For the discussions please respond to the following questions based on the material covered in each chapter (please do every chapter in separate files) – (Minimum 50 words for each chapter).

1. The most important thing I learned in this chapter was ….

2. Use an external sourse for each chapter.

Chapter 12

Alcohol, Tobacco, and Other Drugs: A Community Concern

Chapter Objectives (1 of 2)

After studying this chapter, you will be able to:

Identify personal and community consequences of alcohol and other drug abuse.

Describe the trends of alcohol and other drug use by high school students.

Define drug use, misuse, and abuse.

Define drug dependence.

List and discuss the risk factors for the abuse of alcohol and other drugs.

Explain why alcohol is considered the number one drug abuse problem in America.

Describe the health risks of cigarette smoking.

Define the terms over-the-counter and prescription drugs and explain the purposes of these drugs and how they are regulated.

Define the terms controlled substances and illicit (illegal) drugs and provide examples.

Chapter Objectives (2 of 2)

Characterize recent trends in the prevalence of drug use among American high school seniors.

List and explain four elements of drug abuse prevention and control.

Give an example of primary, secondary, and tertiary prevention activities in drug abuse prevention and control programs.

Summarize the federal government’ s drug abuse control efforts.

List and describe an effective community and an effective school drug abuse prevention program.

List the five facets of a typical workplace substance abuse prevention program.

Name some voluntary health agencies and self-help support groups involved in the prevention, control, and treatment of alcohol, tobacco, and other drug abuse.


Use, misuse, and abuse of mind-altering substances predates recorded history

Chronic alcohol and other drug abuse or dependence is regarded as destructive behavior in most cultures

Affects individuals and the surrounding community

Scope of the Current Drug Problem (1 of 3)

More deaths, illnesses, and disabilities can be attributed to substance abuse than any other preventable health condition

Economic costs include direct costs (health care, premature death, impaired productivity) and indirect costs (crime and law enforcement, courts, jails, social work)

Those abusing are threats to themselves, their families, and their communities

Sources: Horgan, C., K. C. Skwara, and G. Strickler (2001). Substance Abuse: The Nation’s Number One Health Problem. Princeton, NJ: Robert Wood Johnson Foundation; Centers for Disease Control and Prevention (2008). “Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004.” Morbidity and Mortality Weekly Report, 57(45): 1226–1228; Centers for Disease Control and Prevention (2016). Data on Drug-Poisoning Deaths. National Center for Health Statistics. Available at http://www.cdc.gov/nchs/data/factsheets/factsheet_drug_poisoning.htm; Centers for Disease Control and Prevention (2013). Alcohol-Related Disease Impact (ARDI) application. Available at www.cdc.gov/ARDI; Sacks, J. J., K. R. Gonzales, E. E. Bouchery, L. E. Tomedi, and R. D. Brewer (2015). “2010 National and State Costs of Excessive Alcohol Consumption.” American Journal of Preventive Medicine, 49(5): e73–e79.; Xu, X., E. E. Bishop, S. M. Kennedy, S. A. Simpson, and T. F. Pechacek (2014). “Annual Healthcare Spending Attributable to Cigarette Smoking: An Update.” American Journal of Preventive Medicine, 48(3): 326–33; National Institute on Drug Abuse (2014). Trends and Statistics. Available at https://www.drugabuse.gov/related-topics/trends-statistics#costs; and U.S. Department of Health and Human Services (2014). The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: 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. Available at http://www.cdc.gov/tobacco/data_statistics/sgr/50th-anniversary/index.htm.

Scope of the Current Drug Problem (2 of 3)

Data from: Johnston, L. D., O’Malley, P. M., Miech, R. A., Bachman, J. G., & Schulenberg, J. E. (2016). Monitoring the Future national survey results on drug use, 1975-2015: Overview, key findings on adolescent drug use. Ann Arbor: Institute for Social Research, The University of Michigan. Available at http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2015.pdf.

Scope of the Current Drug Problem (3 of 3)



Psychoactive drugs

Drug use

Drug misuse

Drug abuse

Drug (chemical) dependence

Psychological dependence

Factors that Contribute to Alcohol, Tobacco, and Other Drug Abuse

Risk factors – factors that increase the probability of drug use

Protective factors – factors that lower the probability of drug use

Both can be genetic or environmental


Inherited Risk Factors

Most research related to drug dependence and inherited risk is on alcoholism

Research has shown genetic and biological markers may predispose someone to increased susceptibility to develop alcohol-related problems

Environmental Risk Factors

Personal factors

Home and family life

School and peer groups

Sociocultural environment

Types of Drugs Abused and Resulting Problems

Legal drugs

Alcohol, nicotine, nonprescription (over-the-counter) drugs, prescription drugs

Controlled substances and illegal (illicit) drugs

Marijuana, narcotics, cocaine and crack cocaine, hallucinogens, stimulants, depressants, club drugs and designer drugs, anabolic drugs, inhalants




Legal Drugs

Can be legally bought and sold in the marketplace

Includes drugs that can be closely regulated, likely regulated, and not regulated at all


Number one drug problem in the United States

Binge drinking

Underage drinking

Problem drinkers


Blood alcohol concentration (BAC)

Fetal Alcohol Spectrum Disorders

Fetal Alcohol Syndrome


Psychoactive and addictive drug present in tobacco products

Environmental tobacco smoke (ETS) or secondhand smoke

Synar Amendment

Tobacco use is single most preventable cause of disease, disability, and death in the U.S.

Community efforts: tax increases on cigarettes


Over-the-Counter Drugs (OTCs)

Legal drugs other than alcohol and tobacco that can be purchased without a physician’s prescription

Carefully regulated by the Food and Drug Administration (FDA)

Most only provide symptomatic relief, not a cure

Subject to misuse and abuse


Prescription Drugs

Can be purchased only with a physician’s prescription because they have serious side effects for some people

Regulated by the FDA

Subject to misuse and abuse; opioid pain relievers

Risk of dependence and unintentional overdose

Development of drug-resistant strains of pathogens

Controlled Substances and Illicit Drugs

Those regulated by the Controlled Substances Act of 1970

Cannot be cultivated, manufactured, bought, sold, or used within the confines of the law

Schedule I – high potential for abuse; no accepted medical uses

Schedules II-V – have medical uses; scheduled based on potential for risk of dependence or abuse

Drug Enforcement Agency (DEA) responsible for enforcing Controlled Substances Act


Products derived from hemp plant

Most abused illicit drug in the U.S.

Often used in conjunction with other drugs – polydrug use

Acute effects – reduced concentration, slowed reaction time, impaired short-term memory, impaired judgment

Chronic effects – damage to the respiratory system (if smoked), amotivational syndrome

Synthetic Marijuana

Emerging cause for concern

Chemically produced with properties similar to THC

Pose serious threat to communities – potential for abuse and other adverse health effects, long-term effects unknown

In 2011, five chemicals used to produce synthetic marijuana were added to Schedule I of the CSA

States have banned synthetic marijuana


Opium and its derivatives, morphine and heroin, come from an oriental poppy plant

Narcotics numb the senses and reduce pain

High potential for abuse

Opium poppies do not grow in U.S.; drug trafficking problems

Heroin addiction leads to significant community health problems


Cocaine and Crack Cocaine

Cocaine is the psychoactive ingredient in the leaves of the coca plant

Powerful and addictive euphoriant/stimulant

Purified forms – salt (white powder), dried paste (crack)

In 2015, annual prevalence of cocaine use among high school seniors at lowest reported level of 2.5%


Produce illusions, hallucinations, changes in perceptions

Synesthesia – mixing of the senses

Both naturally derived and synthetic

LSD, mescaline, peyote, mushrooms


Drugs that increase the activity of the central nervous system


Schedule II prescription drugs; widely abused

Methamphetamines often made in clandestine labs


El Paso Intelligence Center (EPIC/National Secure System NSS)

Total of all clandestine laboratory incidents involving methamphetamine


Slow down the central nervous system

May lower anxiety and inhibitions

Tolerance develops

Strong physical dependence

Alcohol, barbiturates, benzodiazepines

Club Drugs and Designer Drugs

Illicit drugs, primarily synthetic, most commonly encountered at nightclubs and raves

MDMA (ecstasy) most popular club drug

Rohypnol – “date rape” drug

Designer drugs – synthesized by amateur chemists in secret labs

Constantly change design to stay ahead of law enforcement



Anabolic Drugs

Protein-building drugs

Anabolic/androgenic steroids, testosterone, human growth hormone

Have some legitimate medical uses

Sometimes abused by athletes and body builders

Acute and chronic side effects


Collection of psychoactive breathable chemicals

Paint solvents, motor fuels, cleaners, glues, aerosol sprays

Easy availability

Low cost

Often drug choice of young

Acute and chronic effects

Prevention and Control of Drug Abuse

Requires knowledge of:

Causes of drug-taking behavior

Sources of illicit drugs

Drug laws

Treatment programs

Community organizing skills

Persistence, and the cooperation of various individuals and agencies


Levels of Prevention

Primary prevention aimed at those who have never used drugs

Secondary prevention aimed at those who have used, but are not chronic abusers

Tertiary prevention aimed at drug abuse treatment and aftercare, including relapse prevention

Elements of Prevention



Public policy

Law enforcement

Education and treatment goals same:

Reduce demand for drugs

Public policy and law enforcement goals same:

Reduce supply and availability of drugs

Governmental Drug Prevention and Control Agencies and Programs (1 of 2)

Include a multitude of federal, state, and local agencies

Aim to reduce either the supply of or the demand for drugs

Office of the National Drug Control Policy, The White House (2013). National Drug Control Budget FY 2014 Funding Highlights. Washington, DC: The White House. Available at http://www.whitehouse.gov/sites/default/files/ondcp/policy-and-research/fy_2014_drug_control_budget_highlights_3.pdf. Accessed June 25, 2013.

Federal drug control spending by function, fiscal years 2012-2014.

Governmental Drug Prevention and Control Agencies and Programs (2 of 2)

Federal Agencies and Programs

Office of National Drug Control Policy

Department of Health and Human Services

Substance Abuse and Mental Health Services Administration (SAMSHA)

National Institute on Drug Abuse

Department of Justice

Bureau of Alcohol, Tobacco, Firearms, and Explosives (ATF)

Department of Homeland Security


State and Local Agencies and Programs

State departments of health, education, mental health, justice, and law enforcement all address drug abuse prevention and control issues

Some states have passed laws that conflict with federal laws

Local communities have individuals, task forces, or agencies to prioritize problems and decide approaches for solving them

Nongovernmental Drug Prevention and Control Agencies and Programs

Community-based drug education programs

School-based drug education programs

DARE, student assistance programs, peer counseling programs

Workplace-based drug education programs

Employee assistance programs

Voluntary health agencies

Discussion Questions

How can risk factors for drug abuse be utilized to aid in drug abuse prevention?

How should federal, state, and local funds be used to successfully deal with drug abuse problems?