Chapter 3 Drug Policy

Question 1

Average American in 1900

Answer 1

• about 90% could read or write at least a little, but only 15% graduated from high school
• if you were born in 1900, your life expectancy was around 47; if you were 10 in 1900, your life expectancy was about 60
• their main source of news was the newspaper; radio wouldn’t commence for 20 years
• babies were born at some and there was little routine medical care of vaccinations

Question 2

Patent medicines

Answer 2

• sold freely for vaguely defined illnesses and often contained cocaine, codeine, alcohol, or some combination.
• it is entirely possible that much medication success had a lot to do with the placebo effect
• with no laws to govern manufacture, ingredient information or advertising claims, the buyer was at some disadvantage

Question 3

Limited effective drugs

Answer 3

• relatively few drugs actually produced effects, and the negative effects of morphine and cocaine were not well understood
• the invention of the hypodermic needle and syringe in the 1850s was a great advance in treating pain, but it also made dependence much more likely and more common
• dependence on morphine did not pose significant health risk so many people continued to use it to avoid withdrawal
• morphine addicts were not unusual and morphine dependence was considered a medical issue; morphine addicts were pitied rather than considered degenerates

Question 4

Instrumental impact of legislation

Answer 4

refers to changes, both good and bad, that are the result of enacting the legislation

Question 5

Symbolic impact of legislation

Answer 5

affects those who advocate for a position in terms of votes, admiration, and support. Legislation does not even need to be passed to have symbolic impact

Question 6

1906 Pure Food and Drug Act

Answer 6

• a response to uproar caused by Upton Sinclair’s “The Jungle”
• mandated that all foods, beverages, and drugs have the ingredients clearly labeled in decreasing order
• the advertising claims didn’t have to be accurate and the drugs or food didn’t have to be safe; they merely had to list the contents

Question 7

1912 Sherley amendment to the PFD Act

Answer 7

• made “false and fraudulent” claims on medicine bottles unlawful
• the way the law was written, however, required that the manufacturer was liable only if they KNEW the claims were false

Question 8

1914 Harrison Narcotic Act

Answer 8

• intended to regulate and draw tax income from opiates and cocaine
• set the precedent of a prescription as necessary to access certain medication; physicians could prescribe these items for legitimate medical purposes
• suppressing withdrawal symptoms was soon seen as an illegitimate use of the drugs; physicians who prescribed opiates for this use were prosecuted, so a black market was born

Question 9

1922 Jones-Miller Act

Answer 9

• imposed serious penalties for illegal possession of opiates or cocaine
• The Narcotics Division was aggressively enforcing their interpretation of the Harrison Act and arrested many physicians accordingly
• opiate users were now considered morally weak and legal focus was now on removing the substance rather than treating the user; approach continued until 1925

Question 9

Controlled Substances Act of 1970

Answer 9

created a way of classifying controlled substances that placed them into categories (or “schedules”) based on the drug’s medical use and its abuse liability
- a drug was placed in Schedule 1 if it had no recognized medical use and high abuse liability
- lower schedules indicate that the drug has legitimate medical uses

Question 9

Prohibition

Answer 9

• prior to the passage of prohibition, alcohol consumption was common; almost everyone drank and they drank a lot
• statewide prohibitions generally didn’t last long
• a variety of forces supported the idea of a nationwide ban on alcohol use and the 18th amendment was passed in 1919
• ## in 1933, the 18th amendment was repealed

Question 10

The DEA

Answer 10

• created in 1973 after the Controlled Substances Act in 1970

Question 10

Schedules of common drugs

Answer 10

I: heroin, marijuana, MDMA, LSD
II: cocaine, oxycontin, pentobarbital, adderall
III: anabolic steroids, ketamine, marinol
IV: benzodiazepines
V: “lightweight” painkillers with minimum of codeine

Question 10

1938 Food Drug and Cosmetic Act

Answer 10

• in response to a series of poisonings by an antibiotic “elixir” which had a dangerous solvent
• mandated that products intended as drugs be tested for safety in order to be marketed; mandated instructions for use on the label or a statement that the drug was to be used as prescribed
• changed the role of the FDA into a regulatory agency. The FDA reviewed safety information pre-market and could prevent marketing if the information wasn’t satisfactory
• the FDA could now recall drugs that were ineffective or dangerous

Question 11

Changes in drug law after 1970

Answer 11

• mandatory minimums, which were removed in the Controlled Substances Act, returned in the 1980s
• in 1986, the penalty for 5 grams of crack cocaine was that of 500 grams of powder cocaine: a 100:1 difference. This was changed by the Fair Sentencing Act to 18:1

Question 12

Congress laws passed in 1962 that expanded pre-market testing

Answer 12

• explicit safety testing and effectiveness testing were now required
• laws were promoted by the effects of thalidomide, a drug prescribed yo thousands of women in Great Britain and Germany, among other countries, for pregnancy-induced nausea
• thalidomide produces phocomelia

Question 13

Current rules for testing

Answer 13

• animal testing must take place before any human testing
• at least two species must be used
• the length of drug exposure must correlate with the length of time a human would take the drug
• the company then submits an application to the FDA for human studies
• the drug is then tested in humans in three phases, starting with healthy humans and ending with clinical trials
• once approved, the FDA can still withdraw approval if there are significant reports of adverse effects