Comprehensive Drug Abuse Prevention Research Articles

The Drug Abuse Prevention and Control Act of 1970: Retrospective Assessments of Disparate Treatment and Consequential Impact

ABSTRACTAlthough the basic paradigm of the U.S. federal drug policy targeting the supply and demand reduction has not changed since its enactment in 1970, there have been seriously undesirable disparate treatments and impacts among various population groups. Although U.S. Congress could not define what is discrimination, it did provide two major criteria for the assessment of discriminatory practices as follows: (a) disparate treatment—basing a key decision on association with any of the five prohibited individual’s demographic classifications (race, color, religion, sex, or national origin); and (b) disparate impact—correlation between any of the five prohibited demographic classifications and the key outcomes. In reference to those criteria, this article describes evidence-based indicators of national failure of the Comprehensive Drug Abuse Prevention and Control Act.

Don’t eat the brown acid: Induced ‘malnovation’ in drug markets

Title II, the Controlled Substances Act (CSA), of the Comprehensive Drug Abuse Prevention and Control Act of 1970 (CDAPCA) created the present system of drug scheduling and regulation. This paper illustrates how the CSA created the incentives for induced ‘malnovation’ (innovation intended to circumvent legislation, and thus foil policymakers’ intended ends) into drug markets, namely “designer drugs.” As a result of this induced malnovation, drug markets have not only increased in the variance of products available that are often sold under similar street names, but there is also a tendency towards creating more dangerous drugs in an attempt to stay outside of the regulation.

Don't Eat the Brown Acid: Induced Malnovationn in Drug Markets

Title II, the Controlled Substances Act (CSA), of the Comprehensive Drug Abuse Prevention and Control Act of 1970 created the system of drug scheduling and regulation used to this day. This paper illustrates how the CSA created the incentives for induced ‘malnovation’ (innovation intended to circumvent legislation, and thus foil policymakers’ intended ends) into drug markets, namely “designer drugs.” As a result of this induced malnovation, drug markets have not only increased in variance of products available that are often sold under similar street names, but there is a tendency towards creating more dangerous drugs in an attempt to stay outside of the regulation.

The Federal Controlled Substances Act: Schedules and Pharmacy Registration

The Federal Comprehensive Drug Abuse Prevention and Control Act of 1970, more commonly known as the Controlled Substances Act, became effective on May 1, 1971.1,2 This federal law contains 3 different titles. Title I deals with the establishment of rehabilitation programs for drug abusers, Title II addresses the registration and distribution of controlled substances, and Title III discusses issues related to the importation and exportation of controlled substances.2 The main segment of interest to pharmacists is Title II. This RxLegal column is the first of a 4-part series that provides an overview of key components of this important federal law. The goal of the Controlled Substances Act is to improve the manufacturing, importation and exportation, distribution, and dispensing of controlled substances.1 To achieve this goal, manufacturers, distributors, and dispensers of controlled substances must be registered with the Drug Enforcement Administration (DEA), the agency charged with enforcement of the Act on the federal level. Registration of these entities with the DEA results in the formation of a “closed system” for controlled substances distribution. This closed system allows for controlled substances to be traced from initial manufacture to final dispensing to the patient. Controlled substances are generally defined as medications that are considered easily abusable. Under the Controlled Substances Act, these medications are categorized into 5 schedules.1 Definitions of each schedule with corresponding examples of medications are presented in Table 1. Schedule I medications have the highest abuse potential, while medications in Schedule V have a low abuse potential. In addition to the schedules, the Controlled Substances Act contains information on scheduled listed chemical products or SLCPs. These listed chemicals are products that contain ephedrine, pseudoephedrine, or phenylpropanolamine that may be marketed or distributed legally in the United States as nonprescription drugs. Table 1. Schedules of controlled substances1 Of note, some states have passed laws allowing for the medical or recreational use of marijuana.2 These state laws do not alter the fact that marijuana remains a Schedule I medication under federal law. In addition, medications may be removed or added to a schedule or be switched from one schedule to another. The US Attorney General has the authority to add, remove, or switch. The Attorney General generally works with the Secretary of the Department of Health and Human Services to determine a medication’s schedule. Every pharmacy that dispenses controlled substances is required to register with the DEA.1 Prior to obtaining a DEA registration, a pharmacy must have a state license for operation. A DEA pharmacy registration is obtained by completing the Application for New Registration (ie, DEA Form-224). Instructions for completing the form are found on the US Department of Justice DEA Office of Diversion Control Web site (http://www.deadiversion.usdoj.gov/drugreg/reg_apps/224/224_instruct.htm).3 Pharmacies can also apply electronically for a new or renewed registration (http://www.deadiversion.usdoj.gov/drugreg/reg_apps/pdf_apps.htm).4 Once approved, a pharmacy must renew registration every 3 years. Some drug products such as pseudoephedrine, phenylpropanolamine, and ephedrine-containing medications are classified as SLCPs as described previously.1 These chemicals may be used inappropriately to compound illegal substances such as methamphetamine (ie, crystal). If a pharmacy were to engage in the wholesale distribution of these chemicals, a DEA chemical registration would be required in addition to the registration for handling controlled substances. This is rarely the case, because most pharmacies are retail distributors of these chemicals (ie, regulated sellers) and not wholesale distributors. A regulated seller legally sells the aforementioned chemicals only for personal use either directly to walk-in customers or via other face-to-face transactions. Once granted, a DEA registration may be suspended or revoked by the US Attorney General.1 Reasons for suspending or revoking a registration include the following: Falsifying the application for the registration Having a prior conviction of a felony related to a controlled substance or a List I chemical (ie, phenylpropanolamine or pseudoephedrine) Having a suspension, revocation, or denial of a state license Committing an act that “renders registration inconsistent with the public interest” Being excluded from Medicare or Medicaid programs The Attorney General may also deny registration or renewal.1 In so doing, he or she determines whether issuing the registration or renewal would be inconsistent with the public interest. This decision is made by weighing factors such as state licensing board or professional disciplinary authority recommendations, compliance with laws regarding controlled substances, and a prior conviction record related to any aspect of controlled substances (ie, manufacture, distribution, or dispensing). The second article in this series will focus on requirements for controlled substances prescriptions.

The Native American Church, Peyote, and Health: Expanding Consciousness for Healing Purposes

Since the passage of the Comprehensive Drug Abuse Prevention and Control Act of 1970, Native American Church (NAC) members have continually had to defend their legal right to use the sacred cactus peyote (Lophophora williamsii). This legal right was established with the passage of 21 CFR 1307.31, which exempts peyote's Schedule I status for NAC members. The exemption, however, continues to be challenged by power‐based social arrangements. This article provides a brief history of the NAC, its use of peyote, the Native American beliefs behind the use of peyote, and psychopharmacological data concerning the cactus. It is argued that NAC members do not use peyote as a hallucinogenic drug but as a means whereby members expand access to parts of their consciousness for healing purposes. These healing purposes foster health, balance, respect, and a sense of community among NAC members and their social relations, providing a means of maintaining individual and social justice for Native Americans.

Mechanism of action and therapeutic uses of psychostimulants.

1. Kevin F Foley, PhD MT(ASCP)[⇑][1] 1. is with the Department of Biomedical Technologies, University of Vermont, Burlington VT 1. Address for correspondence: Kevin F Foley PhD MT (ASCP), Assistant Professor, University of Vermont, Department of Medical Laboratory and Radiation Sciences, 302 Rowell Building, 106 Carrigan Drive, Burlington VT 05405. (802) 656-2506. kfoley{at}uvm.edu. The name stimulant can be given to any drug that increases the rate of a physiologic function. The term psychostimulant is more specific, referring to compounds that have direct neurological effects, typically: heightened alertness, increased energy, appetite suppression, and sometimes euphoria. Use of psychostimulants is widespread and occurs in both recreational and clinical settings. Therapeutic monitoring and screening for use and abuse of these drugs is common in clinical laboratories. Understanding the physiological effects and uses of stimulants will be of value to clinical and forensic laboratory scientists. EXAMPLES OF PSYCHOSTIMULANTS Table 1 lists several psychostimulants that are commonly prescribed, have widespread illicit use, or are well-known by the general public. Table 1 also identifies the control schedule of each compound. Many psychostimulants are listed as controlled substances under the Controlled Substances Act, Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. Schedules I through IV are assigned to compounds based on their abuse potential and their medical utility. Schedules II through V contain drugs which have known medical uses whereas Schedule I compounds have no current, sanctioned medical use. THERAPEUTIC USES OF PSYCHOSTIMULANTS Amphetamine has long been known to be a mental stimulant. Because of its psychostimulant properties, amphetamine has been used successfully by U.S. fighter pilots because it enhances cockpit performance by reducing the effects of fatigue.1 Since amphetamine heightens alertness it has found use in the treatment of narcolepsy and in attention-deficit hyperactivity disorder.2 The drug Adderall® for example, is used widely in… ABBREVIATIONS: ADHD = attention-deficit hyper-activity disorder; CNS = central nervous system; MDA = 3,4-methylenedioxyamphetamine; MDMA = 3,4-methylenedioxymethamphetamine; NC = not controlled; OTC = over the counter. [1]: #corresp-1

Ecstasy: It's the Rave

National statistics reveal an alarming trend concerning the use of 3,4-methylenedioxymethamphetamine, which is better known as ecstasy. Results from the Monitoring the Future survey of 50,000 secondary youth reveal that use among 8th graders rose to 3.1%, 5.4% among 10th graders, and 8.2% among 12th graders. High school faculty and staff must be cognizant of this growing trend, understand the physiological effects of use, and recognize protective and risk factors among youth. It is imperative that school personnel and community-based organizations work together to implement primary, secondary, and tertiary prevention strategies as part of a comprehensive drug abuse prevention program.

The Reality of Prescribing Opioids in Texas: An Interview with a Drug Agent

The goal of the federal government in regulating opioid analgesics through the Controlled Substance Act, Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, is to ensure availability of these agents when medically indicated while minimizing abuse and illegal diversion. The act classifies drugs and other substances into schedules, I through V, depending on the “potential or actual patterns of abuse, degree of risk or likelihood for psychic or physiological dependence” (1). The act does not restrict physician decisions regarding which of these drugs to prescribe, in what amounts, or for what duration. However, state laws vary greatly, and many states regulate the prescription of opioids for pain in ways that the federal laws do not. In 1994, the Agency for Health Care Policy and Research of the US Department of Health and Human Services identified concern about regulation of controlled substances as a barrier to effective pain relief. Fear of professional license suspension or revocation often exists when large quantities of opioids are provided to a patient, even with sufficient proof of medical need (2).

Jackson County Partnership: Developing an Effective Coalition

The Community Partnership Demonstration Program allows a community to develop and carry out a long-range, comprehensive, and self-sustaining alcohol and other drug abuse prevention program. A case study that shows the use of coalition building to carry out a prevention program is presented. The case study is followed by a discussion of the principles involved in forming and maintaining a coalition. Discussion about using the coalition method for implementing health promotion and prevention programs in rural or underserved communities and the important role that health educators can play follow.

Federal Court Jurisdiction in Civil Forfeitures of Personal Property Pursuant to the Comprehensive Drug Abuse Prevention and Control Act

Federal Court Jurisdiction in Civil Forfeitures of Personal Property Pursuant to the Comprehensive Drug Abuse Prevention and Control Act

The Scope of Real Property Forfeiture for Drug-Related Crimes under the Comprehensive Forfeiture Act

Congress passed the Comprehensive Drug Abuse Prevention and Control Act of 1970' in response to the growing menace of drug abuse in the United States.2 As initially enacted, application of its criminal forfeiture provision was restricted to defendants convicted of participating in continuing criminal enterprises (CCE) under 21 U.S.C. ? 848.3 The initial success of the forfeiture provision in combating narcotics trafficking was limited.4 The statute was subsequently amended by the Comprehensive Forfeiture Act of 19846 to impose forfeiture under 21 U.S.C. ? 8536 upon all defendants convicted of drug felonies.7 This Comment considers the use of section 853 in the forfeiture of

Community organization and school liaisons: how to get programs started.

This paper briefly reviews four intervention models, Rothman's community organization, Green's system-centered education, Rogers' innovation-decision process, and Watzlawick's planned change, for their applicability to help initiate community-based programs for drug abuse prevention and health promotion in youth. An expanded model is described, including preprogram assessment of the target population, community, and drug use problem, and continuous evaluation of program process and product. School liaisons are emphasized as a key factor in early adoption and demonstration of a community-based program for youth. The expanded model, including school liaisons, is applied to a comprehensive community drug abuse prevention project being implemented in the Greater Kansas City area. The model--and the project--suggest methods for organizing communities for long-term drug prevention, initially at the level of school and school district, and later to the family, mass media, and community organizations in a proximal-to-distal sequence of programming.

Discriminatory decision making at the legislative level: An analysis of the Comprehensive Drug Abuse Prevention and Control Act of 1970.

This paper is an analysis of the Comprehensive Drug Abuse Prevention and Control Act of 1970. Consistent with value-conflict perspectives, previous research on the social origins of drug legislation suggests that coercive laws occur when the behavior of minority and other subordinate groups become threatening. Liberalizing drug legislation is enacted when the interests of dominant groups seem juxtaposed to existing punitive legislation. The present analysis explores the process of legislative decision making when both subordinateand superordinate groups engage in drug-related behaviors which run counter to dominant norms and values. To do so, a detailed analysis of the congressional committee hearings and floor debates which preceded enactment of the 1970 Act was conducted. This analysis revealed that Congress did not pass a strictly coercive drug control policy at the risk of stigmatizing superordinate groups. Nor did it choose to liberalize drug penalties across the board. Congress perceived that strictly liberal policies might undermine both the instrumental goal of reducing illicit drug activity, and the symbolic goal of expressing general societal disapproval of illicit drug use. Instead, the legislation that emerged from congressional debates contained both liberal and coercive provisions reflecting the requirements of dealing with two targeted populations: young middle and upper class white drug users who became identified as victims of drug traffickers; and large-scale and professional drug dealers who became identified as enemy deviants—the true source and symbol of the drug problem. Liberal, and essentially discriminatory, provisions permitted the protection of the former from stigmatization as criminal felons. Coercive, but apparently nondiscriminatory, provisions provided the threat and potential for severe punishment of the latter. The discriminatory features of the 1970 Act are identified and explicated. And, the implications of the Act's provisions for race- or class-based decisions in the application of sanctions are discussed.

A free clinic approach to drug abuse

The Haight-Ashbury Free Medical Clinic was founded in 1967 as a social statement of community need by the particular population of disenfranchised young people who flocked to the Haight-Ashbury district of San Francisco. Since that time we have responded to this need and have provided comprehensive drug abuse prevention and detoxification programs as well as a wide spectrum of health and psychosocial care unavailable through conventional public health facilities of the City. Fundamental to our delivery of care is the basic philosophy of nonpunitive, nonjudgmental free medical and psychosocial care to all who apply. Specifically, the HAFMC provides counseling and drug detoxification facilities, including a 24-hour resuscitation squad and intensive psychological services. Our personnel are widely recognized for their professional knowledge and street expertise in their effectiveness in dealing with the addicted individual. In this study the epidemiology, sociology, and pharmacology of the various commonly encountered drugs are described, as well as some specific and oft times life-saving techniques.

Comprehensive Drug Abuse Prevention and Control Act of 1970

Comprehensive Drug Abuse Prevention and Control Act of 1970