Humans have experimented with narcotic and hallucinogenic plants since before recorded history, discovering their properties as they tested plants for edibility or were attracted by the odors of some leaves when these were burned. Ancient cultures used narcotic plants to relieve pain or to heighten pleasure; they used hallucinogenic plants to induce trance-like states during religious ceremonies. …
The federal strategy to reduce illicit drug use is based on the Comprehensive Drug Abuse Prevention and Control Act of 1970, Title II (PL 91-513)—commonly called the Controlled Substances Act. This act establishes the criteria for "scheduling," or categorizing, all substances regulated under existing federal law. (See Table 2.1.)…
Before people begin to use a drug more or less regularly, they have to use it for the first time. The government's drug experts call first use of a drug its "incidence" of use or the event of "initiation." The government's chief drug survey, the National Survey on Drug Use and Health (formerly called the National Household Survey on Drug Abuse, conducted annually by the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Depart…
Drug use during pregnancy places both mother and infant at risk for serious health problems. A child may become addicted to heroin in its mother's womb—provided the child is born at all (fetal death is a possibility). Cocaine use by the pregnant mother carries similar risks to the fetus and may kill the mother too. LSD use may lead to birth defects. PCP users may have smaller-than-normal babies who later turn out to have poor muscle control. Learning disabilities are associated wit…
The United States justice system has been affected since the early 1900s by attempts to eradicate various drugs. The first legislation aimed at drugs was the Harrison Act of 1914, which outlawed opiates and cocaine. Following that act, laws were passed or amended at intervals, but the war on drugs began in earnest in the early 1970s after Congress passed the Comprehensive Drug Abuse and Control Ac…
While the accuracy of the above statement is deba-table, there's no question that many policy makers see drugs as a major threat to our national well-being and accordingly propose strong measures to combat that perceived threat. Figure 6.1 and Figure 6.2 present contrasting maps of the perceived drug threat in the 1990s and in the new century. …
In the aftermath of the September 11, 2001, terrorist attacks on the United States, the federal government's approach to combating drug production and trade beyond our borders—the subject of this chapter—has come to merge with the war on terror. The principal agency charged with this effort is the Bureau of International Narcotics and Law Enforcement Affairs (which abbreviates its name as INL). The INL is a part of the U.S. Department of State. The case for the convergence b…
Though not all experts agree on a single definition of drug addiction, the 2000 Diagnostic and Statistical Manual of Mental Disorders-IV Text Revision, or DSM-IV-TR (Washington, DC: American Psychiatric Association, 2000), is the most widely used reference for diagnosing and treating mental illness and substance-related disorders. In the current DSM, the nation's psychiatrists draw a distinction between "substance abuse" on the one hand and "substance dependence…
The human immunodeficiency virus (HIV) was first detected in 1981 and has been claiming lives since then all over the world. The virus causes an infectious disease that, if left untreated, rapidly develops into acquired immunodeficiency syndrome (AIDS). People often use the abbreviations HIV and AIDS interchangeably, but there is a definite progression. HIV infection comes first and AIDS is the last stage of the disease. A small percentage of those testing positive for HIV remain unaffected by t…
The Office of National Drug Control Policy (ONDCP), a part of the White House, issued a report in 2004 on the economic costs of drug abuse, The Economic Costs of Drug Abuse in the United States: 1992-2002 (http://www.whitehousedrugpolicy.gov/publications/economic_costs/economic_costs.pdf). The report included such costs as those to the health care system; the cost of crime associated w…
Drug abuse existed long before the Nixon administration declared a "war on drugs" in the 1970s. More than thirty years later this "war" continues with no end in sight. Not surprisingly, the war on drugs, and/or the national policy under which it has been fought by administrations of both major parties, have many critics. One major alternative to the "war" …
AAA Foundation for Traffic Safety 607 14th St. NW, Ste. 201 Washington, DC 20005 (202) 638-5944 FAX: (202) 638-5943 E-mail: info@aaafoundation.org URL: www.aaafoundation.org/home Adult Children of Alcoholics P.O. Box 3216 Torrance, CA 90510 (310) 534-1815 E-mail: info@AdultChildren.org URL: www.adultchildren.org Al-Anon/Alateen Family Group Headquarters, Inc. 1600 Corporate Landing Pkwy. Virginia …
One of the seldom noted but most valuable services provided by the government is statistical information on subjects of national interest and concern. Substantial resources are expended by the federal government in tracking trends in drug use in the United States, both from a health policy and an enforcement policy perspective, both nationally and internationally. The national policy on combating …
Many definitions of health exist. Most definitions consider health as an outcome—the result of actions to produce it, such as good nutrition, immunization to prevent disease, or medical treatment to cure disease. The American Heritage Dictionary defines health as fixed and measurable—"the overall condition of an organism at a given time." However, health also may be vie…
Preventing disease involves a wide range of interrelated programs, actions, and activities. Some prevention measures are sweeping global policy initiatives, such as national and state government actions to reduce health risks by limiting air pollution and other toxic exposures or standards to assure the safety of food and water supplies. Others are focused efforts of public health professionals an…
The practice of medicine often is considered to be both science and art because identifying the underlying causes of disease and establishing a diagnosis require that health care practitioners use a combination of scientific method, intuition, and interpersonal (communication and human relations) skills. Diagnosis relies on the powers of observation; listening and communication skills; analytical …
Many definitions of health exist. Most definitions consider health as an outcome—the result of actions to produce it, such as good nutrition, immunization to prevent disease, or medical treatment to cure disease. The American Heritage Dictionary defines health as fixed and measurable—"the overall condition of an organism at a given time." However, health also may be vie…
Degenerative diseases are noninfectious disorders characterized by progressive disability in the patient. Patients often can live for years with their diseases. Although they may not die from degenerative diseases, patients' symptoms usually grow more disabling and they often succumb to common complications of their disorders. …
Genetics, the study of biologic inheritance, explains how and why certain traits, such as hair color and blood types, run in families. Each individual develops from a single fertilized egg, which contains all the information necessary for the development of innate mental and physical characteristics. This information is carried in twenty-three pairs of rod-shaped chromosomes (containing thousands …
Infectious (contagious) diseases are caused by microorganisms—viruses, bacteria, parasites, or fungi—transmitted from one person to another through casual contact, such as influenza; through bodily fluids, such as HIV (human immunodeficiency virus); or via contaminated food, air, or water supplies. Infectious diseases also may spread by vectors of disease such as insects or arthropod…
Mental health may be measured in terms of an individual's abilities to think and communicate clearly, learn and grow emotionally, deal productively and realistically with change and stress, and form and maintain fulfilling relationships with others. Mental health is a principal component of wellness—self-esteem, resilience, and the ability to cope with adversity influence how people …
The National Center for Complementary and Alternative Medicine (NCCAM), an institute of the National Institutes of Health (NIH), was created in 1992 because consumers of complementary and alternative medicine (CAM) and health care practitioners wanted to know whether available alternative medical options are safe and effective. NCCAM is "committed to the clinical study of promising CAM subs…
This chapter contains information drawn from an early release of the January to June 2003 National Health Interview Survey, with estimates from 1997 through 2002 for comparison, which asks about the health behaviors of Americans—the lifestyles and health risks they assume, such as being overweight, smoking, consuming alcohol, and how they feel about their health. It also considers the effec…
The U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, tracks nationwide health trends and reports its findings in several periodicals, especially its Advance Data series, HIV/AIDS Surveillance Reports, and Morbidity and Mortality Weekly Reports. The CDC's National Center for Injury Prevention and Control provides data about deaths and disability caused by accidents …
Preventing disease involves a wide range of interrelated programs, actions, and activities. Some prevention measures are sweeping global policy initiatives, such as national and state government actions to reduce health risks by limiting air pollution and other toxic exposures or standards to assure the safety of food and water supplies. Others are focused efforts of public health professionals an…
The practice of medicine often is considered to be both science and art because identifying the underlying causes of disease and establishing a diagnosis require that health care practitioners use a combination of scientific method, intuition, and interpersonal (communication and human relations) skills. Diagnosis relies on the powers of observation; listening and communication skills; analytical …
Americans in 2006 are fatter than ever, the heaviest since the government started tracking patterns of body weight for the U.S. adult population in the first half of the twentieth century. An estimated 127 million adults weigh more than is considered healthy, and of this group, more than sixty million are considered obese. According to the Centers for Disease Control (CDC) and U.S. Surgeon General…
During the twentieth century, advances in public health and medical care helped Americans to lead longer, healthier lives. Two important measures of the health of the population are infant mortality (death) rates and life expectancy at birth rates. Infant mortality rates significantly decreased and life expectancy increased by thirty years. Table 2.1 shows the decline in infant mortality between 1…
That diet and appetite are closely linked to psychological health and emotional well-being is widely recognized. Psychological factors often influence eating habits. Many people overeat when they are bored, stressed, angry, depressed, or anxious. Psychological distress can aggravate weight problems by triggering impulses to overeat. Emotional discomfort drives many people to overeat as a way to re…
Genetics, which is the branch of biology that studies heredity, concerns the biochemical instructions that convey information from generation to generation. In order to appreciate the role of genetics in health and illness, it is important to understand the interaction of genes, chromosomes, and genomes and to learn how deoxyribonucleic acid (DNA) functions as the information molecule of living or…
The Centers for Disease Control and Prevention (CDC) define chronic diseases as prolonged illnesses that do not resolve spontaneously and are rarely cured completely. According to the CDC, chronic illnesses such as cardiovascular disease, cancer, respiratory disease, cerebrovascular disease, and diabetes account for 70% of all deaths in the United States and almost half of the years of potential l…
One of the most disturbing observations about overweight and obesity in the United States is the epidemic of super-sized kids. A survey of adolescents in thirteen European countries, the United States, and Israel found that the United States, followed by Greece and Portugal, had the highest percentage of overweight teens (Inge Lissau et al., "Body Mass Index and Overweight in Adolescents in…
Americans have long been consumed with losing weight, seemingly willing to suffer deprivation and to embrace each new diet that debuts—even if the "new diet" is simply a twist on an ages-old weight-loss plan. The fixation with weight loss is so longstanding that even the word diet has assumed a new meaning. Used as a verb, diet means to eat and drink a prescribed selection of …
Degenerative diseases are noninfectious disorders characterized by progressive disability. Patients often can live for years with their diseases. Although they may not die from degenerative diseases, patients' symptoms usually grow more disabling and they often succumb to complications of their disorders. …
One credible hypothesis about the source of the epidemic of overweight and obesity in the United States is the progressive decrease in physical activity expended in daily life—for work, transportation, and household chores. Some researchers contend that the average caloric intake of Americans has not substantially increased; instead by reducing daily physical activity, the caloric imbalance…
Infectious (contagious) diseases are caused by microorganisms—viruses, bacteria, parasites, or fungi—transmitted from one person to another through casual contact, such as influenza; through bodily fluids, such as HIV (human immunodeficiency virus); or via contaminated food, air, or water supplies. Infectious diseases also may spread by vectors of disease such as insects or arthropod…
The economic impact of obesity is considerable. The World Bank estimated the cost of obesity in the United States as 12% of the national health-care budget in the late 1990s. The increasing prevalence of overweight and obesity in the United States has resulted in a corresponding increase in direct and indirect health-care costs. Direct health-care costs are those incurred for preventive measures, …
The politics of obesity demand that we revisit campaign contribution laws and advocate for a government agency—independent of industry—with clear responsibility for matters pertaining to food, nutrition, and health. —Marion Nestle, professor and chair of the Department of Nutrition, Food Studies, and Public Health at New York University, in "The Ironic Politics of Obesi…
Americans in 2004 are fatter than ever, the heaviest since the government started tracking patterns of body weight for the U.S. adult population in the first half of the twentieth century. An estimated 100 million adults weigh more than is considered healthy, and of this group, more than forty-four million are considered obese. According to the Centers for Disease Control (CDC) and U.S. Surgeon Ge…
During the twentieth century, advances in public health and medical care helped Americans to lead longer, healthier lives. Two important measures of the health of the population are infant mortality (death) rates and life expectancy at birth rates. Infant mortality rates significantly decreased and life expectancy increased by thirty years. Table 2.1 shows the decline in infant mortality between 1…
One of the challenges facing public-health professionals as they seek to combat obesity among Americans is helping consumers to distinguish myths, lore, legends, and outright fraud from accurate, usable information about nutrition, diet, exercise, and weight loss. Some of these inaccuracies are so longstanding and deeply rooted in American culture that even the most educated consumers unquestionin…
Mental health may be measured in terms of an individual's abilities to think and communicate clearly, learn and grow emotionally, deal productively and realistically with change and stress, and form and maintain fulfilling relationships with others. Mental health is a principal component of wellness—self-esteem, resilience, and the ability to cope with adversity influence how people …
That diet and appetite are closely linked to psychological health and emotional well-being is well known. Psychological factors often influence eating habits. Many people overeat when they are bored, stressed, angry, depressed, or anxious. Psychological distress can aggravate weight problems by triggering impulses to overeat. Emotional discomfort drives many people to overeat as a way to relieve a…
One of the most disturbing observations about overweight and obesity in the United States is the epidemic of super-sized kids. A survey of adolescents in thirteen European countries, the United States, and Israel found that the United States, followed by Greece and Portugal, had the highest percentage of overweight teens (Inge Lissau, et al., "Body Mass Index and Overweight in Adolescents i…
Americans have long been consumed with losing weight, seemingly willing to suffer deprivation and to embrace each new diet that debuts—even if the "new diet" is simply a twist on an ages-old weight-loss plan. The fixation with weight loss is so longstanding that even the word diet has assumed a new meaning. Used as a verb, diet means to eat and drink a prescribed selection of …
One credible hypothesis about the source of the epidemic of overweight and obesity in the United States is the progressive decrease in physical activity expended in daily life—for work, transportation, and household chores. Some researchers contend that the average caloric intake of Americans has not substantially increased; instead by reducing daily physical activity, the caloric imbalance…
The economic impact of obesity is considerable. The World Bank estimated the cost of obesity in the United States as 12 percent of the national health-care budget in the late 1990s. The increasing prevalence of overweight and obesity in the United States has resulted in a corresponding increase in direct and indirect health-care costs. Direct health-care costs are those incurred for preventive mea…
At the international level, the World Health Organization (WHO) has developed an aggressive plan to combat an escalating global epidemic of overweight and obesity—"globesity"—throughout the world. The WHO guidelines on diet and exercise, The Expert Consultation on Diet, Nutrition and the Prevention of Chronic Disease, released in 2003, advocate such actions as lowering intakes of sugar, salt, and saturated fats. They also recommend sharply limiting the marketing of fo…
One of the challenges facing public-health professionals as they seek to combat obesity among Americans is helping consumers to distinguish myths, lore, legends, and outright fraud from accurate, usable information about nutrition, diet, exercise, and weight loss. Some of these inaccuracies are so longstanding and deeply rooted in American culture that even the most educated consumers unquestionin…
Many obesity researchers and health professionals believe that the most effective way to win the war on obesity is to intensify efforts to prevent overweight and obesity among children, adolescents, and adults. They assert that over time, prevention is far more cost effective than the expenditures associated with weight-loss efforts and medical treatment of obesity-related diseases. They also obse…
Many obesity researchers and health professionals believe that the most effective way to win the war on obesity is to intensify efforts to prevent overweight and obesity among children, adolescents, and adults. They assert that over time, prevention is far more cost effective than the costs associated with weight-loss efforts and medical treatment of obesity-related diseases. They also observe tha…
The National Center for Complementary and Alternative Medicine (NCCAM; formerly the Office of Alternative Medicine, established in 1992) is an institute of the National Institutes of Health (NIH). The center was created because consumers of complementary and alternative medicine (CAM) and health care practitioners wanted to know whether available alternative medical options were safe and effective…
To date, the United States is losing the battle against overweight and obesity. More Americans than ever before are overweight and obese, and by their own admission, more people are gaining weight than losing it. Gallup Poll data collected in July 2003 revealed that more than one-third of Americans said they had gained "a little" weight, and 9 percent admitted they had gained "…
The U.S. Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, tracks nationwide health trends and reports its findings in several periodicals, especially its Advance Data series, its annual HIV/AIDS Surveillance Reports, and Morbidity and Mortality Weekly Reports. The CDC's National Center for Injury Prevention and Control provides data about deaths and disability caused by…
The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, tracks nationwide health trends, including overweight and obesity, and reports its findings in several periodicals, especially its Health, United States and Morbidity and Mortality Weekly Reports. The National Vital Statistics Report and Vital and Health Statistics, issued by the CDC National Center for Health Statistics (NC…
A November 2004 Gallup Poll revealed that knowledge about diet and the risks of overweight do not necessarily translate into behavioral change. A significant majority (62%) of Americans believed they should lose weight, even though less than half (41%) considered themselves overweight, and even fewer (29%) were actively trying to lose weight. It appears that Americans are somewhat confused about t…
The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, tracks nationwide health trends, including overweight and obesity, and reports its findings in several periodicals, especially its Health, United States and Morbidity and Mortality Weekly Reports. The National Vital Statistics Report and Vital and Health Statistics, issued by the CDC National Center for Health Statistics (NC…
Drugs are nonfood chemicals that alter the way a person thinks, feels, functions, or behaves. This includes everything from prescription medications, to illegal chemicals like heroin, to popular and widely available substances like alcohol, tobacco, and caffeine. A wide variety of laws, regulations, and government agencies exist to control the possession, sale, and use of drugs. Different drugs ar…
Alcohol, tobacco, and caffeine have been used around the world for centuries. They are firmly entrenched in modern life—socially, economically, and politically. Virtually every society uses one or more of these drugs. Alcohol has been used for medicinal purposes for centuries, primarily for sedation. Until 1842, when modern surgical anesthesia began with the use of ether, only heavy doses o…
Contrary to popular belief, ethanol (the alcohol in alcoholic beverages) is not a stimulant; it is a depressant. Although many of those who drink alcoholic beverages feel relaxation, pleasure, and stimulation, these feelings are in fact caused by the depressant effects of alcohol on the brain. …
Alcohol is an addictive substance, but not everyone who drinks it becomes addicted. Most of those who drink alcohol do not become alcoholics. Scientists cannot explain what individual traits account for the difference, but they suspect that a wide variety of factors may make a person more susceptible to addictions of all kinds. Alcoholism was recognized as a disease more than two hundred years ago…
The use of tobacco in North America dates back to pre-Columbian days. After Christopher Columbus landed in the New World in 1492, he and later European settlers were introduced to tobacco by Native Americans. The use of tobacco products, especially cigarettes, increased greatly in the United States in the twentieth century. Smoking was often associated with romance, relaxation, and adventure; movi…
Three surveys provide comprehensive coverage of the use of drugs, alcohol, and tobacco by American youth, as well as their attitudes about using these substances. The surveys presented in this chapter include:…
The alcohol and tobacco industries play large roles in the American economy. Both industries not only provide jobs and income for those involved in growing, manufacturing, and selling these products, they also contribute significant tax revenues to the federal, state, and local governments. …
Taxation is an age-old method by which the government raises money. Alcoholic beverages have been taxed since colonial times, and tobacco products have been taxed since 1863. The alcohol and tobacco industries contribute a great deal of tax money to federal, state, and local governments.…
As Americans sit down to their morning cups of coffee or tea or drink a cola, few think about the fact that they are taking a drug. A drug is any substance that affects the mood or the state and function of the body. According to this definition, the caffeine in many of our favorite beverages is a drug. …
A July 2004 Gallup Poll found that 62% of Americans drink alcoholic beverages, such as liquor (distilled spirits), wine, or beer, down from 66% in 2002, yet up from 58% in 1996. (See Table 10.1.) Nearly four in ten (38%) were "teetotalers," or total abstainers. Since about 1990, the levels of those who drank alcoholic beverages remained below the 71% the Gallup Poll recorded in 1976, 1977, and 1978.…
AAA Foundation for Traffic Safety 607 14th St. NW, Ste. 201 Washington, DC 20005 (202) 638-5944 FAX: (202) 638-5943 E-mail: info@aaafoundation.org URL: http://www.aaafoundation.org Action on Smoking and Health (ASH) 2013 H St. NW Washington, DC 20006 (202) 659-4310 URL: http://www.ash.org Al-Anon Family Group Headquarters 1600 Corporate Landing Pkwy. Virginia Beach, VA 23454-5617 (757) 563-1600 FA…
The various agencies of the U.S. Department of Health and Human Services (HHS) produce important publications on the consumption of alcohol, tobacco, and drugs in the United States and their health effects. Reports of the surgeon general and special reports to Congress are published through this office. The Substance Abuse and Mental Health Services Administration (SAMHSA), an agency of HHS, produ…
