges the United Nations Commission on Narcotic Drugs to complete work on a new draft convention against illicit traffic in narcotic drugs and psychotropic substances. Urges the President to direct the Secretary of State to enter into negotiations with Mexico to create the Mexico-United States Intergovernmental Commission on Narcotics and Psychotropic Drug Abuse and Control. Urges Pakistan to adopt and implement a comprehensive narcotics control program. Requires the Secretary of State to report to the Congress with respect to the adoption and implementation of such program. Urges the President to instruct the U.S. Ambassador to the United Nations to request that the problem of illicit drug production in Iran, Afghanistan, and Laos be raised at the International Conference on Drug Abuse and Illicit Drug Trafficking. Increases FY 1987 authorization for drug education programs abroad. Requires the Director of the U.S. Information Agency and the Administrator of the Agency for International Development to include in their annual reports to the Congress a description of the drug education programs carried out by their respective agencies. Urges the President to take certain actions regarding narcotics control in Mexico. Title III: Interdiction—National Drug Interdiction Improvement Act of 1986—Subtitle

1034  Appendix

A: Department of Defense Drug Interdiction Assistance—Defense Drug Interdiction Assistance Act—Requires the Secretary of Defense to use specified funds to acquire certain equipment and aircraft for drug interdiction assistance activities of the Department of Defense. Requires the Secretary of Defense to make such aircraft available to the U.S. Customs Service. Directs the Secretary of Defense and the Secretary of Transportation to provide for the assignment of Coast Guard personnel to naval vessels for law enforcement purposes. Authorizes appropriations for the installation of 360-degree radar on Coast Guard surveillance aircraft. Requires the National Drug Enforcement Policy Board to submit a report to specified congressional committees on the manner and extent to which the Department of Defense should be involved narcotics law enforcement activities. Requires the Secretary of Defense to submit a report to specified congressional committees containing a discussion of: (1) the extent to which students enrolled in schools operated by the Department of Defense are receiving drug and substance abuse education; and (2) the extent to which such education should include peer counseling classes. Amends the Uniform Code of Military Justice to include driving under the influence of drugs as an offense. Allows the Department of Defense to provide certain assistance to civilian law enforcement personnel. Provides for congressional approval of such assistance and for review by the General Accounting Office. Increases by one the number of Marine Corps officers authorized to be on active

duty in grades above major general during any period that a Marine Corps officer is serving as Director of the Department of Defense Task Force on Drug Enforcement. Allows the Secretary of Defense to use authorized funds to acquire equipment for the Civil Air Patrol for drug interdiction surveillance and reporting missions. Requires the Secretary of the Air Force to report to specified congressional committees on the use of such funds. Subtitle B: Customs Enforcement—Customs Enforcement Act of 1986—Part 1: Amendments to the Tariff Act of 1930— Amends the Tariff Act of 1930 to establish certain entry and reporting requirements for aircraft, vessels, and vehicles arriving in the United States and the Virgin Islands. Sets forth penalties for violations of such requirements. Makes aviation smuggling illegal. Establishes civil and criminal penalties for such violations. Authorizes the issuance of search warrants for places suspected of containing: (1) merchandise brought into the United States unlawfully; (2) property subject to forfeiture under the customs laws; or (3) evidence of customs violations. Authorizes the seizure and forfeiture of smuggled merchandise. Provides that compensation for informers shall not exceed 25 percent of the amount recovered. (Current law requires that such compensation equal 25 percent of such recovery.) Authorizes the Secretary of Transportation to require the production of foreign landing certificates to comply with international obligations.

Appendix  1035

Permits the Secretary to authorize customs officials to exchange information or documents with foreign customs or law enforcement agencies under certain circumstances.

or aircraft available for use by the Customs Service; (3) the reimbursement of private citizens for certain expenses; and (4) publicizing the availability of rewards.

Allows the Secretary, when authorized by treaty or executive agreement, to station customs officers in foreign countries to examine persons or merchandise prior to their arrival in the United States. Provides that merchandise seized at a foreign station may be transported to the United States for customs proceedings. Permits the stationing of foreign customs officers in the United States (if similar privileges are extended to the United States). Establishes penalties for making fraudulent statements to such foreign officials.

Authorizes appropriations for the Fund.

Part 2: Undercover Customs Operations—Sets forth certain requirements with regard to undercover investigative operations of the U.S. Customs Service, including: (1) the use of authorized funds; (2) the liquidation of corporate and business entities established or acquired as part of an undercover operation; (3) the deposit of proceeds from such operations; and (4) the conduct of financial audits of each undercover operations. Part 3: Customs Service Authorizations and Forfeiture Fund—Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize FY 1987 appropriations to the Department of the Treasury for the U.S. Customs Service. Extends the authority of the Customs Forfeiture Fund through FY 1991. Makes such Fund available for: (1) purchases by the Customs Service of evidence of smuggling of controlled substances and violations of the currency and foreign transaction reporting requirements; (2) the equipping for law enforcement functions of any vessel, vehicle,

Part 4: Miscellaneous Customs Amendments—Subjects recreational vessels to applicable customs regulations. Allows any customs officer needing assistance in making an arrest, search, or seizure, to demand such assistance from any person. Subjects any person who refuses such assistance to criminal penalties. Part 5: Amendments to the Controlled Substances Import and Export Act— Amends the Controlled Substances Import and Export Act to make it unlawful for any U.S. citizen on board any aircraft, or any person on board an aircraft owned by a U.S. citizen or registered in the United States, to manufacture or distribute or possess with intent to distribute, a controlled substance. Subtitle C: Maritime Drug Law Enforcement Prosecution Improvements Act of 1986—Maritime Drug Law Enforcement Prosecution Improvements Act of 1986— Makes it unlawful for any person on board a vessel of the United States, or on board a vessel subject to the jurisdiction of the United States, to manufacture or distribute, or possess with intent to manufacture or distribute, a controlled substance. Subtitle D: Coast Guard—Authorizes additional appropriations for the Coast Guard. Subtitle E: United States-Bahamas Drug Interdiction Task Force—Authorizes the establishment of a United States-Bahamas Drug Interdiction Task Force. Authorizes appropriations for such Task Force and for

1036  Appendix

the construction of a Coast Guard-Bahamas drug interdiction docking facility. Subtitle F: Command, Control, Communications, and Intelligence Centers—Authorizes appropriations to the U.S. Customs Service for the establishment of command, control, communications, and intelligence centers. Subtitle G: Transportation Safety— Amends the Federal Aviation Act of 1958 to allow States to establish criminal penalties for certain activities involving aircraft registration certificates. Requires the operator of an aircraft to make the aircraft’s certificate of registration available for inspection by any law enforcement officer. Establishes criminal penalties for certain violations in connection with: (1) aircraft registration; and (2) the air transportation of controlled substances. Requires any person having an ownership interest in any aircraft to report any transfer of ownership of such aircraft. Directs the Secretary of Transportation to conduct a study to determine the relationship between the use of controlled substances and highway safety. Requires the Secretary to report the results of such study to the Congress. Subtitle H: Department of Justice Funds for Drug Interdiction Operations in Hawaii—Authorizes additional appropriations to the Department of Justice for drug interdiction operations in Hawaii. Subtitle I: Federal Communications Commission—Allows the Federal Communications Commission to revoke the license of any person found to have used such license to distriute controlled substances. Title IV: Demand Reduction- Subtitle A: Treatment and Rehabilitation—Alcohol

and Drug Abuse Amendments of 1986— Amends the Public Health Service Act to authorize FY 1987 appropriations for certain alcohol abuse and drug abuse programs. Designates the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) an agency of the Public Health service. Makes the following entities agencies of ADAMHA: (1) the National Institute on Alcohol Abuse and Alcoholism; (2) the National Institute on Drug Abuse; and (3) the National Institute of Mental Health. Makes various revisions to ADAMHA, including: (1) establishing the Alcohol, Drug Abuse, and Mental Health Advisory Board; (2) establishing advisory councils for ADAMHA agencies; and (3) establishing an Office for Substance Abuse Prevention. Requires the Secretary of Health and Human Services to: (1) establish an Alcohol and Drug Abuse Information Clearinghouse; and (2) make grants for prevention, treatment, and rehabilitation demonstration projects for high risk youth. Extends the authorization of appropriations for certain alcohol and drug abuse research projects through FY 1987. Requires the Director of the National Institute of Mental Health to develop and publish information respecting the causes and means of preventing suicide. Amends the Federal Food, Drug, and Cosmetic Act to require the Secretary of Health and Human Services to establish requirements for quality factors for infant formulas. Requires the Secretary to conduct a study on alkyl nitrites and report the results of such study to specified congressional committees.

Appendix  1037

Urges the Public Health Service to take certain actions regarding the health consequences of alcohol abuse. Expresses the sense of the Congress that the entertainment and written media industry should refrain from producing material which glamorizes the use of illegal drugs and alcohol. Urges the categorization of films which promote alcohol abuse and drug use. Directs the Secretary to establish guidelines for the care and treatment of research animals. Requires the Secretary to arrange for an alcoholism and alcohol abuse treatment study. Subtitle B: Drug-Free Schools and Communities Act of 1986—Drug-Free Schools and Communities Act of 1986—Part 1: Financial Assistance for Drug Abuse Education and Prevention Programs—Authorizes appropriations for FY 1987 through 1990 for State and local drug abuse education and prevention programs. Part 2: State and Local Programs—Sets forth the kinds of State and local programs for which such grants are to be used. Part 3: National Programs—Authorizes the Secretary to make grants to institutions of higher education or consortia for drug abuse education and prevention programs. Directs the Secretary of Education to carry out Federal education and prevention activities on drug abuse. Authorizes various programs for drug abuse education and prevention efforts for Indians and Hawaiian natives. Part 4: General Provisions—Sets forth provisions for program participation of children and teachers from nonprofit private schools.

Subtitle C: Indians and Alaska Natives— Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986—Part I: General Provisions—Sets forth the purposes of this Act. Part II: Coordination of Resources and Programs—Directs the Secretary of the Interior and the Secretary of Health and Human Services to develop and enter into a Memorandum of Agreement to better coordinate the provision of alcohol and substance abuse treatment and prevention services for Indians and Alaska natives. Allows the governing body of any Indian tribe to establish a Tribal Action Plan to coordinate available resources and programs in an effort to combat alcohol and drug abuse among its members. Establishes within the Office of the Assistant Secretary of Indian Affairs an Office of Alcohol and Substance Abuse. Requires the Secretary of the Interior to publish an alcohol and substance abuse newsletter to report on Indian alcohol and substance abuse projects and programs. Part III: Indian Youth Programs—Requires the Secretary of the Interior and the Secretary of Health and Human Services to review Federal, tribal, State, local, and private programs: (1) providing educational services to Indian children; (2) providing family and social services for Indians; and (3) relating to youth employment, recreation, cultural, and community activities. Requires the Assistant Secretary of Indian Affairs to develop and implement pilot programs in selected schools funded by the Bureau of Indian Affairs which further the purposes and goals of this Act.

1038  Appendix

Allows Tribal Action Plans to make provisions for the establishment, funding, licensing, and operation of emergency shelters or half-way houses for Indian youth who are alcohol or substance abusers. Urges States to require its law enforcement officers to place any Indian youth arrested for alcohol or substance abuse in such shelter or halfway house. Authorizes appropriations for FY 1987 through 1989 for the construction, renovation, and operation of such shelters and half-way houses. Directs the Secretary of the Interior to require the compilation of data relating to the number and types of child abuse and neglect cases seen and the type of assistance provided. Part IV: Law Enforcement and Judicial Services—Requires the Secretary of the Interior and the Secretary of Health and Human Services to review Federal, tribal, State, and local programs providing law enforcement or judicial services for Indian tribes. Directs the Secretary of the Interior to: (1) provide assistance to the Papago Tribe of Arizona for the investigation and control of illegal narcotics traffic on the Papago Reservation; and (2) establish and implement a program for the eradication of marijuana cultivation within Indian country. Authorizes appropriations. Part V: Bureau of Indian Affairs Law Enforcement—Increases the maximum sentence (from six months to one year) and fine (from $500 to $5,000) which a tribal court can impose for any offense. Directs the Secretary of the Interior to establish a training program in the investigation and prosecution of offenses relating to illegal narcotics and in alcohol and substance

abuse prevention and treatment for specified personnel. Requires the Memorandum of Agreement to include a provision for the development and implementation of a procedure for the emergency medical assessment and treatment of every Indian youth arrested or detained for alcohol or substance abuse offenses. Directs the Secretary of the Interior to construct or renovate and staff juvenile detention centers. Authorizes appropriations for FY 1987 through 1989. Requires the Secretary of the Interior to: (1) provide for the development of a Model Indian Juvenile Code; and (2) compile data regarding cases involving Indians where alcohol or substance abuse is determined to be a contributing factor. Part VI: Indian Alcohol and Substance Abuse Treatment and Rehabilitation— Requires the Secretary of the Interior and the Secretary of Health and Human Services to review health service programs for Indians. Sets forth Indian Health Service responsibilities, which includes providing a comprehensive alcohol and substance abuse treatment program. Requires the Secretary of the Interior to develop and implement a program for acute detoxification and treatment for Indian youth who are alcohol and substance abusers. Authorizes appropriations. Directs the Secretary of Health and Human Services to make grants to the Navajo tribe to establish a demonstration program in Gallup, New Mexico, to rehabilitate adult Navajo Indians suffering from alcoholism or alcohol abuse. Authorizes appropriations for FY 1988 through 1990.

Appendix  1039

Requires the Secretary of Health and Human Services to compile data regarding Indian Health Service involvement in cases or incidents which involved alcohol or substance abuse. Subtitle D: Miscellaneous Provisions— Amends the Domestic Volunteer Act of 1973 to authorize a special initiative (including action grants) to increase volunteerism in preventing drug abuse. Authorizes appropriations for FY 1987 through 1989. Establishes the National Trust for Drug Free Youth. Directs the Secretary of Labor to collect information on the incidence of drug abuse in the workplace. Title V: United States Insular Areas and National Parks—Subtitle A: Programs in United States Insular Areas—United States Insular Areas Drug Abuse Act of 1986—Requires the President to report annually to the Congress on the efforts of Federal agencies in preventing the illegal entry of controlled substances into the United States. Authorizes law enforcement officers of the Governments of American Samoa and the Northern Mariana Islands to: (1) execute and serve warrants, subpoenas, and summons issued under the authority of the United States; (2) make arrests without warrants; and (3) make seizures of property to carry out the purposes of this Act, the Controlled Substances Import and Export Act, and other applicable narcotics laws. Authorizes the Attorney General and the Secretary of Health and Human Services to train such law enforcement officers and provide certain law enforcement equipment. Authorizes the Attorney General and the Secretary of Health and Human Services to provide technical assistance and equipment

to the Governments of Guam, Puerto Rico, and the Virgin Islands to enforce applicable drug abuse laws. Authorizes appropriations to the Governments of Guam, Puerto Rico, and the Virgin Islands for specified purposes. Subtitle B: National Park Service Program—National Park Police Drug Enforcement Supplemental Authority Act— Authorizes additional appropriations for National Park Police for personnel, training, equipment, and facilities. Title VI: Federal Employee Substance Abuse Education and Treatment—Federal Employee Substance Abuse Education and Treatment Act of 1986—Makes the Office of Personnel Management responsible for developing appropriate prevention, treatment, and rehabilitation programs and services for drug and alcohol abuse among Federal employees. Requires OPM to submit annual reports to the Congress regarding such programs. Requires the Director of OPM to establish a Government-wide drug and alcohol abuse education program. Requires the head of each executive agency to establish employee alcohol and drug abuse assistance programs. Requires OPM to establish program guidelines. Directs the Secretary of Health and Human Services to conduct a substance abuse insurance coverage study and report the results of such study to the Congress. Title VII: National Antidrug Reorganization and Coordination—National Antidrug Reorganization and Coordination Act—Requires the President to submit recommendations to the Congress for legislation to reorganize the executive branch to more effectively combat drug traffic and abuse.

1040  Appendix

Title VIII: President’s Media Commission on Alcohol and Drug Abuse Prevention—President’s Media Commission on Alcohol and Drug Abuse Prevention Act— Establishes the President’s Media Commission on Alcohol and Drug Abuse Prevention. Requires the Commission to transmit annual reports on its activities to the President and the Congress. Title IX: Denial of Trade Benefits to Uncooperative Major Drug Producing or Drug-Transit Countries—Narcotics Control Trade Act—Denies the products of every major drug producing and drug-transit country most-favored-nation treatment until the President determines that significant progress has been made in remedying those policies. Title X: Ballistic Knife Prohibition— Ballistic Knife Prohibition Act of 1986— Amends the Federal criminal code to prohibit the possession, manufacture, sale, importation, and mailing of ballistic knives (knives with a detachable blade that are propelled by a spring-operated mechanism). Title XI: Homeless Eligibility Clarification Act—Homeless Eligibility Clarification Act—Subtitle A: Emergency Food for the Homeless—Amends the Food Stamp Act of 1977 to include food served to homeless individuals within the definition of food. Revises the definition of household. Subtitle B: Job Training for the Homeless—Amends the Job Training Partnership Act to make the homeless eligible for job training programs. Subtitle C: Entitlements Eligibility—Directs the Secretary of Health and Human Services to develop a system under which individuals can apply for supplemental security income benefits (SSI) prior to their discharge or release from public institutions.

Provides that veterans’ benefits may not be denied an applicant on the basis that the applicant is homeless. Title XII: Commercial Motor Vehicle Safety Act of 1986—Commercial Motor Vehicle Safety Act of 1986—Limits the number of driver’s licenses any person who operates a commercial vehicle can have at any time to one. Requires operators of commercial vehicles to report out-of-State traffic violations to the license-issuing State and employer. Requires an employee who loses the right to operate a motor vehicle to report such loss to the employer. Prohibits an employer from permitting an employee to operate a commercial vehicle during any period where the employee: (1) has a suspended license; or (2) has more than one driver’s license. Directs the Secretary of Transportation to establish minimum Federal standards for operators of commercial vehicles. Requires the Secretary to establish a clearinghouse and depository of information pertaining to the licensing and identification of operators of commercial motor vehicles. Lists offenses which result in disqualifying a person from operating a commercial motor vehicle. Establishes a grant program for States for issuing classified driver’s licenses. Sets forth grant requirements. Provides for the withholding of State highway funds for not complying with such regulations. Establishes civil and criminal penalties for certain violations of the Commercial Vehicle Safety Act. Directs the Secretary to conduct a review of regulations pertaining to the use of alcohol by operators of commercial motor vehicles.

Appendix  1041

Requires the Secretary to revise certain regulations to require trucks and truck tractors manufactured after July 24, 1980, to have brakes operating on all wheels. Directs the Secretary to conduct a demonstration project to assess the benefits of continuous use of unarmed radar equipment on highway safety. Title XIII: Cyanide Wrongful Use—Requires the Administrator of the Environmental Protection Agency to conduct a study of the manufacturing and distribution process of cyanide. Title XIV: Senate Policy Regarding Funding—Expresses the sense of the Senate that amounts authorized to carry out the provisions of this Act should be provided as new budget authority for FY 1987. Title XV: National Forest System Drug Control—National Forest System Drug Control Act of 1986—Grants certain specially trained officers and employees of the Forest System special law enforcement powers. Amends the Controlled Substances Act to provide criminal penalties for any person who assembles, maintains, or places a boobytrap on Federal property where a controlled substance is being manufactured, distributed, or dispensed. Source: H.R. 5484 (99th); Pub.L. 99–570

As a result of the new law, more money was spent on law enforcement efforts to reduce drug trafficking, as well as on programs to reduce demand for drugs (education programs in schools). Despite the increased attention to law enforcement efforts and education programs, the public was still very concerned about the potential dangers of drug use and addiction. Even though there were tougher penalties for drug dealing and use, many people still used harmful drugs like cocaine, crack, heroin, and marijuana. In 1988, Congress decided to pass a new law to boost the first law. The result was the Anti–Drug Abuse Act of 1988. The new law again increased some of the penalties for particular offenses. For example, if a person was killed as the result of the actions of a drug-trafficking organization, the people responsible could face the death penalty. Because the dangers of crack cocaine use were so apparent, Congress chose to create a new sentence for those convicted of possessing small amounts of the drug. They could be sentenced of a minimum of five years, and a maximum of 20 years in prison.

Anti–Drug Abuse Act (1988)

In addition to increased punishments, the new law established the Office of National Drug Control Policy within the executive office. This new office would be responsible for coordinating federal antidrug efforts. There were also allocations put aside for treatment for those suffering from drug abuse issues, and for demand reduction programs.

In 1986, Congress passed the Anti–Drug Abuse Act of 1986 that increased mandatory sentences for drug trafficking, possession, and use. At the time, public concern about drug use was high, and demands for federal action to address the problem were common.

Anti–Drug Abuse Act of 1988 Title I: Coordination of National Drug Policy—Subtitle A: National Drug Control Program—National Narcotics Leadership Act of 1988—Establishes the Office of National Drug Control Policy in the

1042  Appendix

Executive Office of the President. Names as principals of this Office a Director of National Drug Control Policy (Director) and Deputy Directors for Demand Reduction and Supply Reduction, all to be appointed by the President, with the advice and consent of the Senate. Establishes within the new Office a Bureau of State and Local Affairs, to be headed by an Associate Director for National Drug Control Policy, also to be appointed by the President. Sets forth responsibilities of the Director, including requirements that the Director: (1) transmit a consolidated National Drug Control Program (Program) budget proposal; and (2) submit to the Congress annual reports on a National Drug Control Strategy. Describes required report contents. Describes limitations in connection with Program agency budget reprogramming or transfer requests. Provides for coordination among executive branch departments and agencies, including a requirement that the head of a Program agency notify the Director in writing of any proposed policy changes relating to Program activities. Requires the Director to respond promptly as to whether the change is consistent with the National Drug Control Strategy. Terminates the National Drug Enforcement Policy Board and the White House Office of Drug Abuse Policy and repeals specified provisions of the National Narcotics Act of 1984 and of the Drug Abuse Prevention, Treatment, and Rehabilitation Act in connection with these entities. Prohibits the expenditure of funds for activities of the National Narcotics Border Interdiction System after 30 days following appointment of the Director.

Instructs the Director to report to the President and to the Congress concerning the need for coordinating, consolidating, or otherwise reorganizing agencies and functions of the Federal Government involved in drug supply reduction and demand reduction. Terminates the Office of National Drug Control Policy five years after this subtitle’s enactment, repealing all subtitle provisions relating to the Office and its functions. Authorizes appropriations to fund the Office during its five-year existence. Subtitle B: Department of Justice Civil Enforcement Enhancement—Justice Department Organized Crime and Drug Enforcement Enhancement Act of 1988— Requires the Director to report to the Congress, within one year of this title’s enactment, for reorganizing existing Department of Justice divisions and programs or creating new Department divisions in the interest of more effective civil and criminal law enforcement. Directs the Attorney General to ensure that high priority is attached to the enforcement of civil law by Department of Justice components involved in prosecuting organized crime and controlled substances violations. Authorizes appropriations in connection with these civil enforcement enhancement efforts. Requires the Attorney General to: (1) report to the Congress on these efforts and on resources needed to implement the policy underlying them; and (2) beginning in FY 1990, submit as part of the budget request a separate request for appropriations to the Department of Justice Interagency Law Enforcement Appropriation Account for reimbursement to agencies participating in the Organized Crime Drug Enforcement Task Forces.

Appendix  1043

Title II: Treatment and Prevention Programs—Subtitle A: Provisions Relating to Public Health Service Act—Comprehensive Alcohol Abuse, Drug Abuse, and Mental Health Amendments Act of 1988 Chapter 1: Revision and Extension of Alcohol and Drug Abuse and Mental Health Services Block Grant—Amends the Public Health Service Act to authorize FY 1989 through 1991 appropriations for the alcohol and drug abuse and mental health services block grant program. Sets forth formulas for determining allotments among the various States and territories. Earmarks a specified portion of Hawaii’s allotment to be available only for Native Hawaiians. Conditions FY 1989 payments to a State upon the State’s agreement to spend the funds exclusively for substance abuse programs, using at least half the funds for an enumerated series of permissible activities addressing intravenous drug abuse prevention and treatment programs. Authorizes the Secretary of Health and Human Services (HHS), with respect to funds available for substance abuse programs, to permit States to use the amounts for construction of substance abuse facilities. Describes conditions under which such a waiver is authorized. Decreases the percentage of funds authorized for administrative expenses. Conditions FY 1991 payments to a State for mental health services upon the State’s agreement to use at least 55 percent of the funds for new services and programs for a limited period of time. Permits the waiver of this condition under certain circumstances. Requires States to provide for periodic independent peer review with respect to the quality and appropriateness of treatment services provided by entities funded under this chapter. Increases the percentage of allotments

that must be used for specified mental health and alcohol and drug abuse activities. Requires States to use at least 50 percent of allotments for alcohol and drug abuse activities for FY 1990 and thereafter for intravenous drug abuse prevention and treatment programs. Requires States to agree to: (1) maintain expenditures for services under this chapter at a specified level, subject to waiver under extraordinary economic conditions; (2) use at least ten percent of funds for programs and services designed for women, especially those who are pregnant or who have dependent children; and (3) use at least ten percent of funds for mental health services for programs for seriously emotionally disturbed children and adolescents. Describes a variety of other conditions that a State must meet in order to receive funds under this chapter, including requirements relating to treatment for intravenous drug abuse, outreach activities, substance abuse spending priorities, and data collection. Requires recipient States to agree to establish and maintain a State mental health planning council to perform specified duties, including the monitoring of both the allocation and adequacy of mental health services within the State. Conditions FY 1989 funding to a State upon the State’s agreement to establish a revolving fund to make loans for the costs of establishing group housing for persons recovering from alcohol or drug abuse. Requires the State to assure continuing operation of the fund in order to receive payments for FY 1990 and thereafter. Requires reporting: (1) by States in connection with new mental health services and programs; and (2) by the Secretary of HHS to the Congress, by October 1, 1990, on State activities under the alcohol and drug abuse and mental health services block grant program. Directs the

1044  Appendix

Secretary to provide technical assistance to States in connection with the program. Directs the Secretary, acting through the Director of the National Institute on Alcohol Abuse and Alcoholism and the Director of the National Institute on Drug Abuse, to evaluate alcohol and drug abuse treatment programs to determine their quality and appropriateness and to submit to specified congressional committees, within six months of this Act’s enactment, a plan for such an evaluation. Directs the Secretary, acting through the Director of the National Institute of Mental Health (NIMH), to develop and maintain an ongoing program of research on community mental health programs and services. Describes required program features. Authorizes the NIMH Director to establish research centers to carry out evaluations required under the program.

Prevention to be used for: (1) the alcohol and drug abuse information clearinghouse; (2) prevention, treatment, and rehabilitation model projects for high-risk youth; and (3) model projects for pregnant and postpartum women and their infants. Revises provisions governing the duties of the Director of the Office for Substance Abuse Prevention to: (1) target expressly health professionals involved in drug abuse education, prevention, and intervention as a group for whom clinical training programs must be supported; and (2) implement programs, through appropriate schools, to train health care and social work personnel to diagnose and treat alcohol and drug abuse. Revises criteria used to determine award priority in connection with grants for drug abuse and alcohol abuse prevention projects for high-risk youth.

Instructs the Comptroller General, by the end of FY 1990, to prepare and submit to specified congressional committees a report assessing the extent to which States have submitted and implemented comprehensive mental health services plans.

Amends the Public Health Service Act to direct the Secretary of HHS, acting through the Administrator of the Alcohol, Drug Abuse, and Mental Health Administration, annually to collect data on the incidence and prevalence of various forms of mental illness and substance abuse, both nationally and in major metropolitan areas. Instructs the Administrator to ensure that specified types of data are collected. Requires annual surveys in connection with collection of these data, with summaries and analyses made available to the public. Directs the ADAMHA Administrator to develop uniform standards for data collection.

Chapter 2: Revision and Extension of Certain Programs of Alcohol, Drug Abuse, and Mental Health Administration— Amends the Public Health Service Act to authorize FY 1989 through 1991 appropriations to the Office for Substance Abuse

Authorizes the Secretary, through the ADAMHA Administrator, to make grants for the purpose of reducing the waiting list of public and nonprofit private programs that provide drug abuse treatment services. Lists eligibility criteria, as well as conditions and

Directs the Administrator of the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) to: (1) develop a model plan for a community-based system of care for chronically mentally ill individuals; and (2) develop a model insurance plan for consideration by the Director of the Office of Personnel Management and the Congress.

Appendix  1045

limitations applicable to such grants. Authorizes appropriations. Directs the Secretary of HHS, acting through the Director of the Office for Substance Abuse Prevention, to make grants to establish projects for drug and alcohol abuse prevention, education, and treatment with respect to pregnant and postpartum women and their infants. Gives priority to projects for low-income women and for innovative projects regarding the use of drugs, including cocaine and crack, about which insufficient information exists. Describes application and evaluation procedures. Empowers the Secretary, acting through the ADAMHA Administrator, to make grants to public and private entities for demonstration projects to: (1) determine the feasibility and long-term effectiveness of offering drug abuse treatment and vocational training in exchange for public service; (2) conduct outreach activities in connection with drug abuse and AIDS; and (3) provide drug abuse treatment services to pregnant and postpartum women and their infants. Requires the Secretary to provide for program evaluations and for the dissemination of derivative information. Directs the Secretary to establish demonstration projects that provide grants to the States to enable them to provide effective treatment and treatment referrals to drug abusers. Describes criteria to govern grant awards. Requires the Secretary to select projects that focus on treatment of at least one of the following: (1) adolescents; (2) minorities; (3) pregnant women; (4) female addicts and their children; and (5) public housing residents. Requires, in addition, the selection of at least one project that includes a centralized local referral unit meeting specified criteria. Sets forth application procedures

and priority concerns. Requires systematic evaluation of the projects on a long-term basis to determine their impact on treated individuals and on the community. Authorizes appropriations. Authorizes FY 1989 through 1991 appropriations for alcohol abuse and alcoholism research. Authorizes corresponding appropriations for drug abuse research. Includes individuals between 21 and 24 years old among those to be expressly targeted in suicide-related information that the Secretary of HHS publishes and makes available to the public and to health professionals. (The current focus is on persons 21 years old and younger.) Directs the Secretary, through the ADAMHA Administrator, to: (1) make grants and enter into agreements with public and nonprofit private entities to undertake research and studies concerning the causes, diagnosis, treatment, control, and prevention of mental illness; and (2) establish a National Mental Health Education Program for a variety of treatment improvement, research support, and data collection purposes, including the establishment of a clearinghouse for mental health research and treatment programs. Directs the Secretary, through the NIMH Director, to make grants to States and nonprofit private agencies for: (1) mental health services demonstration projects and research projects involving community services for chronically mentally ill individuals, seriously emotionally disturbed children and youth, the elderly, and homeless chronically mentally ill persons; (2) demonstration projects for the prevention of youth suicide; (3) demonstration projects for improved recognition and treatment of depressive disorders; and (4) demonstration projects for prevention and treatment relating to

1046  Appendix

sex offenses. Authorizes similar grants for demonstration projects covering prevention services for persons at risk of developing mental illness. Lists permissible grant uses. Limits grants to no more than three consecutive one-year periods. Authorizes FY 1989 and 1990 appropriations, earmarking a specified percentage for projects in rural areas.

to study the current use of involuntary commitment for inpatient or outpatient treatment of mental illness and report results to the Congress; and (3) request the National Academy of Sciences to review the research of the National Institutes of Health and the Alcohol, Drug Abuse, and Mental Health Administration and submit results to the Congress.

Makes miscellaneous amendments to the Public Health Service Act to: (1) designate the Office of Substance Abuse Prevention as an agency of the Alcohol, Drug Abuse, and Mental Health Administration; (2) require triennial rather than annual reporting on the Administration’s prevention activities; (3) eliminate the Alcohol, Drug Abuse, and Mental Health Advisory Board; (4) authorize the Administrator to accept voluntary services and to conduct certain kinds of research training; (5) permit the Secretary, acting through the Administrator, to make grants (authorizes FY 1989 through 1991 funding) of up to $100,000 for the acquisition of small instrumentation necessary for research, on the condition that the grant will be contemporaneously utilized by at least two grantees; and (6) target expressly pregnant women and their children in connection with certain grant programs.

Chapter 4: Miscellaneous—Amends the Public Health Service Act to instruct the Director of the National Institute on Drug Abuse and the States to take specified actions in connection with military facilities identified by the Commission on Alternative Utilization of Military Facilities as usable to house nonviolent persons for drug abuse treatment purposes. Amends the Federal Property and Administrative Procedures Act of 1979 to permit the transfer of such properties to the States for donation to drug abuse treatment centers.

Amends the Anti-Drug Abuse Act of 1986 to extend the deadline by which the Secretary of HHS must report to the Congress on the extent to which drug abuse treatment is covered by private insurance, public programs, and other payors. Chapter 3: Reports and Studies—Directs the Secretary of HHS to: (1) study and report to the Congress on the relationship between mental illness and substance abuse and ways to treat persons having both problems; (2) contract with an independent expert entity

Subtitle B: Employee Assistance Programs—Directs the Secretary of Labor to establish a grant program to enable employers to develop employee drug and alcohol abuse assistance programs. Authorizes FY 1989 through 1991 appropriations. Subtitle C: Indian Alcohol and Substance Abuse Prevention and Treatment— Amends the Indian Alcohol and Substance Abuse Prevention and Treatment Act of 1986 to add as duties of the Office of Alcohol and Substance Abuse: (1) monitoring the performance in achieving compliance with minimum performance standards through remedial plans of Tribal Action Plans; and (2) reporting to the Congress instances when remedial plans are needed to address program deficiencies. Permits Tribal Action Plans to include provisions for Plan modification.

Appendix  1047

Authorizes FY 1990 through 1992 appropriations for grants to Indian tribes to develop Tribal Action Plans. Authorizes the Secretaries of the Interior and of HHS to enter into long-term leases of tribally owned or leased facilities to house programs under this subtitle if there is no Federal facility available and if the cost of constructing one would exceed the cost of the lease. Permits the leasing of a tribal facility for use as a regional treatment center only if all the tribes within the Indian Health Service area served consent to the lease. Extends through FY 1992 the authorization of appropriations for pilot programs in selected Indian schools to determine the effectiveness of summer youth programs in preventing alcohol and substance abuse among Indians. (Under current law, the authorization expires at the end of FY 1989.) Specifies permitted uses of halfway houses. Authorizes FY 1990 through 1992 appropriations for halfway houses and emergency shelters for Indian youth. Directs the Secretary of the Interior to assist the St. Regis Band of Mohawk Indians of New York in developing tribal law enforcement and judicial systems to aid in the investigation and control of illegal narcotics traffic on their reservation along the Canadian border. Authorizes FY 1989 through 1990 appropriations for this assistance. Extends through FY 1992 the authorization of appropriations for assistance to the Tohono O’odham Tribe of Arizona for illegal narcotics traffic investigation and control. Extends through FY 1992 the authorization of appropriations for: (1) marijuana eradication programs in Indian country; and (2) Bureau of Indian Affairs law enforcement and judicial training programs.

Prohibits the Indian Health Service from refusing to give necessary interim treatment to any Indian youth arrested or detained for offenses relating to alcohol or substance abuse. Extends through FY 1991 the authorization of appropriations for the construction or renovation of juvenile detention centers and through FY 1992 the authorization of appropriations for staffing and operating these types of centers. Makes corresponding provisions with respect to youth regional treatment centers under the Indian Health Service Youth Program. Extends through FY 1992 the authorization of appropriations for rehabilitation and follow-up services under the Indian Health Service Youth Program. Provides for the inclusion of family members of affected youth in treatment services under the Program. Repeals provisions establishing and governing a demonstration program to determine the most effective and cost-efficient means of training Indians in health promotion matters. Directs the Secretary of HHS, in administering programs of training and community education, to consider and make available the results of the demonstration project for children of alcoholics that was funded by the Office of Minority Health of the Department of HHS. Extends through FY 1992 the authorization of appropriations for training and community education. Decreases funds authorized for the Navajo Alcohol Rehabilitation Demonstration Program for FY 1989 and 1990. Authorizes appropriations for the Program for each subsequent fiscal year. Establishes an urban Indian program under which the Secretary of HHS is authorized to make grants to certain urban Indian organizations to provide health-related services

1048  Appendix

in school and community-based education, prevention, treatment, or rehabilitation of alcohol and substance abuse in urban cen­ ters. Sets forth grant criteria. Authorizes FY 1990 through 1992 appropriations. Revises the administrative structure of the Office of Alcohol and Substance Abuse within the Office of the Assistant Secretary of the Interior for Indian Affairs. Places responsibility for the appointment both of employees of this Office and of the Indian Youth Programs Officer with this Assistant Secretary. Authorizes the Secretary of HHS to enter into contracts with both public and private providers of alcohol and substance abuse treatment services to assist in the Indian Health Service Program. Authorizes FY 1989 through 1992 appropriations for such contracts. Authorizes appropriations for FY 1989 through 1992 for costs of publishing an alcohol and substance abuse newsletter relating to Indians. Subtitle D: Native Hawaiian Health Care—Native Hawaiian Health Care Act of 1988—Authorizes the Secretary of HHS (Secretary) to make a grant to or contract with Papa Ola Lokahi (an organization comprising specified governmental, academic, and social entities) to develop a Native Hawaiian comprehensive health care master plan of health promotion and disease prevention services with respect to Native Hawaiians. Authorizes FY 1990 appropriations. Authorizes the Secretary to make grants to qualified entities to provide comprehensive health promotion and disease prevention services, as well as primary health services, to Native Hawaiians. Gives preference to

Native Hawaiian health centers and organizations with respect to such grants. Requires grant recipients to provide specified services, including health education, immunizations and other preventive medical services, nutrition services, and physician services. Authorizes other services as well. Sets forth various conditions relating to the grants, including limitations on fund uses and geographic distribution, and matching fund requirements. Authorizes FY 1991 through 1992 appropriations. Authorizes grants to Papa Ola Lokahi to plan Native Hawaiian health centers to serve specified Native Hawaiian communities. Authorizes FY 1990 appropriations. Authorizes the Secretary to make grants to Papa Ola Lokahi to: (1) implement and update of the comprehensive health care master plan developed in accordance with this Act; (2) train appropriate Native Hawaiian health care personnel in health promotion and disease prevention education; and (3) identify and study diseases prevalent among Native Hawaiians. Authorizes FY 1990 through 1992 appropriations. Sets forth administrative requirements with respect to grants under this subtitle, including conditions to be met by grantees, evaluation procedures, and reporting requirements. Limits new spending authority under this subtitle to amounts provided in appropriation Acts. Subtitle E: Provisions Relating to Certain Drugs—Declares any criminal conviction punishable by imprisonment for more than one year for violations of the Federal Food, Drug, and Cosmetic Act involving anabolic steroids or a human growth hormone subject to criminal forfeiture under the Controlled Substances Act to be a conviction for a violation of this latter Act.

Appendix  1049

Directs the Comptroller General to study and report to the Congress by June 1, 1989, on the extent of anabolic steroid and human growth hormone use among high school and college students and other adults. Lists required report contents. Amends the Federal Food, Drug, and Cosmetic Act to make it a criminal offense to distribute or to possess with the intent to distribute any anabolic steroid other than in accordance with a physician’s order for the purpose of treating disease. Authorizes the imposition of longer prison terms if distribution or intent is directed to an individual under age 18. Declares butyl nitrite to be a banned hazardous product under the Consumer Product Safety Act, except in connection with commercial purposes other than use in products for inhaling or otherwise introducing it into the human body for euphoric or physical effects. Establishes a Joint Federal Task Force on Illegal Drug Laboratories, made up of persons appointed by the Administrators of the Environmental Protection Agency (EPA) and the Drug Enforcement Administration (DEA), to formulate, establish, and carry out a program for the cleanup and disposal of hazardous waste produced by illegal drug laboratories. Lists factors to be considered in formulating this program. Directs: (1) the Task Force to recommend guidelines for cleanup of such laboratories in the interest of protecting the public health and environment; and (2) the Administrators of EPA and DEA to formulate and publish such guidelines within 180 days after this Act’s enactment. Directs the Attorney General to make grants and enter into contracts for demonstration projects for the safe clean-up and disposal of potentially dangerous substances associ-

ated with illegal drug laboratories. Requires evaluations of these activities, as well as reporting to the Congress. Makes available FY 1989 amounts to carry out this grant program. Directs the Administrators of EPA and DEA to: (1) report to the President and to the Congress on the program established by the Task Force and on its implementation; and (2) report to the Congress on the evaluations made of the Attorney General’s demonstration project grant program. Subtitle F: Certain Provisions with Respect to Veterans—Directs the Administrator of Veterans Affairs to evaluate the inpatient and outpatient drug and alcohol treatment programs operated by the Veterans Administration, including a determination of their medical advantages and cost-effectiveness. Authorizes FY 1989 through 1991 appropriations: (1) for costs of this evaluation; and (2) exclusively for providing hospital, nursing home, domiciliary, and medical care to eligible veterans with alcohol or drug dependence or abuse disabilities. Subtitle G: Miscellaneous Health Amendments—Chapter 1: Technical and Conforming Amendments to Health Omnibus Programs Extension of 1988—Makes technical amendments and corrections of provisions in titles II, VI, VII, and IX of the Health Omnibus Programs Extension of 1988. Chapter 2: Technical and Conforming Amendments to the Public Health Service Act—Amends Public Health Service Act provisions relating to peer review of specified types of grant applications for costs of disseminating research findings or developing research agendas. Amends the National Institute on Deafness and Other Communication Disorders and

1050  Appendix

Health Research Extension Act of 1988 to direct the Secretary of HHS to establish in the National Institute on Deafness and Other Communication Disorders (Institute) the National Deafness and Other Communications Disorders Advisory Board to: (1) review, evaluate, and periodically update the required plan regarding activities in connection with relevant disorders; (2) maintain liaison with other appropriate advisory bodies; and (3) submit annual reports to the Secretary. Authorizes the Secretary to establish a Deafness and Other Communication Disorders Interagency Coordinating Committee to coordinate national research efforts and all Federal health programs and activities relating to the relevant disorders. Requires the committee to report annually to specified Federal health care leadership entities. Sets out administrative features concerning administrative expenses of the Institute. Makes technical amendments and corrections of provisions in titles IV, V, VII, VIII, XXIII, XXIV, and XXV (both the first and second versions, as added by the Health Omnibus Programs Extension of 1988) of the Public Health Service Act. Chapter 3: Technical and Conforming Amendment to Federal Food, Drug, and Cosmetic Act—Makes a technical correction of a Federal Food, Drug, and Cosmetic Act provision added by the Health Omnibus Programs Extension of 1988. Chapter 4: Miscellaneous—Prescribes the prospective interaction, with respect to the effect on title VIII of the Public Health Ser­ vice Act, of the Nursing Shortage Reduction and Education Extension Act of 1988 (H.R. 4833) and the Health Omnibus Programs Extension of 1988, upon their enactment.

Title III: Drug Abuse Education and Prevention—Subtitle A: Drug and Alcohol Abuse Education Programs—Chapter 1: Alcohol Abuse Education Programs— Amends the Elementary and Secondary Education Act of 1965 to authorize the Secretary of Education to develop materials for innovative alcohol abuse education programs, especially ones that focus on the effect of alcoholism on the families, particularly the children, of alcoholics. Requires programs for which such materials are developed to be designed for young children, particularly those in grades five through eight. Authorizes the Secretary of Education to make grants to training programs for educators that are designed to: (1) increase awareness of children’s problems that may be caused by an alcoholic parent; (2) enhance educators’ ability to identify children at risk for alcohol abuse; (3) inform educators concerning referral of children of alcoholics for appropriate professional treatment; and (4) train educators to inform the public about the special problems of children who have an alcoholic parent. Chapter 2: Drug Abuse Education for Participants in the Special Supplemental Food Program for Women, Infants, and Children—Amends the Child Nutrition Act of 1966 to include: (1) drug abuse among health problems covered by such Act; (2) drug abuse education along with the nutrition education provided under such Act; and (3) drug abuse education and instruction relating to such education under specified requirements for State plans. Adds two members to the National Advisory Council on Maternal, Infant, and Fetal Nutrition. Requires one of them to be an expert in drug abuse education and prevention, and

Appendix  1051

the other an expert in alcohol abuse education and prevention. Directs the Secretary of Agriculture: (1) within six months after enactment of this Act, to study appropriate methods of drug abuse education instruction; and (2) to prepare and distribute drug abuse education materials. Authorizes appropriations. Chapter 3: Amendments to the Drug-Free Schools and Communities Act of 1986— Amends the Drug-Free Schools and Communities Act of 1986 to increase the FY 1989 authorization of appropriations for financial assistance for drug abuse education and prevention programs. Limits the percentage of State allotments that may be used for administrative costs. Includes among permissible State programs intrastate drug and alcohol abuse education and prevention centers. Allows up to ten percent of participants in innovative State programs under such Act to be individuals who are not high-risk youth, if the Secretary of Education determines that their participation will not significantly diminish the amount or quality of services provided to high-risk youth. Limits amounts made available to a State to expenditures under authorized State programs that demonstrate benefits for individual participants. Amends State application provisions to require additional information. Revises responsibilities of State educational agencies in connection with the development, identification, and dissemination of model curriculum materials concerning drug abuse education and prevention. Revises standards for drug abuse education curricular and teaching materials and the information from which they are developed. Requires local drug abuse education and prevention programs to include outreach

activities for school dropouts and guidance counseling programs and referral services for the parents and immediate families of drug and alcohol abusers. Requires biennial State reporting to the Secretary of Education concerning State and local programs funded under such Act. Describes required report format and contents. Directs the Secretary of Education to make grants to State and local educational agencies and to institutions of higher education for programs to train teachers and other educational personnel concerning drug and alcohol abuse education and prevention. Sets forth application procedures and requirements. Authorizes FY 1989 through 1992 appropriations. Includes as one of the duties of the Secretary of Education under such Act the coordination of activities that complement media efforts of anti-drug abuse groups. Directs the Secretary to summarize and consolidate the required biennial State reports and to submit the summary, with recommendations for future education and prevention efforts, to the Associate Director of the Office of National Drug Control Policy and to the Congress. Requires the Secretary to: (1) conduct an independent evaluation of a representative sample of programs funded under such Act in the interest of identifying successful projects; and (2) submit both an interim and final report of results to the Congress. Directs the Secretary to: (1) develop model criteria and forms for data collection with respect to programs assisted under such Act and disseminate these materials to established regional centers as a resource for State and local educational programs; and (2) provide for the development of age-appropriate drug abuse education and prevention curricula and materials for use in early child

1052  Appendix

development programs, including Head Start and other federally assisted programs.

grant application requirements, as well as application approval priorities.

Chapter 4: Community-Based Volunteer Demonstration Projects for Drug Abuse Education and Prevention Services and Activities—Amends the Domestic Volunteer Service Act of 1973 to authorize the Director of the ACTION Agency to make grants to public and nonprofit organizations for innovative, community-based volunteer demonstration projects that provide comprehensive drug abuse education and prevention services and activities to youth during the summer months.

Directs the Secretary of HHS to coordinate this program with the programs and activities of the Attorney General and with those under the Juvenile Justice and Delinquency Prevention Act of 1974. Authorizes appropriations for FY 1989 through 1991.

Enumerates permissible activities, including: (1) extending effective school-based programs to the summer months; (2) offering summer recreational, volunteer service, and youth development activities as positive alternatives to illicit drug use; and (3) incorporating drug abuse education and prevention activities in public and private programs serving youth during the summer months.

Chapter 2: Program for Runaway and Homeless Youth—Directs the Secretary of HHS to make grants to public and private nonprofit entities for research, demonstration, and services projects for runaway and homeless youth, especially projects relating to illicit use of drugs. Enumerates possible projects, including: (1) individual, family, and group counseling; (2) community education; (3) rural area assistance; (4) information and training to individuals providing youth services; and (5) research on the effects on such youth of their own or family members’ drug abuse, and correlations between such use and suicide attempts.

Gives priority to projects that serve high-risk youth and provide opportunities for parent involvement.

Directs the Secretary to give grant priority to agencies and organizations with experience in providing services to such youth.

Authorizes appropriations for FY 1989 through 1991.

Limits grants to three years’ duration.

Subtitle B: Drug Abuse Education and Prevention—Chapter I: Drug Education and Prevention Relating to Youth Gangs—Directs the Secretary of Health and Human Services (HHS), through the Administration on Children, Youth, and Families, to make grants and contracts for drug education and prevention projects and activities to: (1) prevent and reduce youth drug abuse and participation in gang-committed, drugrelated crimes; and (2) support local law enforcement outreach activities. Sets forth

Directs the Secretary, within 180 days after the end of a fiscal year for which funds are appropriated for this subpart, to report to the President and specified congressional leadership. Details required report contents. Authorizes appropriations for FY 1989 through 1991, but only if the aggregate amount appropriated to carry out title III (Runaway and Homeless Youth) of the Juvenile Justice and Delinquency Prevention Act of 1974 for the fiscal year in question is not less than such amount for the preceding fiscal year.

Appendix  1053

Sets forth application procedures, required contents, and criteria to govern review. Chapter 3: Community Program—Directs the Secretary of HHS to make grants to eligible States to develop community services, as well as partnerships designed to develop community activities directed at drug abuse prevention through education, training, and recreation projects. Describes: (1) application procedures, including a requirement that an applicant State must demonstrate a need for the proposed activities; and (2) formulas to be used in allotting grant amounts. Reserves a specified portion of funds for programs designated as “activities and projects of national significance.” Lists priorities to be considered in awarding grants. Provides for project evaluations. Authorizes appropriations for FY 1989 through 1993. Directs the Secretary of HHS, acting through the Administrator of the Office of Juvenile Justice and Delinquency Prevention, to develop and carry out a structured evaluation of various approaches used in the United States to reduce drug abuse. Requires the Secretary to report evaluation results to the Congress at specified times. Authorizes FY 1989 through 1993 appropriations. Subtitle C: Miscellaneous—Defines terms used in this title. Title IV: International Narcotics Control—Subtitle A: General Provisions— International Narcotics Control Act of 1988—Presents the table of contents and definitions relevant to this title. Subtitle B: Multilateral Narcotics Control Efforts—Expresses the sense of the Congress concerning the need for an antinarcotics force in the Western Hemisphere. Instructs the President to direct the U.S. Ambassador to the Organization of Ameri-

can States (OAS) to initiate diplomatic discussions with other member nations in the interest of securing an agreement to form a multinational force to combat illegal drug smuggling organizations. Requires the Secretary of State to report to specified congressional committees on progress. Directs the President, if an agreement is reached, to submit to the Congress supplemental budget requests for FY 1989 and 1990 to cover the U.S. share of costs. Urges the President to seek the establishment in other relevant regions of the world of multilateral anti-narcotics forces similar to the contemplated Western Hemisphere force. Encourages the United Nations to consider ways and means of establishing an international force to stop drug trafficking. Expresses the sense of the Congress that the President should: (1) call for international negotiations for the purpose of agreeing to establish an international drug force to pursue and apprehend major international drug traffickers; and (2) convene, as soon as possible, an International Conference on Combatting Illegal Drug Production, Trafficking, and Use in the Western Hemisphere. Directs the Secretary of State to consult with the heads of appropriate Federal agencies and departments and with the governments of Western countries involved in cocaine trafficking or use about the feasibility of creating a comprehensive, integrated, multinational plan to reduce or eliminate the international cocaine trade. Requires reporting to the Congress concerning such a plan, means of achieving its objectives, and resources required and available for such efforts. Expresses the sense of the Congress that the Assistant Secretary of State for International

1054  Appendix

Narcotics Matters should: (1) seek the establishment of a regional anti-narcotics training center in the Caribbean; and (2) both contribute to and seek contributions of other countries to such a center. Amends the Foreign Assistance Act of 1961 (FAA) to authorize FY 1989 appropriations to the President exclusively for U.S. contributions to: (1) the United Nations Fund for Drug Abuse Control; and (2) the OAS InterAmerican Drug Abuse Control Commission’s Legal Development Project and Law Enforcement Training Project. Expresses the sense of the Senate that the President should begin discussions with foreign governments concerning the feasibility and advisability of establishing an international criminal court to expedite cases involving international drug trafficking and other international crimes. Subtitle C: Authorizations and Earmarkings of Foreign Assistance—Amends the Foreign Assistance Act of 1961 (FAA) to authorize FY 1989 appropriations for international narcotics control assistance to other countries and to international organizations. Sets a minimum expenditure level for the testing and use of safe, effective herbicides for aerial eradication of coca. Instructs the President to monitor the environmental and health-related effects of such herbicide use and to report results to the Congress. Requires an immediate report to specified congressional committees upon any determination that herbicide use in this context is harmful to the environment or to the health of individuals. Makes available a portion of FY 1989 grant military assistance funds to arm, for defensive purposes, extant aircraft used in narcotics eradication or interdiction efforts. Applies the standard 15 days’

notice requirement to specified congressional committees in connection with this reprogramming. Earmarks amounts from funds for international military education and training to be used solely for: (1) education and training involving equipment used in narcotics interdiction and eradication efforts in Latin America and the Caribbean; and (2) the expenses of deploying Department of Defense mobile training teams in a requesting country to conduct training in military-related skills to improve its tactical operations in narcotics interdiction. Limits this assistance to foreign law enforcement agencies or other units organized expressly for narcotics enforcement and to countries that meet criteria set out in this title. Waives provisions that would prohibit the use of grant military assistance funds to procure weapons or ammunition for foreign law enforcement entities when they are organized specifically for narcotics enforcement in countries meeting the criteria of this title. Directs the President to report to the Congress within 15 days before funds are obligated for this type of assistance. Describes required report contents. Provides for human rights reporting with respect to countries authorized to receive assistance. Earmarks an amount to be available solely for assistance for countries in Latin America and the Caribbean. Directs the President to reallocate funds withheld from countries failing to take adequate steps to halt illicit drug production or trafficking for use by countries that have met their illicit drug eradication targets or have otherwise taken significant steps to halt illicit drug production or trafficking. Prescribes conditions to govern transfers among international narcotics control assistance

Appendix  1055

funds and reprogramming of security assistance resulting from these reallocations. Subtitle D: Provisions Relating to Specific Countries—Urges the Assistant Secretary for International Narcotics Matters to pay greater attention, and provide more narcotics control assistance, to those countries that are drug-transit countries (but not major ones) cooperating with U.S. international narcotics control efforts. Earmarks a minimum FY 1989 amount to be available for their assistance. Permits security assistance to Bolivia for FY 1989 only if the President certifies to the Congress that the Government of Bolivia has enacted and is implementing specified types of legislation to eradicate illicit coca production. Sets nonwaivable conditions that the Government of Bolivia must meet before the President may make the certification necessary to obligate and expend FY 1989 U.S. assistance funds suspended because of major illicit drug activities (certification). Requires that project agreement documents for projects in particular areas of Brazil contain a clause calling for suspension of FY 1989 development assistance if specified coca-related objectives are not met. Deletes a provision of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1988 that earmarked funds for narcotics interdiction and control programs for Bolivia. Directs the President, in making FY 1989 determinations with respect to the certification necessary for assistance to Peru, to give foremost consideration to whether the Government of Peru made substantial progress in meeting its coca eradication targets during the previous year.

Describes conditions that must be met before FY 1989 funds may be made available for the Agency for International Development’s project in the Upper Huallaga Valley of Peru. Limits FY 1989 international narcotics control assistance made available for Mexico. Makes additional assistance available only if specified congressional committees are notified in accordance with normal applicable reprogramming procedures. Urges the Government of Mexico to cooperate fully with the United States with respect to drug law enforcement and especially in connection with the effective prosecution of those responsible for the murder and torture of specified Drug Enforcement Administration (DEA) personnel. Directs the President, in making FY 1989 determinations with respect to the certification necessary for assistance to Mexico, to consider the Mexican Government’s response to U.S. proposals to establish and implement a joint U.S.-Mexico airborne apprehension capability and air surveillance operations. Encourages the Government of Mexico, upon ratification of the Mutual Legal Assistance Treaty with the United States, to furnish banking information pursuant to the treaty that would permit the successful U.S. investigation and prosecution of major narco-terrorists who use Mexican financial institutions to launder their profits. Includes Colombia among the countries authorized to have more than six members of the U.S. armed forces assigned to carry out international security assistance programs. Authorizes supplemental FY 1988 appropriations, to remain available until expended, to be used exclusively for defense articles to the Colombian armed forces to support their anti-narcotics efforts.

1056  Appendix

Earmarks amounts, to be available until expended, to assist Colombia in providing protection against narco-terrorist attacks on judges, other government officials, and members of the press. Requires congressional notification at least 15 days before funds may be obligated. Directs the President, in making determinations with respect to the certification necessary for assistance to Pakistan, to take into account the extent to which the Government of Pakistan is increasing specified anti-narcotics activities. Directs the President to review and report to the Congress within six months of this Act’s enactment on U.S. narcotics raw material policy, determining the options available to reduce U.S. reliance on licit opium gum from foreign sources. Expresses the sense of the Congress that: (1) the U.S. Government should pursue efforts to press the Government of Afghanistan, and work with the Mujahadeen, to reduce heroin production and trafficking in areas under their respective control and to encourage eradication, interdiction, and crop substitution in Afghanistan; and (2) an initiative should be developed which could be put in place as the Mujahadeen and successors to the present Kabul regime begin to exert greater civil authority. Directs the President to prepare and transmit to the Congress periodic reports containing determinations with respect to any involvement by the Government of Laos (and other governments in the region) in illicit drug production and trafficking. Describes required report contents, depending on the determinations reached. Subtitle E: Annual Report and Certification Process—Requires the President’s an-

nual report to the Congress pursuant to the FAA to: (1) express in numerical terms the maximum reductions in illicit drug production achievable during the next fiscal year; and (2) describe the U.S. assistance for the preceding fiscal year that was denied to each major illicit drug producing country and each major drug-transit country. Revises the FAA definition of “United States assistance” to exclude certain assistance for narcotics education and awareness activities. Directs the President to report to the Congress annually, rather than biannually, listing each major illicit drug producing country and major drug-transit country. Includes this report in the required midyear report on international narcotics control activities and operations. Establishes a timetable according to which the Secretary of State must establish numerical standards and other guidelines for determining which countries will be considered as major drug-transit countries for FAA purposes. Requires reports to appropriate congressional committees in connection with these standards and their modification. Sets forth a transitional timetable for 1988. Waives restrictions on FY 1989 U.S. assistance to any major drug-transit country if the President certifies to the Congress that: (1) significant drug-related money laundering is not occurring there with government knowledge or complicity; (2) the country previously was a major illicit drug producing country but has effectively eliminated illicit drug production during each of the preceding two years; and (3) the country is cooperating fully with the United States or has taken adequate steps on its own in satisfying specified anti-narcotics goals.

Appendix  1057

Amends provisions of the FAA governing annual certification procedures for bilateral and multilateral assistance, adding as criteria for certification whether the country has cooperated fully with the United States or has taken adequate steps on its own to: (1) satisfy goals agreed to in an applicable bilateral narcotics agreement with the United States or comparable multilateral agreement; and (2) prevent and punish bribery and other forms of public corruption that facilitate illicit drug activity or discourage drug law enforcement. Revises the FAA definition of “bilateral narcotics agreement” to permit multilateral agreements as an alternative to bilateral ones. Imposes more stringent certification requirements with respect to a major illicit drug producing or drug-transit country that also produces licit opium. Adds to current requirements a variety of considerations the President must respect in determining whether to certify a country for assistance. Amends the Trade Act of 1974 to make corresponding revisions with respect to annual certification procedures for trade and aviation sanctions. Requires the Secretary of State annually to establish numerical standards and other guidelines for determining which countries will be considered to be major drug-transit countries for such Act’s purposes. Subtitle F: Miscellaneous Provisions Relating to Assistance Programs—Applies the standard reprogramming procedures of the FAA to any transfer by the U.S. Government to a foreign country for narcotics control purposes of any property seized by or otherwise forfeited to the Government in connection with narcotics-related activity. Requires annual reports to the Congress of such transfers.

Expresses the sense of the Congress that suppression of international narcotics trafficking is among the most important U.S. foreign policy objectives. Directs the President to take all reasonable steps to ensure that assistance under the FAA and the Arms Export Control Act is not provided to or through any individual or entity that the President knows or has reason to believe: (1) has been convicted of a violation of, or a conspiracy to violate, any U.S. or foreign law relating to narcotics, psychotropic drugs, or other controlled substances; or (2) is or has been an illicit trafficker in any such substance. Requires the President to issue regulations, subject to congressional review, specifying steps to be taken in carrying out this provision. Urges the Secretary of State to take appropriate corrective action to improve the Department of State’s procurement operations in order to assure timely and efficient procurement of property and services for international narcotics control assistance. Prohibits the use of narcotics control assistance funds to acquire real property for use by foreign military, paramilitary, or law enforcement forces. Amends the FAA to permit reimbursement for Department of Defense services in providing international narcotics control assistance. Directs the President to: (1) take all reasonable steps to ensure that aircraft and other equipment made available for foreign countries are used only in ways consistent with the purposes underlying their availability; and (2) report on any misuse in this context and U.S. actions taken to prevent future misuse.

1058  Appendix

Subtitle G: Department of State Activities—Makes the Secretary of State responsible for coordinating all Government assistance to support international efforts to combat illicit narcotics production or trafficking. Requires the Secretary to submit annual reports to the appropriate congressional committees. Describes required report contents. Allows reports to be classified to the extent necessary. Amends the State Department Basic Authorities Act of 1956 to authorize appropriations, without fiscal year limitation, for use in paying rewards for information leading to the arrest or conviction of individuals for certain extraterritorial narcotics-related offenses. Prohibits the issuance of a passport and requires the Secretary of State to revoke any passport previously issued to any individual who is convicted of certain drug law offenses if the individual used a passport or otherwise crossed an international border in committing the offense. Applies these restrictions during the period when the person is either imprisoned or on parole or other supervised release in connection with the offense in question. Permits exceptions in emergency circumstances or for humanitarian reasons. Directs the Department of State, the U.S. Customs Service, and the Immigration and Naturalization Service to develop a comprehensive machine-readable travel and identity document border security program, including an integrated cooperative data exchange system incorporating law enforcement data on various types of offenders. Requires these agencies to submit to the President and to the Congress a detailed implementation plan regarding this program. Lists agencies that will be required to contribute appropriate law enforcement data to the exchange sys-

tem. Authorizes FY 1989 appropriations. Requires all designated agencies to maintain their participation in the program in FY 1990 through 1992. Directs the Secretary to place greater emphasis on updating extradition treaties and on negotiating mutual legal assistance treaties with major illicit drug producing and drug-transit countries. Requires the Secretary and the Attorney General jointly to develop a model extradition treaty with respect to narcotics-related violations, a model mutual legal assistance treaty, and model comprehensive anti-narcotics legislation. Directs the Secretary to distribute these materials to each U.S. mission abroad and to report to the Congress within six months of this title’s enactment. Expresses the sense of the Congress that Regional Security Officers and other security personnel at U.S. embassies and other civilian posts abroad should be directed to expand their investigative activities with respect to illicit drug use and trafficking by Government personnel and their dependents. Urges the Secretary to permit the assignment of additional DEA agents to U.S. diplomatic missions in foreign countries where illicit narcotics production or trafficking is, or is likely to become, a significant problem. Subtitle H: International Banking Matters—Urges the Secretary of the Treasury (Secretary) to negotiate with finance ministers of foreign countries to establish an international currency control agency to analyze currency transaction reports and serve as a central information source for international drug enforcement agencies. Directs the Secretary to enter into negotiations with the appropriate finance leadership of countries whose financial institutions do

Appendix  1059

business in U.S. currency to: (1) reach at least one international agreement to ensure that adequate records of U.S. currency transactions in excess of $10,000 are maintained; and (2) establish a mechanism for making such records available to U.S. law enforcement officials. Instructs the Secretary to submit an interim progress report to specified congressional committees and a final report to the same committees and to the President. Requires the President to impose appropriate penalties and sanctions with respect to any country: (1) whose financial institutions the Secretary determines are substantially engaging in currency transactions involving the proceeds of international narcotics trafficking affecting the United States; and (2) that is not negotiating an agreement for exchanging records. Terminates presidential authority to impose such sanctions on June 30, 1994. Amends the Export-Import Bank Act of 1945 to permit pre-FY 1991 Export-Import Bank financing of sales of defense articles or services to economically less developed countries if: (1) the Bank is requested to guarantee or insure the sale and the authority to do so would not exceed five percent of the Bank’s guarantee and insurance authority in any given fiscal year; and (2) the President determines, in accordance with prescribed criteria (pro-democratic and anti-drug) that the sale is in the U.S. national interest. Requires both a presidential determination that the required Bank guarantee would be in the national interest and notification to the Congress of this determination before the Bank Board may approve the guarantee in question. Subtitle I: Miscellaneous Provisions—Expresses the sense of the Congress that the intelligence community should be more ac-

tively involved in covert actions to combat illicit international drug trafficking. Corrects technical errors in the FAA and in the Anti-Drug Abuse Act of 1986. Expresses the sense of the Congress that the Director of National Drug Control Policy should: (1) review the entire drug control problem to determine priorities for resource allocation, especially with respect to assistance to the Airwing Operations of the Department of State’s Bureau of International Narcotics Matters and assistance to control youth gangs that traffic in illegal drugs; and (2) consider recommending supplementary resources as necessary. Directs appropriate agency heads prescribing regulations under the Drug-Free Workplace Act of 1988 contained in this Act to: (1) establish only requirements consistent with U.S. international obligations; and (2) consider applicable laws and regulations of foreign countries. Title V: User Accountability—Subtitle A: Opposition to Legalization and Public Awareness—Declares the congressional finding that the legalization of illegal drugs is an unconscionable surrender in the war on drugs. Requires the Director of National Drug Control Policy to develop a program to inform the American public of this Act’s provisions concerning penalties for the use or possession of illegal drugs. Subtitle B: National Commission on Drug-Free Schools—Establishes a National Commission on Drug-Free Schools to prepare criteria to identify drug-free schools and develop recommendations for identifying model programs to meet these criteria. Requires the Commission to report to the President and the Congress within one year

1060  Appendix

of this Act’s enactment. Specifies required report contents. Authorizes appropriations. Subtitle C: Preventing Drug Abuse in Public Housing—Chapter 1: Regulatory and Enforcement Provisions—Amends the United States Housing Act of 1937 to require public housing agencies to use leases that prohibit public housing tenants or persons under their control from engaging in criminal activity on or near public housing premises, declaring such criminal activity to be a cause for terminating the tenancy. Directs the Secretary of Housing and Urban Development (HUD) to study and report to the Congress on the extent to which security activities in public housing projects are funded by annual contributions under the performance funding system for operation of lower income housing projects. Describes required report contents. Directs the HUD Secretary to report to the Congress on the effect of specified public housing tenancy and administrative grievance procedure regulations on the ability of public housing agencies to evict or otherwise respond to tenants who engage in criminal activity. Amends the Omnibus Crime Control and Safe Streets Act of 1968 to include as permissible activities under the Bureau of Justice Assistance block grants program actions to address problems of drug trafficking in public housing. Amends the Controlled Substances Act to include leasehold interests among the classes of property subject to forfeiture under such Act. Chapter 2: Public Housing Drug Elimination Pilot Program—Public Housing Drug Elimination Act of 1988—Authorizes the Secretary of HUD to make grants

to public housing agencies for programs to eradicate drug-related crime in public housing projects. Lists permissible grant uses, including the hiring of security personnel, physical improvements designed to enhance security, training and supporting voluntary public housing tenant patrols, and employing persons to investigate drug-related crime on public housing property. Sets forth application criteria. Requires the Secretary to report to the Congress on activities under this chapter. Authorizes appropriations. Chapter 3: Drug-Free Public Housing— Drug-Free Public Housing Act of 1988— Directs the Secretary of Housing and Urban Development to: (1) establish in the Department of Housing and Urban Development’s Office of Public Housing a clearinghouse on drug abuse in public housing; and (2) establish a regional training program for public housing officials confronting such problems. Subtitle D: Drug-Free Workplace Act of 1988—Drug-Free Workplace Act of 1988— Sets forth drug-free workplace requirements for Federal grantees and contractors. Sets forth grounds for suspension, termination, or debarment of grantees or contractors who have violated such requirements. Sets forth rules for related proceedings and the effect of such debarment. Requires grantees or contractors, within 30 days after receiving notice from an employee of a conviction for a drug law violation in the workplace, to: (1) take appropriate personnel action up to and including termination against the employee; or (2) require the employee to participate satisfactorily in an approved drug rehabilitation program. Provides for waiver of the requirements of this title in the interest of the Federal Government or the general public.

Appendix  1061

Repeals corresponding provisions enacted as part of the Treasury, Postal Service and General Government Appropriations Act, 1989.

specified features of this subtitle’s implementation; and (2) the Congress to consider the report and enact appropriate changes no later than September 1, 1989.

Subtitle E: President’s Media Commission on Alcohol and Drug Abuse Prevention—Authorizes appropriations for the President’s Media Commission on Alcohol and Drug Abuse Prevention for FY 1989 through 1991.

Title VI: Anti-Drug Abuse Amendments Act of 1988—Anti-Drug Abuse Amendments Act of 1988—Subtitle A: Chemical Diversion and Trafficking—Chemical Diversion and Trafficking Act of 1988— Amends the Controlled Substances Act to establish recordkeeping and reporting requirements for persons who manufacture, distribute, import, or export a listed precursor or essential chemical, a tableting machine, or an encapsulating machine. Prohibits transactions involving these items unless the recipient provides proper identification.

Subtitle F: Drug-Free America Policy— Declares it to be U.S. policy to create a drugfree America by 1995. Subtitle G: Denial of Federal Benefits to Drug Traffickers and Possessors—Denies Federal benefits (grants, contracts, loans, licenses, and public housing): (1) for up to five years to any person convicted for the first time of any Federal or State drug trafficking offense; (2) for up to ten years upon the second conviction for such an offense; and (3) permanently upon a third or subsequent conviction. Imposes one or a combination of the following sanctions on persons convicted for the first time of drug possession offenses: (1) ineligibility for Federal benefits for up to one year; (2) required successful completion of an approved drug treatment program; or (3) required community service. Extends benefit ineligibility for up to five years with respect to possessors convicted for a second or subsequent time. Permits penalty waivers under certain circumstances if the offender submits to a long-term treatment program for addiction. Suspends the benefit ineligibility period if the offender attempts to enter a drug rehabilitation program or is rehabilitated either through such a program or otherwise. Exempts Government witnesses from penalties under this subtitle. Requires: (1) the President to report to the Congress before May 1, 1989, concerning

Includes confidentiality provisions with respect to records, authorizing an aggrieved person to bring a civil action against violators. Amends the Controlled Substances Import and Export Act to require importers and exporters of listed chemicals to notify the Attorney General of importations or exportations within 15 days before the transaction in question. Provides for exceptions with respect to transactions with regular business customers of the regulated person, if the relationship is reported to the Attorney General. Authorizes the Attorney General to order the suspension of a transaction. Requires written notice justifying such an order. Entitles the affected regulated person to a hearing, if requested. Sets forth a timetable to govern activities of the Attorney General and of the Director of the Office of Management and Budget in connection with the promulgation of regulations relating to these provisions. Establishes criminal penalties for persons who knowingly or intentionally import or export a listed chemical with

1062  Appendix

intent to manufacture a controlled substance or with reasonable cause to believe that the chemical will be used for such a purpose. Applies civil penalties to persons who fail to meet notification requirements, unless the failure is intentional, in which case criminal penalties apply. Lists the precursor chemicals and essential chemicals regulated under this Act. Describes transactions exempted from reporting and recordkeeping requirements, including certain lawful distributions in the usual course of business between agents or employees of a single regulated person and transactions involving listed chemicals contained in a drug lawfully marketable under the Federal Food, Drug, and Cosmetic Act. Amends the Controlled Substances Act to apply criminal penalties to persons who knowingly or intentionally: (1) possess a listed chemical with intent to manufacture a controlled substance; (2) possess or distribute a chemical having reasonable cause to believe that it will be used for such a purpose; (3) receive or distribute reportable amounts of chemicals in de minimis amounts so as to evade reporting and recordkeeping requirements; (4) distribute a listed chemical unlawfully; or (5) possess listed chemicals with knowledge that recordkeeping or reporting requirements have not been met and fail to remedy the violation. Authorizes as an additional penalty an injunction preventing any person convicted of a felony violation of controlled substances laws regarding listed chemicals from engaging in any regulated transaction involving a listed chemical for up to ten years. Amends sections of the Controlled Substances Act that describe prohibited acts and penalties to account expressly for new violations instituted in this subtitle.

Grants the Attorney General subpoena power with respect to precursor and essential chemicals. Subjects all listed precursor and essential chemicals, drug manufacturing equipment, tableting and encapsulating machines, and gelatin capsules that have been imported, exported, manufactured, possessed, or distributed in violation of such Act (as well as all conveyances and equipment) to forfeiture to the United States. Directs the Attorney General to maintain an active domestic and international program to curtail the diversion of chemicals used in the illicit manufacture of controlled substances. Subtitle B: Asset Forfeiture Amendments—Asset Forfeiture Amendments Act of 1988—Amends the Federal judicial code to decrease the percentage of program related use required in connection with automatic data processing equipment purchased or leased with monies from the Department of Justice Assets Forfeiture Fund (Fund). Authorizes the Attorney General to transfer residual amounts from the Fund to the Building and Facilities Account of the Federal Prison System only at the end of FY 1989. (Under current law, the authority applies at the end of each fiscal year.) Distinguishes between Fund amounts for authorized expenditures that must be specified in appropriations Acts and those that need not be so. Authorizes the Attorney General to exempt certain contract services from specified advertising and procurement requirements if necessary to maintain the security and confidentiality of an investigation. Revises provisions concerning the delegation of authority to pay awards for information or

Appendix  1063

assistance leading to a forfeiture. Increases to $250,000 the allowable award amount in this context.

respect to property transferred to a State or local law enforcement agency that participated directly in the seizure or forfeiture.

Enumerates topics to be included in the Attorney General’s annual report to the Congress concerning the Fund. Requires an additional annual report concerning the value of property forfeited but not attributable to the Fund.

Instructs the Attorney General and the Secretary of the Treasury to: (1) develop and maintain a joint plan to coordinate and consolidate post-seizure administration of property seized under controlled substances laws; and (2) prescribe regulations for expedited administrative procedures for seizures under specified Acts for violations involving the possession of personal use quantities of controlled substances. Prescribes specifications the procedures must meet. Subjects them to a public comment period.

Subjects the Fund to annual audits by the Comptroller General. Authorizes appropriations for those functions for which amounts must be specified in appropriations Acts. Authorizes the transfer of unobligated amounts of up to $150,000,000 of residual Fund amounts to the Special Forfeiture Fund at the end of FY 1990 through 1992. Establishes in the Treasury the Special Forfeiture Fund, to be available to the Director of National Drug Control Policy. Directs the President to: (1) include in the budget submission a separate request for the use of Special Fund amounts, reflecting the priorities of the National Drug Control Strategy; and (2) submit to the Congress a detailed report on Fund deposits and expenditures. Amends provisions of the Controlled Substances Act with respect to the disposition of forfeited property to authorize the Attorney General to transfer such property to any foreign country that participated in the seizure and meets certain criteria. Exempts from forfeiture for drug abuse violations conveyances to the extent of the interest of an owner who did not know of or consent to the relevant unlawful act or omission. Directs the Attorney General to assure that equitable sharing principles are applied with

Establishes expedited procedures for seized conveyances. Subtitle C: State and Local Narcotics Control and Justice Assistance Improvements—Part 1: State and Local Narcotics Control and Justice Assistance Improvements—Amends the Omnibus Crime Control and Safe Streets Act of 1968 with respect to the Bureau of Justice Assistance to: (1) shift responsibility for appointment of the Director from the Attorney General to the President, with the advice and consent of the Senate; and (2) add to the Director’s duties that of preparing recommendations on the State and local drug enforcement component of the National Drug Control Strategy, to be submitted to the Associate Director of the Office on National Drug Control Policy. Broadens the scope of the Bureau of Justice Assistance grant program, designating the restructured programs as the Edward Byrne Memorial State and Local Law Enforcement Assistance Programs. Emphasizes programs to support national drug control priorities and to assist multijurisdictional and multiState organizations in controlling drugs.

1064  Appendix

Adds to the list of permitted grant uses a number of activities, including: (1) drug demand reduction education programs; (2) programs to target domestic sources of controlled substances; (3) antiterrorism plans; (4) financial investigative programs and information sharing systems; and (5) various programs to improve the criminal and juvenile justice systems. Requires each program funded under this part to contain an evaluation component. Sets forth revised State application requirements to reflect the shifted emphasis on drug-related programs. Increases the allowable Federal portion of program costs for FY 1989. Describes limitations applicable to the grants. Sets forth revised provisions for allocating and distributing funds under these formula grants. Describes procedures for State distribution of grant monies to local governments. Revises the program of discretionary grants to provide additional Federal assistance to public and private entities for a number of educational, technical assistance, and demonstration programs consistent with the purposes of this part. Sets forth provisions with respect to the allocation of funds for these grants and relevant application requirements. Directs the National Institute of Justice to develop guidelines to assist State and local government in evaluating programs under this part, requiring the Institute’s Director to report annually to the President, the Attorney General, and the Congress concerning the evaluations and research and development activities funded under this part. Requires the Bureau of Justice Assistance to prepare a Program Brief and an Implementation Guide for proven projects to be funded with grants under this part. Requires: (1) States receiving formula grants to submit to the Director of the Bureau of

Justice Assistance reports containing specified information with respect to the use of grant funds; and (2) the Director to report to specified congressional leadership concerning States’ use of grant monies. Adds to authorized functions of the Bureau of Justice Statistics the responsibility for collecting, analyzing, and disseminating specified types of drug enforcement information and for improving various types of criminal justice records and information systems. Extends through FY 1992 the authorization of appropriations for: (1) the Bureau of Justice Statistics; (2) the National Institute of Justice; (3) other functions of the Office of Justice Programs and the Bureau of Justice Assistance; and (4) various other justice system improvement programs. Part 2: Regional Information Sharing Systems Grants—Replaces the current program of grants for drug law enforcement programs with provisions authorizing the Director of the Bureau of Justice Assistance to make grants to State and local criminal justice agencies and nonprofit organizations to identify and remove criminal activities that overlap jurisdictional boundaries. Specifies permitted grant uses, all in the interest of establishing and operating information sharing systems. Part 3: Public Safety Officers’ Death Benefits Improvement—Amends the Omnibus Crime Control and Safe Streets Act of 1968 to increase from $50,000 to $100,000 the benefits paid to survivors of public safety officers (law enforcement officers and fire fighters) who die as a result of injury sustained in the line of duty. Directs the Bureau of Justice Assistance to adjust public safety officer death benefits to reflect the annual change in the Consumer

Appendix  1065

Price Index. Makes the date of death the determining date with respect to the amount payable to beneficiaries. Permits nondependent parents to be beneficiaries. Instructs the Director of the Bureau of Justice Assistance to establish national programs to assist families of public safety officers who have died in the line of duty. Subtitle D: Authorizations of Appropriations for the Department of Justice, Prisons, and Related Law Enforcement Programs—Authorizes FY 1989 appropriations, in addition to those provided in regular appropriations Acts, for the Immigration and Naturalization Service (INS) for additional personnel and for uses consistent with increased commitment to the Organized Crime Drug Enforcement Task Forces (OCDETF). Authorizes the Director of the OCDETF pilot project to undertake specified activities. Directs the Attorney General to evaluate the program’s effectiveness after its first year. Instructs the Attorney General, through the Investigative Division of the INS, to establish a pilot program in four cities to improve the capabilities of the local INS offices and of local law enforcement agencies to respond to inquiries about aliens involved with controlled substances. Authorizes FY 1989 appropriations, in addition to those provided in regular appropriations Acts, to the following agencies and activities for specified drug control purposes: (1) the Bureau of Alcohol, Tobacco and Firearms; (2) the Drug Enforcement Administration (DEA), including funds to establish a DEA Drug Education Program; (3) the Federal Bureau of Investigation; (4) the U.S. Marshals Service; (5) support of U.S. prisoners in non-Federal institutions;

(6) the Federal Prison System; (7) U.S. Attorneys in the Department of Justice; and (8) the Federal judiciary, including the Courts of Appeals, district courts, other judicial services, the Federal Public Defender and Community Defender organizations, juror fees and expenses, and security equipment. Directs the Judicial Conference of the United States to prepare and submit to specified congressional entities a report evaluating the impact of drug-related criminal activity on the Federal judiciary. Establishes a National Advisory Commission on Law Enforcement to study and analyze the methods and rates of compensation of Federal, State, and local law enforcement personnel in the interest of identifying inequities and recommending changes to eliminate them. Requires the Commission to report findings and recommendations to the President and to specified congressional leadership. Terminates the Commission 60 days following submission of the required report. Authorizes FY 1989 appropriations, in addition to those provided in regular appropriations acts, for: (1) drug interdiction equipment for the Border Patrol within the Department of Justice; (2) Border Patrol personnel enhancement; (3) designing improvements for the INS border patrol station at San Clemente, California; and (4) establishing an INS Drug Education Officers program. Instructs the President to direct the Office of National Drug Control Policy to develop a comprehensive plan for using at least eight existing facilities associated with specified agencies to develop law enforcement technologies. Requires the plan to be submitted to the Congress within 90 days of this Act’s

1066  Appendix

enactment. Lists facilities to be examined in developing the plan. Directs the Comptroller General to monitor plan development.

present when seized illegal drug contraband is destroyed by Bahamian government personnel.

Authorizes FY 1989 appropriations, in addition to those provided in regular appropriations Acts, for improving the Federal Law Enforcement Training Center. Directs the Secretary of the Treasury to expand the advanced training programs for Federal law enforcement agencies at the satellite facility in Marana, Arizona, and to report to appropriate congressional committees concerning the planned expansion.

Authorizes additional FY 1989 appropriations for the U.S. National Central Bureau of Interpol to increase personnel and to upgrade telecommunications equipment.

Authorizes: (1) the Departments of Defense and of State to provide, on a cost reimbursable basis, foreign language training to special agents of Federal civilian agencies involved in drug law enforcement; and (2) the DEA, U.S. Customs Service, and the INS to detail investigative personnel for language training at the relevant Department of Defense and Department of State facilities. Authorizes appropriations for this training. Authorizes FY 1989 appropriations, in addition to those included in regular appropriations Acts, to the DEA for the United States-Bahamas Drug Interdiction Task Force. Conditions availability of the funds upon receipt of a specified contribution by the Commonwealth of the Bahamas. Expresses the sense of the Congress that: (1) the Commonwealth of the Bahamas should aggressively pursue the extradition of Nigel Bowe and the consummation of the pending extradition treaty with the United States by the end of 1988; (2) the U.S. Government should cooperate with the Bahamas both in providing information regarding allegations of corruption and in responding to requests for the extradition of U.S. citizens indicted for drug-related offenses in the Bahamas; and (3) DEA agents should be physically

Directs the DEA Administrator to take actions as necessary to establish and operate a special purposes facility for use by the Air Wing at a site having direct aircraft access to public aviation facilities. Authorizes appropriations. Subtitle E: Money Laundering—Money Laundering Prosecution Improvements Act of 1988—Amends the Federal criminal code to exclude monetary transactions involving bona fide attorney fees from consideration as unlawful activity for particular racketeering law purposes. Revises the definition of “monetary instrument” for money laundering purposes. Amends the Bank Secrecy Act to include within the definition of “financial institution” a number of entities engaging in activities similar to those usual to financial institutions, including vehicle sales businesses, persons involved in real estate closings and settlements, and any other businesses designated by the Secretary of the Treasury as having cash transactions with a high degree of usefulness in criminal, tax, or regulatory matters. Amends Federal law to prohibit financial institutions from issuing checks or money orders to individuals in connection with transactions involving U.S. money in amounts or denominations of $3,000 or more unless the individual provides proper identification and the institution verifies that the individual has an account there.

Appendix  1067

Authorizes the Secretary of the Treasury to require any domestic financial institution to obtain information, keep records, and submit reports concerning: (1) its transactions involving monetary instruments that exceed amounts the Secretary prescribes; and (2) other parties to the transactions. Amends the Federal Deposit Insurance Act and the National Housing Act to impose a civil penalty of up to $10,000 on insured institutions and their principals and personnel that willfully or through gross negligence violate recordkeeping and reporting requirements. Increases from $1,000 to $10,000 the corresponding penalty with respect to uninsured financial institutions. Revises provisions describing the range of uninsured entities subject to financial recordkeeping requirements. Authorizes the Secretary of the Treasury to delegate to the Postal Service powers and duties in connection with records and reports on monetary instruments transactions. Authorizes a financial institution or its officers and employees notifying a Government authority concerning information potentially relevant to a legal violation to include information concerning any corporation involved in the suspected illegal activity. (Currently law calls only for information concerning any individual or account involved in such activity.) Amends the Right to Financial Privacy Act of 1978 to exempt from confidentiality requirements financial records transferred to the Attorney General by other Federal entities when there is reason to believe that the records may be relevant to criminal offenses. Denies confidentiality of financial information when a financial institution or supervisory agency provides the Attorney General

or a State law enforcement agency with financial records of any officer, director, employee, or controlling shareholder (or a major borrower acting in collusion with any of these), if there is reason to believe the record is relevant to either crimes by these persons against such an institution or agency or violations of statutes governing recordkeeping and reporting on monetary instruments transactions. Revises the good faith defense to account for this exception. Permits descriptions of records, rather than the records themselves, to be presented to a grand jury when the volume of paperwork makes actual presentation impractical. Directs the Secretary of the Treasury to study the feasibility of withdrawing the legal tender status of $100 Federal Reserve notes. Enumerates required report contents, to be submitted to the Congress within 180 days of this Act’s enactment. Subtitle F: Sense of Congress that Proposals to Legalize Illicit Drugs Should be Rejected—Expresses the sense of the Congress that proposals to legalize illicit drugs should be rejected and consideration given only to proposals that directly attack the supply of, and demand for, illicit drugs. Subtitle G: Firearms Provisions—Amends the Federal criminal code to establish criminal penalties applicable to any person who knowingly: (1) travels to another State to acquire or transfer a firearm for use in racketeering, drug law violations, or a crime of violence; or (2) transfers a firearm knowing that it will be used to commit a crime of violence or a drug trafficking crime. Directs the Attorney General to: (1) develop a dealer-accessible system for the immediate and accurate identification of felons who attempt to purchase firearms; (2) establish a

1068  Appendix

plan for implementing the system 30 days following a required report to the Congress within one year of this Act’s enactment; and (3) study, report to the Congress, and make results available to the public concerning the possibility of an effective method of making rapid and accurate identification of other persons who try to purchase firearms but are ineligible to do so by reason of specified unlawful acts relating to the shipment of firearms in interstate or foreign commerce. Revokes probation of any defendant found to be in actual possession of a firearm. Imposes criminal penalties on any person who knowingly possesses or causes to be present a firearm or other dangerous weapon in a Federal facility. Increases the penalties in cases when the offender has intent that a firearm or other dangerous weapon be used in the commission of a crime. Requires conspicuous posting at Federal facility entrances indicating that these acts constitute criminal offenses. Denies conviction for the offense if such notice is not posted at the facility in question. Subtitle H: Investigative Powers of Postal Service Personnel and National Forest System Drug Control—Amends the Federal criminal code to permit certain Postal Service personnel to carry firearms and make seizures of property under specified circumstances. Amends the Controlled Substances Act to allow the Postal Service to carry out the Attorney General’s civil forfeiture activities with respect to controlled substances and related articles and conveyances. Directs that proceeds of Postal Service forfeitures be deposited in the Postal Service Fund. Amends the National Forest System Drug Control Act of 1986 to double the number

of Forest Service personnel whom the Secretary of Agriculture may designate and specially train as officers to enforce controlled substances law and other Federal criminal law relating to National Forest System lands. Extends the authority of such persons beyond the boundaries of National Forest System lands when the investigation or law enforcement in question affects the administration of such lands. Directs the Forest Service to cooperate with the Attorney General in carrying out seizure and forfeiture provisions relating to controlled substances. Empowers the Secretary of Agriculture to designate law enforcement officers of other Federal agencies to exercise specified law enforcement powers when assisting Forest Service personnel in relevant activities. Authorizes the Forest Service to accept law enforcement designation from another Federal or State agency in order to cooperate in multi-agency anti-drug law enforcement task force investigations. Amends the Anti-Drug Abuse Act of 1986 to authorize additional appropriations to the Secretary of Agriculture for FY 1989 and thereafter to be used for the employment and training of Forest Service law enforcement personnel and for associated equipment and facilities. Authorizes corresponding appropriations to the Secretary of the Interior for National Park Service and, under a new subtitle to be cited as the Bureau of Land Management Drug Enforcement Supplemental Authority Act, Bureau of Land Management law enforcement personnel and activities. Amends the Federal criminal code to impose criminal penalties on persons who place hazardous or injurious devices on Federal lands with reckless disregard of the risk to another person or with the intent either to violate the

Appendix  1069

Controlled Substances Act or to obstruct the harvesting of timber. Amends the Controlled Substances Act to establish criminal penalties for creating a serious hazard to life, harming the environment, or polluting water when the violator knowingly uses a chemical, poison, or other hazardous substance on Federal lands in connection with unlawful acts relating to controlled substances. Credits amounts imposed as penalties to the Drug Pollution Fund, to be established in the Treasury, for use in cleaning up pollution resulting from the offending actions. Describes procedures that executive agency heads must follow in order to receive Fund monies for such expenses. Amends the Federal criminal code to revise the monetary component of criminal penalties for arson involving timber. Directs the Secretary of Agriculture and the Attorney General each to submit to specified congressional committees a report on their respective activities in expediting investigations with respect to criminal laws relating to controlled substances manufactured or distributed on National Forest System lands. Subtitle I: Travel Expenses and Health Care of Department of Justice Personnel Serving Abroad—Amends the Federal judicial code to authorize Department of Justice appropriations for any fiscal year to pay travel and health care expenses of employees serving abroad and their families. Subtitle J: Program-Related and Study Provisions—Amends the Contract Services for Drug Dependent Federal Offenders Act of 1978 to increase amounts authorized for FY 1988 and 1989 for the Administrative Office of the U.S. Courts’ program of drug aftercare for certain conditionally released offenders.

Instructs the Director of the National Institute of Corrections to establish and operate a national center for training Federal, State, and local prison officials to conduct drug rehabilitation programs for criminals convicted of drug-related crimes and for drugdependent criminals. Authorizes FY 1989 through 1991 appropriations. Subtitle K: Manufacturing Offenses— Amends the Controlled Substances Act to impose criminal penalties for creating a substantial risk of harm to human life while illegally manufacturing a controlled substance. Subtitle L: Serious Crack Possession Offenses—Amends the Controlled Substances Act to increase the criminal penalties with respect to persons convicted for the possession of a mixture or substance containing cocaine base. Subtitle M: Miscellaneous Drug Enforcement—Authorizes the DEA, beginning in FY 1989, to pay bonuses to its employees who make substantial use of one or more languages, other than English, in performing their official duties. Subtitle N: Sundry Criminal Provisions— Amends Federal criminal code provisions relating to penalties for firearms violations to revise definitions of “violent felony” and “conviction” to include violent acts of juvenile delinquency. Amends penalty provisions of the Controlled Substances Act to impose a mandatory term of life imprisonment without release with respect to violators convicted for a third felony drug offense. Directs the U.S. Sentencing Commission to issue or revise its sentencing guidelines to make specified types of provisions with respect to: (1) defendants convicted of Controlled Substances Import and Export

1070  Appendix

Act violations involving importation by aircraft and other vessels (calls for imprisonment for no less than 63 months); and (2) violations of the Controlled Substances Act involving any person under the age of 18. Amends the Controlled Substances Act to apply mandatory minimum sentencing provisions to offenses involving the distribution of five grams or less of marijuana to persons under age 21. Includes as a prohibited criminal act under the Controlled Substances Act: (1) possessing a controlled substance with the intent to distribute it in or near a school; (2) distributing, possessing, or manufacturing a controlled substance within 100 feet of a playground, public or private youth center, public swimming pool, or video arcade facility; and (3) receiving a controlled substance from a person under age 18. Increases the criminal penalties imposed on persons who use firearms in connection with violent crimes, drug trafficking crimes, and certain other firearms offenses. Authorizes interception of wire, oral, or electronic communications in cases involving Federal firearms violations. Subjects property involved in money laundering transactions to both civil and criminal forfeiture. Applies criminal penalties in money laundering cases when the offender is dealing with property that has been represented to be the proceeds of some form of unlawful activity (current law covers only proceeds in fact). Adds a number of specific money laundering offenses to the Federal criminal code list of unlawful activities.

Calls for transfer for criminal prosecution of delinquency proceedings in district courts involving minors convicted of certain types of drug trafficking offenses. Imposes a sentence of up to 20 years on persons who provide or possess certain controlled substances or an alcoholic beverage in Federal prison. Makes any penalties imposed on inmates who provide or possess contraband in prison consecutive to the sentence being served. Directs the U.S. Sentencing Commission to issue or revise its sentencing guidelines to call for imprisonment for no less than 63 months with respect to persons who provide or possess contraband in Federal prison. Authorizes the United States Postal Service to investigate money laundering offenses. Includes violations involving specified amounts of methamphetamine as prohibited acts subject to criminal penalties under the Controlled Substances Act. Amends Federal law with respect to money laundering offenses. Establishes criminal penalties for activities with the intent either to evade or defeat tax requirements. Amends jurisdictional provisions of the Ballistic Knife Prohibition Act of 1986. Amends Federal criminal code provisions relating to common carrier operation by persons under the influence of alcohol or drugs. Amends Federal criminal code provisions relating to the importation, manufacture, distribution, and storage of explosive materials to: (1) impose criminal penalties on persons who possess an explosive in any airport subject to Federal Aviation Administration authority; (2) increase penalties in connection with violations with respect to persons who possess an explosive in any Federal airport

Appendix  1071

or building; and (3) increase the severity of penalties imposed on persons who use or carry an explosive in connection with a felony. Amends the Speedy Trial Act of 1974 with respect to time limits applicable to defen­ dants absent on the day set for trial who subsequently appear under a bench warrant or similar process. Amends Assimilative Crimes Act provisions relating to penalties for operating a motor vehicle while under the influence of drugs or alcohol. Presumes that individuals operating motor vehicles in Federal areas consent to submit to alcohol and drug tests when arrested for any offense under circumstances giving the police officer reasonable grounds to believe the person was driving under the influence of alcohol or drugs. Describes procedures associated with such testing. Revokes driving privileges in such areas to any person who declines to submit to testing after being informed of his or her rights. Includes various offenses within the District of Columbia against foreign officials, official guests, and international protected persons among those subject to criminal penalties. Amends the Controlled Substances Act to: (1) impose criminal penalties for offenses involving marijuana plants; (2) delete certain limitations on penalties for simple possession of a controlled substance; and (3) increase the penalties applied in connection with continuing criminal enterprise. Amends the Federal criminal code to revise criminal penalties for operating vehicles while under the influence of alcohol or drugs to: (1) include the operation of locomotives within the penalty framework; and (2) in-

crease penalties in cases involving death or serious bodily injury. Amends the Federal Rules of Criminal Procedure to add a rule describing procedures to be followed by a defendant intending to claim a defense of actual or believed exercise of public authority on behalf of a law enforcement or Federal intelligence agency at the time of the alleged offense. Amends provisions of the Federal criminal code relating to witnesses and evidence to provide for the temporary transfer to the United States, for the purposes of giving testimony in a criminal proceeding, of persons in the custody of another country. Imposes a civil penalty of up to $10,000 per violation on any individual who knowingly possesses a controlled substance in a personal use amount. Prohibits consideration of the income and net assets of the violator in determining the penalty amount. Requires a hearing and permits judicial review in connection with orders imposing such penalties, but only if requested by the individual subject to the order. Authorizes the Attorney General to institute a civil action, subject to a five-year statute of limitations, to recover the penalty if the individual neither requests a hearing nor seeks judicial review. Directs the Attorney General to dismiss proceedings in such cases upon request of the penalized individual if that person meets specified conditions after the expiration of three years. Includes former officials and their families within the scope of criminal penalties against persons who assault, resist, or otherwise impede certain Federal officials in the performance of official duties. Title VII: Death Penalty and Other Criminal and Law Enforcement Matters— Subtitle A: Death Penalty—Amends the

1072  Appendix

Controlled Substances Act to establish criteria for the imposition of the death penalty with respect to any person who intentionally kills or causes the killing of a law enforcement officer or any other person during the commission of, in furtherance of, or while attempting to avoid apprehension, prosecution, or service of a prison sentence for a felony violation under such Act. Requires the Government, for such offense, to serve notice upon the defendant a reasonable time before trial or acceptance of a plea, disclosing the factors it will seek to prove as a basis for the death penalty. Requires a separate sentencing hearing before a jury, or the court upon motion by the defendant, when the defendant is found guilty or pleads guilty to the offense. Allows the defendant and the Government to present any information relevant to sentencing, without regard to the rules of evidence, but permits information to be excluded if its probative value is substantially outweighed by the danger of unfair prejudice, confusion of the issues, or misleading of the jury. Directs the court, or the jury by unanimous vote, to return a finding as to whether the death sentence is justified based on consideration of both aggravating and mitigating factors. States that, regardless of its findings with respect to these factors, the jury or the court is never required to impose a death sentence. Requires the jury to be so instructed. Directs the court to sentence the defendant to death upon the recommendation that the death sentence be imposed. Prohibits the death sentence with respect to any person who: (1) was under 18 years of age at the time the crime was committed; (2) by reason of mental disease or defect is unable to

understand his or her impending death or its reasons; or (3) is mentally retarded. Sets forth both mitigating and aggravating factors to be considered by the jury or the court when imposing its sentence. Includes among the latter: (1) the intentional nature of the act that resulted in the victim’s death; (2) previous convictions for Controlled Substances Act violations; and (3) the especially heinous, cruel, or depraved nature of the offense. Requires the court to instruct the jury not to consider the race, color, national origin, or sex of the defendant in its consideration of the sentence. Requires each juror to return a signed certificate stating that these features were not considerations in determining the sentence. Directs the Comptroller General to: (1) study the procedures used by States in determining whether to impose the death penalty; and (2) report to the Congress on any factors that may account for the evidence that the race of the defendant or victim influences the likelihood that defendants will be sentenced to death. Allows the court to impose a sentence of life imprisonment without the possibility of parole if the death penalty is not imposed. Describes procedures to apply with respect to defendants’ appeals of death sentences. Entitles a defendant to court-appointed counsel if he or she is or becomes financially unable to obtain adequate representation or reasonably necessary services in any criminal action in which the relevant crime may be punishable by death. Directs the court to fix attorney and other fees in connection with the required services. States that no employee shall be required to participate in or attend any execution

Appendix  1073

carried out under this Act if such participation is contrary to the employee’s moral and religious convictions. Directs the Comptroller General to: (1) review the cost of implementing the procedures for imposing and carrying out a death sentence prescribed by this title, including a study of data relating to the workload of judicial and law enforcement personnel; and (2) report findings to the Congress within four years of this Act’s enactment. Subtitle B: Minor and Technical Criminal Law Amendments—Minor and Technical Criminal Law Amendments Act of 1988— Makes technical and conforming amendments to the Federal criminal code. Increases criminal penalties imposed in cases when a bodily injury results during the commission of the crime of deprivation of rights under color of law. Grants the Associate Attorney General authority to: (1) approve certain civil rights prosecutions; (2) approve prosecutions for flight to avoid service of process; (3) summon special grand juries; (4) request a judicial grant of immunity; and (5) object to the disclosure of classified information under the Classified Information Procedures Act. Grants specially designated Assistant Attorney General authority to approve certain civil rights prosecutions. Grants the Deputy Assistant Attorney General authority to request judicial grants of immunity. Permits the transmission of information on sports betting from a State where such betting is legal to a foreign country where such betting is legal. Permits prosecutions for certain obstruction of justice offenses: (1) to be brought in the district where the official proceeding was

intended to be effected or in the district in which the conduct constituting the alleged offense occurred; and (2) where the culpable conduct is “corrupt persuasion.” Authorizes governmental access to records concerning electronic communication service or remote computing service through the issuance of a trial subpoena. (Current law provides for such access only through the issuance of an administrative or grand jury subpoena.) Amends the Sentencing Reform Act of 1984 to raise the maximum prison term for class B felonies from 20 to 25 years. Amends the Comprehensive Crime Control Act of 1984 to establish conditions for the temporary release (furlough) of persons hospitalized following an acquittal by reason of insanity. Requires copies of certain periodic reports prepared by directors of psychiatric hospitals concerning persons hospitalized for threatening the President, the Vice President, or certain other persons protected by the Secret Service, to be submitted to the Director of the U.S. Secret Service. Extends the power to conduct certain psychiatric and psychological examinations under the Federal criminal code to all psychologists. (Current law extends such power to psychiatrists and clinical psychologists.) Makes conforming amendments to the Federal Rules of Civil Procedure permitting courts to designate psychologists to conduct mental examinations of parties in civil proceedings. Amends the Racketeer Influenced and Corrupt Organizations Act (RICO) to create three additional RICO predicates: (1) murder-for-hire; (2) sexual exploitation of children; and (3) fraud in connection with access

1074  Appendix

devices, such as credit cards and electronic banking cards. Establishes a misdemeanor penalty in connection with the criminal escape of a person being detained for the purpose of exclusion or deportation under the immigration laws. Increases the maximum prison term in connection with specified crimes of sexual abuse, murder for hire, attempted murder, and certain types of racketeering offenses. Amends the Interstate Agreement on Detainers Act to revise provisions applicable to transfers involving the United States when it obtains custody of a State prisoner on Federal charges. Revises the Federal Rules of Criminal Procedure to require a Federal district court to advise a defendant concerning the effects of supervised release terms on the possible penalty before the court accepts a plea of guilty or nolo contendere. Permits the United States to bring an action to enjoin various types of fraud against the Government. Imposes criminal penalties for obstructing Federal audits and for using the term “Secret Service” without authorization. Amends Federal criminal code provisions governing the time for refiling an indictment or information after it is dismissed because it was found to be defective. Authorizes the Government to refund erroneously forfeited bail. Revises the amount of special assessments imposed on persons convicted of Federal misdemeanors. Authorizes a court to impose conditions alternative to fines, restitution, or community service as conditions of probation for felons.

Authorizes a judge or magistrate of the District of Columbia to issue an arrest warrant for a foreign fugitive whose location is unknown. Revises the definition of “petty offense” for purposes of the Federal criminal code, the Rules of Procedure for the Trial of Misdemeanors before United States Magistrates, and the Federal Rules of Criminal Procedure. Imposes criminal penalties on persons who mail locksmithing devices. Amends provisions with respect to the setting of bail pending appeal. Authorizes the emergency installation of pen registers and trap and trace devices under specified circumstances. Amends the Federal criminal code to authorize Federal Prison Industries, Incorporated (Corporation) to issue its obligations to the Secretary of the Treasury. Authorizes the Secretary to purchase such obligations. Limits the aggregate amount of outstanding obligations from exceeding 25 percent of the Corporation’s net worth. Allows the Secretary to: (1) sell such obligations as public debt transactions; and (2) upon the request of the Corporation, invest excess monies from the Prison Industries Fund. Permits Corporation funds to be used to acquire industrial buildings and equipment for corporate operations. Prohibits the use of corporate funds for the construction or acquisition of penal or correctional institutions or camps. Requires the board of directors of the Corporation to include in its annual report to the Congress: (1) a statement of the amount of obligations issued during the fiscal year; and (2) an estimate of the amount of obligations

Appendix  1075

that will be issued in the following fiscal year. Requires the board of directors to employ the greatest possible number of inmates in U.S. penal institutions who are eligible to work. Directs the Corporation to: (1) produce products on an economic basis, but avoid capturing a reasonable share of the market among Federal departments; (2) concentrate on providing to the Federal Government only those products which permit employment of the greatest number of inmates; and (3) diversify products so that sales are broadly distributed among industries. Requires any decision to produce a new product or expand production significantly to be made by the board of directors. Directs the Corporation, before such decision is made, to prepare a written analysis of the plan’s impact on industry and free labor. Requires the Corporation to provide notice of such plans to potentially affected private vendors or trade associations, allowing such parties to submit comments. Directs the Corporation to provide to the board of directors the analysis, comments, and recommendations for action. Requires the Corporation to publish the final decision of the board of directors and, after each six-month period, a list of sales by the Corporation. Subtitle C: Sentencing Amendments— Amends the Sentencing Act of 1987 to require that the Attorney General assign to the United States Parole Commission for supervision any offender on parole from a foreign country who transfers to the United States. Directs the Parole Commission to determine a release date as well as a period and conditions of supervised release for an

offender transferred to serve a prison term in the United States. Sets out criteria to govern such determinations. Describes the appeals process and other features of relevant civil procedure. Amends provisions of both the Federal criminal and civil codes with respect to the standard of appellate review of sentences. Authorizes the United States Sentencing Commission to: (1) retain private attorneys to advise it; and (2) grant incentive awards to its employees. Requires a court to consider the need to protect the public from future crimes of a defendant when terminating or modifying conditions of supervised release. Deletes provisions authorizing a court to treat violations of conditions of supervised release as a contempt of court. Describes procedures to be followed by the United States Sentencing Commission in amending its guidelines and modifying previously submitted amendments that have not taken effect. Amends the Federal Rules of Appellate Procedure with respect to the time for filing a notice of appeal of a sentence. Subtitle D: Victim Compensation and Assistance—Amends the Victims of Crime Act of 1984 to: (1) increase the ceiling amount permitted in the Victims Crime Fund (Fund); (2) make a specified portion of excess Fund monies available to the judiciary to operate a computerized fine receipt system; (3) extend the sunset of the Fund to September 30,1994 (under current law, the Fund expired on September 30, 1988); and (4) revise provisions relating to the use of excess fund monies. Requires a State’s chief executive to certify that victim assistance funds will be made

1076  Appendix

available for grants to programs that will serve previously underserved populations of victims of violent crime. Establishes within the Department of Justice an Office for Victims of Crime, to be headed by a Director appointed by the President, with the advice and consent of the Senate. Directs the Attorney General, acting through the Director of the Office for Victims of Crime, to use a specified portion of Fund monies for grants to assist Native American Indian tribes in developing and operating programs to handle and prosecute child abuse cases. Makes various other amendments to the Victims of Crime Act of 1984, including provisions to: (1) revise criteria governing assistance to State programs of compensation to victims of violent crimes; (2) require that victims of drunk driving and domestic violence be included among those eligible for compensation; (3) add provisions regarding compensation for eyeglasses and other corrective lenses; (4) consider the Virgin Islands as a State for victim assistance grant purposes; and (5) revise the formula used to calculate State victim assistance grant allocations. Subtitle E: Federal Aviation Administration Drug Enforcement Assistance— Federal Aviation Administration Drug Enforcement Assistance Act of 1988— Amends the Federal Aviation Act of 1958 to direct the Federal Aviation Administrator to modify systems relating to aircraft registration, airman’s certification, and fuel system alterations in order to make these systems more responsive to the needs of drug law enforcement authorities. Cites the areas to be modified. Requires the Administrator to issue final regulations implementing such modifications within ten months after the

date of enactment of this subtitle. Authorizes the Administrator to establish and collect user fees to cover the costs associated with these modifications. Prescribes user fee guidelines. Directs the Comptroller General to conduct annual audits of fee collection and use during the first five years of their imposition. Requires the Administrator to report annually to the Congress for a five-year period regarding the progress made under this subtitle. Establishes civil penalties for violations of this subtitle and sets forth administrative procedures and jurisdictional requirements in connection with their imposition. Establishes criminal penalties for an enumerated series of aircraft registration violations. Cites conditions under which an aircraft used in connection with violations may be seized by drug law enforcement authorities. Requires the Administrator to report annually to the Congress for a three-year period on progress regarding: (1) informational assistance to drug law enforcement authorities; (2) registration and certification suspensions; (3) assessments of the appropriate relationship among Federal Aviation Administration (FAA) informational assistance resources; and (4) the training of FAA personnel with respect to controlled substances traffic. Requires the Administrator to report to the Congress on the funding resources needed on an annual basis to implement this subtitle during a five-year period. Requires the Office of Personnel Management to report to the Congress within 120 days after enactment of this subtitle regarding the results of its review of a certain FAA position classification scheme.

Appendix  1077

Directs the Secretary of Transportation to report to the Congress the results of a feasibility and cost/benefit study (with respect to drug interdiction) of requiring aircraft entering the continental United States to have an operating transponder installed and to have a flight plan filed with the FAA before such entry.

into custody and make recommendations for improving Federal practices and facilities for holding juveniles in custody; and (2) review programs of Federal agencies and report on the extent to which they are consistent with specified requirements regarding detention of juveniles (this latter function is authorized, but not required, under current law).

Requires the Secretary of Transportation to report to the Congress the results of a study of: (1) the feasibility of intercepting aircraft deviating from established flight corridors across the borders of the continental United States; and (2) the impact of the establishment of such corridors on safe and efficient aircraft movement and upon drug interdiction.

Revises annual reporting requirements applicable to the Office. Lists required report contents.

Applies this subtitle only to aircraft that are not used to provide specified air transportation. Subtitle F: Juvenile Justice and Delinquency Prevention—Juvenile Justice and Delinquency Prevention Amendments of 1988—Chapter 1: Amendments to the Juvenile Justice and Delinquency Prevention Act of 1974—Amends the Juvenile Justice and Delinquency Prevention Act of 1974 (JJDPA) to: (1) delete language that assigns to the Deputy Administrator of the Office of Juvenile Justice and Delinquency Prevention (Office) supervisory duties in connection with the National Institute for Juvenile Justice and Delinquency Prevention; and (2) direct the Office Administrator to develop and publish in the Federal Register each year a comprehensive plan describing proposed activities relating to specified juvenile delinquency programs. Adds to the duties of the Coordinating Council on Juvenile Justice and Delinquency Prevention, requiring them to: (1) review the reasons why Federal agencies take juveniles

Directs the Administrator of the Office to make grants to provide technical assistance to the States and local private agencies to facilitate compliance with State juvenile justice plan requirements. Increases the minimum formula grant allocation to the States. Adds a number of provisions relating to juvenile crime problems in areas where Indian tribes perform law enforcement functions, including funding for programs to assist the tribes in these functions. Extends through 1993 the period during which the Administrator must promulgate regulations making exceptions in connection with juvenile detention in jails and lockups for adults (the requirement under current law extends through 1989). Requires State plans to address efforts to reduce any disproportion in numbers of juveniles detained or otherwise confined who are members of minority groups. Revises compliance requirements relating to the removal of juvenile offenders from jails and lockups for adults. Revises provisions concerning the national activities of State advisory groups. Authorizes the National Institute for Juvenile Justice and Delinquency Prevention to

1078  Appendix

review reports, data, and standards relating to the U.S. juvenile justice system on a continuing basis. Shifts the research, demonstration, and evaluation functions of the National Institute for Juvenile Justice and Delinquency Prevention (Institute) to the Administrator, acting through the Institute. Adds new functions, requiring: (1) support of research relating to the disproportion of minority group juveniles detained or confined; and (2) the development of model State legislation consistent with specified guidelines. Makes a corresponding shift to the Administrator of technical assistance and training functions. Makes technical amendments that restructure the JJDPA. Revises the Special Emphasis Prevention and Treatment Program with respect to: (1) youth advocacy; and (2) law-related education. Amends provisions relating to the consideration of grant applications, including peer review requirements. Directs the Administrator to study and report to specified congressional committees on: (1) the conditions in detention and correctional facilities for juveniles and the extent to which they meet recognized national standards; and (2) the treatment of American Indian and Alaskan Native juveniles under justice systems administered by the relevant law enforcement group. Reauthorizes appropriations for juvenile justice and delinquency prevention programs. Revises allocations. Makes technical amendments to administrative provisions of the JJDPA, adding requirements relating to withholding of funds, use of funds, payments, and confidentiality of program records.

Directs the Administrator, by grants to and contracts with individuals and public and private nonprofit entities, to establish and support programs and activities that involve families and communities in prevention and treatment programs to address juvenile gangs and drug abuse and trafficking. Describes permissible grant uses and the approval application process, including priority applications. Chapter 2: Amendments to the Runaway and Homeless Youth Act—Amends the Runaway and Homeless Youth Act to restructure current law. Directs the Secretary of Health and Human Services (HHS) to make grants to public and private entities to establish and operate local runaway and homeless youth centers (current law authorizes, but does not require, such grants). Reauthorizes appropriations for runaway and homeless youth programs. Authorizes the HHS Secretary to make grants and provide technical assistance to public and nonprofit private entities to establish and operate transitional living youth projects for homeless youth. Describes eligibility requirements. Sets a due date for the HHS Secretary’s annual report to the Congress on runaway centers. Directs the Secretary of HHS to make grants for a national communication system to assist runaway and homeless youth in communicating with their families and with service providers. Reserves funds for this purpose. Authorizes the HHS Secretary to make grants to: (1) statewide and regional nonprofit organizations to provide technical assistance and training in connection with grantees

Appendix  1079

establishing and operating runaway and homeless youth centers; and (2) States and private entities to carry out research, demonstration, and service projects designed to increase knowledge about and improve services for runaway and homeless youth. Directs the Secretary of HHS to: (1) develop and publish each year in the Federal Register annual program priorities to be observed in making grant awards; (2) coordinate the activities of specified entities in matters relating to communicable diseases. Authorizes FY 1989 through 1992 appropriations for services under this chapter. Chapter 3: Amendments to the Missing Children’s Assistance Act—Amends the Missing Children’s Assistance Act to revise duties of the Administrator by: (1) deleting provisions requiring an analysis, compilation, publication, and dissemination of an annual summary of specified information concerning missing children; (2) requiring an annual report to specified congressional leadership containing an enumerated list of items relating to missing children; and (3) removing a requirement to prepare an annual comprehensive plan for interagency cooperation. Requires the national toll-free telephone hotline to: (1) operate 24 hour on a basis; and (2) coordinate with the national communication system. Requires the national resource center and clearinghouse on missing children to: (1) maintain information on free or low-cost services available for the benefit of missing children and their families, and information about other Federal programs to assist them; and (2) provide State and local governments and other entities with information to facilitate the lawful use of school records

and birth certificates to identify and locate missing children. Repeals provisions governing the Advisory Board on Missing Children, thus eliminating the Board. Authorizes the Administrator to make grants for research, demonstration projects, or service programs designed to: (1) address the needs of missing children and their families following their reunion; (2) reduce the likelihood that individuals under age 18 will be removed from a legal custodian without the consent of the latter; and (3) establish or operate statewide clearinghouses to assist in locating and recovering missing children. Requires the Administrator to use a competitive process in awarding grants or contracts exceeding $50,000. Authorizes FY 1989 through 1992 appropriations. Directs the Administrator to study and report to specified congressional committee leaders concerning the obstacles that prevent or impede individuals who have legal custody of children from recovering them from parents who have removed them unlawfully. Chapter 4: Miscellaneous—Directs the Comptroller General to study and report to specified congressional committee leaders on the extent to which both valid court orders and court orders other than valid court orders are used during a specified five-year period to place juveniles in secure detention facilities, in secure correctional facilities, and in jails and lockups for adults. Subtitle G: Provisions Relating to Prisons, Probation, Parole, and Supervised Release—Directs the United States Sentencing Commission to study the feasibility of requiring prisoners incarcerated in

1080  Appendix

Federal correctional institutions to pay some or all of the costs of their confinement. Assigns to the Bureau of Prisons a number of administrative responsibilities in connection with confinement facilities for civilian nonviolent prisoners located on military installations. Requires the Bureau to exercise these responsibilities in conjunction with the Department of Defense and the Commission on Alternative Utilization of Military Facilities. Amends the Federal criminal code to revoke probation or parole and terminate the supervised release of any person found to be in possession of a controlled substance. Instructs the Director of the Administrative Office of the United States Courts to establish a two-year demonstration program of mandatory drug testing of criminal defendants in eight Federal judicial districts. Sets forth provisions to govern the program. Requires a report to the Congress on the program’s effectiveness, including recommendations as to whether mandatory drug testing of defendants should be made more general and permanent. Adds as a discretionary condition of probation, parole, or supervised release the requirement that the affected individual remain at home during nonworking hours. Subtitle H: Provisions Relating to Courts—Amends the State Justice Institute Act of 1984 to authorize FY 1989 through 1992 appropriations for activities of the State Justice Institute. Amends the Federal judicial code to empower U.S. magistrates to enter a sentence for a misdemeanor or infraction, with the consent of the parties. Describes conditions to govern the introduction and consideration within the Senate of

habeas corpus reform legislation, following submission by the Chief Justice of the United States of the report and recommendations of the Special Committee on Habeas Corpus Review of Capital Sentences. Urges this Special Committee to expedite the filing of its report. Directs the House of Representatives to give fair and expeditious consideration to the Committee’s report. Subtitle I: Provisions Relating to the Federal Bureau of Investigation—Amends the Federal judicial code to authorize the Attorney General and the Federal Bureau of Investigation (FBI) to investigate felonious killings of State and local law enforcement officers. Uniform Federal Crime Reporting Act of 1988- Requires the Attorney General to collect and preserve national data on Federal criminal offenses as part of the Uniform Crime Reports. Directs all Federal agencies that routinely investigate complaints of criminal activity to report details to the Attorney General in a uniform manner. Requires the Attorney General to distribute annual Uniform Crime Reports containing this information to the President, Members of Congress, and various persons and entities involved in law enforcement activities. Authorizes the Attorney General to designate the FBI as the lead agency for performing the functions authorized by this Act and to establish advisory boards. Requires the FBI Director to classify any offense involving illegal drugs and drug trafficking as a part I crime in the Uniform Crime Reports. Authorizes appropriations. Includes railroad police departments and police departments of private colleges and

Appendix  1081

universities among entities to be involved with information exchanges of criminal justice, criminal identification, and other crime records. Subtitle J: Provisions Relating to the Deportation of Aliens Who Commit Aggravated Felonies—Amends the Immigration and Nationality Act to direct the Attorney General to: (1) take into custody any alien convicted of an aggravated felony (murder, drug trafficking crimes, or illicit trafficking in firearms or destructive devices) upon completion of the relevant sentence; (2) establish a system to maintain records of such aliens and train Immigration and Naturalization Service (INS) personnel to act as a liaison to other law enforcement entities with respect to such aliens; and (3) report to the congressional Judiciary Committees on efforts in these areas. Prohibits the voluntary departure of aliens convicted of an aggravated felony. Includes within a class of deportable aliens any alien convicted: (1) of an aggravated felony at any time after entry into the United States; or (2) possessing or carrying unlawfully any firearm, destructive device, or revolver. Establishes criminal penalties to apply to persons deported subsequent to a felony or aggravated felony conviction who reenter the United States, as well as for persons who assist certain deportees in their reentry. Instructs the Attorney General to establish expedited procedures for aliens convicted of aggravated felonies. Sets forth guidelines to govern these procedures. Prohibits reentry into the United States of any alien convicted of an aggravated felony and deported who seeks reentry within ten years after deportation.

Directs the Attorney General to: (1) establish a pilot program in four cities to improve the capabilities of the INS to respond to law enforcement inquiries concerning aliens who are either under investigation or have been arrested or convicted for drug related offenses; and (2) report to the Judiciary Committees on the program. Subtitle K: United States Customs Service—Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize FY 1989 appropriations for the U.S. Customs Service, earmarking part of the funds for use to increase the number of customs inspectors for contraband enforcement and other drug interdiction activities. Authorizes FY 1989 appropriations to the Secretary of the Treasury for payment to the Customs Cooperation Council. Increases the required personnel level with respect to the Customs Service. Directs the Secretary of the Treasury to prescribe regulations designed to ensure uniformity in various decisions made by customs officers. Requires that the regulations be: (1) published in the Federal Register for public review; and (2) submitted to specified congressional committees for review. Directs the Secretary to submit a report to the same committees on the effectiveness of the regulations and recommendations for permanent legislation to effect the decisional uniformity in question. Directs the Secretary of the Treasury to transfer a specified aircraft to the office of the sheriff of Marion County, Indiana, for drug enforcement and prisoner transportation uses. Amends the Tariff Act of 1930 to establish in the Treasury a Customs Forfeiture Fund, to be available to the U.S. Customs Service

1082  Appendix

for expenses associated with their seizures and forfeitures, as well as those by the U.S. Coast Guard. Directs the Commissioner of Customs to report annually to the Congress on Fund receipts and expenditures. Authorizes appropriations. Provides for seizure of certain property under search warrant authority. Adds options for the Secretary of the Treasury in connection with forfeited property, permitting the Secretary to retain property for official use or transfer it to a foreign government that cooperated in joint law enforcement operations. Increases the penalty for failure to declare controlled substances. Amends the Tariff Act of 1930 with respect to materials seized for customs law violations, including provisions relating to: (1) summary forfeiture and sale; (2) judicial condemnation; (3) forfeiture proceedings; and (4) summary sale. Authorizes additional FY 1989 appropriations to the U.S. Customs Service to be used exclusively for research and development in connection with detection of illegal narcotics in cargo containers entering the United States. Directs the Commissioner of Customs to coordinate and share findings associated with this research and to report to the Congress. Directs the Secretary of the Treasury to: (1) prescribe regulations that set forth criteria requiring persons in charge of common carriers to exercise the highest degree of care to know whether controlled substances imported into the United States are on board; (2) issue air carrier controlled substances interdiction regulations for a two-year demonstration program. Sets forth criteria to govern these latter regulations, to be applied

to at least three U.S. international airports classified by the Customs Service as highrisk and based upon the highest volume of cargo and number of aircraft arriving from high-risk points of departure. Requires that the regulations establish procedures for the development and approval of supplemental inspection practices reflecting the nature and level of controlled substance threat that particular foreign locations pose and the ambient security conditions at each foreign airport. Exempts participating air carriers that comply with the program from fines, penalties, and seizure provisions associated with drug smuggling. Commends: (1) Commissioner William von Raab for his outstanding leadership of the United States Customs Service; and (2) Special Agent Bonni Tischler and other officials who participated in Operation C-Chase, which led to the first indictment of an international financial institution for laundering illegal narcotics proceeds. Subtitle L: Coast Guard Drug Law Enforcement—Amends Federal law to indemnify commanders of surface naval vessels on which Coast Guard personnel are assigned from penalties or litigation for damages for firing at or into vessels that refuse to stop upon proper warning. Revises the scope of primary duties of the Coast Guard to include the enforcement of Federal laws above the high seas and waters. Directs the Secretaries of Transportation and of the Treasury to enter into an agreement to increase the effectiveness of Coast Guard and Customs Service maritime drug interdiction activities in the Great Lakes area. Encourages the Secretary of State to negotiate with appropriate Canadian officials to establish an agreement for increased cooper-

Appendix  1083

ation and information sharing between U.S. and Canadian law enforcement officials with respect to efforts on the Great Lakes border. Authorizes FY 1989 appropriations to the Coast Guard for acquisition, construction, and improvements and FY 1989 through 1992 appropriations for operating expenses. Makes all of these amounts available until expended and supplemental to other amounts and personnel strengths. Subtitle M: Interpol Provisions—Authorizes the Attorney General to accept and administer gifts for the purpose of: (1) hosting the International Criminal Police Organization’s (INTERPOL) American Regional Conference in the United States in 1989; and (2) making a commemorative gift of up to $10,000 to the INTERPOL General Secretariat on the opening of its headquarters in Lyon, France. Subtitle N: Child Pornography and Obscenity—Child Protection and Obscenity Enforcement Act of 1988—Chapter 1: Child Pornography—Amends the Federal criminal code to make it illegal to use a computer to transport information in interstate or foreign commerce concerning the visual depiction of minors engaging in sexually explicit conduct (child pornography). Establishes criminal penalties for buying, selling, or transferring the custody of a minor: (1) knowing that, as a consequence of the sale or transfer, the minor will be used in child pornography; or (2) with the intent to promote child pornography. States that such sale or transfer must involve: (1) the minor or other actor traveling in interstate or foreign commerce; (2) communications in interstate or foreign commerce; or (3) conduct in a territory or possession of the United States.

Requires any person who produces a book, magazine, periodical, film, videotape, or other matter which contains any visual depiction of sexually explicit conduct (which is shipped or intended for shipment in interstate or foreign commerce, or contains material shipped in interstate or foreign commerce) to maintain certain records regarding the performers portrayed in such conduct. Directs the Attorney General to issue regulations regarding the maintenance and availability of such records. Includes the sexual exploitation of children as a predicate offense to the Racketeer Influenced and Corrupt Organizations (RICO) statute. Chapter 2: Obscenity—Makes it a Federal criminal offense for any person engaged in the business of selling or transferring obscene matter to knowingly receive or possess, with the intent to distribute, obscene matter which has been transported in interstate or foreign commerce. Makes it a Federal criminal offense to knowingly use a facility or means of commerce to sell or distribute obscene matter in interstate or foreign commerce. Establishes a rebuttable presumption, with respect to Federal criminal offenses involving obscene matter, that obscene matter produced in one State (or outside the United States) which is subsequently located in another State (or in the United States) was transported, shipped, or carried in interstate (or foreign) commerce. Establishes: (1) criminal forfeiture procedures with respect to Federal offenses involving obscene material; and (2) criminal and civil forfeiture procedures with respect to Federal offenses involving child pornography.

1084  Appendix

Includes communications by means of cable or subscription television within the prohibition against broadcasting obscene language. Amends the Communications Act of 1934 to: (1) modify the penalty provisions of such Act with respect to obscene telephone communications; and (2) impose criminal penalties on persons who make any indecent telephone communication for commercial purposes to any person, regardless of the recipient’s age or consent. Adds obscenity offenses to the list of crimes for which the Government may obtain wiretaps. Amends the Federal criminal code to impose criminal penalties on any person who knowingly sells or possesses with intent to sell obscene matter on Federal property. Subtitle O: Miscellaneous—Amends Internal Revenue Code provisions requiring the filing of information returns relating to cash received in a trade or business to impose on payors who cause others to fail to file a return the same civil and criminal sanctions (increased by this subtitle) applicable to the principal who fails to file. Authorizes the Secretary of the Treasury to disclose information from such information returns to officers and employees administering Federal criminal statutes not related to tax administration. Broadens the scope of undercover operations that the Internal Revenue Service is authorized to undertake. Sets forth rules with respect to the conduct of such operations, including provisions relating to required audits and to the use of proceeds. Amends the Internal Revenue Code to require the Internal Revenue Service (IRS) to reimburse costs of pertinent investigations of State and local law enforcement agencies

that provide information which substantially contributes to the recovery of Federal taxes imposed with respect to illegal drug-related activities. Includes as reimbursable costs: (1) reasonable expenses; (2) per diem expenses; and (3) salaries and overtime compensation. Limits the amount of such reimbursement to ten percent of the sum ultimately recovered. Directs the IRS to maintain records of information provided by State and local law enforcement agencies and to notify them when their information results in a tax recovery. Directs that ten percent of any amount recovered as the result of information offered by such governmental units be deposited in a separate account, to be used for payments to the eligible law enforcement agencies, with any surplus to be withdrawn and deposited in the Treasury as internal revenue collections. Revises the Federal criminal code definition of “scheme or artifice to defraud” with respect to mail fraud offenses. National Commission on Measured Responses to Achieve a Drug-Free America by 1995 Authorization Act—Establishes a Commission to develop a proposed uniform code of State laws representing measured responses to achieve a drug-free America by 1995, including such possible subjects as: (1) appropriate penalties for drug offenses; (2) appropriate use of drug testing; (3) cooperative ventures among the Federal, State, and local levels; and (4) reducing demand through education efforts. Directs the Commission to report its proposals to the Mayor of the District of Columbia and to all State Governors. Expresses the sense of the Congress that the Mayor of the District of Columbia and all State Governors should convene State conferences for a drug-free America by 1995 to consider the Commis-

Appendix  1085

sion’s proposals and make recommendations. Authorizes appropriations.

victim’s age and relationship to the offender in connection with specified types of crimes.

Directs the President to instruct the Office of National Drug Control Policy to develop a comprehensive plan to use no fewer than eight existing facilities of specified executive departments and agencies to develop technologies for application to Federal law enforcement agency missions and to provide support to Federal law enforcement agencies. Lists facilities to be considered in developing the plan. Directs the Comptroller General to monitor plan development and to report to appropriate congressional committees on progress.

Instructs the Director of the Bureau of Justice Statistics, through the annual National Crime Survey, to collect and publish more accurate data concerning domestic violence, especially child abuse and elder abuse. Authorizes appropriations.

Instructs the Secretary of the Air Force to: (1) issue regulations to ensure that the Civil Air Patrol has an integral role in drug interdiction and eradication activities; and (2) submit to specified congressional committees quarterly reports that include details concerning these activities. Establishes as a bureau within the Department of Justice the United States Marshals Service, headed by a Director appointed by the President, with the advice and consent of the Senate. Directs the President to appoint a U.S. marshal for each judicial district of the United States and for the Superior Court of the District of Columbia. Sets forth procedures for filling vacancies in the Office of a U.S. Marshal. Specifies the powers and duties of the Service. Prescribes a schedule of fees that the Service may collect. Authorizes the Attorney General to use funds appropriated to the Service for the support of U.S. prisoners in non-Federal institutions. Directs the Attorney General to require the inclusion in uniform crime reports of the

Title VIII: Federal Alcohol Administration—Amends the Federal Alcohol Administration Act to add a new title to be cited as the Alcoholic Beverage Labeling Act of 1988. Makes it unlawful, effective one year following this Act’s enactment, for any person to manufacture, import, or bottle an alcoholic beverage in the United States that does not bear in a conspicuous place a warning that: (1) women should not drink alcoholic beverages during pregnancy because of the risk of birth defects; and (2) alcoholic beverage consumption impairs one’s ability to drive a car or operate machinery and may cause health problems. Imposes civil penalties on violators. Preempts State law with respect to alcoholic beverage labeling. Directs the Secretary of the Treasury to report to the Congress any available scientific information that would justify a change in the labeling requirements. Title IX: Miscellaneous—Subtitle A: Alcohol and Drug Traffic Safety—Drunk Driving Prevention Act of 1988—Directs the Secretary of Transportation to make basic and supplemental grants to States to be used exclusively to improve the effectiveness of law enforcement with respect to drivers operating motor vehicles while under the influence of alcohol. Requires recipient States to agree to maintain aggregate expenditures from all other sources for drunk driving enforcement programs at or above the average level in the two years preceding

1086  Appendix

enactment of this program. Limits a State to grants in three fiscal years and sets maximum amounts applicable to each of these years. Describes eligibility criteria for basic grants, requiring the State to: (1) provide for an expedited driver license suspension or revocation system for persons who operate motor vehicles while under the influence of alcohol; and (2) operate a self-sustaining drunk driving prevention program that uses fines generated from drunk driving offenses for prevention programs in communities. Sets forth additional criteria for supplemental grant eligibility, requiring the State to: (1) provide for mandatory blood alcohol content testing under certain circumstances; (2) provide an effective system to prevent drivers under age 21 from obtaining alcoholic beverages; (3) have laws against the possession of open alcoholic beverage containers or the consumption of alcoholic beverages in vehicles; and (4) require, with limited exception, the suspension of registration, and return to the State of the license plates, in connection with any motor vehicle owned by an individual convicted of specified alcohol-related driving offenses. Authorizes FY 1989 through 1991 appropriations for the grant program. Instructs the Secretary of Transportation to arrange with the National Academy of Sciences to conduct a study to determine the appropriate blood alcohol concentration level to use in presumptions as to whether a person is driving under the influence of alcohol. Requires submission of the report, for immediate transmittal to the Congress, within 15 months after this Act’s enactment. Authorizes FY 1989 appropriations. Directs the Secretary also to conduct a study concerning the exchange of information between the Federal Government and State law

enforcement officials on all arrests for drunk driving and to report results to the Congress within one year of this Act’s enactment. Authorizes appropriations. Instructs the Secretary of Transportation, through the National Highway Traffic Safety Administration, to: (1) establish a threeyear pilot, regional program to train law enforcement officers to identify individuals who are operating a motor vehicle while under the influence of alcohol or controlled substances; and (2) report to the Congress on the program’s effectiveness. Authorizes appropriations. Directs the Secretary to design a pilot grant program in not more than four States for controlled substances testing of first-time driver license applicants. Describes the State selection process and requirements to be met by States in administering sanctions under the program. Directs the Secretary to report to the Congress on program results. Authorizes appropriations. Subtitle B: Truck and Bus Safety and Regulatory Reform—Truck and Bus Safety and Regulatory Reform Act of 1988—Amends the Motor Carrier Safety Act of 1984 to prohibit the Secretary of Transportation from exempting any person or commercial motor vehicle from complying with any commercial motor vehicle safety regulation or from waiving application of such regulation solely on the grounds that the commercial carrier’s operations take place entirely within a municipality or its commercial zone. (Grandfathers certain commercial motor vehicle operators who operated entirely within a municipality or its commercial zone during the one-year period ending on the date of enactment of this subtitle.) Directs the Secretary to: (1) delay application of Federal safety regulations to foreign

Appendix  1087

motor carriers in border commercial zones for a one-year period beginning on the date of enactment of this subtitle if certain conditions are met; and (2) report to the Congress on the effects of the delay. Directs the Secretary to: (1) study the hours of service regulations pertaining to commercial motor vehicle operators to determine any relationship among them, operator fatigue, and the frequency of serious accidents involving such vehicles; (2) report study results to the Congress; and (3) initiate a rulemaking proceeding regarding commercial motor vehicle operator compliance with the relevant regulations (including the use of onboard monitoring devices to record speed, driving time, and other information). Stipulates that any rule promulgated by the Secretary shall ensure that such devices are used solely for monitoring operator productivity, and not for harassment. Requires the Secretary to issue regulations establishing minimum uniform standards for a biometric identification system for commercial motor vehicle operators. Authorizes the Secretary to use specified funds to implement a pilot project demonstrating such a system. Directs the Secretary to initiate a rulemaking proceeding regarding the use of flares as an alternative to bidirectional emergency reflective triangles. Requires the Secretary to report to the Congress regarding: (1) the need for improved brake systems for commercial motor vehicles operating on the Federal-aid highway system; and (2) the results of a study on whether speed control devices enhance safe operation of commercial motor vehicles. Authorizes the Secretary to extend for up to 12 more months the 60-month delay period granted to States before Federal pre-emption

applies if a State requests such an extension to further consider adoption of safety regulations compatible with Federal law. Directs the Secretary to initiate a rulemaking proceeding for the purpose of adopting improved methods of ensuring proper maintenance of commercial motor vehicle brake systems. Calls for the promulgation of derived regulations by December 31, 1990. Amends Federal motor carrier law to require foreign motor carriers to obtain a certificate of registration from the Interstate Commerce Commission (ICC) as a condition of providing interstate transportation of property (including exempt property) in the United States. Requires a copy of such certificate to be in the carrier’s vehicle any time it provides such transportation. Authorizes the Secretary to issue regulations permitting foreign motor carriers and foreign motor private carriers providing transportation of property under a registration certificate to meet Federal insurance requirements for financial responsibility only during those periods in which they provide such transportation in the United States. Repeals the requirement that the ICC report annually to the Congress on the extent to which cost savings resulting from direct sales at a food and grocery seller’s shipping point are passed on to the ultimate consumer. Makes technical amendments of provisions relating to the liability of freight forwarders under receipts and bills of lading and the associated statute of limitations. Subtitle C: Comptroller General Study— Directs the Comptroller General to: (1) study and report to the Congress on the effect of additional resources to certain components of the Federal criminal justice system and of new penalties and laws on specified Federal

1088  Appendix

entities relating to criminal justice; and (2) use resulting information to develop a model that can be used to help determine appropriate staff and budget responses for effectively implementing changes in resources, laws, or penalties. Subtitle D: Insular Areas—Insular Areas Drug Abuse Amendments of 1988— Amends the United States Insular Areas Drug Abuse Act of 1986 to add the Secretary of Education as a principal in administering such Act’s enforcement and administration provisions. Applies such Act to substance abuse generally rather than limiting it solely to drug abuse. Replaces current authorizations with an authorization for FY 1989 and subsequent fiscal years for grants to the Governments of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico (amounts to remain available until expended), and Palau, to be spent in accordance with an approved plan. Directs the Secretary of the Treasury to provide the Government of American Samoa with a vessel for narcotics enforcement and other law enforcement activities. Authorizes appropriations. Authorizes appropriations for a grant to the Government of Guam to be spent for drug abuse law enforcement equipment in accordance with an approved plan. Amends crime victim assistance provisions of the Victims of Crime Act of 1984 to remove certain authority restrictions currently applied with respect to U.S. territories and possessions. Authorizes FY 1990 and subsequent fiscal year appropriations, to remain available until expended, to the Government of the Virgin

Islands, to be spent in accordance with an approved plan. Requires the Attorney General and the Secretaries of Health and Human Services and of Education to provide appropriate law enforcement training, technical assistance, and equipment upon the request of the government of any insular area covered under such Act. Directs the Attorney General to assign necessary personnel to serve in the office of the U.S. Attorney for the Virgin Islands to assist in the prosecution of narcotics law violations. Authorizes appropriations, effective FY 1989, for a grant to the Virgin Islands Government to be used for a substance abuse facility in accordance with an approved plan. Brings Palau within the jurisdiction of such Act. Authorizes the major Federal law enforcement entities, including the Drug Enforcement Administration and the Customs Service, upon the request of the Palau Government, to cooperate with Palau’s law enforcement agencies in investigating U.S. criminal law violations there. Sets October first as the transmission date for the President’s annual reports to specified congressional committees on the illegal transit of controlled substances from insular areas into the United States and from other nations into the insular areas. Title X: Supplemental Appropriations— Urgent Supplemental Appropriations Act of 1989 to Meet the Dire Emergency Created by the Crisis of Drug Abuse—Makes supplemental FY 1989 appropriations to provide additional funding for treatment and rehabilitation for drug users and for law enforcement relating to this Act and other anti-drug legislation.

Appendix  1089

Chapter I: Department of Justice— Appropriates supplemental FY 1989 funds to the Department of Justice for: (1) legal activities; (2) the Federal Bureau of Investigation; (3) the Drug Enforcement Administration; (4) the Immigration and Naturalization Service; (5) the Federal Prison System; and (6) the Office of Justice Programs. Appropriates supplemental FY 1989 funds to: (1) the Department of State for administration of foreign affairs; and (2) the Judiciary for the Courts of Appeals, district courts, and other judicial services. Chapter 2: Department of Labor—Provides supplemental FY 1989 appropriations to the Departments of Labor, Health and Human Services (for the Alcohol, Drug Abuse and Mental Health Administration), and Education (for school improvement programs) and to ACTION. Chapter III: Department of Agriculture—Appropriates supplemental FY 1989 funds to the Department of Agriculture’s Food and Nutrition Service and to the Food and Drug Administration of the Department of Health and Human Services. Chapter IV: Department of Transportation—Provides supplemental FY 1989 appropriations to the Department of Transportation for the Coast Guard. Chapter V: Department of the Treasury—Appropriates supplemental FY 1989 funds to: (1) the Department of the Treasury for the Bureau of Alcohol, Tobacco and Firearms and for the U.S. Customs Service; and (2) the Executive Office of the President for the Office of National Drug Control Policy. Chapter VI: General Provisions—Limits the availability for obligation of all appro-

priations under this title to FY 1989, unless expressly provided otherwise. Source: H.R. 5210 (100th); Pub.L. 100-690

George Bush: Address to Nation on the National Drug Control Strategy (1989) In the mid- to late 1980s, illicit drug use was increasing across the United States, as was concern with the dangers associated with such use. In the Anti–Drug Abuse Act of 1988, Congress created a new office, the Office of National Drug Control Policy (ONDCP), that was intended to coordinate the federal response to the problem. The hope was that a more concerted and orga­ nized effort to reduce drug use would reduce the demand for drugs. Moreover, a more coordinated effort by law enforcement agencies on the federal and state levels would reduce overlap and waste, leading to a more efficient and effective law enforcement response. The new Office of National Drug Control Policy was responsible for establishing an annual Drug Control Strategy that would outline the president’s plan to address the drug problem. In this address, Bush addressed the nation to discuss the nation’s drug problem. He began by showing some drugs (crack cocaine) that were allegedly purchased in a park adjacent to the White House. He then told the viewers that he had worked with the ONDCP and its first director, Bill Bennett, as well as officials from the state and local governments and experts in many facets of criminal justice, to prepare the new strategy.

1090  Appendix

He described the new strategy as being a coordinated and cooperative effort by all federal agencies to fight drugs using the programs and strategies that already exist (but in a more effective manner). He described four major elements of the strategy. The first was to focus on law enforcement. In this regard, Bush proposed more than double the amount of federal money given to state and local law enforcement agencies. This way, they can catch the drug dealers. He also wanted to increase the criminal justice system in the local, state, and federal levels. This meant building more prisons, jails, and courts, and hiring more prosecutors. Another aspect of this was to spend $50 million to fight crime in public housing projects. The second part of the Drug Control Strategy was to work with other countries to reduce the manufacturing of drugs. He specifically mentioned Colombia, which processes much of the cocaine in the United States. He announced $65 million in emergency assistance to assist the Andean countries (Colombia, Bolivia, and Peru) fight the cocaine cartels. The strategy allocated $2 billion for the next five years in military and law enforcement assistance for these countries. Further, Bush proposed spending more than a billion dollars to stop those drugs from being smuggled into the United States at the borders. The third part of the Drug Control Strategy was drug treatment. Bush noted that many addicts need treatment who are not receiving it. He told the U.S. public that it was time to expand our treatment systems and do a better job of providing services to those who need them. He proposed spending $321 million in federal spending on drug treatment. The final part of the new Drug Control Strategy was to stop illegal drug use before it

starts. He proposed spending a quarter of a billion dollars for school and community prevention programs to help young people stay away from drugs. He also proposed working with advertisers and media firms to create educational messages about the dangers of drug use.

George Bush: Address to the Nation on the National Drug Control Strategy September 5, 1989 Good evening. This is the first time since taking the oath of office that I felt an issue was so important, so threatening, that it warranted talking directly with you, the American people. All of us agree that the gravest domestic threat facing our nation today is drugs. Drugs have strained our faith in our system of justice. Our courts, our prisons, our legal system, are stretched to the breaking point. The social costs of drugs are mounting. In short, drugs are sapping our strength as a nation. Turn on the evening news or pick up the morning paper and you’ll see what some Americans know just by stepping out their front door: Our most serious problem today is cocaine, and in particular, crack. Who’s responsible? Let me tell you straight out—everyone who uses drugs, everyone who sells drugs, and everyone who looks the other way. Tonight, I’ll tell you how many Americans are using illegal drugs. I will present to you our national strategy to deal with every aspect of this threat. And I will ask you to get involved in what promises to be a very difficult fight. This is crack cocaine seized a few days ago by Drug Enforcement agents in a park just across the street from the White House. It could easily have been heroin or PCP. It’s as innocent-looking as candy, but it’s turning

Appendix  1091

our cities into battle zones, and it’s murdering our children. Let there be no mistake: This stuff is poison. Some used to call drugs harmless recreation; they’re not. Drugs are a real and terribly dangerous threat to our neighborhoods, our friends, and our families. No one among us is out of harm’s way. When 4-year-olds play in playgrounds strewn with discarded hypodermic needles and crack vials, it breaks my heart. When cocaine, one of the most deadly and addictive illegal drugs, is available to school kids—school kids—it’s an outrage. And when hundreds of thousands of babies are born each year to mothers who use drugs—premature babies born desperately sick—then even the most defenseless among us are at risk. These are the tragedies behind the statistics, but the numbers also have quite a story to tell. Let me share with you the results of the recently completed household survey of the National Institute on Drug Abuse. It compares recent drug use to 3 years ago. It tells us some good news and some very bad news. First, the good. As you can see in the chart, in 1985 the Government estimated that 23 million Americans were using drugs on a “current” basis; that is, at least once in the preceding month. Last year that number fell by more than a third. That means almost 9 million fewer Americans are casual drug users. Good news. Because we changed our national attitude toward drugs, casual drug use has declined. We have many to thank: our brave law enforcement officers, religious leaders, teachers, community activists, and leaders of business and labor. We should also thank the media for their exhaustive news and editorial coverage and for their air time and space for antidrug messages. And finally, I want to thank President and Mrs. Reagan for their

leadership. All of these good people told the truth: that drug use is wrong and dangerous. But as much comfort as we can draw from these dramatic reductions, there is also bad news, very bad news. Roughly 8 million people have used cocaine in the past year. Almost 1 million of them used it frequently—once a week or more. What this means is that, in spite of the fact that overall cocaine use is down, frequent use has almost doubled in the last few years. And that’s why habitual cocaine users, especially crack users, are the most pressing, immediate drug problem. What, then, is our plan? To begin with, I trust the lesson of experience: No single policy will cut it, no matter how glamorous or magical it may sound. To win the war against addictive drugs like crack will take more than just a Federal strategy: It will take a national strategy, one that reaches into every school, every workplace, involving every family. Earlier today, I sent this document, our first such national strategy, to the Congress. It was developed with the hard work of our nation’s first Drug Policy Director, Bill Bennett. In preparing this plan, we talked with State, local, and community leaders, law enforcement officials, and experts in education, drug prevention, and rehabilitation. We talked with parents and kids. We took a long, hard look at all that the Federal Government has done about drugs in the past—what’s worked and, let’s be honest, what hasn’t. Too often, people in government acted as if their part of the problem—whether fighting drug production or drug smuggling or drug demand—was the only problem. But turf battles won’t win this war; teamwork will. Tonight, I’m announcing a strategy that reflects the coordinated, cooperative commitment of all our Federal agencies. In short,

1092  Appendix

this plan is as comprehensive as the problem. With this strategy, we now finally have a plan that coordinates our resources, our programs, and the people who run them. Our weapons in this strategy are the law and criminal justice system, our foreign policy, our treatment systems, and our schools and drug prevention programs. So, the basic weapons we need are the ones we already have. What’s been lacking is a strategy to effectively use them. Let me address four of the major elements of our strategy. First, we are determined to enforce the law, to make our streets and neighborhoods safe. So, to start, I’m proposing that we more than double Federal assistance to State and local law enforcement. Americans have a right to safety in and around their homes. And we won’t have safe neighborhoods unless we’re tough on drug criminals—much tougher than we are now. Sometimes that means tougher penalties, but more often it just means punishment that is swift and certain. We’ve all heard stories about drug dealers who are caught and arrested again and again but never punished. Well, here the rules have changed: If you sell drugs, you will be caught. And when you’re caught, you will be prosecuted. And once you’re convicted, you will do time. Caught—prosecuted—punished. I’m also proposing that we enlarge our criminal justice system across the board—at the local, State, and Federal levels alike. We need more prisons, more jails, more courts, more prosecutors. So, tonight I’m requesting—all together—an almost $1.5 billion increase in drug-related Federal spending on law enforcement. And while illegal drug use is found in every community, nowhere is it worse than in our public housing projects. You know, the poor

have never had it easy in this world. But in the past, they weren’t mugged on the way home from work by crack gangs. And their children didn’t have to dodge bullets on the way to school. And that’s why I’m targeting $50 million to fight crime in public housing projects—to help restore order and to kick out the dealers for good. The second element of our strategy looks beyond our borders, where the cocaine and crack bought on America’s streets is grown and processed. In Colombia alone, cocaine killers have gunned down a leading statesman, murdered almost 200 judges and 7 members of their supreme court. The besieged governments of the drugproducing countries are fighting back, fighting to break the international drug rings. But you and I agree with the courageous President of Colombia, Virgilio Barco, who said that if Americans use cocaine, then Americans are paying for murder. American cocaine users need to understand that our nation has zero tolerance for casual drug use. We have a responsibility not to leave our brave friends in Colombia to fight alone. The $65 million emergency assistance announced 2 weeks ago was just our first step in assisting the Andean nations in their fight against the cocaine cartels. Colombia has already arrested suppliers, seized tons of cocaine, and confiscated palatial homes of drug lords. But Colombia faces a long, uphill battle, so we must be ready to do more. Our strategy allocates more than a quarter of a billion dollars for next year in military and law enforcement assistance for the three Andean nations of Colombia, Bolivia, and Peru. This will be the first part of a 5-year, $2 billion program to counter the producers, the traffickers, and the smugglers.

Appendix  1093

I spoke with President Barco just last week, and we hope to meet with the leaders of affected countries in an unprecedented drug summit, all to coordinate an inter-American strategy against the cartels. We will work with our allies and friends, especially our economic summit partners, to do more in the fight against drugs. I’m also asking the Senate to ratify the United Nations antidrug convention concluded last December. To stop those drugs on the way to America, I propose that we spend more than a billion and a half dollars on interdiction. Greater interagency cooperation, combined with sophisticated intelligence-gathering and Defense Department technology, can help stop drugs at our borders.

programs were set up to deal with heroin addicts, but today the major problem is cocaine users. It’s time we expand our treatment systems and do a better job of providing services to those who need them. And so, tonight I’m proposing an increase of $321 million in Federal spending on drug treatment. With this strategy, we will do more. We will work with the States. We will encourage employers to establish employee assistance programs to cope with drug use; and because addiction is such a cruel inheri­ tance, we will intensify our search for ways to help expectant mothers who use drugs.

And our message to the drug cartels is this: The rules have changed. We will help any government that wants our help. When requested, we will for the first time make available the appropriate resources of America’s Armed Forces. We will intensify our efforts against drug smugglers on the high seas, in international airspace, and at our borders. We will stop the flow of chemicals from the United States used to process drugs. We will pursue and enforce international agreements to track drug money to the front men and financiers. And then we will handcuff these money launderers and jail them, just like any street dealer. And for the drug kingpins: the death penalty.

Fourth, we must stop illegal drug use before it starts. Unfortunately, it begins early—for many kids, before their teens. But it doesn’t start the way you might think, from a dealer or an addict hanging around a school playground. More often, our kids first get their drugs free, from friends or even from older brothers or sisters. Peer pressure spreads drug use; peer pressure can help stop it. I am proposing a quarter-of-a-billion-dollar increase in Federal funds for school and community prevention programs that help young people and adults reject enticements to try drugs. And I’m proposing something else. Every school, college, and university, and every workplace must adopt tough but fair policies about drug use by students and employees. And those that will not adopt such policies will not get Federal funds—period!

The third part of our strategy concerns drug treatment. Experts believe that there are 2 million American drug users who may be able to get off drugs with proper treatment, but right now only 40 percent of them are actually getting help. This is simply not good enough. Many people who need treatment won’t seek it on their own, and some who do seek it are put on a waiting list. Most

The private sector also has an important role to play. I spoke with a businessman named Jim Burke who said he was haunted by the thought—a nightmare, really—that somewhere in America, at any given moment, there is a teenage girl who should be in school instead of giving birth to a child addicted to cocaine. So, Jim did something. He led an antidrug partnership, financed by

1094  Appendix

private funds, to work with advertisers and media firms. Their partnership is now determined to work with our strategy by generating educational messages worth a million dollars a day every day for the next 3 years— a billion dollars’ worth of advertising, all to promote the antidrug message. As President, one of my first missions is to keep the national focus on our offensive against drugs. And so, next week I will take the antidrug message to the classrooms of America in a special television address, one that I hope will reach every school, every young American. But drug education doesn’t begin in class or on TV. It must begin at home and in the neighborhood. Parents and families must set the first example of a drug-free life. And when families are broken, caring friends and neighbors must step in. These are the most important elements in our strategy to fight drugs. They are all designed to reinforce one another, to mesh into a powerful whole, to mount an aggressive attack on the problem from every angle. This is the first time in the history of our country that we truly have a comprehensive strategy. As you can tell, such an approach will not come cheaply. Last February I asked for a $700 million increase in the drug budget for the coming year. And now, over the past 6 months of careful study, we have found an immediate need for another billion and a half dollars. With this added $2.2 billion, our 1990 drug budget totals almost $8 billion, the largest increase in history. We need this program fully implemented—right away. The next fiscal year begins just 26 days from now. So, tonight I’m asking the Congress, which has helped us formulate this strategy, to help us move it forward immediately. We can pay for this

fight against drugs without raising taxes or adding to the budget deficit. We have submitted our plan to Congress that shows just how to fund it within the limits of our bipartisan budget agreement. Now, I know some will still say that we’re not spending enough money, but those who judge our strategy only by its pricetag simply don’t understand the problem. Let’s face it, we’ve all seen in the past that money alone won’t solve our toughest problems. To be strong and efficient, our strategy needs these funds. But there is no match for a united America, a determined America, an angry America. Our outrage against drugs unites us, brings us together behind this one plan of action—an assault on every front. This is the toughest domestic challenge we’ve faced in decades. And it’s a challenge we must face not as Democrats or Republicans, liberals or conservatives, but as Americans. The key is a coordinated, united effort. We’ve responded faithfully to the request of the Congress to produce our nation’s first national drug strategy. I’ll be looking to the Democratic majority and our Republicans in Congress for leadership and bipartisan support. And our citizens deserve cooperation, not competition; a national effort, not a partisan bidding war. To start, Congress needs not only to act on this national drug strategy but also to act on our crime package announced last May, a package to toughen sentences, beef up law enforcement, and build new prison space for 24,000 inmates. You and I both know the Federal Government can’t do it alone. The States need to match tougher Federal laws with tougher laws of their own: stiffer bail, probation, parole, and sentencing. And we need your help. If people you know are users, help

Appendix  1095

them—help them get off drugs. If you’re a parent, talk to your kids about drugs—tonight. Call your local drug prevention program; be a Big Brother or Sister to a child in need; pitch in with your local Neighborhood Watch program. Whether you give your time or talent, everyone counts: every employer who bans drugs from the workplace; every school that’s tough on drug use; every neighborhood in which drugs are not welcome; and most important, every one of you who refuses to look the other way. Every one of you counts. Of course, victory will take hard work and time, but together we will win. Too many young lives are at stake. Not long ago, I read a newspaper story about a little boy named Dooney who, until recently, lived in a crack house in a suburb of Washington, DC. In Dooney’s neighborhood, children don’t flinch at the sound of gunfire. And when they play, they pretend to sell to each other small white rocks that they call crack. Life at home was so cruel that Dooney begged his teachers to let him sleep on the floor at school. And when asked about his future, 6-year-old Dooney answers, “I don’t want to sell drugs, but I’ll probably have to.” Well, Dooney does not have to sell drugs. No child in America should have to live like this. Together as a people we can save these kids. We’ve already transformed a national attitude of tolerance into one of condemnation. But the war on drugs will be hard-won, neighborhood by neighborhood, block by block, child by child. If we fight this war as a divided nation, then the war is lost. But if we face this evil as a nation united, this will be nothing but a handful of useless chemicals. Victory—victory over drugs—is our cause, a just cause. And with your help, we are going to win. Thank you, God bless you, and good night.

Source: George Bush: “Address to the Nation on the National Drug Control Strategy.” September 5, 1989. Online by Gerhard Peters and John T. Woolley, American Presidency Project. http://www .presidency.ucsb.edu/ws/?pid=17472.

Executive Order 12880: National Drug Control Program (1993) (Bill Clinton) In this Executive Order, President Clinton established the National Drug Control Program. This office was a follow-up to the Special Action Office of Drug Abuse Prevention established by Nixon, and the Office of National Drug Control Policy established by President Bush. Like the other offices, the National Drug Control Program was located within the Executive Office of the President. That way, the advisors would be close in proximity to the president. The National Drug Control Program was, like the other offices, a way to oversee the federal approach to fighting drug abuse. The goal was to ensure a comprehensive and coordinated effort to reduce the number of people abusing drugs. The program would work with other countries to reduce the drugs produced there in a policy of counternarcotics. In addition to this responsibility, the director of the office was to assist in collecting and analyze statistics related to drug treatment programs and anti–drug abuse policies, and disseminate that information to those who are interested. Finally, the director was to provide advice to agencies about new ways to improve interagency cooperation and treatment.

1096  Appendix

The text of the Executive Order is presented below.

William J. Clinton Executive Order 12880—National Drug Control Program November 16, 1993 The Office of National Drug Control Policy has the lead responsibility within the Executive Office of the President to establish policies, priorities, and objectives for the Nation’s drug control program, with the goal of reducing the production, availability, and use of illegal drugs. All lawful and reasonable means must be used to ensure that the United States has a comprehensive and effective National Drug Control Strategy. Therefore, by the authority vested in me as President by the Constitution and the laws of the United States of America, including the National Narcotics Leadership Act of 1988, as amended (21 U.S.C. 1501 et seq.), and in order to provide for the effective management of the drug abuse policies of the United States, it is hereby ordered as follows: Section 1. General Provisions. (a) Because the United States considers the operations of international criminal narcotics syndicates as a national security threat requiring an extraordinary and coordinated response by civilian and military agencies involved in national security, the Director of the Office of National Drug Control Policy (Director), in his role as the principal adviser to the National Security Council on national drug control policy (50 U.S.C. 402(f)), shall provide drug policy guidance and direction in the development of related national security programs.

(b) The Director shall provide oversight and direction for all international counternarcotics policy development and implementation, in coordination with other concerned Cabinet members, as appropriate. (c) An Interagency Working Group (IWG) on international counternarcotics policy, chaired by the Department of State, shall develop and ensure coordinated implementation of an international counternarcotics policy. The IWG shall report its activities and differences of views among agencies to the Director for review, mediation, and resolution with concerned Cabinet members, and if necessary, by the President. (d) A coordinator for drug interdiction shall be designated by the Director to ensure that assets dedicated by Federal drug program agencies for interdiction are sufficient and that their use is properly integrated and optimized. The coordinator shall ensure that interdiction efforts and priorities are consis­ tent with overall U.S. international counternarcotics policy. (e) The Director shall examine the number and structure of command/ control and drug intelligence centers operated by drug control program agencies involved in international counter-narcotics and suggest improvements to the current structure for consideration by the President and concerned members of the Cabinet. (f) The Director, utilizing the services of the Drugs and Crime Data Center and Department of Justice Clearinghouse, shall assist in coordinating and enhancing the dissemination of statistics and studies relating to anti-drug abuse policy. (g) The Director shall provide advice to agencies regarding ways to achieve efficiencies in spending and improvements to

Appendix  1097

interagency cooperation that could enhance the delivery of drug control treatment and prevention services to the public. The Director may request agencies to provide studies, information, and analyses in support of this order. Sec. 2. Goals, Direction, Duties and Responsibilities with Respect to the National Drug Control Program. (a) Budget Matters. (1) In addition to the budgetary authorities and responsibilities provided to the Director by statute, 21 U.S.C. 1502, for those agency budget requests that are not certified as adequate to implement the objectives of the National Drug Control Strategy, the Director shall include in such certifications initiatives or funding levels that would make such requests adequate. (2) The Director shall provide, by July 1 of each year, budget recommendations to the heads of departments and agencies with responsibilities under the National Drug Control Program. The recommendations shall apply to the second following fiscal year and address funding priorities developed in the annual National Drug Control Strategy. (b) Measurement of National Drug Control Strategy Outcomes. (1) The National Drug Control Strategy shall include long-range goals for reducing drug use and the consequences of drug use in the United States, including burdens on hospital emergency rooms, drug use among arrest­ ees, the extent of drug-related crime, high school dropout rates, the number of infants exposed annually to illicit drugs in utero, national drug abuse treatment capacity, and the annual national health care costs of drug use.

(2) The National Drug Control Strategy shall also include an assessment of the quality of techniques and instruments to measure current drug use and supply and demand reduction activities, and the adequacy of the coverage of existing national drug use instruments and techniques to measure the total illicit drug user population and groups at-risk for drug use. (3) The Director shall coordinate an effort among the relevant drug control program agencies to assess the quality, access, management, effectiveness, and standards of accountability of drug abuse treatment, prevention, education, and other demand reduction activities. (c) Provision of Reports. To the extent permitted by law, heads of departments and agencies with responsibilities under the National Drug Control Program shall make available to the Office of National Drug Control Policy, appropriate statistics, studies, and reports, pertaining to Federal drug abuse control. William J. Clinton The White House, November 16, 1993. Source: Federal Register, Vol. 58, No. 221, Thursday, November 18, 1993. http://www .archives.gov/federal-register/executive -orders/pdf/12880.pdf

Memorandum for Selected United States Attorneys (Medical Marijuana) (2009) In recent years, more states have passed laws (or voters have approved laws) that have made the use of medical and/or recreational marijuana legal. These laws vary from state to state in terms of the amount of drug that can be in a person’s possession, who

1098  Appendix

can buy it and under what circumstances, and other similar details. Even though the states may have legalized or decriminalized marijuana, these acts are still illegal under federal law. That means that these users may not be convicted of state offenses, but can be arrested and convicted under federal law. For many years, the federal government, and in particular the Drug Enforcement Administration, has raided marijuana growers and dispensaries in an effort to enforce federal laws. However, President Barack Obama has backed away from that policy. As a candidate for the presidency in 2008, candidate Obama promised that if he became president, he would not order federal raids against medical marijuana dispensaries. In 2009, shortly after he became president, the Deputy Attorney General, David Ogden, issued a memorandum to the 93 U.S. Attorneys. In the memo, he announced that it should not be a priority to prosecute individuals who use medical marijuana in a way that is compliant with state laws. He also said that the president was not going to spend resources to carry out raids on stateapproved dispensaries. However, he made it clear that marijuana use for non-medical reasons would not be allowed. This memo is printed below.

MEMORANDUM FOR SELECTED UNITED STATES ATTORNEYS FROM: David W. Ogden, Deputy Attorney General SUBJECT: Investigations and Prosecutions in States Authorizing the Medical Use of Marijuana This memorandum provides clarification and guidance to federal prosecutors in States that

have enacted laws authorizing the medical use of marijuana. These laws vary in their substantive provisions and in the extent of state regulatory oversight, both among the enacting States and among local jurisdictions within those States. Rather than developing different guidelines for every possible variant of state and local law, this memorandum provides uniform guidance to focus federal investigations and prosecutions in these States on core federal enforcement priorities. The Department of Justice is committed to the enforcement of the Controlled Substances Act in all States. Congress has determined that marijuana is a dangerous drug, and the illegal distribution and sale of marijuana is a serious crime and provides a significant source of revenue to large-scale criminal enterprises, gangs, and cartels. One timely example underscores the importance of our efforts to prosecute significant marijuana traffickers: marijuana distribution in the United States remains the single largest source of revenue for the Mexican cartels. The Department is also committed to making efficient and rational use of its limited investigative and prosecutorial resources. In general, United States Attorneys are vested with “plenary authority with regard to federal criminal matters” within their districts. USAM 9-2.001. In exercising this authority, United States Attorneys are “invested by statute and delegation from the Attorney General with the broadest discretion in the exercise of such authority.” Id. This authority should, of course, be exercised consistent with Department priorities and guidance. The prosecution of significant traffickers of illegal drugs, including marijuana, and the disruption of illegal drug manufacturing and trafficking networks continues to be a core priority in the Department’s efforts against

Appendix  1099

narcotics and dangerous drugs, and the Department’s investigative and prosecutorial resources should be directed towards these objectives. As a general matter, pursuit of these priorities should not focus federal resources in your States on individuals whose actions are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana. For example, prosecution of individuals with cancer or other serious illnesses who use marijuana as part of a recommended treatment regimen consistent with applicable state law, or those caregivers in clear and unambiguous compliance with existing state law who provide such individuals with marijuana, is unlikely to be an efficient use of limited federal resources. On the other hand, prosecution of commercial enterprises that unlawfully market and sell marijuana for profit continues to be an enforcement priority of the Department. To be sure, claims of compliance with state or local law may mask operations inconsistent with the terms, conditions, or purposes of those laws, and federal law enforcement should not be deterred by such assertions when otherwise pursuing the Department’s core enforcement priorities. Typically, when any of the following characteristics is present, the conduct will not be in clear and unambiguous compliance with applicable state law and may indicate illegal drug trafficking activity of potential federal interest: • unlawful possession or unlawful use of firearms; • violence; • sales to minors; • financial and marketing activities inconsistent with the terms, conditions, or purposes of state law, including evidence of money laundering activity and/ or financial gains or excessive amounts

of cash inconsistent with purported compliance with state or local law; • amounts of marijuana inconsistent with purported compliance with state or local law; • illegal possession or sale of other controlled substances; or • ties to other criminal enterprises. Of course, no State can authorize violations of federal law, and the list of factors above is not intended to describe exhaustively when a federal prosecution may be warranted. Accordingly, in prosecutions under the Controlled Substances Act, federal prosecutors are not expected to charge, prove, or otherwise establish any state law violations. Indeed, this memorandum does not alter in any way the Department’s authority to enforce federal law, including laws prohibiting the manufacture, production, distribution, possession, or use of marijuana on federal property. This guidance regarding resource allocation does not “legalize” marijuana or provide a legal defense to a violation of federal law, nor is it intended to create any privileges, benefits, or rights, substantive or procedural, enforceable by any individual, party or witness in any administrative, civil, or criminal matter. Nor does clear and unambiguous compliance with state law or the absence of one or all of the above factors create a legal defense to a violation of the Controlled Substances Act. Rather, this memorandum is intended solely as a guide to the exercise of investigative and prosecutorial discretion. Finally, nothing herein precludes investigation or prosecution where there is a reasonable basis to believe that compliance with state law is being invoked as a pretext for the production or distribution of marijuana for purposes not authorized by state law. Nor does this guidance preclude investigation or prosecution, even when there is clear and

1100  Appendix

unambiguous compliance with existing state law, in particular circumstances where investigation or prosecution otherwise serves important federal interests. Your offices should continue to review marijuana cases for prosecution on a case-bycase basis, consistent with the guidance on resource allocation and federal priorities set forth herein, the consideration of requests for federal assistance from state and local law enforcement authorities, and the Principles of Federal Prosecution. cc: All United States Attorneys Lanny A. Breuer Assistant Attorney General Criminal Division B. Todd Jones United States Attorney District of Minnesota Chair, Attorney General’s Advisory Committee Michele M. Leonhart Acting Administrator Drug Enforcement Administration H. Marshall Jarrett Director Executive Office for United States Attorneys Kevin L. Perkins Assistant Director Criminal Investigative Division Federal Bureau of Investigation Source: U.S. Department of Justice. http:// www.justice.gov/opa/documents /medical-marijuana.pdf

Cole Memorandum (Marijuana Dispensary Raids) (2011) When Barack Obama ran for president, he promised that, if he became president, he

would not order federal raids against medical marijuana dispensaries. In 2009, the deputy attorney general, David Ogden, issued a memo in which he informed U.S. attorneys that the president did not want to use resources to carry out raids on state-approved marijuana dispensaries. However, on October 7, 2011, federal prosecutors in California, which has legalized medical marijuana, announced efforts to crack down on dispensaries. Federal law enforcement agencies conducted raids on dispensaries, an act which clearly showed a commitment to enforcing the federal laws against marijuana possession and distribution. The memo, written in 2011, was authored by Deputy Attorney General James Cole. This memo gave the Justice Department the ability to enforce federal law, even in states where it was legal. The memo is below.

Cole Memo June 29, 2011 MEMORANDUM FOR UNITED STATES ATTORNEYS FROM: James M. Cole, Deputy Attorney General SUBJECT: Guidance Regarding the Ogden Memo in Jurisdictions Seeking to Authorize Marijuana for Medical Use Over the last several months some of you have requested the Department’s assistance in responding to inquiries from State and local governments seeking guidance about the Department’s position on enforcement of the Controlled Substances Act (CSA) in jurisdictions that have under consideration, or have implemented, legislation that would sanction and regulate the commercial cultivation and distribution of marijuana purportedly for medical use. Some of these

Appendix  1101

jurisdictions have considered approving the cultivation of large quantities of marijuana, or broadening the regulation and taxation of the substance. You may have seen letters responding to these inquiries by several United States Attorneys. Those letters are entirely consistent with the October 2009 memorandum issued by Deputy Attorney General David Ogden to federal prosecutors in States that have enacted laws authorizing the medical use of marijuana (the “Ogden Memo”). The Department of Justice is committed to the enforcement of the Controlled Substances Act in all States. Congress has determined that marijuana is a dangerous drug and that the illegal distribution and sale of marijuana is a serious crime that provides a significant source of revenue to large scale criminal enterprises, gangs, and cartels. The Ogden Memorandum provides guidance to you in deploying your resources to enforce the CSA as part of the exercise of the broad discretion you are given to address federal criminal matters within your districts. A number of states have enacted some form of legislation relating to the medical use of marijuana. Accordingly, the Ogden Memo reiterated to you that prosecution of significant traffickers of illegal drugs, including marijuana, remains a core priority, but advised that it is likely not an efficient use of federal resources to focus enforcement efforts on individuals with cancer or other serious illnesses who use marijuana as part of a recommended treatment regimen consistent with applicable state law, or their caregivers. The term “caregiver” as used in the memorandum meant just that: individuals providing care to individuals with cancer or other serious illnesses, not commercial operations cultivating, selling or distributing marijuana. The Department’s view of the efficient use of limited federal resources as articulated in the

Ogden Memorandum has not changed. There has, however, been an increase in the scope of commercial cultivation, sale, distribution and use of marijuana for purported medical purposes. For example, within the past 12 months, several jurisdictions have considered or enacted legislation to authorize multiple large-scale, privately-operated industrial marijuana cultivation centers. Some of these planned facilities have revenue projections of millions of dollars based on the planned cultivation of tens of thousands of cannabis plants. The Ogden Memorandum was never intended to shield such activities from federal enforcement action and prosecution, even where those activities purport to comply with state law. Persons who are in the business of cultivating, selling or distributing marijuana, and those who knowingly facilitate such activities, are in violation of the Controlled Substances Act, regardless of state law. Consistent with resource constraints and the discretion you may exercise in your district, such persons are subject to federal enforcement action, including potential prosecution. State laws or local ordinances are not a defense to civil or criminal enforcement of federal law with respect to such conduct, including enforcement of the CSA. Those who engage in transactions involving the proceeds of such activity may also be in violation of federal money laundering statutes and other federal financial laws. The Department of Justice is tasked with enforcing existing federal criminal laws in all states, and enforcement of the CSA has long been and remains a core priority. cc: Lanny A. Breuer Assistant Attorney General Criminal Division B. Todd Jones United States Attorney

1102  Appendix

District of Minnesota Chair, AGAC Michele M. Leonhart Administrator Drug Enforcement Administration H. Marshall Jarrett Director

Executive Office for United States Attorneys Kevin L. Perkins Assistant Director Criminal Investigative Division Federal Bureau of Investigations Source: U.S. Department of Justice. http:// www.justice.gov/oip/docs/dag-guidance -2011-for-medical-marijuana-use.pdf

Recommended Resources

Abbell, Michael. 2010. Extradition to and from the United States. Boston: Martinus Nijhoff Publishers.

Extradition of offenders, or moving of fugitives from one country to another to face criminal charges, can be legally complicated. While the United States has agreements with other countries to allow for extradition, some countries will not make that kind of agreement. This book describes the legal basis for extradition and the conditions under which it can occur.

alcohol, tobacco, and illicit drugs. Other chapters focus on drug use by youth, drug treatment, and drug trafficking. The final chapter revolves around anti­ drug efforts and their criticisms. Anderson, David, Susan Beckerleg, Degol Hailu, and Axel Klein. 2007. The Khat Controversy: Stimulating the Debate on Drugs. New York: Berg.

Khat is a drug that has been used in Africa for many years for its euphoric qualities. Today it is used as a mild stimulant as part of everyday life. The World Health Organization, however, has warned against the use of khat as potentially harmful. This debate is the center of this book.

Adler, Patricia A., Peter Adler, and Patrick O’Brien. 2012. Drugs and the American Dream. Malden, MA: John Wiley and Sons.

A collection of essays and readings on the sociological correlates of both licit and illicit drug use in the United States is presented in this book. Readers of this book will have more insight about the history of drug use, social correlates of drug use, drug lifestyles, and societal responses to drug use.

Babor, Thomas, Jonathan Caulkins, Griffith Edwards, Benedict Fischer, David Foxcroft, Keith Humphreys, Isidore Obot, Jurgen Rehm, Peter Reuter, Robin Room, Ingeborg Rossow, and John Strang. 2010. Drug Policy and the Public Good. New York: Oxford University Press.

Alters, Sandra M. 2012. Alcohol, Tobacco and Illicit Drugs. Detroit: Gale Cengage Learning.

This reference source provides general facts and data related to illicit drugs and drug use. Chapters in the book describe the use of, and patterns of use, regarding 1103

Drug abuse causes a significant burden to public health by causing disease, disability, and other social problems. Policy makers are interested to develop policies that will address these problems effectively. This book is written by international experts and scientists as a

1104   Recommended Resources

way to provide the scientific basis for antidrug policies that will work. Bancroft, Angus. 2009. Drugs, Intoxication and Society. Malden, MA: Polity.

The four main arguments in this book are: that the distinctions between categories of drugs, and between substances that are defined as drugs and those that are medicines, are arbitrary; that the experiences of intoxication are shaped by culture, environment, and the user; that the blame for the drug problems is often placed on the drugs and less on the individual and society; and that the definition of, and solutions to, the drug problem have been used to control and stigmatize the user. The book also explores the idea of the “pharmaceutical society” that develops medicines to treat medical conditions and created conditions for its medicines to treat. Barlow, Joy. 2010. Substance Misuse. Philadelphia: Jessica Kingsley Publishers.

This edited book provides professionals with current research on all aspects of substance misuse. The articles, by leading international contributors, provide essential information on long-term recovery, prevention, and workforce development. Issues surrounding how drug use affects children and families are explored. Barnard, Marina. 2007. Drug Addiction and Families. Philadelphia: Jessica Kingsley Publishers.

Drug use can have a profound impact on the user, but also on the user’s family. This book explores the experiences of families who are attempting to live with a family member’s drug problems. Bauder, Julia. 2008. Drug Trafficking. Detroit: Greenhaven Press.

This edited book includes many articles about drug trafficking that give answers

to the questions: Can drug trafficking be stopped? Are efforts to stop drug trafficking harming the United States? How does the War on Drugs affect Latin America? Are efforts to stop drug trafficking helping the war on terror? Different authors give diverse answers to these questions. Belenko, Steven R. 2000. Drugs and Drug Policy in America: A Documentary History. Westport, CT: Greenwood Press.

Belenko provides a review of the origins and development of American’s drug policies through 271 original documents. Through the documents, he shows that there is a periodic concentration on particular drugs (i.e., cocaine in the 1980s). Another theme is the tension between the medical model of controlling drugs and the punitive enforcement approach. A third theme is the shifts in drug policies that were impelled by political and media events instead of scientific knowledge. Finally, it is clear that the goals of the war on drugs have not been achieved. Benavie, Arthur. 2009. Drugs: America’s Holy War. New York: Routledge.

The economic costs of the War of Drugs is the subject matter of this text. The argument is presented that the antidrug policies in the United States are actually making social ills (i.e., murder, property crimes, AIDS, erosion of civil liberties, incarceration rates, corruption) worse. The author posits that an end to the War on Drugs would provide enormous benefits, domestically and internationally. Bewley-Taylor, David R. 2012. International Drug Control: Consensus Fractured. New York: Cambridge University Press.

The existing international control framework for controlling drugs is the topic of this book. While most members

Recommended Resources  1105

of the international community agree on many aspects of the drug control regime undertaken by the United Nations, there are diverging views on the nonmedical and nonscientific uses of controlled substances. The rationales and scenarios that can lead to moving the international community beyond the current framework are examined. Bickel, Warren K., and Richard J. DeGranpre. 1996. Drug Policy and Human Nature. New York: Plenum Press.

The formation of drug policy is analyzed in this book. The first section examines basic research in drug abuse, and the second focuses on changing drug use (i.e., treatment and prevention). The third section examines innovations in treatment services. The assumptions behind public policy and the social and cultural factors that influence drug policies are also sections included in the book. Brick, John. 2003. Handbook of the Medical Consequences of Drug Abuse. New York: Haworth Press.

The medicinal effects of drugs are provided by the author. The book begins with basic explanations of the effects of drugs, and then provides a detailed explanation of how these drugs affect the major organs of the body. Calahan, Joan B. 2013. Adult Drug Courts: Brief Overview and Assessments. New York: Nova Publishers.

Drug courts have become a popular diversion program to keep first-time, nonviolent drug offenders out of prison. Not only do they save money (since the offenders are not being held in a jail or prison), but they also ensure the offender gets treatment for their drug abuse. In the long run, it is hoped that the drug courts help in reducing repeat crimes

and recidivism. This book focuses on these issues. Carpenter, Ted Galen. 2003. Bad Neighbor Policy: Washington’s Futile War on Drugs in Latin America. New York: Palgrave Macmillan.

The author of this book provides an argument that the United States continues to put pressure on Latin American countries to reduce their production of drugs. The regions have been sprayed with chemicals that eradicate crops and harm the environment. This has a profound effect on the farmers in the region, who are already impoverished. All of this has resulted in government repression, civil unrest, and violence. Cass, Connie. 2003. “Candidates’ Past Pot Use No Big Deal: Dems Seeking Presidency Talk Frankly About Inhaling.” San Francisco Chronicle, November 29.

Candidates for the presidency are choosing to discuss past drug use, and it is not a big deal among voters anymore. Castiglioni, Sara, Ettore Zuccato, and Ro­ berto Fanelli. 2011. Illicit Drugs in the Environment. Hoboken, NJ: Wiley.

Research indicated that traces of illicit drugs were being found in the water in many cities, which can have a big impact on the health of the environment and the people living there. The list of drugs found in wastewater is quite lengthy. While chemicals from industrial or agricultural activities are contributing to this problem, pharmaceuticals are a recent addition. These issues are discussed in this book. Chastain, Zachary. 2013. Cocaine: The Rush to Destruction. Broomall, PA: Mason Crest.

Written for a younger reader, this book presents basic information about co-

1106   Recommended Resources

caine. It provides some of the history, chemical elements, and the effects and dangers of the drug. A short glossary of key terms is provided, along with sources for additional information. Chastain, Zachary. 2013. Tobacco: Through the Smoke Screen. Broomall, PA: Mason Crest.

The dangers of tobacco use are part of this book. Also included are the history of tobacco, the effects of using the drug on the body, and ways to stop smoking (or using tobacco). A glossary of important terms is included at the end for quick reference.

Many basic concepts are covered in this book about drugs. Some examples of topics are why people take drugs, the effects of drugs, dance/club drugs, the gateway hypothesis, drugs and crime, binge drinking, harm reduction, treatment, crop eradication, and drug courts. Durrant, Rossil, and Jo Thakker. 2003. Substance Use and Abuse: Cultural and Historical Perspectives. Thousand Oaks, CA: Sage.

The authors provide the reader with a multidisciplinary understanding of drug use that involves biological, psychological, cultural, and historical perspectives.

Chouvy, Pierre-Arnaud. 2010. Opium: Uncovering the Politics of the Poppy. Cambridge, MA: Harvard University Press.

Etingoff, Kim. 2013. Abusing Over-theCounter Drugs: Illicit Uses for Everyday Drugs. Broomall, PA: Mason Crest.

This book focuses on the forces behind illicit narcotics production in the Golden Triangle and Golden Crescent regions of Asia. The author provides an analysis of the historical, economic, and ecological forces behind the growth of the illicit drug production. He shows how and why the crop eradication policies of the United States and United Nations have failed, and will more than likely fail again in the future.

Abuse of over-the-counter drugs is becoming more common, and may become even more of a problem since they are legal purchases for most people. Etingoff describes these medications, who uses them, their dangers, and treatment options for those addicted.

Contreras, Randol. 2013. The Stick-up Kids: Race, Drugs, Violence and the American Dream. Berkeley: University of California Press.

The author provides an insider’s look at the Dominican drug robbers, known as “stickup kids” who are known to raid and torture drug dealers to rob them of their heroin and cash. It is a study in social forces that produce violent and selfdestructive people. Coomber, Ross, Karen McElrath, Fiona Measham, and Karenza Moore. 2013. Key Concepts in Drugs and Society. Los Angeles: Sage.

Faupel, Charles E., Greg S. Weaver, and Jay Corzine. 2014. The Sociology of American Drug Use. New York: Oxford University Press.

A sociological approach to drug use is presented in this text book. It begins with a history of drug use, followed by information on different drugs. The social correlates of drug use are described, including demographic, institutional, health, economic, and cultural correlates are included. Society’s responses, including preventive and therapeutic responses, are also part of the book. Finlator, John. 1973. The Drugged Nation: A “Narc’s” Story. New York: Simon and Schuster.

John Finlator was the head of the Bureau of Drug Abuse Control, and gives

Recommended Resources  1107

an “insider’s account” to the early days of the War on Drugs. Fisher, Gary L., and Thomas C. Harrison. 2009. Substance Abuse: Information for School Counselors, Social Workers, Therapists, and Counselors. Boston: Pearson.

This textbook on drugs and drug abuse provides a comprehensive description and analysis of the issues related to substance abuse. The different types of drugs are described, after which a comprehensive analysis of the role of the mental health professional in helping addicts and users is given. The book gives information about drug use by different ethnic and cultural groups, ethical issues related to treatment, assessing addiction, and treatment options. Fraser, Suzanne, and David Moore. 2011. The Drug Effect: Health, Crime and Society. New York: Cambridge University Press.

This author has compiled material from experts who explore the social and cultural meanings of drug use. The book also addresses key questions of drug use and addiction through interdisciplinary perspectives. Friedman, Lauri S. 2012. Drug Abuse. Detroit: Greenhaven Press.

This book is a collection of essays by experts in the field of drug abuse to address different perspectives of the problem. Some address the question if drug abuse is a problem, and others focus on if marijuana should be decriminalized. The question of how society should respond to the problem of drug abuse is also in the book. Frydl, Kathleen J. 2013. The Drug Wars in America. New York: Cambridge University Press.

In this book, Frydl argues that the U.S. War on Drugs was not an organized

effort to reduce drug use in the United States, but instead was a way to advance other state agendas such as policing inner cities or exercising power abroad. In the end, the War on Drugs only serves to drain government resources and degrade the American justice system. Gahlinger, Paul M. 2004. Illegal Drugs: A Complete Guide to their History, Chemistry, Use and Abuse. New York: Plume.

A comprehensive reference book that provides information on every drug currently prohibited under federal law. For each drug, the author provides the history of the drug, chemical properties, effects, possible medical uses, recreational uses, and potential side effects. Glendinning, Chellis. 2005. Chiva: A Village Takes on the Global Heroin Trade. Gabriola Island, BC: New Society Publishers.

Chiva is a street name for heroin, and is the topic of this book. The author describes the global trade in chiva and its effects, particularly on a small town in New Mexico that has been truly affected by the drug trade. Gossop, Michael. 2013. Living with Drugs. Burlington, VT: Ashgate Publishing.

Drugs are with us to stay, and campaigns to rid the world of drugs are futile. That means that we have to learn to live with drugs. Topics in this book include why people take drugs, the ways in which people take drugs, and the effects of taking drugs. It is a balanced examination of everyday drug use, from caffeine and nicotine to the more hazardous drugs such as hallucinogens. The risks associated with these drugs are assessed, as compared to the popular acceptance of drugs. Gray, James P. 2012. Why Our Drug Laws Have Failed and What We Can Do about

1108   Recommended Resources It. Philadelphia: Temple University Press.

Written by a former trial judge and federal prosecutor, the book argues that drug prohibition in the United States is one of the country’s biggest failures. The author presents information about drug-related crimes, increasing incarceration rates, and explores experiments in drug medicalization, regulation, and control. Henderson, Harry. 2005. Drug Abuse. New York: Facts on File.

This is a reference book that provides general information about drugs, drug use, and drug policy in the United States. It provides information about the laws that regulate drugs, a chronology listing important dates in the drug scene, and summary information about the organizations and agencies that are involved in drug abuse research, education, prevention, and treatment programs, along with drug policy advocacy. Hughes, Rhidian, Rachel Lart, and Paul Higate. 2006. Drugs: Policy and Politics. Maidenhead, UK: Open University Press.

In this edited book, different policies involving drugs are analyzed. Articles on social exclusion, gender, young people, harm, and health are all part of the book. Husak, Douglas N. 2002. Legalize This! The Case for Decriminalizing Drugs. London: Verso.

The current laws that criminalize drug use cause a half a million to be imprisoned, which costs millions of dollars, more than is spent on education. Current drug policies lead to personal suffering, corruption, and contempt for the law. The reasons for decriminalizing drugs are presented and discussed in this book.

Inciardi, James, Duane C. McBride, and James E. Rivers. 1996. Drug Control and the Courts. Thousand Oaks, CA: Sage.

The authors provide a history of drug policy in the United States, as well as the current status of drug control programs. They note a growing need for HIV and AIDS screening for offenders. They also describe the effectiveness of compulsory and coerced drug treatment programs. Isralowitz, Richard E., and Peter L. Myers. 2011. Illicit Drugs. Santa Barbara, CA: Greenwood.

These authors provide an international perspective of the drug trade. Primary documents and reference information is also provided to the reader. Jonnes, Jill 1999. Hep-Cats, Narcs, and Pipe Dreams: A History of America’s Romance with Illegal Drugs. Baltimore: Johns Hopkins University Press.

At one time in the United States, morphine and cocaine were legally sold and routinely used for even minor ailments. But this changed when the government made many drugs illegal. Over time, different groups have been associated with different drugs, such as jazz musicians or 1960s flower children. Many people have played key roles in the development of drugs, or drug laws. The events and people who were part of the drug history of the United States are described in this book. Kleiman, Mark A. R., Jonathan P. Caulkins, and Angela Hawken. 2011. Drugs and Drug Policy: What Everyone Needs to Know. New York: Oxford University Press.

The authors in this book describe the pharmacology, economics, and politics of drugs and drug policy. They explore

Recommended Resources  1109

the benefits and relationships to diseases, crime, and terrorism. Many common questions about drugs and drug policy are answered, and many myths explored. Leary, Timothy. 1997. Flashbacks: A Personal and Cultural History of an Era: An Autobiography. New York: J. P. Tarcher.

This is a personal account of Leary’s experiences as a rogue psychologist, psychedelic guru, and spiritual explorer. Leary, Timothy, and Beverly Potter. 2000. Change Your Brain. Berkeley, CA: Ronin Publishing.

Leary and Potter describe Leary’s early research on psychedelics in the 1950s and 1960s. Information on Leary’s perspective on drugs and their relationship to behavior, creativity, and spirituality is provided. Levinthal, Charles F. 2012. Drugs, Behavior and Modern Society. Boston: Allyn and Bacon.

An introductory text on drug use and abuse, this book covers basic information about the topic. It begins by describing the history of drug use, followed by patterns of drug use, the effects drugs have on the body, and the drugs classes (stimulants, narcotics, hallucinogens, marijuana, alcohol, nicotine, caffeine, steroids, and depressants). Focus is also put on preventing substance abuse and treatment for abuse. Marez, Curtis. 2004. Drug Wars: The Political Economy of Narcotics. Minneapolis: University of Minnesota Press.

Marez uses historical writings, graphic works, films, and music about drugs that both demonize and celebrate the drug trade. He states that mass media and popular culture helped to construct the War on Drugs and the public’s percep-

tion of it. Moreover, the way the War on Drugs is represented is made more complex by the participation of capitalists, who expect to make a profit from the drug trade (i.e., chemical companies and the prison industry). Marion, Nancy E. 2013. The Medical Marijuana Maze: Policy and Politics. Durham, NC: Carolina Academic Press.

While medical marijuana remains illegal federally through the Controlled Substances Act, many states are choosing to allow medical use of the drug for patients suffering from debilitating diseases. This book describes the current status of medical marijuana in states and federally. In addition, the involvement of the executives (state and federal), interest groups, bureaucracies, and the media are discussed. McKenna, Cailin R. 2007. Trends in Substance Abuse Research. New York: Nova Science Publishers.

This edited series of essays and papers provides a collection of research related to drugs: the health effects, the treatment, and drug oversight. Overall, they are research studies that advance the knowledge of those who work in the field of substance abuse or study it in some way. Meyer, Stephen. 2014. Alcohol, Tobacco and Illicit Drugs. Detroit: Gale Cengage Learning.

This reference source provides facts and data about illicit drugs and drug use. There are chapters on the use of, and patterns of use, regarding alcohol, tobacco, and illicit drugs. Other chapters focus on drug use by youth, drug treatment, and drug trafficking. The final chapter revolves around antidrug efforts and their criticisms.

1110   Recommended Resources Miller, Malinda. 2013. Ecstasy: Dangerous Euphoria. Broomall, PA: Mason Crest.

This book focuses on the drug called Ecstasy. It takes into account the drug’s history, its effects, and legal consequences. Treatment options for those addicted to Ecstasy is incorporated. National Research Council. 2010. Understanding the Demand for Illegal Drugs. Washington, DC: National Academies Press.

The National Institute of Justice asked the National Research Council to study the current research on the demand for illicit drugs. The findings revolve around the drug markets, prevention and treatment, available data and research, and indicator systems. Some of the recommendations of the committee indicate the need for longitudinal research, an evaluation of treatment diversion programs, continued analysis of treatment programs, and demonstration projects. Nelson, Sheila. 2013. Hallucinogens: Unreal Visions. Broomall, PA: Mason Crest.

This book is an easy-to-read text about hallucinogens. The author provides facts about the drugs, their history, and the dangers of using hallucinogens. A glossary of key terms is included for more information. Perl, Raphael. 2003. Drug Control: International Policy and Approaches. Washington, DC: Congressional Research Service.

General information pertaining to opi­ oids is the content of this book. The author provides basic information about opioids: their history, effects, dangers, and treatment. A glossary is also provided for key terms related to opioids. Sanna, E. J. 2013. Marijuana: Mind-Altering Weed. Broomall, PA: Mason Crest.

This book begins with describing marijuana, and the effects it has on those who use it. The dangers of using the drug are described, and the consequences of use. There is also a discussion of possible modes of treatment for those addicted to it. Sharp, Elaine B. 1994. The Dilemma of Drug Policy in the United States. New York: HarperCollins.

The history of the U.S. federal drug policy is the focus of this book. Beginning with Nixon’s War on Drugs, this book describes President Carter’s approach to drugs, followed by current drug policies. Policies regarding drug treatment and drug abuse prevention are also part of this book. Steinberg, Michael K., Joseph J. Hobbs, and Kent Mathewson. 2004. Dangerous Harvest: Drug Plants and the Transformation of Indigenous Landscapes. New York: Oxford University Press.

The demand for drugs has transformed many indigenous cultures and their landscapes. The global drug trade has degraded many environments. This book presents case studies from various cultural landscapes that are central to the worldwide drug trade.

An overview of U.S. policies toward narcotics-producing nations regarding crop eradication programs, interdiction, law enforcement, international cooperation, and economic assistance.

Walker, Ida. 2013. Addiction in America: Society, Psychology, and Heredity. Broo­ mall, PA: Mason Crest.

Sanna, E. J. 2013. Heroin and Other Opioids: Poppies’ Perilous Children. Broomall, PA: Mason Crest.

Addiction to drugs is the topic of this book. This included the psychology of addiction, and heredity and addiction.

Recommended Resources  1111

Other topics are the effects of addiction on society and treatment for addiction. Walker, Ida. 2013. Alcohol Addiction: Not Worth the Buzz. Broomall, PA: Mason Crest.

Alcohol use and abuse is common in the United States, probably because it is legal. Walker provides information about alcohol, including its history, the effects on the body, and treatment of alcoholism. Information on teenagers’ use of alcohol is added. Walker, Ida. 2013. Painkillers: Prescription Dependency. Broomall, PA: Mason Crest.

Many Americans suffer with pain every day and take medicine to relieve it. This book discusses painkillers, as well as the abuse of these medicines. OxyContin, a drug that is often abused, is part of this book. Finally, a description of treatment options for those addicted is included. Walker, Ida. 2013. Sedatives and Hypnotics: Deadly Downers. Broomall, PA: Mason Crest.

Basic information about sedatives and hypnotics is provided to the reader in this book. The author discusses what sedatives and hypnotics are, how they

work, effects of the drugs, and misuse of the drugs. A glossary of important terms is provided along with a section for those who want more information on the topic. Watkins, Christine. 2013. Club Drugs. Detroit: Greenhaven Press.

This book by Watkins is a collection of essays that describe different aspects of club drugs—their harm, date rape drugs, ketamine, and the law enforcement community’s response. Two new drugs, spice and bath salts, are included as well. Yates, Rowdy, and Margaret S. Malloch. 2010. Tackling Addiction: Pathways to Recovery. Philadelphia: Jessica Kingsley Publishers.

Treating those who have become addicted to drugs is difficult, because there is no simple way to help them. More attention is being given to “recovery,” the process by which an individual moves from using drugs to being drug-free. This book is a compilation of essays by researchers and practitioners in the fields of health, addiction, and criminal justice that tackle some concepts related to addiction and treatment.

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About the Editors and Contributors

Editors Nancy E. Marion is a professor of political science at the University of Akron, Akron, Ohio. She holds a Master’s and PhD in political science from the State University of New York– Binghamton, and has taught criminal justice for over 20 years. She is author and co-author of numerous books on the interaction of politics and criminal justice, including the co-authored book Killing the President: Assassinations, Attempts, and Rumored Attempts on U.S. Commanders-in-Chief (ABC-CLIO, 2010). Willard M. Oliver is a professor of criminal justice in the Department of Criminal Justice at Sam Houston State University, Huntsville, Texas. He holds a Master’s and PhD in political science from West Virginia University, and has taught criminal justice for 20 years. He is author and co-author of numerous books on policing, criminal justice, and policy, including the co-authored book Killing the President: Assassinations, Attempts, and Rumored Attempts on U.S. Commanders-in-Chief (ABC-CLIO, 2010). His areas of research include policing, criminal justice policy, and the history of crime and criminal justice.

Contributors John H. Barnhill, is an independent scholar in Houston. Kimberly Bellon, BSW, is a clinical research assistant at Santa Clara Valley Medical Center’s Rehabilitation Research Center in San Jose, California. She is a certified brain injury specialist and has given numerous presentations on outcomes following traumatic brain injury and spinal cord injury. Ron Chepesiuk is an award-winning author of 25 books and more than 4,000 magazine, newspaper, and Internet articles. A Fulbright Scholar and an instructor in the Journalism Department of UCLA’s Extension Division, he has appeared on several national television programs to talk about gangsters and organized crime. Jacob A. Cunningham, MA, teaches history at Hebrew Union College-Jewish Institute of Religion, Los Angeles, CA. He studied at the University of California, Santa Cruz, and did his graduate work at the University of California, Los Angeles. 1113

1114   About the Editors and Contributors

Laura L. Finley earned her PhD in sociology from Western Michigan University in 2002. She is assistant professor of sociology and criminology at Barry University in Miami Shores, Florida. Dr. Finley is the author/coauthor/editor of 11 books and numerous book chapters and journal articles, including the Encyclopedia of Domestic Violence (Greenwood, 2013). She is actively involved in serving domestic violence victims and in raising awareness about abuse. Joshua B. Hill, PhD, is an assistant professor of Criminal Justice and Security Studies at Tiffin University in Tiffin, Ohio. He has written extensively on terrorism, the politics of criminal justice, and research methods. His most current research focuses on cybercrime and the presidency. Melanie Lowe Hoffman is a program coordinator at the Center on Violence against Women and Children at Rutgers University School of Social Work. Melanie has a master’s in public administration from the Robert F. Wagner School of Public Service at NYU. Kathryn H. Hollen is a science writer who has worked extensively with the National Institutes of Health, especially the National Cancer Institute, as well as many other organizations devoted to the life sciences. Hua-Lun Huang, PhD, is associate professor of sociology at University of Louisiana at Lafayette. Richard E. Isralowitz, PhD, is professor and director of the Regional Alcohol and Drug Abuse Resources Center at Ben Gurion University. Isralowitz is author of numerous books and publications on drug use and abuse; he is a Fulbright Scholar and a Distinguished International Scientist with the National Institute on Drug Abuse. Robert J. Kelly is Broeklundian Professor Emeritus at Brooklyn College and the Graduate School of the City University of New York. He served on the Manhattan Terrorism Task Force after 9/11 and consulted with the Department of Homeland Security (Northeast Region) and the National Institute of Justice on Terrorism and Organized Crime; he also teaches a seminar at the United Nations in the Permanent Delegate Seminar on Nationalism. Kelly has published numerous articles and books on terrorism, organized crime, and social distress. Stephanie A. Kolakowsky-Hayner, PhD, CBIST, is the director of rehabilitation research at the Santa Clara Valley Medical Center in San Jose, California. Dr. Kolakowsky-Hayner holds an appointment as a clinical assistant professor affiliated in the Department of Orthopaedic Surgery, Stanford University School of Medicine, and is also a member of the Brain Injury Association of California Board of Directors, the Academy of Certified Brain Injury Specialists Board of Governors, the Bay Area Brain Injury Task Force, and the American Spinal Injury Association Prevention Committee. Stacy O’Hara Leiter is a graduate student in International Politics at the University of Akron. Her primary research interests revolve around democratization, political institutions, and political behavior.

About the Editors and Contributors  1115

Jesse L. Maghan, professor and director of the Forum for Comparative Correction, is a specialist in justice operations and organizational development with a specific focus on incarcerated radicals and intelligence-led penology. He has an extensive background in corrections and police operations internationally. Along with Robert J. Kelly, Dr. Maghan is co-editor of Hate Crime: The Global Politics of Polarization, published by Southern Illinois University Press (1998). He served as the first director of training for the New York City Police Department and commissioner for training, New York City Department of Correction. Anthony J. Marion is an aspiring author and fiction writer. His primary academic pursuits are in economics; he also has an affinity for sports of all kinds. Jacob A. Marion is a student at the University of Akron. His academic interests are in music. Wendy L. Martinek, PhD., is associate professor of political science at Binghamton University–State University of New York, Binghamton, New York. She specializes in the study of judicial politics, with a particular interest in the judicial selection politics at the federal level and decision making in both the United States Courts of Appeals and state courts of last resort. David E. Newton holds a BA in chemistry, an MA in education from the University of Michigan, and an EdD in science education from Harvard University. He is the author of more than 400 textbooks, encyclopedias, resource books, research manuals, laboratory manuals, trade books, and other educational materials. He taught mathematics, chemistry, and physical science in Grand Rapids, Michigan, for 13 years; was professor of chemistry and physics at Salem State College in Massachusetts for 15 years; and was adjunct professor in the College of Professional Studies at the University of San Francisco for 10 years. His most recent book for ABC-CLIO was DNA Steroids and Doping in Sports: A Reference Handbook (2013). Howard Padwa, PhD, works as a researcher in Los Angeles. He studied at the University of Delaware, the London School of Economics, and L’Ecole des Hautes Etudes en Sciences Sociales in Paris before earning his PhD at the University of California, Los Angeles. Lindsay Powley is a graduate student in Security Studies at the University of Akron, where she studied Political Science and French. Her primary interest is understanding the way culture, history, and politics interact. Alexandra Redcay is a consultant trainer and guest lecturer at Rutgers University in New Brunswick, New Jersey. She has over 17 years of direct practice, management, research, and training experience working in child welfare, juvenile justice, and the education systems. She is particularly interested in measurement design and LGBTQ youth issues. Brady Root is pursuing a graduate degree at the Rutgers University School of Social Work. She has studied and worked in the field of violence prevention for five years and is currently the prevention education assistant for the Office for Violence Prevention and Victim Assistance at Rutgers University.

1116   About the Editors and Contributors

Joseph D. Serio was the only American to work in the Organized Crime Control Department of the Ministry of Internal Affairs of the USSR (1990–1991). Spending a total of seven years in the former Soviet Union, he was a consultant to the international corporate investigative and business intelligence firm, Kroll Associates. He became the director of its Moscow office for Times, the Washington Post, and other media outlets. In addition to his experience in the former Soviet Union, he has studied criminal justice issues at police academies in China, Poland, Spain, and England. He is currently editor-in-chief of Crime and Justice International, published by the Office of International Criminal Justice, and co-coordinator of the U.S. Department of State’s International Law Enforcement Academy in Roswell, New Mexico. Adam Stilgenbauer graduated from Walsh University with degrees in government and foreign affairs, and philosophy. He is currently working on his master’s degree in Public Administration at the University of Akron, where he is interested in public policy and nonprofits. James A. Swartz, PhD, is an associate professor in the Jane Addams College of Social Work at the University of Illinois at Chicago where he has taught on mental health policy including drug policy, research and statistics, and program evaluation for the past 10 years. He earned his doctorate in clinical psychology in 1990 from the Northwestern University Medical School, Department of Psychiatry and Medical Sciences. Jeffrey A. Walsh, Ph.D., is an associate professor of criminal justice at Illinois State University, Normal, Illinois. He teaches courses in Juvenile Justice and studies predatory crimes and community structural correlates of crime. Steven Harmon Wilson is associate dean of liberal arts at Tulsa Community College’s Metro Campus. From 2003 to 2006 he was associate professor of history at Prairie View A&M University in Texas. Wilson received his MA and PhD in history from Rice University, where he focused on American legal and constitutional history. He previously earned a BS in electrical engineering at Rice and, before becoming a historian, worked at the National Security Agency and at NASA. Elizabeth A. Winter, PhD, LSW, is a faculty member in the Child Welfare Education and Research Programs in the School of Social Work at the University of Pittsburgh. Her interests include child maltreatment, addiction, traumatic stress, child welfare–involved sexual minority youth, and child welfare workforce development. She has provided clinical services since 1998. Sharon Zucker is the prevention education coordinator at the Rutgers University Office for Violence Prevention and Victim Assistance. She holds an MPA with a certificate in domestic violence studies, and helped develop the SCREAMing to Prevent Violence curriculum for SCREAM Theater.

Index

*Page numbers in bold indicate main entries. Abortion, 69, 400 Above & Beyond, 362 Above the Influence (ATI) Campaign, 662 Abraham, Murray, 813 Abrego, Juan Garcia, 450–451 Abscam investigation, 620 Acamprosate, 35, 903 Access to Recovery Program, 669 Accommodation Program, 830 Acetaminophen (Tylenol), 61, 718 Acetophenazie, 774 Acetylcholine, 674, 676–677, 859 Acid, 85 Acid Test festivals (San Francisco), 434 Actifed, 718 Acupuncture, 904 Acushnet, 655–656 Acute intoxication, 508 Acute pain, 61 Adam, Samuel Hopkins, 779 Adams, John, 158 Adderall, 166, 816 Addiction, 1–6, 54, 249, 275, 296, 892– 893; alternative treatments for, 49–51; behavioral, 1, 2–3, 8, 100–103; cross, 236–237; disease model of, 256–257; growth of, lxvii; Internet, 100; liability in, 7; medications, 7–11; to morphine, 616–617; multisubstance, 236; opiate, 7, 240, 257–258, 278, 706, 860; to opiates, 7, 240, 258, 278, 706, 860; physical,

1; polysubstance, 236; psychological, 1; public policies and, 275–279; rage, 100; relationship, 201; sexual, 101; Shakespeare on, xxxix; substance, 859– 864; theories of, 891–894; treatment for, 902–907; vaccines, 7–8, 9 Addiction Research Center (ARC), 651, 743, 776 Addiction Severity Index, 903 Addictive personality, 11–13 Addictive voice recognition technique (AVRT), 50 Adipex, 849 Adolescents: alcoholism and, 42, 43; as drivers, 347–348; drug use and, 612, 977–981; gateway drugs and, 429–432; tobacco use by, 13–16, 612 Adulterants, 306 Advisory Commission on Drug Addiction, 211 Advisory Commission on Narcotic and Drug Abuse (1963), 16–17, 749–750 Advisory Committee on the Traffic on Opium and Other Dangerous Drugs, 915 Aerosols, 287, 501 Affordable Care Act, 697 Afghanistan: illegal drug trade in, 438–439; U.S. invasion of, lxxxiv African Americans: alcoholism and, 43; crack cocaine and, 196; drug use and, 17–20 1117

1118  Index

Agonists, 903 Agriculture, U.S. Department of (USDA), growth of marijuana, lviii AIDS, 158, 213, 320, 327, 328, 489–491, 590, 652, 891. See also HIV Air America, 160, 167 Akron Oxford Group, 828 Al-Anon, lxvi, 20–22, 30, 41, 172 Al-Anon Family Groups, 21, 23, 24 Alateen, lxvii, 22–24, 30, 41, 172 Albin, Peter, 522 Alcohol, xxv, xxxi, 327; as addictive, 7, 860; American Medical Association (AMA) on, lvii; associated diseases and, xlv; banning sale of, to Native Americans, lii; biblical references to, xxxvii; bootlegging and smuggling and, 24–27; denatured, lx; dependence on, 34; as depressant, 250; as disease, xliv; domestic abuse and, 259–262; early cure for, xxxviii; as hard drug, 466; interactions with prescribed medications, 819–820; for medicinal purposes, lix; military control of, lvii; mutual aid societies for, 28–30; physical violence and, 260–261; politics of, xlii; as predatory drug, 744–745; pregnancy and, 965; prohibition and, xlvi; raves and, 254; sexual assaults and, 31, 37–39, 335; studies using, 676; to subdue victims, 30–32; testing for, 310; withdrawal from, 590, 961 Alcohol, Drug Abuse, and Mental Health Administration, 650, 854 Alcohol, Drug Abuse, and Mental Health Reorganization Act (ADAMHA) (1992), 27–28 Alcohol and Drug Abuse Education Act Amendments (1974), 421 Alcohol and Tobacco Tax and Trade Bureau, 131 Alcohol Awareness Month, 642 Alcoholics, children of, 170–173 Alcoholics Anonymous (AA), xxxiv, lxii, 4, 5, 20, 22, 23, 28, 29, 30, 35, 39–42, 49, 113, 197, 257, 516, 607, 632, 640,

649, 679, 792, 793, 827, 862, 869, 905, 909–911, 960–961 Alcoholism, lxii, lxviii, 3, 42–47, 84, 85, 516 Alcohol Program, 164 Alcohol-related birth defects (ARBD), 404, 405, 407–408 Alcohol-Related Neurodevelopmental Disorder (ARND), 407 Alcohol Tax Unit, 390 Alcohol use, xxxvii, xxxviii, 32–37, 84, 265, 612, 855–856; female, 396–399; significant events in, through history, xxxvii–lxxxvii Aleve, 718 Alexander, Karen, 89 Alfano, 734 Alice in Chains (music group), 887, 888 Alito, Samuel, 413 All Addictions Anonymous, 197 Allende, Salvador, 191, 585 Alliance for Cannabis Therapeutics, 785 Alpazolam, 242 Alpert, Richard (Ram Dass), lxviii, 47–49 Alpha-endorphin, 675 Alpha-ethyltryptamine, 770 Alpha-methyltryptamine, 462 Alprazolam, 774, 816, 820, 901 Al Qaeda, 315, 883, 951 Alternative activities, 162 Alternative addiction treatment, 49–51 Alternative crop programs, 196 Alternative development, 235 Alternatives, 755–756 Alvarez, Raul Lopez, 154 Alvarez-Machain, Humberto, 155, 156 Alzheimer’s disease, 590 Ambien (zolpidem), 92, 748, 774 Ambrose, Miles J., 699 American Academy of Addictionology, 54 American Academy of Family Physicians, 591 American Academy of Pain Medicine, 860 American Alliance for Medical Cannabis, 159

Index  1119

American Association for the Cure of Inebriates, 52 American Association for the Cure of Inebriety (AACI), xlviii, xlix, l American Association for the Study and Cure of Inebriety (AASCI), 1, 51–53 American Association of Advertising Agencies, 723 American Association of Public Health Physicians, 355 American Bar Association, 208; Committee on Narcotics, 126 American Beverage Association (ABA), 366 American Cancer Society, 679, 824, 830, 897 American Civil Liberties Union (ACLU), 81, 221, 803 American College of Physicians, 591 American Council on Alcohol Problems, 75 American Federation of Labor, liii American Heart Society, 897 American Indian/Alaska Native (AI/AN), 663–670 American Indian Religious Freedom Act Amendment (AIRFA) (1994), 462 American Legacy Foundation, 579 American Lung Association, 399, 681 American Medical Association (AMA), xlvi, lvii, lxii, lxvi, lxx, 35, 52, 54, 126, 208, 591, 627, 649 American Medical Society for the Study of Alcohol and Other Narcotics, 53 American Medical Temperance Association (AMTA), 53 American Pain Society, 860 American Pharmaceutical Association, xlvi, lii American Philosophical Society, 810 American Psychiatric Association, 249, 429, 568–569, 649, 962 American Public Health Association, 208, 649, 672 Americans for Non-Smokers’ Rights, 829 Americans for Safe Access, 159, 590

American Social Hygiene Association, 211, 212 American Society for the Promotion of Temperance, xlv, 56 American Society of Addiction Medicine (ASAM), 54–55, 860 Americans with Disabilities Act (1990) (ADA), 785–786 American Temperance Society (ATS), 56–58 American Temperance Union, 57 American Tobacco Company, 224 American Tract Society, 56 Amezcua Contrera organization, 284, 523 Amino acids, 674, 676–677 Amitriptyline, 773 Ammonia, 180, 817 Amobarbital, 774, 816, 818 Amoxapine, 773 Amphetamines, xxxi, xxxiii, 58–60, 327; as controlled drug, 217; effects of, 98; as hard drug, 466; male ejaculation and, 840; pregnancy and, 967; prevalence of, 270; as stimulant, 816, 848; studies using, 676; synthesization of, l; testing for, 309, 310, 940, 941; trade and trafficking of, 317; use and abuse of, 16, 84, 359; withdrawal from, 961 Amytal, 92, 330, 774 Anabolic-androgenic steroids (AAS), 430, 841, 843–846 Anabolic Steroid Control Act (1990), lxxxii Anabolic Steroid Control Act (2004), 842 Anabolic steroids, 285, 286, 816, 859–860 Anadrol anabolic steroid, 843 Analgesics, 60–63, 718 Anastas, Robert, 851 Andean Counterdrug Initiative (2001), xxix, 64 Andean Strategy, 138–139 Andean Trade Preference Act (1991), 63–65, 139 Andean Trade Promotion and Drug Eradication Act (ATPDEA), 64 Androstenedione, 843 Angel dust, 871

1120  Index

Anhedonia, 674 Anileridine, 707 Animal House (movie), 103–104 Animals (music group), 479 Annan, Kofi, lxxxiv, 436 Anomie Theory, 893 Anorectic drugs, 848 Anorexia, xxxiii, 590 Anslinger, Harry J., lxiii, 65–68, 125, 241, 270, 291, 394–396, 433, 497, 514, 539, 569, 624, 692, 740, 742, 908 Antabuse. See Disulfiram (Antabuse) Antagonists, 10, 903 Anthony, Susan B., xlvi Anti-alcohol education, I, liii Antianxiety drugs, 4, 967 Anticonvulsants, 92 Antidepressants, 2, 8–9, 61–62, 68–70, 675, 967 Anti-Drug Abuse Act (1986), xxviii, lxxx, 71, 73, 110, 235, 308–309, 312, 336, 343, 379, 652, 788, 821, 1029–1041 Anti-Drug Abuse Act (1988), xxviii, lxxx, 72–73, 106, 291, 483, 700, 701–702, 788, 839, 1041–1090 Anti-Drug Abuse Acts, 71–73, 229, 303, 951 Anti-Drug Enforcement Act, 337 Antimanics, 774 Anti-Meth Campaign, 662 Antipsychotics, 774, 967 Antipyretics, 718 Anti-Saloon League (ASL), li, lvii, 66, 73– 75, 762, 764, 765, 766–767, 798, 838, 881, 948, 953, 964 Antismoking efforts, 899 Anxiety, 76 Anxiety disorders, 3, 76–77 Anxiolytics, 4, 329–330, 818–819, 901, 961 Appearance- and performance-enhancing drugs (APEDs), 430 Appetite suppressants, 848 Arbuckle, John, xlvii Areca nut, 455 Arellano, Luis Fernando Sanchez, 895, 896 Arellano Felix, Alicia, 895

Arellano Felix, Benjamin, 894, 895 Arellano Felix, Eduardo, 895 Arellano Felix, Enedina, 895 Arellano Felix, Francisco Rafael, 895 Arellano Felix, Ramon, 894, 895 Arellano Felix Cartel, 116, 315, 448, 523, 604, 833, 894, 895 Argas, Virgil Banco, 377 Arias, Amulfo, 689–690 Arizona Investigative Support Center, 485 Armed Career Criminal Act, 382 Arms trafficking, 453 Armstrong, Lance, 77–80, 520, 738 Armstrong, Lance, Foundation, 79 Arrestee Drug Use Monitoring (ADAM) Program, 330–332 Arsenic, 180 Aschenbrandt, Theodor, xlix, 424–425 Ashbury, Munroe, 460 Ashcroft, John, 783 Asian drug trade, 325, 440–441 ASPIRA, 662 Aspirin, 60, 718, 870 Asset forfeiture, xxx, lxxv–lxxvi, 80–82, 294, 349, 350 Asset Forfeiture Amendments Act (1986), 338 Association Against the Prohibition Amendment (AAPA), 82–84, 949, 971 Association for Non-Smokers’ Rights, 829 Association of American Railroads, 826 Atarax, 774 Athletes for Hope, 79 Ativan, 330, 816, 818 Atkinson, Leslie “Ike,” 564 Austin, Richard Lyle, 80 Authors, drug use and, 84–86 Aviation Drug-Trafficking Control Act (1984), lxxviii, 86–87 Avila, Jaime, 386 Ayala, Jorge “Rivi,” 118, 119 Aykroyd, Dan, 104 Baba, Neem Karoli, 47, 48 Babylonian Talmud, xxxviii Bacon, Kevin, 492

Index  1121

Badalamenti, 734 Bad Boys, 89–91 Bad Boys II, 89 Bad Boys III, 89 Baeyer, Adolf von, xlvii, 91, 818 Bagley, Bruce, 139 Bail Reform Act (1984), 788 Baker, Chet, 370, 542, 742 Bales, Susan Ford, 109 Ballester, Pierre, 78 Ballesteros, Juan Ramon Matta, 377 Balloon effects, 322 Barbados, rum use in, xli Barbiturates, xxxi, xxxii, 91–93; as addictive, 7, 860; as controlled substance, 217, 918; as depressant, 250, 251; examples of, 818; first, xlvii; prevalence of, 270; restrictions on, lxxii; testing for, 310, 940; toxicity of, 819; in United Kingdom, lxx; use and abuse of, 16, 330, 359 Barbituric acid, 818 Barietta, Nicholas Arditio, 689–690 Barile, Richard, 525–526 Barnes, Nicky, 93–95, 408 Barr, William P., 137–138 Barry, Diane, 187 Barry, Marion S., 95–97 Baseball, steroids in, 846–848 Bass, Elizabeth, lxi Bates, Charles “Chris,” 97–98 Bath salts, 97–99, 252, 362, 871, 919 Bauer, Steven, 813 Bavaria, ban on tobacco in, xl–xli Bay, Michael, 89 Bay Area Laboratory Co-operative (BALCO), 520, 845–846, 847 Bayer, selling of heroin as cough suppressant, lii The Beachcombers (music group), 188 Beard, George M., 52 Beatles (music group), 370, 371 Beatniks (Beats), 99–100, 226, 434 Becker, Howard, 541 Beecher, Lyman, 56, 762 Behavioral addiction, 1, 2–3, 8, 100–103

Behavioral pharmacology, 729 Behavioral therapy, 9, 684 Behrman, U.S. v., 557, 936 Belcher, Steve, 372 Beltrán Leyva Cartel, 604 Belushi, John, lxxvii, 103–106, 385, 482, 781 Benactyzine, 774 Benadryl, 718 Bennett, William, lxxxii, 106–107, 110, 137, 214, 291, 702, 751 Benzedrine, 58, 84 Benzene, 180 Benzodiazepines, 10, 92, 748, 818, 819; as addictive, 7, 8, 860; as agonists, 676; as depressant, 250, 251; as prescribed drugs, 820; as psychotherapeutic drug, 773; testing for, 310, 940; use and abuse of, 330, 901–902 Benzphetamine, 816, 849 Bernal-Madrigal, Juvenal, 283 Bertram, Eva, 700 Besninger, Peter, 421 Beta-endorphin, 675 Betel, chewing of, 849 Betel quid, 454 BG Medical Technologies, 591 Bias, Len, lxxix, 71, 109–110 Biden, Joseph, 380 Big Brother and the Holding Company, 461, 522 Biggie Smalls, 487 Big Moe (rapper), 872 Biker gangs, 205, 206 Bilonik, Ricardo, 690–691 Binge drinking, 31, 34–35, 37, 38, 110– 114, 977 Bin Laden, Osama, 951 Biochemical pharmacology, 729 Biogenesis clinic, 805 Biological reasons for substance abuse, 114, 892 Biological treatment, 903–904 Birth defects, 69 Bishop, Ernest S., 128, 211 Black, Galen, 363

1122  Index

Black, James, 764 Black market, xlvii, 275, 433 Blackmun, Harry, 155, 302, 364 Black Pope, 149 Black tar heroin, 115–117, 707, 712, 714 Black Tuna gang, 315 Black Widow. See Blanco, Griselda Blair, Henry W., liii Blair, Thomas S., lix Blanco, Griselda, 117–119, 198, 199, 240 Blanco, Michael Corleone, 118, 119 Blige, Mary J., 661 Blood: chemical analyses of, 345; drug testing of, 311 Blood alcohol content (BAC), 33, 119–122, 345, 347, 348 “Blotter acid,” 561 Blow, 122–124 Blue, Rupert, 211 Blue Bay Healing Center, 668–669 Blue Flame (music group), 479 Blue Magic, 565–566 Blue Ribbon Movement, 797–798 Blue Ribbon Reform Club, 29 Blues Brothers, 104 Blumberg, H., 622 Bockmiller, Joanne, 785 Boerne, City of v. Flores, 365 Bogart, Humphrey, lxvii Boggs, Hale, 125, 270 Boggs Act (1951), lxvi, 67, 71, 124–126, 216, 218, 270, 359, 395, 559, 624, 628, 629, 787, 804, 839, 865, 907–909 Bog Moe, 487 Boldenone undecylenate anabolic steroid, 843 Bomb Arson Tracking System, 132 Bonds, Barry, 738, 846, 847 Bonilla, Rodrigo Lara, lxxix, 282, 586–587 Bonner, Robert C., 186 Bontril, 849 Booker, U.S. v., 312, 821 Bootleggers, 766 Border Anti-Narcotic Network, 485 Bosch, Anthony, 805

Boston Tea Party, xliii Botticelli, Michael, 292 Bourne, Peter, 160 Bowling, Bo, 738 Bowman, Alfredo, 512 Box labs, 595 Boylan, John J., 127 Boylan Act (1914), 126–129, 838–839 Boys and Girls Clubs of America, 662 Boy Scouts, 669 Brady Handgun Violence Prevention Act (1998), 131, 132 Branch Dravidians, 392 Brandy, lvii Braun, Ryan, 848 Bravo, Alberto, 117, 118 Breaking Bad, 879, 957 Breastfeeding, 966 Breathalyzers, 309 Brennan, William, 364, 827 Brest, Martin, 492 Brevital, 774 Brewer, Jan, 914 Breyer, Charles, 695 Breyer, Stephen, 403 Bribery, 453 Brief intervention, 506–507 Brinkley, Christie, 888 British Medical Research Council, 897 Broadsterdam, 446 Broadus, Calvin Cordozar, Jr., 486 Broadway Jones, 558 Broca’s aphasia, 48 Broin, Norma, 367 Broin v. Philip Morris, 367 Brooks, Alvin, 751 Brown, Bobby, 129–130 Brown, Donald, 807 Brown, Edmund G., Jr., 546 Brown, James, 565 Brown, John, xlviii Brown, Lee, 292, 580, 702 Brown, Robert, lxxiii Brown, Shirley, 401 Brownfield, William R., 136 Brown heroin, 714

Index  1123

Browning, Elizabeth Barrett, 84 Browning, Robert, 84 Brownsville Agreement (1998), lxxxiv Brown & Williamson Tobacco, 578 Bruckheimer, Jerry, 89 Bryden, Robert, 149 Buchman, Frank, 828 BudGenius Medical Technologies, 573 Buprenorphine, 213, 628, 704, 903; as controlled drug, 816; as opiate-addiction treatment drug, 703; as synthetic opiate, 870; testing for, 940; training, 55 Bupropion, 774 Burch, Patricia A., 751 Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), 130–133, 350, 386, 390 Bureau of Chemistry, 780 Bureau of Diplomatic Security, 350 Bureau of Drug Abuse Commission, 134 Bureau of Drug Abuse Control (BDAC), 134, 293, 396, 517–518, 923 Bureau of Identification, 944–945 Bureau of Internal Revenue, 131 Bureau of International Narcotics and Law Enforcement Affairs (BINL), 135–136 Bureau of Narcotics, 241, 291, 908, 909 Bureau of Narcotics and Dangerous Drugs (BNDD), lxv, 4, 134, 216, 293, 396, 632–635, 923–924 Bureau of Social Hygiene, 210, 211, 213, 241 Burham, Lois, 960 Burke, James E., 387, 751 Burns, Ed, 875 Burroughs, William, 85, 99, 226, 434, 545–546, 742 Bush, George Herbert Walker: Address to Nation on the National Drug Control Strategy (1989), 1089–1095; drug policies and legislation under, xxix, lxxvii, lxxxi, lxxxii, 27–28, 63–64, 106, 136–140, 145, 187, 214, 230, 291, 344, 418, 503, 504, 671, 702, 751–752, 787 Bush, George W., drug policies and legislation under, xxix, xxx, lxxxiii, 64,

140–143, 292, 377–378, 643, 671–672, 703, 972 Bush, Jeb, 340 Bush, Laura Lane Welch, 140 BuSpar, 774 Buspirone, 774 Butabarbital, 774 Butisol, 774 Butler, Chad Lamont, 486 Butorphanol, 703 Butyrophenones, 901 Byrne Discretionary Grant Program, 247 Byrne Formula Grant Program, 247 Cabinet Committee on International Narcotics Control, 145–146, 699 Cachexia, 891 Cadmium, 180 Caffeine, 69, 146–148, 327, 466; as addictive, 860; in energy drinks, 365– 366; Food and Drug Administration opposition to, lv; Post, Charley’s opposition to, li; risk of miscarriage and, 967; as stimulant, 848, 849. See also Coffee Caffeine intoxication, 146 Calan, 774 Calderón, Felipe, 524, 604, 605 Caldwell, Samuel, lxiii Cali Cartel, 148–153, 161, 203, 204, 282, 292, 315, 377, 450, 586, 587, 588, 886 Califano, Joseph, Jr., 153–154, 163, 431– 432, 548 California, ban of marijuana, lvii California, University of: criminology program at, 945 California, University of, at Los Angeles (UCLA): Marijuana Research Project of, 785 California Campaign Against Marijuana Planting Conference, 582 California Health and Safety Code, 801 California “Poppy Rebellion,” 709 California Society for the Treatment of Alcoholism and Other Drug Dependencies, 54

1124  Index

Camarena, Enrique “Kiki,” lxxix, 448 Camarena Salazar, Enrique, 154–156, 895 Campaign against Marijuana Planting (CAMP), 156–157 Campfire Girls, 669 Canada, formation of drug habit in, lxx Cancer, 180, 590, 824, 866 CanChew Biotechnologies, 575 Canipa Holdings, 575 Cannabidiol (CBD), 589 Cannabimimetic agents, 253 Cannabinoids, 97, 890; testing for, 309, 310 Cannabis, 10, 157–159, 318, 327–328; Napoleon and, xliv; synthetic, 97–99; trade of, 285, 286–287. See also Marijuana Cannabis Cultivators Club, 695 Cannabis Cultivators Club, U.S. v., 695 Cannabis sacrament, 447 Cannabis Science, Inc., 573, 591 CannaFuel, 574–575 CannaMed, 591 Cannavest Corp., 573 Canseco, Jose, 804, 846, 847 Capone, Al, 131, 358, 762–763 Capote, Truman, 492, 852 Capsaicin, 62 Carbamate, 818 Carbon monoxide, 817 Carcinogens, 180 Cardenas Guillen, Antonio, 452 Cardenas Guillen, Osiel, 451–452, 895 Cardiovascular pharmacology, 729 Cardizem, 774 Cardona, Diego, 188 Carisoprodol, 816 Carnegie, Andrew, 74, 584 Caro-Quintero, Genaro, 832 Caro-Quintero, Jorge, 832 Caro-Quintero, Miguel, 315, 832 Caro-Quintero, Rafael, 154, 447, 448, 832–833 Caro-Quintero syndicate, 284 Carr, Lucien, 434 Carrillo, Ernesto Fonseca, 154, 447, 448 Carrillo-Fuentes, Amado, 315

Carter, Jimmy, drug policies and legislation under, lxxv, 63, 94, 153, 159–161, 167, 234, 420, 437, 657, 693, 852 Carvey, Dana, 462 CASASTART program, 163 CASA WORKS for Families, 163 Cash, Johnny, 371, 737 Cassady, Neal, 99, 434 Castano, Carlos, 283 Castro, Fidel, 450, 689 Castro, Raul, 449 Catalano, Salvatore, 734–735 Catapres, 774 Cathine, 531–532 Cathinone, 98, 531–532 Catholic Church, xxxviii, xxxviii–xxxix, xlii Cato Institute, 381, 784 CB1 receptor, 677 CB2 receptor, 677 Cefalu, Vince, 388 Celecoxib, 61 Center for Indoor Air Research, 900 Center for Mental Health Services, 854 Center for Reproductive Law and Policy (CRLP), 402 Center for Substance Abuse Prevention, 161–163, 263–264, 639, 757, 854 Center for Substance Abuse Treatment, 599, 639, 854 Center on Addiction and Substance Abuse (CASA), 153, 163–164 Center on Alcohol and Drug Abuse, 548 Centers for Disease Control, 13, 111, 112, 397, 399, 898 Centers for Disease Control and Prevention (CDC), 164–166, 347, 405, 730, 842 Central Asian shamanism, 447 Central Intelligence Agency (CIA), 160, 161, 166–168 Centrax, 774 Chain of custody, 940 Chamillionaire, 487 Chapman, Alvah H., Jr., 751 Charles, Ray, 742 Charles I, King of England, xl

Index  1125

Charles II, King of England, xli Chase, Chevy, 103 Chemical Diversion and Trafficking Act (1988), 204–205, 231, 338 Chemotherapy, 730 Cheney, Dick, 138 Cherokee Studios, 104 Cherokee Tribal Child Protective Services, 664–665 Cherrington, Ernest Hurst, 75 Chiang Kai-shek, lxiv Chicago Washingtonian Home, 52 Children of alcoholics, 170–173 Child sexual abuse and substance abuse, 168–170 China: drugs and, lxvi, 173–175; opium addiction in, xliv, 240–242; Opium Wars in, xlv, xlvi, 174–175, 441, 715–716 China Club, 630 China White, 871 Chlamydia, 840 Chloral hydrate, 250, 774, 818 Chlordiazepoxide, 410, 774, 901 Chlorprothixene, 774 Choom Gang, 696 Christopher, James, 553–554 Chronic malignant pain, 61 Chronic nonmalignant pain, 61 Chronic obstructive pulmonary disease (COPD), 399, 681 Chrysostom, St. John, xxxviii Churchill, Winston, 179 Cigarette Labeling and Advertising Act (1965), 885, 898 Cigarettes, l, 175–178, 399; ban of ads from television and radio, lxxii; criminalization of, lix; criticism of, lv; e-, 15, 353–355; Hollywood promotion of, lxv Cigars, 178–182 Cipollone, Antonio, 182–185 Cipollone, Rose, lxxx, 182–185 Cipollone v. Liggett Group, Inc. et al., 182–185, 368, 868 Civil Asset Forfeiture Reform Act (2000), 350–351

Civil War: coffee in, xlvii; morphine in, xlvii Clapton, Eric, 371, 737 Claritin, 718 Clark, Tom, 801 Clean Indoor Air Act, 829 Clemens, Roger, 738, 846 Clinical pharmacology, 730 Clinton, William (Bill), drug policies and legislation under, xxix, lxxxiii, 135, 153, 185–188, 230, 292, 361, 414, 580, 583, 671, 702, 722, 943 Clomipramine, 773 Clonazepam, 774, 816, 820 Clonidine, 774 Clorazepate, 816 Clozapine, 901 Club drugs, 252, 274, 870 Coalition Against Drug Abuse, 447 Coalition for Rescheduling Cannabis, 159, 215 Coast Guard, U.S., lvi–lvii Cobain, Kurt, lxxxiii, 188–190, 482, 887–889 Cobb, Irvin S., 82 Coca, 190–192 Coca-Cola, l, li–lii, liii, liv, lxiii, 193–194 Cocaethylene, 195 Cocaine, xxxiii, 10, 194–197, 327, 328; as addictive, 7, 278, 329, 860, 892; as agonists, 674; anxiety and, 76; availability of, 977, 978; banning of non-medicinal use of, liv; Belushi, John, and, 105; as controlled substance, 217, 298; destruction of Colombian, lxxviii; effects of, 98; electronic dance music and, 362; Farley, Chris, and, 385; freebase, 194; Freud, Sigmund, and, xlix–l, 425–426; as hard drug, 466; as “illicit drug,” 320, 855; isolated, xlvi; media glamorization of, lxxv; as miracle cure, l; nicotine addiction and, 866; Oregon ban of, l; paraphernalia and, 300; powder form of, 228; pregnancy and, 966–967; prostitution and, lv; purity and, 306; raves and, 253; removal from Coca-Cola,

1126  Index

liii, 193; for soldiers, xlix; as stimulant, 848; studies using, 676; testing for, 309, 310, 940, 941; trade and trafficking of, lxxvii, 122, 315, 317, 318; use and abuse of, 35, 58, 72, 85, 98, 254, 265, 320, 612; victimization and, 31, 969; withdrawal from, 962. See also Crack cocaine Cocaine Anonymous, lxxviii, 197–198 Cocaine cowboys, 239 Cocaine Cowboys (film), 198–200 Cocaine hydrochloride, 194, 281 Coca leaf, xxxviii, lxxxvii Cockroach effects, 322 Cocoa, 146 Codeine, 166, 200–201, 706, 940; as analgesic, 61; as controlled drug, 816; production from opiate plant, 703, 707 Codependency, 201–202 Coffee: black-market, xlvii; Boston Tea Party and, xliii; in Civil War, xlvii; as essential to commerce, xlviii; imports of, xlix; instant, liv; ironies of, xliii; prepackaged, xlvii; soft drinks versus, lxxv; in World War I, lvii. See also Caffeine Coffee break, lxvi Coffee drinkers, condemnation of, xxxix Coffeehouses, xl, xli Coffee roaster, xlv Coffee vending machines, lxiv Cognitive based therapy, 567 Cognitive behavior therapy (CBT), 4–5, 251, 904, 905 Cold turkey, 704 Cold War, 907 Cole Memorandum (2011), 1100–1102 Coleridge, Samuel Taylor, xliv Collins, Fred, 339 Colombian cartels, 202–204, 280–282, 325, 603 Colombian heroin syndicates, 282–283 Colon, Miriam, 815 Columbia Presbyterian Medical Center, 614 Columbus, Christopher, xxxviii, 158, 476 Combat Methamphetamine Act (2005), 59, 204–206, 372

Comey, James B., 393 Commerce Clause, 783 Commission on Crime, 161 Commission on Marijuana and Drug Abuse, 206–209 Commission on Narcotic Drugs, xxxiv, 921 Committee on Drug Addiction, 210–211 Committee on Drug Addictions, 211–213 Common Law Doctrine of Necessity, 784 Common Sense for Drug Policy (CSDP), 159, 213 Communion wine, xlii Community Anti-Drug Coalitions of America, 662 Community-based processes, 162, 756 Community Epidemiology Work Group, 652 Community Mental Health Services Act, 777 Community Rights Council, 784 Community treatment programs, 567 Community Trials Intervention to Reduce High-Risk Drinking, 758–759 Compassionate Use Act (1996), 214–216, 590, 695 Compelling interest test, 364 Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act (1970), 649 Comprehensive Crime Control Act (1984), 80, 788 Comprehensive Drug Abuse and Prevention and Control Act (1970). See Controlled Substances Act (1970) Comprehensive Drug Abuse Prevention and Control Act (1978), lxxv–lxxvi Comprehensive Methamphetamine Control Act (1996), 205, 218–219, 595 Compulsions, 101, 219–220 Compulsive computer use, 100 Compulsive shopping, 100 Conant, Marcus, 220–221 Conant v. Walters, 220–221 Confessions of an English Opium Eater (De Quincey), xlv

Index  1127

Confidentiality Information Protection and Statistical Efficiency Act (2002), 647 Conflict theory, 893–894 Congressional Black Caucus, 18, 382 Congressional report on Contra drug connection, lxxxii Connally, John, 145 Conseco, Jose, 738 Consolidated Priority Organization Target List, 717 Constantine, Thomas A., 895 Consumer’s Union, 208 Conte, Victor, 520, 845–846 Continued drug use, 249 Continuing care, 905 Continuing Drug Enterprise Penalty Act (1986), 337 Contras, 690 Controlled Dangerous Substances Act, 268, 300 Controlled Drugs Act (U.K.) (1985), lxxix Controlled substances, 815–816 Controlled Substances Act (1970), xxviii, lxiii, 58, 91, 98, 159, 196, 200, 204, 206, 214, 215, 216–218, 217, 218, 219, 222, 222–224, 230, 252, 255, 268, 270, 285, 293, 294, 303, 341, 349, 356, 372, 382, 463, 470, 480, 499, 500, 550, 570, 590, 594, 600, 632, 651, 657, 695, 698, 704, 707, 719, 731, 783, 787, 788, 815, 839, 841, 849, 870, 891, 917, 951. See also Schedule entries Controlled Substances Analogs Enforcement Act (1986), 338 Controlled Substances Import and Export Act, 296, 337, 382 Controlled Substances Registration Protection Act, 788 Controlled Substances Technical Amendments (1986), 338 Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances (1998), xxxv Convention for Limiting the Manufacture and Regulating the Distribution of Narcotic Drugs, lxi

Convention of Peking, xlvi–xlvii Convention on Psychotropic Substances, 922 Co-occurring conditions, 76 Corben, Billy, 198 Corgard, 774 Corn alcohol, xlii Correctional Grant Programs, 247 Corrective advertising, 900 Corti, Adriano, 735–736 Corti, Count, lxi Cough and cold remedies, 718 Council, 408–409 The Council, 93–94 Council for Tobacco Research, 184, 224–226, 867, 899–900 Council of the American Medical Association (AMA), lix A Counterblaste to Tobacco, xxxix Counterculture, 226–228, 460, 886 Counterdrug Technology Assessment Center, 701 Counterfeit drugs, 842 Counterfeiting, 453 Counter-Terrorism Committee of the Security Council, 920 “Country Boys,” 564 Couric, Katie, 804–805 Cox, James M., 470 Cox, Mabel Judson, 469 COX-2 inhibitors, 61 Coyotes, 913 Crack babies, 229 Crack cocaine, xxxi, xxxiii, lxxvi, 466; availability of, 977, 978; Bias, Len, and, 109–110, 194–197; epidemic of, lxxxi; fair sentencing and, 379–380; as hard drug, 466; as “illicit drug,” 320, 855; male ejaculation and, 840; media hype of, lxxx; in New York, lxxix; raves and, 254; smoking, 96, 228; as stimulant, 848; trade and trafficking of, 318, 320; use and abuse of, 35, 71, 72. See also Cocaine Crack-Cocaine Equitable Sentencing Act, 380 Crack epidemic, 228–230

1128  Index

Crafts, Wilbur F., lii, liii Cranston, Bryan, 876, 957 Crime, heroin addicts and, lxxi Crime Control Act (1984), lxxix, 350 Crime Control Act (1990), 230–232 Crime victims, 232–234 Criminalization process, 541–543 Criminal justice, 945 Criminal networks, 325 Criminal possession, 304–305 Criminal Records Upgrade Program, 247 Crocker, Barbara, 469 Crocker, Mary, 469 Crocker, Virginia, 469 Crohn’s disease, 590 Crop eradication, 234–236, 933, 934 Cropper, Steve, 104 Crop substitution, 235 Cross-addiction, 236–237 Cross-tolerance, 236–237, 317, 728 Crothers, Thomas, 43, 52, 515, 963 Crowe, William J., Jr., 751 Cruz, Nelson, 848 Cruz, Penélope, 124 Crystal Meth Anonymous, 197 Crystal meth as hard drug, 466 Cuellar, Jorge Madrazo, lxxxiv Cultural Deviance theories, 893 Cumming, Hugh S., 742 Currency, tobacco as, xl Curtis, Cliff, 124 Customs Enforcement Act (1986), 295, 337 Cyanide, 817 cycling, 842 Cyclooxygenase enzyme, 61 Cylert, 774 Cyrus, Miley, 371, 737 Dadeland “Massacre” (Miami, Florida) (1979), 199, 239–240 Dai, Bingham, 240–242 Dalmane, 774, 819 Daly, James R. L., lii Dance Safe, 362, 468 Dangerous Drugs Act (U.K.) (1967), lviii, lx, lxix

Daniel, Price, 269, 628 Darvocet, 286, 870 Darvon, 870 Dass, Ram. See Alpert, Richard (Ram Dass) Date-rape drugs, 31, 37, 92, 242–244, 286, 330, 334–336, 529, 745, 819 Davis, Clive, 522 Davis, Jefferson, 469 Davis, Katharine Bemet, 212 Davis, Miles, 370, 514 Davis, Nathan S., 52, 53 Davis, Sammy, Jr., 742 Dayton, H. B., 622 Deadheads, 443, 444, 445 Deca-Durabolin anabolic steroid, 843 Declaration and the Comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control, 918 Decongestants, 59 Decriminalization, lxxv, 208–209, 214, 244–245 Dederich, Charles, 868–869 Deep relaxation, 905 Dehydroepiandrosterone, 842 Deinstitutionalization, 322 Delaware Prophet, 29, 792 De Leon, Oscar Malherbe, 451 Delgado, Diego, 123 Delirium tremens (DTs), 251 Della Torre, Franco, 735 De Louette, Roger, 423 Demand control failures, 322 Demand reduction, xxix, 245–248, 295, 700–701 Demand Reduction Coordinators, 295 Demerol, 816, 870 Denarco, 725 De Niro, Robert, 105 Denormalization, 751 Denver, Bob, 370 De Palma, Brian, 813 Department of Defense Authorization Act (1982), 788 Depenalization, 214 Dependence, 2, 248–250

Index  1129

Depo-Testosterone anabolic steroid, 816, 843 Depp, Johnny, 124 Depressants, 10, 250–252, 285, 287, 859, 860 Depression, 3, 590 Deprol, 774 De Quincey, xlv De Saint-Pierre, J. H. B., xliii Designer drugs, xxxiii, 252–255, 870 Desipramine, 773 Desoxyn, 816 Desyrel, 774 Detoxification, 4, 250, 267, 357, 903 Devils Disciples, 206 Dewine, Mike, 154 Dexamyl, 84 Dexedrine, 84 Dextroamphetamine, 59, 774, 848 Dextromethorphan (DXM), 85, 200, 462, 463, 718, 771, 849, 872 Dextropropoxyphene, 703 Diabetes, 590 Diacetylmorphine, 870 Diagnostic and Statistical Manual of Mental Disorders (DSM): alcohol dependence in, 44–45; caffeine in, 146; codependency and, 201; dependence in, 249; drug typologies in, 326–327; hallucinogen persisting perception disorder in, 410; impulse control disorders in, 101; panic in, 76 Dianabol anabolic steroid, 843, 844 Diazepam, 774, 816, 820, 901 Didrex, 816, 849 Dietary steroids, 842 Diethylpropion, 849 Diethyltryptamine, 770 Diet pills, 718 Differential Labeling theory, 893 Differential Reinforcement, 893 Diggers, 460–461 Digoxin, 870 Dilaudid, 754 Dillinger, John, 496 Diltiazem, 774

Diluents, 306 DiMaggio, Joe, 614 2,5-Dimethoxy-4-methylamphetamine (DOM, STP), 771 Dimethyltryptamine (DMT), 255–256, 462, 770, 771 Disease model: of addiction, 256–257; of alcoholism, 516 Disparate impact, 785 Disparate treatment, 785 Distilled spirits, xliii Disulfiram (Antabuse), 4, 8, 35, 903 Diversion, 305 Divinorin A, 463 Dixie Chicks (music group), 661 Dixie Elixirs and Edibles, Inc., 575 Dixie Nightingales, 807 DJ Screw (rapper), 872 Doctor shop, 749 Dodd, Thomas, 270 Dodson, John, 386, 388 Dogoloff, Lee I., 751 Dole, Robert, 187 Dole, Vincent, xxxiv, 67, 257–259, 396, 598, 692, 693 Dole, Vincent P., Treatment and Research Institute for Opiate Dependency, 259 Dolichothele, 328 Dolophine, 816 Domestic abuse: alcohol and, 259–262; drugs and, 262–264 Domestic Chemical and Diversion Act (1993), 205 Domestic Council Drug Abuse Task Force, lxxiv–lxxv Domestic Highway Enforcement Program, 484 Domestic Marijuana Investigation Project, 484 Domestic Policy Council, 592 Dominican drug organizations, 284–285 Donana, 328 Donovan, Raymond J., 620 Dopamine, 1, 68, 195, 674, 727, 859, 892 Dopamine blockers, 774 Dopamine high, 12

1130  Index

Doping, 77–78 Doral, 774 Doremus, U.S. v., lviii, 128, 472, 627, 631, 691, 837, 934–936 Dosage, 249 Dougherty, James, 613–614 Douglas, William O., 801 Dover, Thomas, xliii Dover’s Powder, xliii Downregulation, 674, 676 Doxepin, 773 Doyle, Arthur Conan, 192 Doyle-Murray, Brian, 103 “Drank,” 873 Drinking patterns, 35–36 Driving under the influence (DUI), 129, 345–347 Driving while intoxicated (DWI), 345–347 Dronabinol, 890 Drug abuse, 264–267; prescription, 430; as problem, xxv–xxvi; treatment for, xxxiii– xxxiv. See also Substance abuse Drug Abuse and Treatment Act (1972), 267–269 Drug Abuse Control Act (1965), 517 Drug Abuse Control Amendments Act (1965), 134, 216, 269–271, 414, 517 Drug abuse industrial complex, lxxiv Drug Abuse Office and Treatment Act (1972), 217, 268, 651 Drug Abuse Prevention and Control Act (1970), lxxi Drug Abuse Resistance Education (DARE), xxix, lxxviii, 141, 245, 271–273, 881 Drug Abuse Strategy Council, 268 Drug Abuse Warning Network (DAWN), lxxiv, 273–275, 307, 356, 748, 854 Drug addiction, lx, lxvii, lxxii Drug and Alcohol Services Information System, 854 Drug cartels, 279–285; Arellano Felix, 116, 315, 448, 523, 604, 833, 894, 895; Beltrán Leyva, 604; Colombian, 202– 204, 280–282, 325, 603; Guadalajara, 447–449, 832, 895; Gulf, 450–453, 523, 604; Juárez, 448, 523–525; Juárez/

Vicente Carillo Fuentes organization, 604; La Familia Michoacana, 604; Mexican, 283–284, 914; New Juárez, 523; Sinaloa, 386, 448, 450, 523, 524, 604, 833, 895, 896; Sonora, 832–833; Southeast Asian, 285; Tijuana, 448, 894–896. See also Cali Cartel; Medellín Cartel Drug classes, 285–288 Drug Control Act, 518 Drug Control Strategy, xxx Drug courts, xxxiii, 288–290 Drug czars, 106–107, 137, 290–292, 700. See also specific by name Drug dealers, lxxiv Drug Enforcement Administration (DEA), xxviii, lxxiii–lxxiv, 98, 116, 134, 139, 149, 154, 156–157, 199, 215, 221, 234, 239, 246, 292–295, 307, 315, 387, 411, 583, 600, 604, 621, 651, 700, 783, 787, 842, 895, 924, 932, 951, 952, 957 Drug Enforcement Grants, 231 Drug Equality Alliance, 778 Drug-facilitated rape, 334–336 Drug facilitated sexual assault, 31 Drug-Free American Act (1986), 295, 336–338, 858 Drug-Free American Foundation (DFAF), 338–340 Drug-Free Communities Support Program (DFC), 669, 701 Drug-Free Community grantees, 662 Drug-Free Federal Workplace, 340–341 Drug-Free Schools Act (1986), 336 Drug-Free Schools and Communities Act (1997), lxxxiii–lxxxiv, 230–231 Drug-Free Schools and Communities Program, 668 Drug-Free Schools and Community Act (1988-1989), 343–345 Drug-free school zones (DFSZ), 230, 341–343 Drug-Free Workplace, 336 Drug free zones, 943 Drugged driving, 345–349 Drug Importation Act (1848), xlvi

Index  1131

Drug Interdiction and International Cooperation Act (1986), 295–296, 336 Drug intervention programs, 296–297 Drug Kingpin Death Penalty Act (1988, 1994), 298–299, 326 Drug kingpins, 326 Drug laws. See also specific laws: government enforcement of, lxv Drug Medicalization, Prevention and Control Act (1996), 313 Drug mules, 914 Drug nomenclature, 299–300 Drug paraphernalia, 231, 300–303, 313 Drug Penalties Enhancement Act (1986), 337 Drug Policy Alliance Network, 303–304, 621, 833 Drug Policy Foundation, 303 Drug possession, lxxxv, 304–305 Drug Possession Penalty Act (1986), 337 Drug Prevention Demonstration Program, 247–248 Drug Prevention Network of the Americans, 340 Drug production, lxxi Drug purity, 305–308 Drug Reform Act (1986), 30–309 Drug Reform Coordination Network, 661 Drug-related asset seizures, 349–351 Drugs: addiction, 7–11; China and the Chinese and, 173–175; club, 252, 274; counterculture and, 226–228; counterfeit, 842; crime victims and, 232–234; criminalization of, xxx; daterape, 31, 37, 92, 242–244, 286, 330, 334–336, 529, 745, 819; defined, xxv; designer, xxxiii, 252–255, 870; domestic abuse and, 262–264; driving under the influence of, 350; early mention of, xxxviii; gateway, 429–433; hard versus soft, 465–468; illegal, xxv; legal, xxv; legalizing, lxxxiii; legal restrictions on, xxv; legend, 908; over-the-counter, 717– 719; predatory, 744–746; pregnancy and, 964–968; prescription, 747–749; race and, lvi; recreational use of, 794–795;

significant events in, through history, xxxvii–lxxxvii; soft, 433; synthetic, 870– 871; television and, 875–879; as threat to international security, lxxxvi Drug screening and testing, 309–311 Drug-seeking behavior, 249 Drug sentencing, 311–313 Drug smuggling, 67, 314–316 Drug testing, lxxi Drug trade, 317–318 Drug trafficking, 150, 187, 196, 279, 318–321; illegal, lxxvi; networks for, 324–326; organized crime and, 321–324 Drug typologies, 326–330 Drug use: in adolescents, 612, 977–981; African Americans and, 17–20; American, lxxvi; authors and, 84–86; entertainers and, 369–372; forecasting, 330–332; increase in illicit, lxviii; Latinos and, 543–544; prison inmates and, 759–762; as problem, xxv–xxvi; public opinion and, 777–779; risk factors for, 799–800; rural, 808–810; seniors and, 819–820; sexually transmitted diseases (STDs) and, 839–841; undocumented immigrants and, 913–914; in Vietnam, lxxi; withdrawal from, 961–962 Drug Watch International (DWI), 332–334 DTs, 960 Dual track approach, 865 DuMez, A. G., 836 Dunham, Lawrence B., 212, 213, 241 Du Pont, Irene, 82 Du Pont, Pierre, 74, 82–83, 762 DuPont, Robert L., lxxi, lxxv, 651, 688 Durabolin anabolic steroid, 843 Duragesic, 816 Durham-Humphrey Amendment, 907, 908 Dutch policy, 548–549 Duzan, Maria Jimena, 587 Dying Project, 48 Dynorphins, 675, 703 Earle, Delbert, 188 Earle, Mari, 188

1132  Index

Early intervention, 756 Ecgoine, 298 e-cigarettes, 15, 353–355, 677–678 Ecstasy (MDMA), xxxiii, 355–357, 466; anxiety and, 76; as controlled drug, 816; as date-rape drug, 31; as designer drug, xxxiii, 252, 727; electronic dance music and, 362; euphoria and, 970; as hallucinogen, 59, 462, 918; herbal, 719; illicit production of, 320; mescaline masquerading as, 594; “Molly” as name for, 355, 356, 362, 371, 737; as party drug, 463; in pill form, 745–746; pop culture and, 371; pregnancy and, 966; psychedelic properties of, 771; raves and, 254; Shulgin’s introduction of, 825; as synthetic drug, 870, 871; temporary amnesia and, 744; testing for, 941; trade and trafficking of, 315, 318; use and abuse of, 35; victimization and, 969 Edeleanu, Lazar, l Edell, Marc, 182, 183, 184 Education, 756; anti-alcohol, l, liii; prevention, 162; temperance, l Edwards, Justin, 56 Effexor, 774 Ehrlichman, John, 686 Eighteenth Amendment, xxxi, lvii, 24–25, 75, 82, 83, 131, 357–359, 584, 765, 838, 879, 881, 947, 949, 954, 996–997. See also Prohibition; Volstead Act Eighth Amendment, 800, 801 Eisenhower, Dwight D., drug policies and legislation under, 41, 359–360, 497 Elders, Joycelyn, lxxxiii, 360–361 Electric Zoo festival, 362 Electronic dance music (EDM/House Music), 361–363 Elementary and Secondary Education Act (1965) (ESEA), lxxxv Elixir Sulfanilide, 416 Eminem, 371, 737 Emotional neglect, 169 Empirin with Codeine, 749 Enchanted Garden, 852 Encryption technology, 281

Endocannabinoids, 677, 859 Endocrine pharmacology, 729–730 Endogenous cannabinoids, 890 Endorphins, 675, 703 Energy drinks, 146, 147, 365–367 Engle v. R.J. Reynolds, 367–369 Engrosso, Sebastian, 362 Enkephalins, 675, 703 Entertainers, drug use and, 369–372 Environmental approaches, 162, 756 Environmental Protection Agency, 730 Enzyme multiplied immunoassay technique, 940 Ephedra, 372 Ephedrine, 59, 205, 304, 372–373, 600, 738, 849 Equal Employment Opportunity Commission (EEOC), 785–786 Equal protection clause, 343 Equipoise anabolic steroid, 843 Erythroplakia, 454 Escobar, Pablo, lxxvi, lxxvii, lxxix, lxxxi, lxxxiii, 123, 135, 202–203, 281, 282, 315, 319, 373–375, 526, 586, 587, 588 An Essay, Medical, Philosophical, and Chemical on Drunkenness and Its Effects on the Human Body (Trotter), xliv Eszopiclone (Lunesta), 92, 748 Ethanol, 42, 43 Ethchlorvynol (Placidyl), 92 Ethyl alcohol, 42 Ethylene oxide, 180 Etorphine, 707 Euphoria, 970 European Committee to Combat Drugs, 375–376 European Union, 321 Evans, Bill, 370, 514 Exclusionary Rule Limitation Act (1986), 338 Executive Order 10302, 908 Executive Order 11076, 16, 750 Executive Order 12564, 340, 1024–1029 Executive Order 12696, 751, 752 Executive Order 12880, 702, 1095–1097 Executive Order 12992, 702

Index  1133

Executive Order 13008, 702 Executive Order 13023, 702 Exodus Recovery Center, 189 Exogabine, 816 Experience goods, 306 Extradition, 376–378 Fair Sentencing Act (2010), lxxxv–lxxxvi, 196, 312, 379–381, 382, 697, 821–822 Families Against Mandatory Minimums (FAMM), 381–383 Families in Action, lxxv Family Smoking Prevention and Tobacco Control Act (2009), 415 Farley, Chris, 383–386, 617 Farley, Chris, Foundation, 385 Farley, Chris, House, 385 Farley, John, 385 Farley, Kelvin, 385 Farley, Thomas, Sr., 383 Farley, Tom, 385 Fastin, 849 Favela-Astorga, Jesus Rosario, 389 Federal Alcohol Administration (FACA), 389–390 Federal Alcohol Administration Act (1935), lxii, 389–391 Federal Alcohol Syndrome Disorders (FASD), 407 Federal Bureau of Investigation (FBI), 496–497, 132, 209, 391–394 Federal Bureau of Narcotics (FBN), xxvii, lxi, 65, 125, 216, 257, 258–259, 270, 293, 394–396, 497, 514, 518, 569, 624, 628, 651, 740, 742, 768, 839, 864, 923, 932 Federal Bureau of Prisons, 742 Federal Communications Commission, 583 Federal Crime Control Act, 341 Federal Drug Council, 268 Federal Explosives License program, 132 Federal Law Enforcement Training Center, 943 Federal Narcotic Control Board, 394, 740 Federal Railroad Administration (FRA), 826

Federal Security Agency, 414 Federal Trade Commission, 900 Federovitch, Michael, xxxix Females: alcohol use, 396–399; pregnancy, drugs, and, 964–968; tobacco use, 399– 400; victimization, substance abuse, and, 968–971 Fentanyl, 703, 707, 816, 871 Ferguson, Crystal, 402 Ferguson v. City of Charleston, 401–403 Ferlinghetti, Lawrence, 99 Fetal alcohol effects (FAE), 404, 405 Fetal alcohol spectrum disorders (FASDs), 398, 965 Fetal alcohol syndrome (FAS), xxvi, lxxiii, 403–408, 964 Fibromyalgia, 590 Field, Marshall, III, 82 Fifth Amendment rights, 81, 783 Finlator, John, 134 Fiorinal with Codeine, 749 Firearms Owners’ Protection Act (1986), 131 Firestone, Leonard, lxxvii, 108, 418 First Amendment rights, 220–221, 364, 434 First Century Christian Movement, 39 First Temperance Society, xliii Fish, Stuyvesant, 82 Fisher, Guy, 93, 94, 408–409 Fiske, Robert B., 94 5 Hour Energy Shots, 850 Fixx, 147 Flashbacks, xxxiii, 409–411, 562, 728, 861 Flores-Montano, U.S. v., 937–938 Florida v. Jardines, 411–413 Flower Mound, 889 “Flower Power,” 435 Flunitrazepam. See Rohypnol (flunitrazepam) Fluoxetine, 774 Flurazepam, 774 Fluvoxamine, 774 Flynn, Errol, 251 Foley, Matt, 383–384 Folsom, Tom, 95

1134  Index

Food, Drug, and Cosmetic Act (1938), xxvii, xxviii, lxiii–lxiv, 231, 270, 353, 414, 415–417, 908 Food and Drug Administration (FDA), lv, 8, 15, 134, 146, 270, 353, 365, 372, 413–415, 422, 730, 780 Food and Drug Administration Safety and Innovation Act, 252–253 Forced manual eradication, 234–235 Ford, Betty, 108, 417–419 Ford, Betty, Center, lxxvii, lxxxvii, 107– 109, 417–419, 475 Ford, Gerald, drug policies and legislation under, lxxiv–lxxv, lxxvii, 63, 108, 419–421 Ford, Henry, lvi, 74–75, 762 Ford, Rob, 385 Foreal, Derek, 122 Foreign Assistance Act (1961), 504, 959 Formaldehyde, 817 Forman, Thomas “Gaps,” 93 Fort Pitt, 956 Foster, David, 471, 975 Foundry Rescue Mission & Recovery, 958 4-H Clubs, 669 Four Loko, 421–422 Fournier, Anais, 148 Fourteenth Amendment rights, 800, 801 Fourth Amendment rights, xxx, 338, 401, 402, 411–413, 660–661, 826, 827, 937, 941 Fox, Andrew M., 913 Fox, Ruth, 54, 642 Fox, Vicente, 141, 603 Foxy-methoxy, 770 Fradenburg, Chuck, 188 Free-base cocaine, 194 Freebasing, lxxvi Freeman, Jason, 422 Freeway Ricky Ross, lxxvi French Connection, lxxii–lxxiii, 314–315, 423–424, 735, 932–933 Freud, Sigmund, xlix–l, 191–192, 193, 196, 424–427 Frieden, Thomas, 164 Fuentes, Amado Carrillo, 523

Fugitive Slave Law, 584 Fujimori, Alberto, 139 Furek, Malcom, 887 Furman v. Georgia, 298 GABA (gamma amino butyric acid), 42, 250, 676, 859, 901 Gabapentin, 768 Gacha, Jose Gonzalo Rodriquez, 281, 585, 588 Galan, Luis Carlos, 204, 377 Galea, Anthony, 805 Gallardo, Miguel Angel Felix, 447, 448, 895 Gallo, “Crazy Joey,” 93 Gamboa, Saulo Reyes, 523 Gamma-endorphine, 675 Gamma-linolenic acid (GLA), 477 Garcia, Jerry, 443, 445 Garland, Judy, 92 Garza, Juan Raul, 298–299 Gases, 287, 328, 501 Gateway drugs, xxxii, 429–433 Gateway hypothesis, 431, 433–434 Gavin, John, 154 Gaviria, Pablo Escobar, 585 Gaynor, Gloria, 852 GC/MS method, 940 Gelbard, Robert S., 186 Generation X, 885, 887, 888, 889 Genetics, 893 Geneva Convention (1925), 314, 740 Genital herpes, 840 Genital warts, 840 Georgine, Robert A., 751 Gervais, Cedric, 371, 737 Gettman, Jon, 222–223 Getz, Dave, 522 GHB (gamma-hydroxybutyrate acid), 31, 243, 250, 254, 286, 330, 462, 818 Gilmore, Mikal, 886 Gin Act (1736), xlii Ginsberg, Allen, 99, 226, 434–436, 545–546 Ginsberg, Naomi, 434 Ginsburg, Ruth Bader, 403

Index  1135

Giordano, Harry, 396 Girl Scouts, 662, 669 Girl’s Inc., 662 Giuliani, Rudy, 734 Glaucoma, 590 Gleitsman Foundation, 382 Global Commission on Drug Policy, 322– 323, 436 Global Program against Corruption, 920 Global Program against Transnational Crime, 920 Global Settlement Agreement (GSA), 577–578 Gloyd, Charles, 636 Glutamate, 676, 859 Glutethimide, 250, 816 Gnostic Christianity, 447 Goldberg, Whoopi, 462 Golden Crescent, 437–440, 712, 713, 715, 886 Golden Triangle, 279, 440–443, 447, 480, 712–713, 714, 715, 734, 886 Gonorrhea, 840 Gonzalez v. Raich, 215 Good, Joseph C., 401 Gooding, Cuba, Jr., 95 Good Templars, 764 Gordy, Berry, Jr., 807 Gore, Albert, 140 Gospel Temperance Movement, 797 Gotti, John, 734 Government Accountability Office, 583 Grammer, Kelsey, 109 Grano v. Department of Development of Columbus, 786 Grassley, Charles, 387, 388 Grateful Dead, 443–446, 460, 461 Great American Smokeout, 830 “The Great Forswearing,” 867 “The Great Relapse,” 867 Green Berets, 138 Greenfield, Arthur D., 211 Green Haven State Prison, 93 Green Rush, 446–447 Green screen, 255 Gregg v. Georgia, 298

Griggs, Asa, 193 Group Against Smoking and Pollution (GASP), 829 Group therapy, 108, 113, 172, 904 Grunge, 189, 886, 887, 888 Guadalajara Cartel, 447–449, 832, 895 Guerra, Juan Nepomuceno, 450 Guest, Christopher, 103 Gugliotta, Guy, 239 Guillot-Lara, Jaime, 449–450 Gulf Cartel, 450–453, 523, 604 Gun Control Act (1968), 131, 132 Guns N’ Roses (music group), 371, 737 Gurley, James, 522 Gutka, 454–456 Guzman, Chapo, 523 GWPharmaceuticals, 574, 591 Hague Convention, xxxiv, 457–459, 470, 471, 974 Hahn, Paul M., 224 Haight, Henry, 460 Haight-Ashbury, 460–462, 488–489 Haight-Ashbury Free Clinics, 461 Haight-Ashbury Street Fair, 462 Hair, drug testing of, 311 Haiti, coffee production in, xliii Halcion, 330, 816 Haldol, 774 Hallucinations, 730 Hallucinogen persisting perception disorder (HPPD), 410 Hallucinogens, xxxiii, 10, 285, 286, 287, 328, 462–464; as addictive substance, 859, 860; flashbacks from, 861; as “illicit drugs,” 855; marijuana as, 570; sensory changes from, 860; as soft drug, 466; trade and trafficking of, 315. See also LSD Haloperidol, 774 Halsted, William Stewart, li Hamilton, Alexander, 131, 955–956 Handsome Lake Code, 792, 793 Hangovers, 464–465 Hanneman, Jeff, 251 Hanuman Foundation, 48

1136  Index

Hard drugs, 465–467 Harlan, John Marshall, 412–413 Harm reduction, 278, 467–469 Harrison, Constance Cary, 469 Harrison, Francis Burton, 469–470, 471– 472, 975 Harrison Narcotics Act (1914), ix, xxvii, lvi, lvii, 469–470, 470–473, 557, 559, 568, 569, 589, 624, 627, 630, 631, 691, 739, 741–742, 766, 775, 780, 787, 831, 836, 837 Harrison Narcotics Tax Act (1915), xxvii, xxviii, 66, 125, 126, 127, 174, 216, 269, 314, 394, 934–936, 938–940, 952, 953, 975, 990–996 Hashish, xlv, 7, 317, 327–328, 466, 473– 474, 855, 860 Hash oil, 466 Hatch, Orrin G., 219, 380 Hatchetations, 637, 963 Hayden, Joseph “Jazz,” 93 Haynes, Clifford, 94 Hazardous Harmonization in Smoking by European Youth (2002), 14 Hazelden Betty Ford Foundation, 109, 475 Hazelden Center, lxv, 109; merge with Betty Ford Center, lxxxvii Hazelden Foundation, 474–476, 607 Head shops, 97, 300 Health Education Curriculum Analysis Tool, 165 Heartbreakers (music group), 370, 371 Heffter, Arthur, 593 Hefner, Hugh, 657 Heineman, Fred, 219 Heller, Simon, 402 Helms, Chet, 522 Helms, Jesse, 671 Helvering, Sandi Patti, 752 Hemingway, Ernest, 84 Hemp, 476–478 Hemp, Inc., 575–576 HEMP Compounds (HC), 574 Hemp Meds, 575 The Hemp Network (THN), 574 Hemp oil, 477

Hems, Earl, 145 Henao-Montoya syndicate, 283 Hendrix, Jimi, 92, 251, 370, 478–480 Hepatitis C, 213, 966 Herbal Ecstasy, 719 Hernandez, Joel, 785–786 Heroin, xxxi, xxxii, 3, 327, 466, 480–483; as addictive, 7, 8, 329, 866; as alternative to morphine, liii; availability of, 977, 978; Belushi, John, and, 105; binding to receptors, 675; black tar, 115–117, 707, 712, 714; brown, 714; as controlled substance, 217, 298, 816; as cough suppressant, lii; crime and, lxxi; Daly, James R. L., on, lii; drug paraphernalia and, 300; drug produced from opium, 707; Fisher, Guy, and, 409; as hard drug, 466; illicit production of, 320, 855, 886, 887; Mexican, 712, 714; as natural substance in opium, 703; opium poppy and, 712; Petty, George E., on, liii; pregnancy and, 967; purity of, 306; synthesized, xlix, lii, 706; testing for, 940, 941; trade and trafficking of, 315, 317, 318; use and abuse of, 35, 72, 359, 892 Heroin Act (1924), lix Heroin Trafficking Act (1973), 421 Herrera, Helmer Pacho, 149, 151, 152 Herrera-Buitrago, Pacho, 282 Herrera-Nevares, Jaime, 315 Herrera-Nevares crime ring, 283, 315 Hezbollah, 884 Hiett, Laurie, 889 High blood pressure, 590 High-intensity drug-trafficking areas (HIDTAs), 292, 483–486, 701 Highway Traffic Safety Administration, 345 Hill, Virginia, 251 Hill and Knowlton, 225 Hillman, Elsie H., 751 Hip-hop and drugs, 486–488 Hippies, 434, 460, 488–489 Hispanics, alcoholism and, 43 History of Tobacco (Corti), lxi

Index  1137

HIV, 28, 213, 320, 327, 467. See also AIDS Hobson, Richard P., lvi Hobson, Richmond P., lx Hoffman, Philip Seymour, 482, 491–493 Hoffman Estates v . The Flipside, Hoffman Estates, Inc., 301–302 Hofmann, Albert, xxxiii, lxiii, 493–494, 771 Holder, Eric, 133, 215, 387, 388, 609, 696–697 Hole, 888 Home Affairs Select Committee Report (U.K.), lxxxv Homeland Security, Department of, 140, 393 Homeland Security Act (2002), 131, 927, 929 Homeland Security Investigations (HSI), 930 Hookah, 15, 473, 495–496, 823–824 Hoover, Herbert, xxvii, 75, 358 Hoover, J. Edgar, 391, 496–497 Hopkins, Larry, 138 Houston, Whitney, 129, 370 Howard, James J., 654 “Howl” obscenity trial, 434–435 HU-210, 97 HU-211, 97 Hughes, Everett, 541 Hughes, Harold E., 649 Hughes Act, 649 Human chorionoic gonadotropin, 842 Human Genome Project, 256 Human growth hormone, 841 Human Papilloma Virus (HPV), 840 Human Rights Watch, 18 Human Smuggling and Trafficking Center, 135 Human trafficking, 453 Humphrey, Gordon J., 654 Hunt, Reid, 210, 836 Hunt Club, 385 Hunter, Chris, 422 Huss, Magnus, 515 Hutton, E. F., 735–736 Huxley, Aldous, 85, 594 Hydrocodone, 703, 706, 707, 820, 890

Hydrodone synthesis, 200 Hydromorphine, 816 Hydromorphone, 616, 703, 706 Hydroxyzine hydrochloride, 768, 774 Hypnosis, 904, 905 Hypnotics, 329–330, 818–819 Hypodermic needle, xlvi Hythiam, Inc., 768 Ibogaine, 499–500 Ibuprofen (Advil, Motrin), 61, 718 Illegal drugs, xxv Illegal Immigration Reform and Immigrant Responsibility Act (1996), 913 Illicit Drug Anti-Proliferation Act (2003), lxxxv Illicit drugs, 320, 855, 882–884, 886, 887, 977–981 imipramine, 773 Immigration and Customs Enforcement (ICE), 929–932 Improv Olympic theater, 383 Impulse control disorders, 1, 9–10, 100, 102–103 Impulses, 219–220 Inciardi, Jim, 888 Increasing Security along the Southwest Border, 701 Independent Order of Good Samaritans, 29 Independent Order of Rechabites, 29 Indian Alcohol and Substance Abuse Demonstration Program, 247 Indian Health Service (IHS), 665 Indolealkylamines, 462 Information, 756; dissemination of, 162 Ingersoll, John, 923–924 Inhalants, 10, 285–286, 287, 328–329, 500–503, 855; as addictive, 859; dangers of, 860 Inquiry into the Effects of Ardent Spirits on the Human Body and Mind (Rush), xliii Insomnia, 590 Institute for Social Research, 611 Institute on Global Drug Policy, 340 Insulin, 842

1138  Index

Interdepartmental Committee on Narcotics, 907, 908 Intermittent explosive disorder, 100, 260–261 Internal Revenue Act (1862), xlvii International Civilian Police Program, 135 International Conference on Drug Abuse and Illicit Trafficking, 919 International Criminal Police Commission, 392 International Day Against Drug Abuse and Illicit Trafficking, 918 International Drug Strategy Institute, 333 International Forfeiture Enabling Act (1986), 295, 336–337 International Harm Reduction Association, 467 International HIV/AIDS Alliance, 490–491 International Narcotic Research Conference (INRC), 504–505 International Narcotics Control Act (1989), lxxxi, 503–504 International Narcotics Control Board (INCB), xxxiv–xxxv, 192, 617 International Narcotics Control Strategy, 136 International Narcotics Enforcement Officers Association, 518 International Olympic Committee, 738, 842, 843, 844, 845 International Opium Convention, lv, 709, 864 International organizations, xxxiv–xxxv International Scientific and Medical Forum on Drug Abuse, 340 International Sports Federation, 738 International Task Force on Strategic Drug Policy, 340 International Union of Basic and Clinical Pharmacology (IUPHAR), 505 Internet addiction, 100 Interpol, 392 Intervention, 505–507 Intoxication, 507–509, 508 Investigational New Drug program, 509–510

Investigative Programs Asset Forfeiture Program, 350 Ioxapine, 774 Iran, ban of opium, lxvii Iran-Contra Affair (1986), lxxx Iraq, War in, 140 Isaza, Guillermo Cano, 587 Isenberg, David, 138 Isleta Navajo tribe, 669 Issa, Darrel, 388 al Ittihad al-Islami, 884 Jacklin, Judy, 103 Jackson, Curtis, 487 Jackson, Joseph Walter “Joe,” 511 Jackson, Mahalia, 807 Jackson, Michael, 511–513 Jackson 5 (music group), 511 Jackson Brothers, 511 Jacobson, Mary L., 751 Jacoby, Charles, 605 Jaffe, Jerome, 208, 687, 688 Jamahiriya, 530 James I, King of England, opposition to smoking, xxxix Jamestown, 897; tobacco used in, xxxix–xl Jaonou, Phil, 723 Jardines, Joelis, 411–413 Jaybird-Woodpecker (Democratic Association) War, 636 Jay Treaty, 376 Jazz culture, 513–515 Jeffe, Jerome, 893 Jefferson, Thomas, xxxii, xliv, 158, 956 Jefferson Airplane, 460, 461 Jehan, Jean, 314, 423 Jellinek, E. Morton, 515–516, 641 Jin Fuey Moy, U.S. v., 472, 836, 938–940 Joel, Billy, 109 John, Elton, 512 Johns Hopkins Hospital, li John Paul II, 918 Johns Hopkins and Chapel Hill Duke University Eye Center, 785 Johnson, Ben, 845 Johnson, Gary, 582

Index  1139

Johnson, Karen K., 95 Johnson, Lyndon Baines, drug policies and legislation under, 17, 134, 270, 293, 517– 519, 625–626, 642, 680, 750, 923 Johnson, Sterling, Jr., 751 Joint Committee of the New York Bar Association, lxxv Joint Drug Intelligence Group, 485 Join Together, 163–164, 187 Joint Terrorism Task Forces (JTTF), 931 Jolly, Johnny, 873 Jones, Frank, 94 Jones, Homer, 630 Jones, Marion, 519–521, 738, 846 Jones, Quincy, 511 Jones, Russell Tyrone, 486 Joplin, Janis, 460, 482, 521–523 Jordan, Hamilton, 852 Juárez Cartel, 284, 448, 523–525 Juárez/Vicente Carillo Fuentes organization (CFO) Cartel, 604 Jubilee Convention (1913), 954 Jung, George, 122–124, 202–203, 239, 525–526 Jung, Kristina Sunshine, 123 Just Say No, lxxx, 187, 214, 272, 323, 433, 592, 789, 881; Speech by Reagan, Ronald and Nancy (1986), 1019–1024 “Just Say No” clubs, 789 Juvenile Drug Trafficking Act (1986), 337–338 Juvenile Justice Discretionary Grant Program, 247 Juvenile offenders, drug courts for, 290 JWH-018, 97 JWH-073, 97 K2, 97–99, 223, 252 KannaLife Sciences, 575 Karyo, Tchéky, 89 Kaskade, 362 Kast, Eric, 771 Katz, Charles M., 913 Kauffman, Ewing, 751 Keeley, Leslie, 30 Keeley Clubs, 30

Keep a Clear Mind (KACM), 757–758 Kefauver, Estes, 270 Kefauver Commission, 270, 433 Kefauver-Harris Act, 417 Keijzer, Bob, 548 Keith, C., 836 Kelley, Alton, 460 Kelly, Abby, xlvi Kelly, Chris “Mac Daddy,” 486–487 Kennedy, Anthony, 363 Kennedy, John F., drug policies and legislation under, lxviii, 16, 179, 517, 527–528, 614, 624, 749–750, 867, 960 Kenyon, William Squire, 954 Kerlikowske, Gil, lxxxv, 292, 703 Kerouac, Jack, 85, 226, 251, 434, 545–546 Kerr, Norman, li Kerry, John, lxxxii, 140 Kesey, Ken, 85, 227, 434, 444, 561 Kessler, David, 414, 868 Ketamine, 31, 243, 334, 362, 462, 463, 528–531, 744, 745, 771, 816, 966 Ketobimidone, 707 Keyll, Jan, 186 Khat, lxxxvii, 531–534, 848 Kicking the Coffee Habit (Wetherall), lxxvi Kidnappings, 452–453 Kiel, Terrance, 873 Killah Kid Kriz, 422 King, Martin Luther, Jr., 391, 496–497 King, Stephen, 85 King Henry the IV (Shakespeare), xxxix King Kasuals (music group), 479 Kinzey, Stephen J., 206 Kirkpatrick, James, 956 Kirkpatrick, Jean, lxxv Kishline, Audrey, 49 Kleber, Herbert D., 163 Kleptomania, 100 Klonopin, 242, 774, 816 Klum, Heidi, 888 Knight, Gladys, 409 Kochs, Christopher, lvi Kolb, Lawrence, 67, 241, 629, 742, 776 Koop, C. Everett, lxxvii, 534–537, 680, 868 Kramer, John, 767

1140  Index

Kris Kross (music band), 486–487 Kroghm, Egil, Jr., 145 “Kubla Khan” (poem) (Coleridge), xliv Labeling, 541–543 La Catedral, 374 La Cosa Nostra, 734 Lady Gaga, 492 La Familia Michoacana Cartel, 604 La Guardia, Fiorello, 539 The La Guardia Report, 539–541 Laird, Melvin, 145 Lakota Sioux, 669–670 La Linea, 523, 524 La Madrina. See Blanco, Griselda Lamb, Cindy, 618 Lambarène, 499 Landono, Jose Santacruz, 149 Landry, Tom, 751 Larrucea, Maria Teresa, 469 La Russa, Tony, 847 Latinos, drug use and, 543–544 Laudanum, xxvii, xxxii, xxxviii, 84, 706 Lautenberg, Frank R., 654 Law enforcement, xxix, 318, 321, 325–326 Law Enforcement Assistance Administration, xxviii Lawrence, Martin, 89, 90 LDD, 870 LDF, 327 Lead Belly, 521 League of Nations, 212, 739, 864, 915 League of Spiritual Discovery, 227, 546 Leahy, Patrick, 139 Learned effects, 968–969 Learned tolerance, 316 Leary, Timothy, 47, 227, 434, 544–546, 561 Led Zeppelin (music group), 188 Lee, Burton J., III, 751 Lee, Cherilyn, 512–513 Lee, Doria, 469 Lee, Henry, 956–957 Lee, Rensselaer, 187 Lee, Sheila Jackson, 380 Leen, Jeff, 239 Legal Aid, 803

Legal drugs, xxv Legalization, 277, 322, 468–469, 546–550 Legend drugs, 908 Lehder, Carlos, 124, 202–203, 239, 281, 282, 374, 525–526, 585, 586 Leon, Richard J., 353 Leonhart, Michele M., 552–553 Leoni, Téa, 89 Leukoplakia, 454 Levo-alpha-acetylmethadole (LAAM), 329, 703–704, 707, 870 Lewin, Jack, 221 Leyzaola, Julian, 523–524 Liaison Task Panel of the President’s Commission on Mental Health, 693 Libritabs, 774 Librium, xxxii, 745, 774, 818, 901 Licit Opium Imports Act, 231 LifeRing, 41 LifeRing Secular Recovery, 553, 553–555 Lightner, Candy, 618 Lightner, Cari, 618 Lil’ Flip (rapper), 872 Lil Wayne (rapper), 872–873 Linares Castillo, Jose Evaristo, 86 Lincoln, Abraham, xlv–xlvi, 555–557 Linder, Charles O., lix–lx, 557 Linder v. United States, lix–lx, 557–558 Lindesmith, Alfred, 67, 240, 303, 558–559 Lindesmith Center, 303, 833 Liothyronine, 774 Liotta, Ray, 124 Lipoxide, 774 Liquor, xliv, l Little, Clarence Cook, 224, 225 Little Richard (musician), 807 Locke, John, 304 Loewi, Otto, 674 Loggia, Frank, 813 Lohan, Lindsay, 109 Lonamin, 849 Londono, Jose Santacruz, 152 Longhouse Religion, 792–793 Long-term potentiation, 559–560, 676 Lopressor, 774 Lorazepam, 816, 820

Index  1141

Lorea, Joaquin Guzman, 895, 896 Lorillard Tobacco Company, 578 Lorre, Peter, 742 Los Zetas, 895 Love, Courtney, 189, 888 Love Serve Remember Foundation, 48 Low, Seth, 82 Lowinson, Joyce, 160 Lowry, Rich, 888 Loxitane, 774 LSD (lysergic acid diethylamide), xxxi, xxxiii, 560–563; as antagonist, 675; availability of, 977, 978; Cobain, Kurt, and, 189; as controlled substance, 217, 270, 298, 444–445, 816; counterculture and, 214, 227; discovery of, 493–494; electronic dance music and, 362; flashbacks with, 861; as hallucinogenic, 328, 462, 727, 860, 918; Leary, Timothy’s advocation of, 544–546; pregnancy and, 409, 966; prohibited in United Kingdom, lxix; as psychedelic drug, 771, 772; raves and, 59, 254; as soft drug, 466; synthesized, lxiii; testing for, 310; as threat, lxix LSD-25, 47 Lucas, Frank, 94, 95, 563–566 Ludes, 250 Lunesta (eszopiclone), 92, 748 Lung cancer, lxiv Lungren, Dan, 340 Luvox, 774 Lyman, Charles, liii Lysergamides, 462 M, 594–597 M-19 (April 19 Movement), 377, 449 Maastricht Treaty, 375 Madonna, Matty, 93 Mafia, 66, 67, 117, 314, 734 Magnuson, Warren G., lxix Maine Law (1851), 881 Maintenance clinics, 627 Major tranquilizers, 901 Malfunshun (music group), 887 Malloy, Edward A., 751

Mamas and the Papas, 461 Mandatory sentences, lxxxiii, lxxxvii, 196, 268, 286, 313 Mandatory treatment, 567–568 Mann, James R., 471, 975 Mann, Marty, lxiv, 642 Mann Act (1912), 391, 953–954 Mansfield Amendment Repeal Act (1986), 295, 337 Mansfield Amendment to the Foreign Assistance Act (1981), 295, 337 Manske, Richard Helmuth Fredrick, 255 Ma Rainey, 521 Maraniss, David, 696 Margolis, Mark, 815 Marihuana Tax Act (1937), xxvii–xxviii, xxxii, lxiii, 66, 124, 125, 214, 216, 395, 539, 568–570, 570, 572, 589–590, 907, 999–1009 Marijuana, xxvi, xxxi, xxxii, 466, 570–573; as addictive, 7, 860; analgesic effects of, 62; availability of, 977, 978; California ban of, lvii; Cobain, Kurt, and, 189; as controlled substance, 217, 298, 816; counterculture and, 214; dangers of, lxiv; date-rape and, 335; decriminalization of, lxxv, 214, 245; designer drugs and, 252; drug paraphernalia and, 300, 327–328; effects of, 98; euphoria and, 970; growth of, lviii; as “illicit drug,” 855; legalization of, lxx, lxxxvi, 468–469, 550–552, 697– 698, 777–778; medical, 158, 159, 215, 220, 292, 328, 571, 784–785, 891, 1097– 1100; in Mexico, lxxix; in movies, 369– 370; physical dependence and, 207–208; pregnancy and, 965, 967; recreational, 794–795; sexual victimization and, 31; synthetic, 612; testing for, 309, 940; trade and trafficking of, 315, 317; use and abuse of, lxvi, 72, 85, 892. See also Cannabis; Tetrahydrocannabinol (THC) Marijuana: Weed with Roots in Hell and Devil’s Harvest (movie), 796 Marijuana AIDS Research Service, 785 Marijuana Anonymous, 197 Marijuana businesses, 573–577

1142  Index

Marijuana Dispensary Raids (2011), 1100–1102 Marijuana drug laws, lxii–lxiii Marijuana Inventory Tracking Solution, 245 Marijuana Policy Project, 159, 590 Marinol, 158, 220, 223, 890 Maris, Roger, 846 Maritime Drug Law Enforcement Prosecution Improvements Act (1986), 296, 337 Markham, Dean, 17 Marlboro, lviii, lxvi Marley, Bob, 370 Marshall, John, 827 Marshall, Thurgood, 302, 364 Martin, Boyce, 822 Martin, William, 622 Martin, Willie, 939 Martinez, Bob, 107, 291–292, 702 Massachusetts Society for the Suppression of Intemperance (MSSI), 56 Master-Settlement Agreement (MSA), 577–580 Mastrantonio, Mary Elizabeth, 813 Mather, Cotton, xli Mather, Increase, xlii Maxwell House, lviii Mayhew, Christopher, 593–594 Mazanor, 849 Mazindol, 849 McAdoo, William, 836 McCaffrey, Barry, lxxxiii, 292, 580–584, 702 McCain, John, 578 McCarthy, William J., 751 McCollum, Bill, 154 McConaughey, Matthew, 370 McCoy, Alfred, 160 McCoy, Bill, 26, 584–585, 767 McCoy, George, 212 McDougal, Arthur, 807 McFarlane, James, 956 McGwire, Mark, 845, 846–847 McKee, Grace, 613 McKinley, William, 637 MDA, 356

MDEA, 356 MDMA. See Ecstasy (MDMA) MDPV, 98, 252 “Me Decade,” 852 Medellín Cartel, lxxvi, lxxvii, lxxix, lxxx, lxxxi, 119, 122–124, 148, 149, 150, 151, 161, 198, 202–203, 204, 281–282, 315, 373–374, 377, 585–588, 886 Medical marijuana, 158, 159, 215, 220, 292, 328, 571, 588–592, 784–785, 891, 1097–1100 Medical Marijuana, Inc., 574, 591 Medical Marijuana Business Conference, 446 Medications, 903–904 Medicine and Dentistry of New Jersey, University of (UMDNJ) Asian Indian Health Disparities Coalition, 455 Meese, Edwin, 592–593 Meitiner, Howard, 732 Mejilla, Paco, 118 Mellaril, 774 Melson, Kenneth, 133 Melvins (music group), 887 Memorandum for Selected United States Attorneys (Medical Marijuana), 1097–1100 Menzel, Idina, 492 Meperidine, 703, 707, 816, 870 Mephedrone, 98 Meprobamate, 250 Merck & Company, xlv, 425 Mermelstein, Max, 199 Merritt, Gilbert, 822 Merry Pranksters, 227 Mescaline, 85, 270, 328, 462, 466, 593– 594, 728, 771 Mesolimbic reward pathway, 859 Metallica (music group), 371, 737 Metcalf-Volcker Law (1962), 802 Methadone, xxxiv, 4; as controlled drug, 816; distribution of, lxv; harm reduction and, 213, 597–598, 903; heroin addicts and, 257–258; as maintenance drug, 217, 278, 628; opiates and, 903; as prescribed drug, 820; as synthetic drug, 329, 703,

Index  1143

870; testing for, 310, 940; treatment program for, 598–599 Methamphetamine, xxxiii, 58, 599–603; as addictive, 8, 10, 860; as agonist of dopamine, 674; alcohol abusers and abusers of, 666; as controlled drug, 816; crystal, 59; drug paraphernalia and, 300; drug purity and, 306; euphoria and, 970; as hard drug, 466; illegal immigrants and, 913; illicit production of, 320; legislation and, 204–206, 218–219; pregnancy and, 966; pseudoephedrine in making, 718; sexual assaults and, 969; as stimulant, 848; as synthetic drug, 870; testing for, 940; trade and trafficking of, 284, 298, 315, 320; use and abuse of, 265, 370, 379 Methamphetamine Interagency Task Force, 219 Methamphetamine Task Force, 485 Methandrostenolone anabolic steroid, 843 Methaqualone, 250, 251, 781, 816, 818 Methcathinone, 848 Meth labs, 58, 204 Methohexital, 774 Methylene, 252 Methylenedioxy, 320 Methylethyl nitrosamine, 180 Methylone, 362 Methylphenidate (Ritalin), 8, 59, 166, 774, 816, 848, 849 Metopon, 210–211 Metoprolol, 774 Metro faction, 452 Mexican drug cartels, 281, 283–284, 914 Mexican drug trade, 603–605 Mexican drug trafficking, 600 Mexican heroin, 712, 714 Miami, as drug capital of the world, 239–240 “Mickey” chloral hydrate, 818 Midazolam, 816 Migraines, 590 Military and drug use, 606–607 Military drug interdiction, lxxix Miller, Arthur, 614 Miller, John, 630

Miltown, 901 Minaj, Nicki, ft. 2 Chainz (music group), 737 Minimum drinking age, lxxviii Minnelli, Liza, 852 Minnesota, limits on public smoking, lxxiv Minnesota Model, 41, 49, 417, 475, 607–608 Minorities and drug use, 608–609 Minor tranquilizers, 901 Miscarriages, 967 Mises, Ludwig von, lxv Misperception, 38 Mr. Coffee, lxxiii Misuse of Drugs Act (United Kingdom), lxxii Mitchell, George J., 845, 847 Mitchell, John, 145, 957 Mitchell Report, 845, 847 Mitchum, Robert, 370 Mitterrand, Francois, 375 MK-ULTRA project, 743, 771 MMI Biotechnology, 574 MMI Technology, 574 Moderation Management (MM), 41, 49–50, 905 Mogadon, 818 Molasses, tax on, xlii Molasses Act (1733), xlii Molecular pharmacology, 729 Molina-Tarazon, U.S. v., 937 Molla, Jordi, 124 Molly, 355, 356, 362, 371, 737 Monamine, 68 Monamine oxidase, 68 Moncrieffe, Adrian, 609–611 Moncrieffe v. Holder, 609–611 Money laundering, 453 Money Laundering Crimes Act (1986), 338 Monitoring the Future Survey, 611–613, 772 Monk, Thelonious, 370 Monoamine oxidase inhibitors (MAOIs), 68–69, 70, 255, 774 Monoamines, 673–674, 674–675 Monroe, Marilyn, 92, 270, 613–615

1144  Index

Monson, Diana, 783 Monster, 147, 148, 365, 850 Monterey Pop Festival (1967), 461, 479 Montieth, Cory, 482 Montoya-Sanchez organization, 283 Mood disorders, 168 Mood stabilizers, 8, 9, 102 Moonshine production, 26 Moore, Hazel Diane “Rasheeda,” 96 Moore, Kenneth Doniell, 487 Morality policy, 615–616 Moreau, Joseph, xlv Morgan, Alan James, 124 Morphine, xxxii, 616–617, 706, 918; addiction to, lx, 616–617; as analgesic, 61; binding to receptors, 675; Burroughs, William’s use of, 85; in Civil War, xlvii; as controlled drug, 217, 816, 918; discovery of, xlv; as hard drug, 466; heroin as alternative to, liii; as main ingredient in treatment drugs, 725; natural production of, 703; as prescribed drug, 820; production of, xlv; psychoactive agent of, 822–823; studies using, 676; testing for, 940; use and abuse of, 466 Morphinomimetics, 61 Morris, Alex, 148 Morrison, Jim, 85, 482 Morton, John, 929 Moss, Kate, 888 Moss, William, 751 Mothers Against Drunk Driving (MADD), 345, 617–619, 619, 645, 654 Motion sickness pills, 719 Motivational Enhancement Therapy, 19, 567, 904 Motown, 807 Mott, Lucretia, xlvi Muckrakers, 725 Muhammad, Ishmeel, 93 Muhammad Ali, 565 Mullen, Francis, Jr., 619–620, 656 Multidimensional therapy, 905 Multiple sclerosis, 590 Multisubstance addictions, 236

Munday, Michael “Mickey,” 198–199 Murad, Sultan, IV, xl–xli Murphy, Francis, 797 Murray, Bill, 103 Murray, Conrad, 512 Musto, David, 160, 514, 836 Mydland, Brent, 445 Myopia, 970 Nadelmann, Ethan, 303, 621–622 Naldolol, 774 Naloxone, 676 Naloxone auto-injecter Evzio, 481 Naltrexone, 4, 35, 622–623, 676, 903 Nandrolone decanoate anabolic steroid, 843 Nandrolone phenylpropionate anabolic steroid, 843 Nanjing, Treaty of (1842), 441 Napoleon Bonaparte, xliv Naproxen (Aleve), 61, 718 Narcan, 189 “Narco” (narcotic farms), 742 Narcotic Addict Rehabilitation Act (1966), 216, 218, 624–626, 777 Narcotic Anonymous, 197 Narcotic clinics, 626–628 Narcotic Control Act (1956), 67, 71, 124, 126, 216, 218, 270, 359, 396, 559, 624, 628–630, 787, 865 Narcotic Division of the Prohibition Unit, 691–692 Narcotic drug addicts, lix Narcotic Drugs Import and Export Act (1922), 125, 394, 630–631, 740, 907–908 Narcotic farms, 741, 775–776 Narcotic Import and Export Act, 624, 629 Narcotics, xxvi, xxxii, 285, 631–632, 706 Narcotics Addict Rehabilitation Act (1966), lxix, 518 Narcotics and Dangerous Drugs, Bureau of, 518 Narcotics Anonymous (NA), xxxiv, lxv, 4, 632–635 Narcotics Certification Process, 136 Narcotics Control Act (1956), lxvii

Index  1145

Narcotics Control Coordinator, 145 Narcotics Traffickers Deportation Act (1986), 295, 337 Narcotic Technical Support Center, 485 Nation, Carrie, xxvii, 635–638, 880, 963, 971 Nation, David A., 636 National Advisory Commission on Narcotics and Drug Abuse, lxviii National Advisory Council on Drug Abuse, 268 National African American Drug Policy Coalition (NAADPC), 19 National Alcohol and Drug Recovery Month, lxxxii National Anti-Opium Association, 240 National Assets Seizure and Forfeiture Fund, 80 National Association of Criminal Defense Lawyers, 81 National Association of State Alcohol and Drug Abuse Directors, 638–639 National Basketball Association, 842 National Center for Chronic Disease Prevention and Health Promotion, 164 National Center on Addiction and Substance Abuse, 263, 312, 808 National Civil Crusade, 690 National Clearinghouse for Alcohol and Drug Information (U.S.), 639–640 National Coalition Against Domestic Violence, 262 National Collegiate Athletic Association, 842 National Commission on Marijuana and Drug Abuse, xxvii, lxxiii, lxxiv, 214, 509, 657, 687 National Committee for Education on Alcoholism (NCEA), lxiv, 640–641, 649 National Committee on Alcoholism, 641–642 National Council of American Indians (NCAI), 667 National Council of Churches, 208 National Council on Alcoholism, 41

National Council on Alcoholism and Drug Dependence (NCADD), 516, 640–643, 649 National Crime Victimization Survey, 232 National DARE Day, 141 National District Attorney’s Association, 38 National Drug Abuse Conference (1978), 693 National Drug Abuse Training Center, 268 National Drug Control Policy, 309 National Drug Control Strategy, xxx, 137, 291, 582, 643–645, 697, 701, 702, 1089–1095 National Drug-Free Workplace Alliance, 340 National Drug Policy Board, 156, 592, 645, 645–646 National Drug Trade Conference (1913), 471 National Education Association, 208 National Endowment for the Humanities, 106 National Firearms Act (1934), 131 National Football League, 842 National Formulary, 413 National Health Council, 212 National Hockey League, 842 National Household Survey on Drug Abuse, 647–649 National Household Survey on Drug Use, 186–187, 229, 320, 886 National Impaired Driving Prevention Month, 645 National Industrial Recovery Act (NIRA), 390 National Instant Criminal Background Check System (NICS), 132 National Institute Drug Abuse, xxviii National Institute of Mental Health, xxviii, 211, 217, 854; Addiction Research Center of, 776 National Institute on Alcohol Abuse and Alcoholism (NIAAA), 27, 34, 42, 113, 142, 260, 397, 404, 639, 642, 649–651, 650, 854

1146  Index

National Institute on Drug Abuse (NIDA), lxxxii, 3, 4, 5, 27, 42, 43, 114, 142, 195, 215, 229, 268, 320, 510, 601–602, 611, 650, 651–653, 661, 744, 790, 842, 854, 859, 902, 965 National Institutes of Health (NIH), 27, 272, 730, 854 National Interagency Council on Smoking and Health, 885 National Labor Relations Board, 390 National Library of Medicine, 272 National Marijuana Initiative, 582 National Methamphetamine and Pharmaceuticals Initiative, 484 National Minimum Drinking Age Act (1984), 618, 653–655 National Motor Vehicle Theft Act (1919), 391 National Narcotics Border Interdiction System (NNBIS), 655–657, 933 National Northern Border Counternarcotics Strategy, 701 National Organization for Reform of Marijuana Laws (NORML), lxii, lxxi, 134, 159, 208, 222–223, 590, 657–659, 658, 784 National Organization for Youth Safety, 662 National Prohibition Act (1919), lviii. See also Volstead Act National Prohibition Enforcement Bureau, 948 National Public Education Fund, 899 National Public Health Institutes, 164 National Recovery Month, 642 National Research Council, 210, 211, 212, 213; Report on Drug Enforcement Activities, 659–660 National Rifle Association (NRA), 133 National Security Act (1947), 166 National Security Council, 166 National Security Investigations Division, 930 National Smokers’ Alliance (NSA), 830 National Survey on Drug Use and Health (NSDUH), 33, 59, 169, 266, 297, 500, 731, 854, 902, 977

National Targeting Center--Cargo (NTC-C), 928 National Tracing Center (NTC), 132 National Treasury Employees Union v. Von Raab, lxxxi, 660–661, 941 National Treatment Network, 639 National Urban League, 672 National Youth Anti-Drug Media Campaign, 621, 644, 661–663, 701 Native American Church, 363, 462, 727, 793 Native Americans: Alcoholics Anonymous and, 793; alcohol mutual aid societies and, 28–29; banning sale of alcohol to, lii; recovery circles for, 792; substance abuse and, 663–670; tobacco and, 897 Native Free Exercise of Religion Act (1994), 728 Natural Law, 304 Natural (nonsynthetic) opiates, 704 Nausea/vomiting, 590 Navarro, “Fats,” 370, 514–515 Near beer, 949 Needle exchange programs, xxxiv, 468, 490, 671–673 Needle sharing, 277 Nembutal, iv, 91, 330, 774, 818 Neolin, 792 Nephrine reuptake inhibitors (NRIs), 675 Ness, Eliot, 131 Netherlands, control of drugs in, lxxxvi Neuroleptics, 9, 901 Neuromodulators, 673 Neuropharmacology, 729 Neurotransmitters, 1, 68, 673–677 New Age philosophy, 447 Newborn, Phineas, 807 New Edition, 129 New Juárez Cartel (NCJ), 523 Newman, Thomas “Flash,” 754 New York Academy of Medicine, 126 New York City, coffee and, xlvi New York City Medical Committee on Alcoholism, 54 New York City Medical Society on Alcoholism, 54

Index  1147

New York City Parole Commission, 211 New York State Narcotics Addiction Control Program, lxix New York Times, opposition to smoking, xlix New York Urban Coalition, 693 Nicaraguan Contras, 167 Nichopolous, Dr., 754 Nicki Minaj ft. 2 Chainz (music group), 371 Nicotine, xxv, 7, 8, 10, 69, 84, 310, 329, 677–686, 817, 961, 965–966; as addictive, 860; as cause of lung and laryngeal cancer, 866; as hard drug, 466; as psychoactive drug, 849; replacement therapies, 684; as stimulant, 848; studies using, 676; withdrawal, 682–683 Nicotine Anonymous, 197, 679 Nimodipine, 774 Nimotop, 774 Ninth Amendment, 783 Nirvana, 189 Nirvana (music group), 887 Nitrites, 287, 501 Nitrosamines, 180 Nitrous oxide, 771 Nixon, Richard M.: drug policies and legislation of, xxvii, xxviii, lxxi–lxxii, lxxiii, lxxiv, 18, 27, 145, 161, 206, 207, 208, 216, 222, 268, 285, 293–294, 419, 436, 649, 657, 686–688, 699–700, 802, 815, 835, 893, 924; Special Message to the Congress on Drug Abuse Prevention and Control (1971), 1009–1019 No Child Left Behind Act (NCLB) (2001), lxxxv, 344 Noctec, 774 No Fear, 147 Nonsteroidal anti-inflammatory drugs (NSAIDs), 61 Norepinephrine, 69, 675, 727 Noriega, Manuel Antonio, lxxvii, lxxxi, lxxxii, 137, 167, 282, 315, 688–691, 933 Norris, Ryan, 105 North American Free Trade Agreement (NAFTA) (1993), lxxxiii, 524 Norton, Karen, 339

Notorious B.I.G., 487 Novoselic, Krist, 189 Nutt, Levi G., 65, 212, 394, 626, 627, 691– 692, 740, 768 Nyquil, 85 Nyswander, Marie, xxxiv, 67, 257–258, 396, 598, 692–694 Oakland Cannabis Buyers’ Cooperative (OCBC), 695–696, 783 Oakland Cannabis Buyer’s Cooperative, U.S. v., 696 Obama, Barack, drug policies and legislation of, xxix, lxxxiii, 209, 252–253, 288, 292, 312, 378, 379, 386, 387–388, 643, 645, 696–699, 703, 821, 929 Obsessive-compulsion, 1 Ocampo, Jose Olmedo, 151 Ochoa, Jorge, 281, 585, 586 Ochoa, Juan David, 281, 585 Ochoa, Fabio, 281, 585 Ochoa, Fabio, Jr., 586 Ochoa, Fabio, Sr., 586 O’Connor, Sandra Day, 155, 364, 403 Odetta, 521 O’Donnell, Chris, 492 Office of Applied Studies, 854 Office of Demand Reduction, xxix, 700–701 Office of Drug Abuse Law Enforcement (ODALE), lxxiii, 699–700 Office of Drug Abuse Policy, 420 Office of Intelligence, 294 Office of Justice Programs, 247 Office of Juvenile Justice and Delinquency Prevention, lxxiv Office of National Drug Control Policy (ONDCP), xxviii, xxx, lxxxii, 73, 106, 163, 214, 288, 290–291, 292, 307, 309, 320, 343, 345, 483, 504, 583, 643, 667, 669, 696, 698, 700–703, 702, 751, 866, 931, 951 Office of National Narcotics Intelligence, 700 Office of Strategic Services, 166

1148  Index

Office of Substance Abuse Prevention, 161 Office of Supply Reduction, xxix, 701 Office on Smoking and Health, 164 Ohio Anti-Saloon League, 74 O’Leary, Alice, 785 Omnibus Crime Control and Safe Streets Act (1968), 230 Onassis, Jackie, 852 O’Neill, Tip, 110 One pot method, 205 Onondaga people, 792 Opacura, 725 Open society, 833–834 Operant Conditioning, 893 Operational intelligence, 294 Operation Banco, 933 Operation Banshee, 118 Operation Blast Furnace, 933 Operation Blue Lightning, 933 Operation Boomer/Falcon, 933 Operation Camarena, 154 Operation Casablanca, lxxxiv Operation Condor, 933 Operation Cooperation, 932 Operation Fast and Furious, 133, 386–389 Operation Green Ice, 934–935 Operation Grouper, 933 Operation Hellflower, 440 Operation Hybrid, 484 Operation Intercept, lxx–lxxi, 932 Operation Just Cause, 137, 690 Operation Leyenda, 933 Operation Rosebud, 326 Operation Snowcap, 933 Operation Stopgap, 933 Operation Swordfish, 933 Operation Tiburon, 933 Operation Trizo, 933 Operation Understanding, 642 Opiate addiction treatment drugs, 705 Opiates, xxvi, xxxii, 10, 287, 329, 703–705; as addictive, 7, 240, 257–258, 278, 706, 860; as analgesic, 61; as controlled substance, 285; as hard drug, 466; natural (non-synthetic), 704; pregnancy and, 967; semisynthetic, 705; synthetic, 705;

testing for, 309, 310, 940; trade and trafficking and, 317; use and abuse of, 820; withdrawal from, 961 Opioid antagonists, 9, 102 Opioid REMS, 55 Opioids, 674, 675–676 Opioid Therapy, xxxiv Opium, xxxii, xliv, 84, 173–174, 705–708; addiction to, 706; compared to liquor, l; as controlled drug, 816; early use of, xxxvii; influence of, xliv; Iran ban of, lxvii; laws on, xliv; as medicine, xli; opiates derived from, 703; pharmacological effect of, xlvii–xlviii; smoking of, 709, 831–832; trade of, liv, 711–715; use and abuse of, xxxviii, lxiv Opium Addiction in Chicago, 241–242 Opium Control Act (1942), 708–709 Opium dens, xlix, 709–711, 985 Opium Exclusion Act (1909), liv Opium poppies, 282, 317, 440–441, 712 Opium Poppy Control Act (1942), lxiv Opium trade treaty, liv Opium Wars, xlv, xlvi, 174–175, 441, 715–716 Oral fluid tests, 309 Oral submucous fibrosis, 454 Orap, 774 Ordaz, Diaz, 687–688 Order of Good Templars, 29 Order of the Friends of Temperance, 29 Oregon, Employment Division, Department of Human Resources v. Smith, 363–365 Organization of American States, 188 Organized crime, drug trafficking and, 321–324 Organized Crime Control Act (1970), 132 Organized Crime Drug Enforcement Task Force (OCDETF), lxxvii, 716–717, 717 Organized crime groups, 317–318 Organized Drug Enforcement Task Force, 387 Orlaam, 870 Ortega, Ruben B., 751–752 Ortiz, David, 846 Ortiz, Juan Antonio, 451

Index  1149

Orza, Gene, 805 Osgood, Joshua Knox, 797 Osorio-Arellanes, Heraclio, 389 Osorio-Arellanes, Manuel, 389 Other Café (comedy club), 462 Ottoman Empire, tobacco use in, xl–xli Over-the-counter drugs (OTCs), 60, 204, 205, 717–719, 903 Over-the-Counter Review Committee, 717–718 Oxandrin anabolic steroid, 843 Oxandrolone anabolic steroid, 843 Oxford Group, 39–40, 828 Oxycodone, 60, 61, 706, 719–720, 889–890; as controlled drug, 816; as prescribed drug, 820; as synthetic drug, 703; testing for, 940 OxyContin, xxv, xxxi, xxxii, 166, 329, 632, 719–720, 747, 816, 886, 889; as psychotherapeutic drug, 773; as synthetic drug, 870; as timed-release preparation, 719 Oxymetholone anabolic steroid, 843 Oxymorphone, 622, 703 Pacino, Al, 492, 813 Paine, Thomas, 155–156 Pain relievers, 748 Pain seizures, 590 Palladium (club), 853 Palombo, Bob, 117 Panadol, 61 Panama: cocaine transport through, lxxvii; U.S. invasion of, lxxxii Pan-American Coffee Bureau, lxii, lxvi Panesso, Jimenez, 118, 119 Panic attacks, 76 Panic disorders, 76 Pan-Indian imagery, 793 Pantoliano, Joe, 89 Paracelsus, xxxviii Paraldehyde, 250 Paregoric, 706 Parent Drug Corps, 142 Parents Advisory Council on Drug Abuse, 702

Parents movement, 246 Parents Resource Institute for Drug Education (PRIDE) Surveys, 721–723 Paris Protocol (1948), lxv Parke David, 425 Parker, Charles, 370, 515 Parker, Jon, 671 Parker, Quanah, 793 Parker, Willard, xlviii Paroxetine, 774 Parrish, Joseph, xlviii, 52 Parsons, Benjamin, xlv Parsons, Richard D., 752 Partial agonists, 10 Partnership for Drug-Free America, lxxx, 662–663, 667, 723–724, 784 Patent medicines, xxvi–xxvii, 725–726 Paterson, David, 19 Pathological gambling, 100, 101 Patino, Uriel, 386 Patino-Fomeque, Victor Julio, 282, 283 Patriot Act, 204 Paul, Aaron, 957 Paxil, 774 Payne Whitney Psychiatric Clinic, 614 PCP (phencyclidine), xxxi, 328, 329; as anesthetic, 463; breast feeding and, 967; as controlled substance, 298; as hallucinogen, 462, 730–732, 860; psychedelic properties of, 771; as synthetic drug, 870, 871; testing for, 309, 310, 940 Pearl Jam (music group), 887 Pedraja, William, 411–413 Peet’s Coffee and Tea, lxix Pellens, Mildred, 212 Pelletier, Lynn, 423 Pemberton, John, l Pemberton, John Styth, 193 Pemoline, 774 Penn, William, xli Pentazocine, 703 Pentobarbital, 774, 816 People Persecuted by Pablo Escobar (Los Pepes), 375 Pepper, Art, 370, 514

1150  Index

Peralta, Jhonny, 848 Percocet, 166, 329, 632, 719, 720, 816 Percodan, 719 Performance enhancing drugs (PEDs), 519–520, 738, 778, 804, 846 Perlich, Max, 124 Personal Liberty League of the United States, xlix Pet Hemp Emporium, 575 Petty, George E., liii Petty, Tom, 370, 371 Petty, Tom, and the Heartbreakers (music band), 737 Peyote, xxxiii, 270, 328, 363, 669–670, 726–729; buttons of, 593; as controlled drug, 816; as drug, lix; as hallucinogen, 462 Peyotillo, 328 Pfaff, Kristen, 888 Pfeiffer, Michelle, 813 Pharmacology, 729–730; behavioral, 729; biochemical, 729; cardiovascular, 729; clinical, 730; endocrine, 729–730; molecular, 729 Pharmacopoeia of the United States, lvii Pharmacy Act (U.K.), xlviii Pharmacy Act (U.S.) (1868), xlviii Phencyclidine. See PCP (phencyclidine) Phendimetrazine, 816, 849 Phenergan with Codeine, 200, 816 Phenethylamines, 463, 727 Phenobarbital (Nembutal), lv, 91, 330, 774, 818 Phenothizines, 901 Phentermine, 849 Phenyl-2-propanone, 205 Phenylpropanolamine, 59 Philadelphia Committee for the Clinical Study of Opium Addiction, 212 Philip Morris, 224, 578, 579, 830, 900 Phillips, John, 461 Phillips, Sam, 753 Phobias, 76 Phoenix, River, lxxxiii, 482 Phoenix Financial Task force, 485 Phoenix House, lxx, 732–734

Phoenix House Academy, 733 Phusion Projects, 421–422 Physical addiction, 1 Physical dependence, 2 Physical violence, alcohol and, 260–261 Physicians’ Role in the Prevention and Treatment of Substance Abuse, 55 Physostigmine, 825 PhytoSPHERE, 575 Pimozide, 774 Pimp-C, 486 Pimp-C (rapper), 872 Pinchet, Augusto, 191 Pink Floyd (music group), 371, 737 Pinkman, Jesse, 957 Pinochet, Augusto, 585 Pizano, Ernesto Samper, 188 Pizano, Samper, 151–152 Pizza Connection, lxxviii–lxxix, 592, 734–736 Placidyl, 92 “Plan Colombia” effort, 866 PMA, 356 Podhoretz, Norman, 888 Poe, David, Jr., 84 Poe, Edgar Allan, 84 Poe, Henry, 84 Police impersonation, 453 Policy on International Counter Narcotics, 185 Political Declaration and Plan of Action on International Cooperation Towards an Integrated and Balanced Strategy to Counter the World Drug Problem of 2009, 915 Polynuclear aromatic hydrocarbons, 180 Polysubstance addictions, 236 Polyvictimization, 169 Poppers, 502 Poppies, lxiv, lxxii, 329, 441 Poppy juice, xxxvii Poppy plant, 708–709 Poppy seeds, xxxvii Popular culture, 736–739 Porter, Stephen G., 394, 739–741, 775, 864

Index  1151

Porter Narcotic Farm Act (1929), lxi, 625–626, 741–744, 775, 997–999 Portillo-Mez, Lionel, 389 Portugal, decriminalization of drugs in, 244 Posse Comitatus Act (1878), lxxvii Post, Charley, li Postaccident testing, 310 Posters ‘N’ Things v. United States, 302 Posttraumatic stress disorder (PTSD), 3, 76, 168, 356 Pot churches, 447 Potente, Franka, 124 Potentially reduced exposure products (PREPs), 681 Pottawatomie County v. Earls, 310 Powder cocaine, 109, 379 Powell v. Texas, 802 Powis, Robert, 734 Prazepam, 774 Predatory drugs, 744–746 Pregnancy, 964–968 Prelu-27, 849 Prentice, Alfred C., lix Preponderance of the evidence, 81 Prescription Drug Abuse Action Plan, 701 Prescription drugs, xxxi, 370, 430, 747– 749, 908 Prescription shop, 749 Presidential Commission on Narcotic and Drug Abuse, 624 President’s Advisory Commission on Narcotics and Drug Abuse, 396, 528, 749–751, 960 President’s Commission on Law Enforcement and Administration of Justice (the Katzenbach Commission), 518 President’s Commission on Organized Crime, 150, 419–420, 518, 587, 734 President’s Council on Counter-Narcotics, 702 President’s Drug Advisory Council, 751–752 Presley, Elvis, 134, 752–755, 807 Presley, Priscilla, 753 Pressler, Herman P., III, 752

Pretty Lights, 362 Prettyman, E. Barrett, 17, 528 Prettyman Commission, 517, 960 Prevention, 755–759 Prevention education, 162 Prilosec, 718 Primary prevention, 506, 755 Primary reinforcers, 893 Primobolan, 805 Prinze, Freddie, 781 Prison Ashram Project, 48 Prisoners, lxxiii Prison inmates, 759–762 Probable cause, 81 Probation, 305 Problem identification and referral, 162, 756–757 Process addiction, 1 Prohibition, xxvii, xxxvii, lvii, lviii, lxi, 75, 317–318, 357, 390, 762–764, 828, 879, 881. See also Eighteenth Amendment Prohibition Act (1920), 762 Prohibition Amendment, 75 Prohibition Bureau, ix, 65, 766 Prohibition crimes, lxi Prohibition Party, xlviii, 764–765, 838, 964 Prohibition Unit, lviii, 24, 26, 65, 131, 394, 766–768 Project ALERT, 758 Project MATCH, 650 Promazine, 774 Prometa, 8, 768–769 Promethazine, 872 Pronto Demolition, 735 Propellants, 328 Proposition 19 (California), lxxxvi Proposition 36 (California), 278 Proposition 187 (California), 913 Proposition 200 (Arizona), 278, 313 Proposition 215 (California), 215, 220, 590, 695 Propoxyphene, 707, 870 Prostitution, lv Prostitution network, 453 Protection racketeering, 452 Proverbs 31:6-7, xxxvii

1152  Index

Prozac, 69, 673, 774 Pryor, Richard, lxxvi Psalms, 104:14-15, xxxvii Pseudoephedrine, 59, 205, 372–373, 600, 718, 849 Psilocin, 769–771 Psilocybin, lxviii, 462, 727, 769–771, 771 Psychedelics, 727, 771–772, 772, 860 Psychoactive drugs, 226, 227 Psychoanalysis, 424 Psychological addiction, 1 Psychological reasons for substance abuse, 114 Psychotherapeutic drugs, 773–775 Psychotherapeutics, 855 Psychotherapy, 904 Psychotoxic Drug Control Act, 270 Psychotropic substances, 916–918 Public Awareness and Private Sector Initiatives Act (1986), 338 Public Health Cigarette Smoking Act (1969), 885, 898 Public Health Service Act, 336, 647 Public Health Service Narcotics Hospitals, 66, 125, 210 Public Health Service Program for Drug Abuse Research, U.S., lxii Public opinion and drug use, 777–779 Public policy, drug addiction and, 275–279 Public service announcements (PSAs), 662–663 Pubs in Massachusetts, xli Pure Food and Drug Act (1906), xxvii, liii, liv, 193, 413, 470, 568, 589, 725, 779–780, 831–832, 935, 985–990 Pure research, 212 Purple drank, 200 Pyramiding, 842 Pyromania, 100–101 Quaalude, 781–782, 818 Quakers, xli Quarterly Journal of Inebriety, xlix Quazepam, 774 Quezon, Manuel, 470

Quinine, 870 RADD: The Entertainment Industry’s Voice for Road Safety, 645 Radio Shack, 386 Radner, Gilda, 103 Rado, James, 461 Radomski, Kirk, 847 Rage addiction, 100 Ragni, Gerome, 461 Raich, Angel, 783 Raich, Robert, 783 Raich v. Ashcroft, 783–784 Rainbow Gathering (1971), 489 Rainey, Henry T., 630, 739, 836 Rakontur (studio), 198 Ramelteon (Rozerem), 92 Ramirez, Jaime Gomez, 587 Ramirez, Juan Carlos, 151 Ramsey, U.S. v., 937 Rand, Ayn, 84 Randall, Robert, 509, 784–785 Random drug testing, 310 Rangel, Charles, 380 Rape, drug-facilitated, 334–336. See also Date-rape drugs Rapid Fire Marketing, Inc., 575 Rapper 2 Chainz (music group), 872 Raskob, John J., 82, 83 Rastafari, 447 Rational Recovery (RR), 41, 50, 904 Rauwolfia alkaloids, 901 Rave drugs, 870 Ravelo-Renedo, Fernando, 449 Rave parties, 745 Rave Ready, 362 Raves, 59, 254, 361–362, 871 Raytheon v. Hernandez, 785–787 Reagan, Nancy, lxxx, 110, 187, 214, 271, 272, 343, 433, 592, 787–790; “Just Say No” speech by, 1019–1024 Reagan, Ronald: drug policies and legislation of, xxviii–xxix, lxxvii, lxxx, 63, 71, 86, 106, 110, 133, 136, 138, 167, 187, 199, 235, 295, 308, 312, 336, 340, 343, 433, 446, 448, 528, 592, 619, 620,

Index  1153

645, 646, 654, 655, 657, 690, 723, 787– 790, 858, 957–958, 983; “Just Say No” speech by, 1019–1024 Reauthorization Act (2006), 702 Rebound hyperexcitability, 465 Recovery, 790–792 Recovery circles, 792–794 Recreational marijuana, 446, 794–795 Recreational use of drugs, 794–795 Red Bull, 147, 365 Red Dice Holdings, 575 Red Hot Chili Peppers (music group), 371, 737 Red Ribbon Reform Club, 29, 797, 798 Red Road concept, 793 Reduced-risk products, 681 Reefer Madness (movie), lxii, 795–797 Regulate, Control & Tax Cannabis Act, lxxxvi Regulatory failures, 322 Rehabilitation, 862, 904–905 Rehabilitation Act, 336 Rehabilitation Programs Relating to Drug Abuse, 217 Rehnquist, William, 363, 403, 937 Reid, Samantha, 334 Reid Date-Rape Drug Prohibition Act (2000), 334 Reilly, Dick, 723 Reitman, Ben, 558 Relationship addiction, 201 Religious Freedom Restoration Act (1993), 364–365 Religious Land Use and Institutionalized Persons Act (2000), 365 Reno, Janet, lxxxi, lxxxiv, 221, 377 Report of the Indian Hemp Drug Commission, li Research Council on Problems of Alcohol, 515 Research Triangle Institute, 510 Residential Substance Treatment Program, 247 Respirine, 774 Restoril, 816 Restrepo, Fabio, 373

Return to Fantazia, 362 Reubens, Paul, 124 Reverse tolerance, 194, 316 Revia, 622 Review courses, 55 Revolutionary Armed Forces of Colombia (FARC), 315, 883 Revolutionary War, 955 Reye’s syndrome, 60, 718 Reynolds, Beryl Janet, 884 Reynolds, Henry A., 798 Reynolds, R. J., Tobacco, 224, 578 Ribbon Reform Clubs, 29–30, 797–798 Rich, Frank, 662 Richardson, Friend, 944 Ricosuave, 422 RID (Remove Intoxicated Drivers), 618 Rihanna (music group), 371, 737 Rikelman, Julie, 402 Rinker, Al, 461 Ripley, Anne, 828 Risk Evaluation and Mitigation Strategies (REMS), 55 Risk factors for drug use, 799–800 Ritalin, 8, 59, 166, 774, 816, 848, 849 Rivotril, 242 Rm, xli, xlii, xliii Roberts, Jon, 198–199 Roberts, Richard “Richie,” 565 Robinson, Lawrence, 800–801 Robinson v. California, 800–802 Robitussin, 749, 816, 872 Rock, 194 Rock, Chris, 383 Rock and Roll Hall of Fame, 479 Rockefeller, John D., 75, 211 Rockefeller, Nelson, 802–803 Rockefeller drug laws, xxxiii–xxxiv, lxxv, 19, 802–804 Rockefeller Foundation, 210; Bellagio Study and Conference Center, 14 Rocking Kings, 478 Rockstar, 147 Rockstar Energy, 850 Rodriguez, Alex, 738, 804–806, 846, 848

1154  Index

Rodriguez-Orejuela, Gilberto, 149, 150, 152, 282, 377, 586 Rodriguez-Orejuela, Miguel, 149, 150, 152, 282, 377 Rofecoxib, 61 Rogers, Don, 71 Rogers, Edith, 269 Rogers, William, 145 Rohypnol (flunitrazepam), 31, 92, 242, 250, 251, 286, 330, 334, 462, 744, 745, 818, 819, 870, 966 Rojos faction, 452 Rolfe, John, xxxix, 897 Rolleston, J. D., xxxviii Rolling Stones (music group), 371, 737 Rollins, Sonny, 742 Romer, Chris, 446 Romney, Mitt, 339 Roofies, 819 Roosevelt, Franklin D., 83, 358, 389, 392, 416, 763, 907, 925, 949, 972 Roosevelt, Theodore, 391, 780, 973, 985 Root, Elihu, 831, 974 Roper, Daniel C., 836 Rophies, 819 Rosenblatt, Stanley, 367–368 Rosenblatt, Susan, 367–368 Rosenthall, Mitchell S., 732 Ross, Diana, 565 Rothstein, Arnold, 692, 768 Roy, Alvin, 845 Royal College of Physicians (Britain), 884–885, 898 Royal Ribbon Reform Club, 29 Rubell, Steve, 852, 853 Ruby Ridge, Idaho, 392 Ruffin, David, 806–807 Ruiz, Fernando Brito, 149 Rule of Law, 155 Rum, xliii “Rum Row,” 26, 585 Rural drug enforcement, 230 Rural Drug Enforcement Task Force, 943 Rural drug use, 808–810 Rusche, Sue, lxxv

Rush, 194 Rush, Benjamin, xliii, 56, 810–811 Russ, Jeffrey, 362 Russell, Howard H., 74 Russell, JaMarcus, 873 Ryder, Winona, 662 Sabin, Pauline Morton, 971 SADD (Students Against Destructive Decisions), 618, 662, 850–852 Safe and Drug-Free Schools and Communities Act (SDFSCA), lxxxv, 343 Safe and Healthy Students, Office of, as measure of School Climate, 721 Safe Ride or Designated Driver programs, 851 Safe Schools Task Forces, 247 Safe Start Program, 247 Safety First, 304 Sailors, rum for, xli Saint-Domingue: coffee growth in, xlii, xliii; slave uprising in, xliv Salamone, Phillip, 736 Salazar, Angel, 813 Salazar, Enrique Camarena, 832 Salazar, Hector Luis Salma, 895 Salicylates, 60 Saliva tests, 310, 311 Salk, Jonas, 752 Salvinorin A, 462, 463 Sanchez, Jorge Eduardo Costillo, 452 Sanchez et al., U.S. v., 569 Sanchez-Mesa, Ivan, 389 Sanders, Nowell, 954 Sandler, Adam, 383 Sandman, C. W., Jr., lxix Sandweg, John, 929 San Francisco (CA) 1875. First Drug Law in America, xxvii, 895 Sanorex, 849 San Pedro, 328 Santacruz-Londono, Jose, 282 Sativex, 158 Saturday Night Live (SNL), 103–104, 383 Saxony, ban on tobacco, xl–xli Scalia, Antonin, 363–364, 403, 412

Index  1155

Scarface (movie), 813–815 Schechter Poultry Co. v. United States, 390 Schedule I drugs, xxxii, 98, 159, 192, 206, 208, 214, 217, 218, 222, 223, 253, 255, 268, 286, 356, 463, 474, 480, 499, 533, 549, 550, 570, 590, 594, 657, 695, 696, 727, 745, 770, 781, 816, 891, 918, 921, 922 Schedule II drugs, 58, 91, 98, 196, 200, 204, 206, 214, 217, 218, 222, 223, 286, 590, 597, 600, 616, 707, 719, 731, 781, 816, 871, 918, 921, 922 Schedule III drugs, 91, 200, 217, 222, 223, 286, 530, 816, 842, 849, 918, 922 Schedule IV drugs, 91, 217, 222, 223, 286, 533, 591, 816, 849, 918, 922 Schedule of Controlled Substances (I-V), 815–817 Schedule V drugs, 200, 217, 222, 223, 286, 816 Schiller, Tom, 104 Schless, Robert A., lx Schmerber v. California, 941 Schneider, Rob, 383 School Safety Initiative, 247 Schrager, Ian, 852, 853 Schubert, Richard F., 752 Schuchard, Keith, lxxv Scientific Crime Detection Laboratory, 392 Scientific Temperance Instruction, 766 Screening, Brief Intervention, and Referral to Treatment (SBIRT), 644 Scribner, Charles, 82 Scruse, Katherine Esther, 511 Secobarbital (Seconal), 91, 92, 774, 818 Seconal, 92, 330, 774 Secondary prevention, 506, 755 Secondary reinforcers, 893 Second Chance Act (2007), 382 Second City Theatre, 383 Second Geneva Conference (1924), 740 Secondhand smoke, 367–368, 817–818, 900 Secular Organizations for Sobriety (SOS), 50, 904 Sedative-hypnotics, 92

Sedatives, 329–330, 818–819, 961; addictive potential of, 860; as “illicit drugs,” 855; withdrawal from, 961 Seek Early Intervention Opportunities in Health Care, 644 Selective serotonin reuptake inhibitors (SSRIs), 774 Self-Control Theory, 893 Self-derogation perspective, 892 Self-esteem approach, 892 Self-help, 904 Self-injury, 100 Self-Management and Recovery Training (SMART), 50–51, 904 Selig, Bud, 845, 847 Sembler, Betty, 339 Sembler, Mel, 339 Sembler Company, 339 Semisynthetic opiates, 705 Seniors and drug use, 819–820 Sentencing disparities, 820–822 Sentencing for Methamphetamine Offenses, 231 September 11, 2001 terrorist attack, lxxxiv, 244, 392–393 Seriki, Hakeem, 487 Serna, Pepe, 813 Sernyl, 731 Serotonin, 69, 675, 859 Serotonin and norepinephrine reuptake inhibitors (SNRIs), 70 Serotonin reuptake inhibitors (SSRIs), 70, 102, 675 Serpasil, 774 Serrano, Rosso Jose, 152, 588 Sertraline, 774 Sertürner, Friedrich Wilhelm Adam, xlv, 616, 822–823 Seva Foundation, 48 Sewell, Daniel, 487 Sex, transactional, 490 Sexual abuse, 263 Sexual addiction, 101 Sexually transmitted diseases (STDs) and drug use, 839–841 Sexual victimization, 31

1156  Index

Sexual violence, 30–31 al Shabaab, 884 Shafer, Raymond, lxxiii, 207, 208, 268 Shafer Commission, 206, 214, 222, 509, 687 Shake-and-bake production, 205, 601 Shakespeare, William, xxxix Shalala, Donna, 221 Shanghai Conference, 471 Shanghai meetings (1909), 457 Shanghai Opium Commission, liv Shan United Army (SUA), 713 Shawnee people, 792 Shell, Grace, 95–96 Shenar, Paul, 813 Shen Nung, 157 Sherbert v. Verner, 364 Sheridan Correctional Center (Illinois), 744 Shisha, 495–496, 823–824 Shulgin, Alexander “Sasha,” 824–826, 870 Shulgin, Ann, 870 Sieberling, Henrietta, 828 Silkworth, William D., 960 Similarity concept, lxv Simintal, Theodoro Garcia, 896 Simon, David, 875 Simpson, Don, 89 Sinaloa Cartel, 386, 448, 450, 523, 524, 604, 833, 895, 896 Sinclair, Upton, 779 Sixteenth Amendment, lv Skinner v. Railway Labor Executives’ Association, 826–827 Skin-popping, 329 Slaves, xl Sleepinal, 718 Sleeping aids, 718 “Slow Your Roll,” 873 Small, Lyndon F., 210 Smith, Alfred, 363, 364 Smith, Alfred Emanuelo, 83 Smith, Bessie, 521 Smith, Bob, lxii Smith, Catherine Evelyn, 105 Smith, David, 461 Smith, Gary, 190

Smith, Gerrit, xlviii Smith, John, xxxix–xl Smith, Robert, 961 Smith, Robert Holbrook (Dr. Bob), 827–829 Smith, Roger, 752 Smith, U.S. Department of Human Resources v., 727–728 Smith, Will, 89, 90 Smith, William French, 620, 752 Smith Act (1907), liv Smithers, R. Brinkley, 641, 642 Smoker’s rights, 829–830 Smoking, 966; in America, xlix; first ban on, xxxviii–xxxix; Massachusetts bans, xl; New York Times opposition to, xlix; opium, 709; secondhand, 367–368, 817–818. See also Tobacco Smoking Opium Exclusion Act (1909), 174, 314, 470, 740, 831–832, 974 Smuggling, 584–585, 629 Smurfing, 372–373 Snoop Doggy Dogg, 486 Snowden, Mark, 378 Sobriety, 791 Social activities, 249 Social gospel, 74 Social learning theory, 893 Social phobia, 76 Soft drinks, coffee versus, lxxv Soft drugs, 433, 465–467 Soldiers, cocaine for, xlix Soldier’s disease, 616 Solvents, 328 Soma, 816 Somatotropin, 841 Sonata (zaleplon), 92, 748 Sonnenreich, Michael R., lxxiv Sonora Cartel, 832–833 Sons of Liberty, xliii Sons of Temperance, 29, 555 Soros, George, 303, 621, 833–835 Sorrenti, Davide, 888–889 Sosa, Sammy, 845, 846 Soto, Hernando Giraldo, 150 Soto-Barraza, Ivan, 389

Index  1157

Soul Stirrers, 807 Souter, David, 403 Southeast Asian heroin cartels, 285 Southern Arizona Safe Trails Initiative, 485 South Florida Drug Task Force, lxxvii, 620 Southwest Border HIDTA Arizona Partnership, 484–485 Spade, David, 383, 384 Spadora, Hug, 690 Sparine, 774 Spath, Ernst, 593, 727 Speakeasies, 25, 949 Special Action Office for Drug Abuse Prevention (SAODAP), xxvii, xxviii, 622, 687, 699, 835–836 Special Consultative Status with the Economic and Social Council of the United Nations, 339 Special Narcotic Committee (SNC), 836–837 Special Narcotics Task Force (SNTF), 565 Speedball, 105 Spelleman, Alfred, 198 Spice, 97–99, 223, 252 Sporting fraud, 78 Sports, steroids and, 843–846 Spray drift, 234 Stacking, 842 Staley, Layne, 888 Stallone, Sylvester, lxxviii Stamp Act (1765), 956 Stanley, Owsley, 444–445 Stanozolol anabolic steroid, 738, 843 Stanton, Elizabeth Cady, xlvi Starbucks Coffee Company, lxxii, lxxix, lxxx Starr, Mike, 888 State drug and alcohol control laws, 837–839 Stayton, William H., 82 Steroids, 78; anabolic, 841–843, 859–860; anabolic-androgenic, 430; in baseball, 846–848; dietary, 842; sports and, 843– 846; testing for, 941 Steroids Control Act (1990), 231 Stevens, John Paul, 155, 403

Stevenson, Fanny, 85 Stevenson, Robert Louis, 85, 192 Stewart, Julia, 381, 383 Stewart, Potter, 801 Stillbirth, 400, 967 Stimulants, 10, 270, 285, 288, 848–850, 961; as addictive substance, 859; as “illicit drugs,” 855; in increasing alertness and energy, 860; withdrawal from, 961 Stone, Oliver, 370 Stowe, Harriet Beecher, 56 Straight, Inc., 339 Strategic intelligence, 294 Strategy to Combat Transnational Organized Crime, 701 Straw purchasers, 386 Strengthen Efforts to Reduce Drug Use in Our Communities, 644 Stress response dampening, 968–969 Stringer, Korey, 372 Stroup, Keith, 657 Student Nonviolent Coordinating Committee, 95 Students Against Destructive Decisions, lxxvi, 345 Students Against Drunk Driving (SADD), lxxvi, 345, 618, 850, 851 Students Taking Action Not Drugs, 340 Studio 54 (New York City), 852–853 Subcommission on Illicit Drug Traffic and Related Matters in the Near and Middle East, 915 Sublimaze, 816 Sublime (music group), 371, 737 Suboxone, 816, 871 Substance abuse: biological and psychological reasons for, 114; child sexual abuse and, 168–170; initiation of, 856; Native American, 663–670; women, victimization and, 968–971. See also Drug abuse Substance Abuse and Mental Health Services Administration (SAMHSA), 28, 43, 297, 366, 543–544, 599, 647, 808, 840, 853–858, 891, 897, 902; National

1158  Index

Registry of Evidence-Based Programs and Practices, 733 Substance abuse prevention strategies, 755–757 Substance Abuse Services Amendments (1986), 336, 858–859 Substance addiction, 9, 10, 859–864 Subutex, 870–871 Sucart, Yuri, 805 Sudafed, 849 Sudden Infant Death Syndrome (SIDS), 400 Suicide, 69 Sullivan, John L., 637 Summer, Donna, 852 Sunami, 328 Super labs, 595, 600 Suplee, Ethan, 124 Supply-control strategy, 864 Supply reduction, xxix, 704 Supply-side strategy, 864–866 Supremacy Clause, 783 Surgeon General’s Advisory Committee on Smoking and Health, 884–885, 898 Surgeon general’s reports on tobacco, 866–868 Sustained recovery management, 905 Sutton, James, 587 Swayze, Patrick, 384 Sweat patches, 311 Switchboard, 460–461 Switzerland Addiction Research Institute, 35 Synanon (drug program), 868–870 Synanon Game, 869 Synthetic cannabis, 97–99, 220, 252 Synthetic Drug Abuse Prevention Act (2012), 252 Synthetic drugs, 318, 612, 705, 870–871 Syphilis, lvii, 840 Syrup, 200, 871–874 System to Retrieve Information from Drug Evidence (STRIDE), 307 Szara, Stephen, 255 Tab Energy, 147 Tactical intelligence, 294

Taft, Howard, 954 Taliban, 951 Tamoxifen, 842 Tandy, Karen, 340 Taractan, 774 Tariff Act (1930), 295, 337 Tasco, Frank J., 752 Task Force on College Drinking, 650 Taurine, 849 Tax Act (1918), 836 Taxol, 870 Taylor, Elizabeth, 109 Tea, xxxvii, xxxviii, xli Tea Importation Act (1897), lii Teenagers. See Adolescents Television, drugs and, 875–879 Temazepam, 816 Temperance Address, 555 Temperance drink, 193 Temperance education, l Temperance movement, xxvii, 555, 879–882 Temptations (music band), 409, 807 10-Panel Urine Screen, 940 Tenth Amendment, 783 Tenuate, 849 Tepanil, 849 Terrorism, 315, 882–884 Terry, Brian A., 387, 389 Terry, Charles E., 211, 212, 626 Terry, Luther, 536, 867, 884–885, 898 Tertiary prevention, 506, 755 Testosterone, 841 Testosterone cypionate anabolic steroid, 843 Tetracyclics, 773 Tetrahydrocannabinol (THC), 84, 158, 214, 890–891, 940, 967. See also Marijuana Texas Addiction Research Foundation, 516 Texas Heroin Massacre, 885–890 THC (delta-9-Tetrahydrocannabinol), 473– 474, 476, 477, 570, 572, 588–589, 677 THC One Step Marijuana Test Strip, 891 Thebaine, 703, 706, 707 Theft, 453 Therapeutic communities, 257, 791

Index  1159

Thioanthines, 901 Thioridazine, 774 Thomas, Clarence, 403, 696, 786 Thompson, Hunter S., 594 Three 7 Mafia (music band), 872 Three strikes provision, 943 Thujone, 84 Tijuana Cartel, 448, 894–896 Tildine, 707 Tindal, 774 Title V--Tribal Youth Programs, 247 Tobacco, xxxi, 897–899; advertising of, lxx; consumption of, lxix; as currency, xl; death penalty for usage of, xlii; early European bans of, xl–xli; export of, xlii; government subsidies for, lxviii; growing, xxxix; link between lung cancer and, lxiv; price floor for, xl; shipment of, xxxix; surgeon general’s reports on, 866– 868; taxes on, xl; use of, xxxviii, xxxix, 612, 856. See also Nicotine; Smoking Tobacco companies, lxvi–lxvii Tobacco diversion, 132 Tobacco industry lawsuit, lxxx Tobacco Industry Research Committee (TIRC), 184, 867, 897, 899–900 Tobacco Institute, 224–225, 897, 899–901 Tobacco Institute Research Committee/ Council for Tobacco Research, 578 Tobacco Master Settlement Agreement, 899 Tobacco Research Committee (TIRC), 224 Tobacco sales, growth of, lxviii, lxx Tobacco settlement, lxxxiv Tobacco use: adolescent, 13–16, 612; condemnation of, xxxix; female, 399– 400; growth of, lxx Tolerance, 92, 249, 265, 316–317; cross, 236–237, 317; learned, 316; reverse, 194, 315; zero, 71, 323, 344, 983 Topical analgesics, 62 Topiramate, 9 Torrijos Herrera, Omar Efraín, 689, 690 Total abstinence, 344 Tour de France, 78

Towns, Charles B., 127, 128 Towns-Boylan Act (1914), lv–lvi Toxicology Testing, 55 Traffic in Narcotic Drugs (Special Narcotic Committee (SNC)), 836–837 Tramadol, 870 Tranquilizers, 77, 250, 676, 748, 901–902; as addictive, 860; as “illicit drugs,” 855 Transactional sex, 490 Transdisciplinary Tobacco Use Research Centers, 652 Transitional neighborhoods, 893 Transnational organized crime groups, 321–322 Tranxene, 816 Trazadone, 774 Treadway, Walter, 241 Treasury, U.S. Department of, lix Treasury-Postal Appropriations Act (1998), 661 Treatment, 902–907 Treatment Alternatives to Street Crime (TASC), xxvii, xxviii Treaty of Amity, Commerce, and Navigation, 376 Trebach, Arnold S., 303 Trevino, Mario Ramirez, 452 Triazolam, 816 Trichotillomania, 101 Tricyclic and tetracyclic antidepressants, 70 Tricyclics, 62, 773 Trimipramine, 773 Trotter, Thomas, xliv Trudeau, Margaret, 852 Trudeau, Pierre, 852 Trujillo, Carlos, 117 Truman, Harry S, 125, 907–909 Trussell, Ray, 259 Tryptamine analogs, 463 Tryptamines, 462, 770 Tsuwiri, 328 Tubal ectopic pregnancy, 400 Turner, Mary, lxxiii Tweaking, 601 Twelve Concepts, 21

1160  Index

Twelve-step programs, xxxiv, 5, 20, 22, 23, 30, 35, 40, 41, 108, 197–198, 201, 257, 553, 554, 555, 607, 608, 632, 650, 793, 828, 869, 904, 905, 909–911, 961 Twelve Traditions, 20, 21, 23, 30, 40–41, 634, 793 Twenty-First Amendment, lxii, 27, 82, 83, 358, 389, 765, 768, 949, 972 Twining, Thomas, xlii 2C-B, 727 Tyga ft. Wiz Khalifa & Mally Mal (music group), 371, 737 Tylenol, 61, 718 Tylenol with Codeine, 749, 816 UK Music Hall of Fame, 479 Ultracet, 870 Ultram, 870 Underground Kingz (UGK) (music band), 486, 872 Undocumented immigrants, drug use and, 913–914 UNESCO MOST program, 317 UNGASS meeting, 973 Uniform Crime Reports, 392 Uniform State Narcotic Act (1932), 66, 839 Union Cycliste Internationale (UCI), 78 Unisom, 718 United Nations (UN): Commission on Narcotic Drugs (1945), lxxxvi, 865, 914–916; Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 192, 234, 916–917; Convention against Transnational Organized Crime (2000), 459; Convention on Psychotropic Substances (1971), xxxv, lxxii, 917–918; Convention on the Rights of the Child, 973; Drugs and Crime, United Nations Office on (UNODC), 442; Economic and Social Council, xxxiv, xxxv, 915, 917, 922; Fund for Drug Abuse Control, 918; Global Program for Trafficking in Human Beings, 920; International Conference on Drug Abuse and Illicit Trafficking (1987), 918–919; International Day Against Drug

Abuse and Illicit Trafficking, 919–920; International Drug Control Program, 915; Narcotics Commission, 67; NonGovernmental Organizations, 964; Office on Drugs and Crime (UNODC), xxxiv, 317, 671–672, 883, 915, 920–921, 922; reviewing of drug policy in 2016, lxxxvi; Single Convention on Narcotic Drugs (1961), xxxv, lxviii, 192, 323, 459, 591, 915, 916, 921–922, 973; special session on drugs 10-year strategy, lxxxiv; Surveys on Crime Trends and the Operations of Criminal Justice Systems (UN-CTS), 922–923 United States Addiction Research Center, 622 U.S. Agricultural Inspection Service, 927 United States Anti-Doping Agency (USADA), 77–78, 79 U.S. Bomb Data Center, 132 U.S. Border Patrol (USBP), 926 U.S. Bureau of Food and Drugs, 193 United States Cigarette Labeling and Advertising Act (1966), lxviii–lxix U.S. Coast Guard, 895, 924–926, 933 United States-Colombia Extradition Treaty (1981), lxxvi U.S. Customs and Border Protection, 387, 926–929 United States International Drug Control Efforts, 932–934 United States Marshals Service Act (1986), 337, 350 United States National Narcotics Control Act (1956), 934 U.S. Olympic Committee and U.S. Anti-Doping Agency, 520 U.S. Pharmacopoeia, 413 U.S. Postal Inspection Service, 350 U.S. Public Health Service, 742, 897 U.S. Public Health Service Commissioned Corps, 360 U.S. Sentencing Commission, 219, 231, 312, 380, 820–821 United States Tobacco Company, 224

Index  1161

Urdinola, Ivan, 151 Urdinola, Julio, 151 Urdinola-Grajles network, 283 Urinalysis, 121, 309, 940–942 Urine tests, 310, 311 USA PATRIOT Act, 393 Use, 249 Utah, anti-marijuana law in, lvi Vaccines for addictive drugs, 7–8, 9 Valium, xxv, xxxii, 85, 269, 286, 330, 676, 745, 774, 816, 818, 901 Vaping, 353 Varenicline (Chantix), 679, 684–685, 903 Vargas, Virgilio Barco, 504 Velvet Underground (music group), 371 Venlafaxine, 774 Verapamil, 774 Verbal harassment, 263 Versed, 816 Vicodin (hydrocodone), xxxi, 166, 632, 747, 773, 816, 886, 890 Victim impact panels (VIPs), 619 Victimization, women, and substance abuse, 968–971 Victims: alcohol to subdue, 30–32; drugs, and crime, 232–234 Vietnam, drug use in, lxxi Vigol, Philip, 957 Vin Mariani, 193 Vinyl chloride, 180 Violence: domestic, 263; drug trade and, 318; handgun, 131, 132; physical, 260– 261; sexual, 30–31; workplace, 232–233 Violent Crime Control and Law Enforcement Act (1994), 702, 943–944 Viral hepatitis, 840 Virginia Company, xxxix Vivitrol, 622 Vlarelease, 774 Vogel, V. H., 633 Volatile solvents, 287, 501 Volcker, Paul, 436 Volkow, Nora D., 653, 790 Vollmer, August, 944–946 Volstead, Andrew, 762, 946–948

Volstead Act (1919), 24, 25, 26, 27, 65, 73, 75, 358, 584, 585, 653, 762, 766, 767, 780, 838, 947, 948–950. See also Eighteenth Amendment Volstead Prohibition Enforcement Act, 131 Walker, Abraham, 622 Wallace, Bill, 105 Wallace, Christopher George Latore, 487 Walsh, David, 78 Walters, John P., 140–141, 221, 292, 580, 702–703 Wannamaker, John, 584 Warhol, Andy, 852 War in Afghanistan, 140 Warlocks, 444 War of 1812, xlv “War on Crime,” 518 War on Drugs, xxvii, xxviii–xxix, xxx, lxxi–lxxii, lxxxii, lxxxv, 18, 71, 81, 136, 137, 138, 139, 152, 154–155, 161, 166, 186, 187, 196, 208, 239, 268, 290, 312, 320, 370, 377, 433, 436, 546–547, 580, 592, 608–609, 620, 621, 737, 784, 787, 789, 865–866, 875, 876–877, 879, 934, 951–952 War on Terror, 140 Warren, Alvin, 667 Washington, Denzel, 95 Washington, George, xxxii, 158, 924, 955–957 Washingtonian movement, 29, 52 Washington societies, 881 Washington State Medical Use of Marijuana Act (1998), 550 Wasting syndrome, 590, 891 Water pipe, 824 Webb, Edwin, 954 Webb, Gary, 167 Webb et al. v. U.S., lvii, 128, 472, 627, 631, 691, 837, 952–953 Webb-Kenyon Act (1913), 75, 953–955 Webster, William H., 620 Weed and Seed Program, 247 Weicker, Lowell P., Jr., 654 Weil, Andrew, xxvi, 507–508, 892

1162  Index

Weinstein, Jason, 387 Wellbriety Movement, 793 Wellbutrin, 774 Wellness Managed Services (WMS), 574 West, Kanye, 371, 737 Westat, 661 Wetherall, Charles, lxxvi Wheeler, Wayne, 766–767, 948 Wheelerism, 75 Whiskey, lvii Whiskey excise tax, xliv Whiskey Rebellion (1794), xliv, 131, 955–957 White, Byron, 363, 801–802 White, Lee, 17, 517 White, Michael D., 913 White, Walter, 878, 957–958 White, William Allen, lxiii White Bison, 793 White House Conference for a Drug-Free America, 72, 958–959 White House Conference on Narcotics and Drug Abuse, 527–528, 624, 959–960 White House Office of National Drug Control Policy, 580, 659, 755 White House Special Action Office for Drug Abuse Prevention, 688 White House Strategy Counsel on Drug Abuse, 160 Whitman, Walt, 434 Whitney Act (1917), 128 Wigand, Jeffrey, 414 Wiley, Harvey Washington, liv, lv, 413–414, 780 Willard, Frances Elizabeth, xlix, 798, 962, 971 Williams, Edward H., lvi Williams, Otis, 807 Williams, Robin, 105, 462 Wills, Geoffrey, 370, 514 Wilson, Lois, 41 Wilson, William G. (Bill W.), lxii, 827, 828–829, 909, 960–961 Wilson, Woodrow, 358, 469, 948 Winehouse, Amy, 371, 737 Winfrey, Oprah, 79, 129

Winstrol anabolic steroid, 843 The Wire, 875–879, 876–879 Wired X505, 147 Wisconsin v. Yoder, 364 Withdrawal, 4, 59, 69, 248–249, 961–962 Witness Protection Program, 93, 95 Woman’s Christian Temperance Union (WCTU), xxxi, xlviii, xlix, 66, 636–638, 762, 765, 766, 798, 838, 881, 882, 953, 962–964 Woman’s Christian Temperance Union Convention, xlviii Women. See Females Women for Sobriety (WFS), lxxv, 41, 51 Women’s Health Initiative, 400 Women’s Organization for National Prohibition Reform (WONPR), 971–972 Women’s State Temperance Society of New York, xlvi Women’s Temperance Society, xlvi Wood, George, xlvii–xlviii Woodward, Bob, 105 Workplace violence, victims of, 232–233 World AIDS Conference (Geneva), 673 World Anti-Doping Agency (WADA), 738, 845 World Drug Report, 919 World Federation against Drugs, 972–973 World Forum Against Drugs, 972–973 World Health Organization (WHO), xxxv, 355, 921; Committee on Alcoholism, 516; Expert Committee on Drug Dependence, 529; on treating drug addicts, lxvii World Narcotics Conference, 973 World Service Organization, 634 World’s Woman’s Christian Temperance Union, xlix Wrentmore, Elizabeth, 469 Wrentmore, Margaret, 469 Wright, C. R., xlix Wright, Hamilton, liv, 457, 471, 831, 973–975 Wright, Jeff, 422 Wright, Robert, 752 Wu-Tang Clan, 486

Index  1163

Xanax, xxxi, xxxii, 85, 166, 236, 242, 286, 738, 745, 774, 816, 818, 901 Xuereb, Emmanuel, 89 “Ya ba,” 600–601 Yale Center on Alcohol Studies, 649 Yale University: Laboratory of Applied Psychology at, 515; School of Alcohol Studies at, lxiv Yellow Brick Roads, 566 Youth Anti-Drug Media Campaign, 669 Youth prevention-related measures, 856–857 Youth Risk Behavior Surveillance System, 165 Youths. See Adolescents Y’s (formerly YMCAs), 662 Yulin, Harris, 814

Zaleplon (Sonata), 92, 748 Zantac, 718 Zedd, 362 Zeese, Kevin, 303, 687 Zero tolerance, 71, 323, 344 Zero-Tolerance Act, 336 Zero Tolerance Drug Program, 983 Zero Tolerance policy, 619 Zetas, 387, 452, 524 Zetran, 774 Ziegler, John, 844 Zips, 735 Zoloft, 774 Zolpidem (Ambien), 92, 748, 774 Zuleta, Benjamin Herrera, 149 Zurich, ban on tobacco in, xl–xli Zyban, 684, 966