DRUGS AND NARCOTICS

Drugs are articles that are intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in humans or animals, and any articles other than food, water, or oxygen that are intended to affect the mental or body function of humans or animals. Narcotics are any drugs that dull the senses and commonly become addictive after prolonged use.

In the scientific community, drugs are defined as substances that can affect a human's or animal's biological and neurological states. They may be organic, such as the chemical tetrahydrocannabinol (THC), which occurs naturally in marijuana; or synthetic, such as amphetamines or sedatives, which are manufactured in laboratories. Drugs can be swallowed, inhaled through the nostrils, injected with a needle, applied to the skin, taken as a suppository, or smoked. Scientists categorize drugs according to their effects. Among their categories are analgesics, which kill pain, and psychoactive drugs, which alter the mind or behavior. Some psychoactive substances produce psychological highs or lows according to whether they are stimulants or depressants, respectively. Others, called hallucinogens, produce psychedelic states of consciousness; lysergic acid diethylamide (LSD) and mescaline are examples of such drugs. Marijuana is placed in its own category.

U.S. law categorizes these substances differently. Commonly, federal and state statutes distinguish drugs from narcotics. Drugs are substances designed for use in and on the body for the diagnosis, cure, treatment, or prevention of disease. These substances are regulated by the food and drug administration (FDA). Drugs have been defined to include such things as herb tonics, cold salves, laxatives, weight-reduction aids, vitamins, and even blood. Narcotics are defined by statute as substances that either stimulate or dull an individual's senses, and that ordinarily become habit-forming (i.e., addictive) when used over time. The regulation of narcotics falls into two areas. Legal narcotics are regulated by the FDA and are generally available only with a physician's prescription. The production, possession, and sale of illegal narcotics—commonly called controlled substances—are banned by statute.

The U.S. government has expended billions of dollars in a fight to reduce drug use in the United States, citing startling numbers about the number of individuals who use drugs. According to a survey in 2000 by the justice department, more than half of the adults in the United States between the ages of 18 and 34 have used illicit drugs during their lifetime. Moreover, 28 percent of children between the ages of 12 and 17 have used illicit drugs. Although much of the attention has focused upon use of such drugs as marijuana and cocaine, new "club" or "designer" drugs have become popular among some younger individuals. About six million children and young adults over the age of 12 have reported using the designer drug methylene-nmethylamphetamine (MDMA), also known as "ecstasy," which has sparked a national debate about improved drug education in grade schools and high schools in the United States.

Drug Laws

Authority to regulate drug use rests foremost with the federal government, derived from its power to regulate interstate commerce. States are free to legislate so long as their laws remain consistent with federal law. Most states have adopted federal models for their own drug legislation.

Current law has two main objectives. First, it regulates the manufacture, sale, and use of legal drugs such as aspirin, sleeping pills, and antidepressants. Second, it prohibits and punishes the manufacture, possession, and sale of illegal drugs from marijuana to heroin, as well as some dangerous legal drugs.

The distinction between legal and illegal drugs is a twentieth-century phenomenon. During the nineteenth century, there was very little governmental control over drugs. The federal government regulated the smallpox vaccine in 1813 (2 Stat. 806) and established some controls through the Imported Drugs Act of 1848 (9 Stat. 237, repealed by Tariff Act of 1922 [42 Stat. 858, 989]). But addictive substances such as opium and cocaine were legal; in fact, the latter remained a minor ingredient in Coca-Cola soft drinks until 1909. Heroin, discovered in 1888, was prescribed for treating other addictions. California began restricting opium in 1875, but widespread criminalization of the substance would not come for decades.

States began a widespread movement toward control of legal and illegal drugs at the turn of the twentieth century. The federal government joined this process with the pure food and drug act of 1906 (34 Stat. 768, 1906, Ch. 3915, §§ 1–13, repealed by Federal Food, Drug, and Cosmetics Act of 1938), which primarily sought to protect consumers from "misbranded or poisonous" drugs, medicines, and alcohol. It established federal jurisdiction over the domestic manufacture and sale of drugs and also regulated drug imports.

Nevertheless, when Congress passed the Harrison Act of 1914 (Pub. L. No. 223, 38 Stat. 785), which imposed a tax on opium and cocaine, it stopped short of declaring either drug illegal. Most efforts to restrict drug use focused on alcohol. The temperance movement's prohibition crusade culminated in the passage of the eighteenth amendment and the volstead act of 1920 (41 Stat. 305), which made alcohol illegal. Alcohol remained illegal until the repeal of Prohibition in 1933.

Despite numerous amendments, flaws in the Pure Food and Drug Act spurred Congress to replace the statute. In 1938, federal lawmakers enacted the Federal Food, Drug, and Cosmetics Act (FFDC) (21 U.S.C.A. §§ 301 et seq.), which established the Food and Drug Administration (FDA) as the federal agency charged to enforce the law. The FFDC exerted broad control over the domestic commercial-drug market. Over the next two decades, states and the federal government continued to criminalize nonmedicinal and recreational drugs, and by midcentury, the division between legal and illegal drugs was firmly in place. In 1970, Congress passed the Comprehensive Drug Abuse Prevention and Control Act (21 U.S.C.A. §§ 801 et seq.), which continues to be the primary source of federal law on controlled substances.

Over-the-counter and prescription drugs are tightly regulated under the FFDC. This act and the Kefauver-Harris Drug Amendments of 1962 (Pub. L. No. 87-781, 76 Stat. 781) give the FDA a broad mandate. The agency protects consumers from the potential hazards of dangerous drugs, misleading labels, and fraud. The FDA sets standards of safety and quality, and its enforcement duties include the research, inspection, and licensing of drugs for manufacture and sale. Because the law requires that drugs not be adulterated, the FDA ascertains that they conform to legal standards of strength, quality, and purity. It also classifies the drugs that are to be dispensed only by a physician's prescription. Finally, new drugs can be placed on the market only after being approved by the FDA. Traditionally a slow process, FDA approval was speeded up significantly for some drugs in the 1980s and 1990s, largely in response to the AIDS epidemic.

To control the use of dangerous drugs, federal law and most state statutes use a classification system outlined by the Uniform Controlled Substances Act, based on the federal Comprehensive Drug Abuse Prevention and Control Act. This system includes both illegal and dangerous legal drugs. It uses five groups, called schedules, to organize drugs according to their potential for medical use, harm, or abuse, and it imposes a series of controls and penalties for each schedule.

Heroin, hallucinogens, and marijuana are placed on schedule I, as they are thought to have a high potential for harm and no medical use. Other types of opiates and cocaine are on schedule II. Most depressants and stimulants are on schedule III. Some mild tranquilizers are on schedule IV. Schedule V is for drugs that are considered medically useful and less dangerous but that can cause limited physical and psychological dependence, such as cough-syrup mixtures that contain some codeine. Under the law, drugs may be rescheduled as new evidence of their uses or risks becomes apparent, and the attorney general has the authority to add new drugs to the schedules at any time.

Penalties are established according to the severity of the crime. Possession of a controlled substance is the most simple crime involving drugs. Possession with intent to sell is more serious. Selling or trafficking incurs the greatest penalties. The exact penalty for a particular offense depends on numerous factors, including the type of drug, its amount, and the convicted party's previous criminal record. Penalties range from small monetary fines to life imprisonment and even greater punishments. Under a general expansion of federal offenses that can invoke capital punishment, the Violent Crime and Law Enforcement Act of 1994, Pub. L. No. 103-322, 108 Stat. 1796, imposes the death penalty for major drug trafficking. Generally, the highest price paid by drug offenders is prison time for trafficking. In 1999, according to statistics from the department of justice, the average sentence for drug offenders engaged in drug trafficking was 77.1 months, compared to an average of 15.8 months for drug possession.

Between the mid-1980s and early 1990s, lawmakers enacted the harshest drug laws in U.S. history. The impetus for these laws came from the so-called war on drugs, a broad federal and state public-policy push initiated under President ronald reagan that received widespread public support. Among its many initiatives was the creation of the cabinet-level office of the national director of drug control policy, known as the drug czar, to coordinate national and international antidrug efforts.

The war on drugs also created a patchwork of antidrug laws. These included the Anti–Drug Abuse Act of 1986 (Pub. L. No. 99-570, 100 Stat. 3207), which toughened penalties for drug violations involving cocaine, especially its smokable derivative, crack. The law imposed mandatory minimum sentences, even for first-time offenders. For sentencing purposes, it established a ratio that regards one gram of crack as equivalent to 100 grams of powder cocaine. While greatly increasing the number of drug offenders in prisons, the law has provoked considerable controversy over its effect on minorities. The Anti–Drug Abuse Act of 1988 (Pub. L. No. 100-690, 102 Stat. 4181) further increased federal jurisdiction over drug crime. For the first time, it became a federal crime to possess even a minimal amount of a controlled substance. Penalties were added for crimes that involve minors, pregnant women, and the sale of drugs within 100 feet of public and private schools. States toughened their laws, as well. Michigan, for example, imposed life imprisonment without parole for cocaine trafficking (Mich. Comp. Laws Ann. § 333.7403[2][a][i]).

Under the Violent Crime and Law Enforcement Act, Congress exempted certain first-time, non-violent offenders from minimum sentencing. An exempted person must be a first-time offender with a limited criminal history; must not have used violence or possessed a weapon during the offense; could not have organized or supervised activities of others; and must provide truthful information and evidence to the government during the offense.

The fight against illegal drugs has extended to housing. The Anti-Drug Abuse Act mandates that every local public-housing agency insert a clause in its standard lease document that gives the agency the right to evict tenants if they use or tolerate the use of illegal drugs on or near their premises.

The law has been lauded as an effective means of ridding public housing of drug dealers and other criminal activity that comes with it. However, critics have contended that many elderly citizens who live with their children and grandchildren have been unfairly evicted under this zero-tolerance policy. These critics have argued that the eviction of so-called "innocent" tenants violates the 1988 law, as Congress only meant to penalize those persons who have knowledge of drug use. The U.S. Supreme Court, in Department of Housing and UrbanDevelopment v. Rucker, 535 U.S. 125, 122 S. Ct. 1230, 152 L. Ed. 2d 258 (2002), rejected these arguments, ruling that the law clearly gives the housing agency discretion to evict tenants, whether or not they knew about drug use. The case arose when a 63-year-old grandmother in Oakland, California, was evicted when her adult daughter had been caught using crack cocaine three blocks from her mother's house.

Drug Policy and Law Enforcement

The enforcement of U.S. drug laws involves the use of substantial federal and state resources to educate, interdict, and prosecute. Estimates of the total annual cost of drug enforcement ranged from $20 billion to $30 billion in the 1990s. The federal government directs drug enforcement policy through the national director of drug control policy. Policy implementation involves both federal and state agencies, including the Department of Justice, the drug enforcement administration (DEA), the federal bureau of investigation (FBI), the state department, branches of the armed services and the U.S. Coast Guard, and local police departments. Drug enforcement is primarily a national effort, yet because drugs enter the United States from other countries, it also has international considerations.

Crack Cocaine, Race, and the War on Drugs

In the war on drugs in the United States, race is a critical issue. Although statistics indicate that African Americans account for only 12 percent of all illegal drug use, they make up 44 percent of all drug arrests. This racial disparity has drawn the attention of policy makers, politicians, and the courts. Many observers attribute much of it to the severe penalties imposed for offenses involving crack cocaine, which lead to the arrest and conviction of primarily black defendants.

Smokable cocaine, or crack, originated in the 1980s in U.S. inner cities. Because crack costs much less than powder cocaine, it quickly became the choice of poor drug users. In response to the resulting increased use of crack, Congress passed the Anti-Drug Abuse Act of 1986 (Pub. L. No. 99-570, 100 Stat. 3207 [codified as amended in scattered sections of 21 U.S.C.A. §§ 801–970]).

The 1986 law regards one gram of crack as equivalent to one hundred grams of powder cocaine. The u.s. sentencing commission adopted this ratio when it revised the Sentencing Guidelines that same year. In 1988 the Anti-Drug Abuse Act was amended to establish new mandatory minimum sentences. The amendment's sponsor, Representative E. Clay Shaw, Jr. (R-FL), said of the tougher sentences: "Crack is an extraordinarily dangerous drug so we must take extraordinary steps to combat it."

Under federal law the offense of selling five grams of crack, for example, is punishable by a mandatory minimum sentence of five years. To receive the same sentence for trafficking in powder cocaine, an offender would have to sell five hundred grams. Thus, small-time crack dealers can receive longer prison terms than cocaine wholesalers. In addition, mandatory minimum sentences for crack offenses mean that plea bargaining for a reduced sentence is not available. First-time offenses involving crack or powder cocaine are also differentiated. First-time offenders convicted in powder cocaine cases often receive parole and drug treatment; most first-time offenders in crack cases receive jail sentences.

By the early 1990s, the effect of these harsher laws on African Americans was evident. In a survey of 1992 sentencing data, the U.S. Sentencing Commission found that 92.6 percent of offenders sentenced for crack offenses were black, whereas 4.7 percent were white. With regard to cocaine offenses in general, 78 percent of offenders were black, and 6 percent were white.

The Bureau of Justice Statistics in the justice department concluded in 1993 that blacks are jailed longer than whites for drug offenses. The bureau explained that "the main reasons that African Americans' sentences are longer than whites' … was that 83 percent of all federal offenders convicted of trafficking in crack cocaine in guideline cases were black, and the average sentence imposed for crack trafficking was twice as long as for trafficking in powdered cocaine."

Some critics believe that the racial disparities in sentencing are a result of intentional discrimination. They argue that race has long been an issue in drug enforcement laws, from concerns about Chinese laborers and opium at the turn of the twentieth century to fears about blacks and cocaine in the early 1900s that produced headlines such as "Negro Cocaine 'Fiends' Are a New Southern Menace." Other critics take the suggestion of conspiracy further, arguing that the comparatively heavy drug use (as well as violence) in the black community is a result of deliberate attempts by whites to foster black self-destruction.

Not all critics believe that the racial disparities created by the war on drugs are intentional. As of 2003, at least one state court had struck down enhanced penalties for crack offenses as a violation of equal protection under the state constitution (State v. Russell, 477 N.W.2d 886 [Minn. 1991]). In that case the court said that state law treated black crack offenders and white powder cocaine offenders unfairly, although that result may have been unintentional.

On the federal level, several convicted crack offenders have argued that the discrepancy between sentences for crack and powder cocaine violates equal protection or due process, but nearly every appellate court has rejected this argument. In May 1996 the U.S. Supreme Court held that statistics showing that most crack defendants are black do not in themselves support the claim of selective prosecution. Instead, the Court ruled, the burden is on defendants to prove that "similarly situated defendants of other races could have been prosecuted, but were not" (United States v. Armstrong, 517 U.S. 456, 116 S. Ct. 1480, 134 L. Ed. 2d 687).

Lawmakers have also rejected the assertion that racial discrepancies are unjust. In April 1995 the U.S. Sentencing Commission proposed abandoning the guidelines. Determining that the penalties were too harsh, the seven-member commission voted 4 to 3 to equalize penalties for crack and powder cocaine. Although most black members of Congress supported changing the sentencing guidelines, conservatives argued that crack sentencing had nothing to do with race and that revising the guidelines would allow serious offenders to serve little or no time. The penalties remained intact.

Many liberal organizations, including the american civil liberties union, have decried the war on drugs due to the disproportionate impact on racial minorities. The Drug Policy Alliance, which claims to be the leading organization promoting alternatives to the war, has held a number of national conferences on this issue. In 2001, a group of politicians, celebrities, religious leaders, and advocates for drug policy reform submitted a letter to the secretary general of the united nations calling the war on drugs a "de facto form of racism."

As long as the war on drugs remains a priority for domestic policy, prosecution and incarceration for drug crimes will continue on a large scale. The challenge facing legislators, attorneys, and the courts is how to make a system that reduces the effects of drug use on U.S. society, while avoiding excessive punishment of particular societal groups.

further readings

Chepesiuk, Ronald. 1999. The War on Drugs: An International Encyclopedia. Santa Barbara, Calif.: ABC-CLIO.

Mahan, Sue. 1996. Crack Cocaine, Crime, and Women: Legal, Social, and Treatment Issues. Thousand Oaks, Calif.: Sage Publications.

cross-references

Due Process of Law; Equal Protection; Selective Prosecution; Sentencing.

The war on drugs can be traced back to the 1960s, when illicit drugs became especially popular again. The accompanying increase in drug use led to comprehensive antidrug legislation under President richard m. nixon, whose administration introduced the metaphor of war for the drive to enforce drug laws. In the 1980s, under President Reagan, the campaign took its present form. The Reagan administration's public-relations campaign (which popularized the saying "Just say no") was bolstered by stricter state and federal drug laws. Federal spending to enforce drug laws rose from $37 million in 1969 to $1.06 billion in 1983. Over the next decade, it increased to approximately $30 billion, including the full cost of federal, state, and local law enforcement efforts, along with costs incurred by the judiciary and prison and health care systems. In 2003, President george w. bush set aside about $3.4 billion to the DEA alone in the fight against drugs.

Enforcement efforts are shared between federal and state governments. Joint federal-state task forces investigate illegal drug sales for two key reasons. First, states have declared an interest in eradicating the illegal sale and use of controlled substances through the enactment of severe antidrug laws, but they lack the necessary resources. Second, in return for their participation, state law enforcement agencies are eligible for federal funds that are crucial to their operation. Besides helping the agencies to meet administrative expenses, local undercover police officers use these funds to buy drugs so that they can arrest dealers.

As a result of these shared operations, prosecutors have broad discretion in pursuing drug offenses. They may charge defendants under federal law, state law, or sometimes both. The U.S. Constitution's protection against double jeopardy (i.e., being tried twice for the same criminal action) does not apply when separate jurisdictions bring charges, and the dual-sovereignty doctrine allows successive federal and state prosecutions; however, many states prohibit prosecution in their courts if the conduct already has been the subject of a federal prosecution. Prosecutors consider several factors when deciding where to bring charges, including the relative severity of state and federal drug laws; the existence of mandatory minimum sentencing guidelines in federal court; and the comparative leniency of federal rules regarding wiretaps and informants. Although federal law generally is tougher because of its mandatory minimum sentences, nearly every state has enacted laws requiring mandatory prison time for certain drug offenses.

Prosecutors also take into account the kind of drug involved. Under federal sentencing guidelines, crack cocaine is treated much more harshly than is powder cocaine. Prosecutors also may seek civil fines and civil forfeiture of property.

The number of individuals charged with drug offenses by the federal government rose from 11,854 to 29,306 between 1984 and 1999. The percentage of crimes prosecuted by the federal government likewise increased. In 1984, 18 percent of referrals by federal prosecutors involved drug offenses. This number increased to 32 percent in 1999. Between October 1999 and September 2000, the federal government successfully prosecuted 24,206 drug defendants. Ninety-one percent of those convictions resulted in incarceration.

The majority of federal drug offenses involve marijuana, powder cocaine, crack cocaine, and methamphetamine. In 1999, federal officials made 38,288 arrests for drug offenses. Thirty-one percent of those cases involved marijuana, while 28 percent involved powder cocaine; 15 percent involved crack cocaine; and 15 percent involved methamphetamine. The remaining 11 percent involved opiates and other types of drugs.

On February 12, 2002, President George W. Bush announced the creation of the National Drug Control Strategy. The core principles include (1) stopping drug use before it starts; (2) healing America's drug users; and (3) disrupting the drug market. The goals of the initiative include the reduction of drug use by ten percent in the first two years, and by 25 percent over the first five years. The DEA is largely responsible for carrying out this strategy.

In addition to domestic efforts to police drug sales, international efforts are part of the war on drugs. These efforts include interdiction by federal law enforcement agents at the U.S. border to prevent drugs from entering the country. The federal government has also posted DEA agents in other countries, such as Bolivia and Colombia, as part of a broader campaign to prevent the flow of drugs into the United States. Throughout the 1980s and 1990s, the United States applied diplomatic pressure to the governments of Bolivia and Colombia to persuade them to end drug production in their countries. In order to continue receiving U.S. aid and government-backed loans, foreign nations have had to cooperate with the antidrug initiatives of Washington. In March 1996, President bill clinton cut off such aid to Colombia for lack of cooperation.

The funding in Colombia did not end in 1996, despite a strong opposition to the policies against funding the drug war through South American countries. The United States has invested an estimated $30 billion in the war on drugs in Latin America, yet the influx of drugs into the United States continues. An estimated 80 percent of drugs in the United States originate in South America, many in Colombia.

In 2000, President Clinton approved a spending bill that called for $1.3 billion in aid to the Colombian government. Members of Congress expressed concern that financing the Colombian government would spread the ongoing civil war in that country, which claimed more than 35,000 lives in the 1990s. Much of the bill was designed to provide Colombia with military equipment, and it also called for training of Colombian soldiers. Colombian leaders promised that the aid would cut drug production in that country by half.

The courts have played a significant role in the war on drugs. Broadly speaking, under the fourth amendment, they have expanded the power of the police to conduct searches and seizures. In a series of decisions during the 1980s and 1990s, the U.S. Supreme Court ruled that police officers have the power to conduct warrantless searches of bus passengers, car interiors, mobile homes, fenced private property and barns, luggage, and trash cans. In Minnesota v. Dickerson, 508 U.S. 366, 113 S. Ct. 2130, 124 L. Ed. 2d 334 (1993), the Court held that no warrant was needed to seize narcotics that are recognizable by "plain feel" while an officer is frisking a suspect for concealed weapons.

In contrast, the Court restricted the power of state and federal governments to use civil fines and civil forfeiture of property as penalties in drug cases. In a 1989 case that had a substantial bearing on prosecutorial initiative in drug enforcement, the Court held that the government could not recover both a criminal fine and a civil penalty in separate proceedings (United States v. Halper, 490 U.S. 435, 109 S. Ct. 1892, 104 L. Ed. 2d 487). In 1993, the Court curtailed civil forfeiture laws by ruling that confiscation of property is subject to the Eighth Amendment's protections against excessive fines (Austin v. United States, 509 U.S. 602, 113 S. Ct. 2801, 125 L. Ed. 2d 488).

Movement to Legalize Marijuana for Medical and Other Purposes

For many decades, the federal government has classified marijuana as a controlled substance that cannot be used legally except for scientific research projects. Although state governments continue to make the possession, distributions, and use of marijuana a crime, nine states have legalized the use of the drug for medicinal use. Through the use of ballot initiatives, voters approved these so-called "medical marijuana" laws in eight of these states, including California. Advocates contend that persons who are afflicted with serious illnesses such as AIDS, cancer, and multiple sclerosis are helped by smoking marijuana. The federal government contested the constitutionality of these laws, believing that federal drug laws prevent the states from making exceptions.

The federal government's efforts to end the distribution of medical marijuana in California led to a U.S. Supreme Court decision, United States v. Oakland Cannabis Buyers' Cooperative, 532 U.S. 483, 121 S. Ct. 1711, 149 L. Ed. 2d 722 (2001). The Court agreed with the federal government, concluding that the federal Controlled Substances Act did not recognize the use of marijuana for medical purposes.

The case grew out of a 1996 vote in California. Citizens had brought about an initiative called the Compassionate Use Act of 1996. The law sought to provide seriously ill persons with legal clearance to purchase marijuana for medicinal use. It permitted patients and their primary caregivers to possess or to cultivate marijuana for medical purposes if approved by a physician. Following the law's enactment, numerous organizations started "medical cannabis dispensaries" to distribute marijuana to eligible patients. The Oakland Cannabis Buyers' Cooperative was one of those organizations. The nonprofit cooperative employed a doctor and registered nurses to screen prospective members through a personal interview and a review of the treating physician's written statement. If the person met the requirements, the cooperative issued the person an identification card that entitled him or her to purchase marijuana from the organization.

The federal government sued the cooperative in 1998 and asked the federal district court to issue an injunction banning the cooperative from distributing and manufacturing marijuana. The court agreed that the cooperative had violated the federal controlled-substance law and issued the injunction. On appeal, the Ninth Circuit Court of Appeals reversed the lower court's decision. It ruled that a "medical necessity exemption" existed and that the district court could apply its equitable discretion and permit the cooperative to assert such an exemption.

Subsequently, the U.S. Supreme Court reversed the Ninth Circuit in an 8-0 decision. Justice clarence thomas, writing for the Court, looked to the provisions of the Controlled Substances Act to determine whether the courts could make medical necessity a defense. Thomas noted that marijuana is classified as a schedule I substance. The only express exception to the unlawfulness of possession, manufacture, or distribution is for government-approved research projects. Taking these provisions into account, Justice Thomas concluded that there was clearly no statutory exemption.

Although certain groups continue to advocate making marijuana use legal, the movement has lost steam since the decision in Oakland Cannabis—especially those groups that advocate making marijuana use legal for any purpose, including recreational use. These individuals claim that marijuana is no more harmful than alcohol, which is regulated but has not been outlawed since Prohibition was reversed in the 1930s. This movement, generally led by some small liberal and radical groups, has never had backing among politicians and is even less likely to garner support in light of Oakland Cannabis.

further readings

Brickey, Kathleen F. 1995. "Criminal Mischief: The Federalization of American Criminal Law." Hastings Law Journal (April).

Contrera, Joseph G. 1995. "The Food and Drug Administration and the International Conference on Harmonization." Administrative Law Journal of the American University 8 (winter).

Duke, Steven B. 1995. "Drug Prohibition: An Unnatural Disaster." Connecticut Law Review (winter).

"Executive Summary: Mandatory Sentencing." 1995. CQ Researcher (May 26).

Inciardi, James A. 1986. The War on Drugs. Palo Alto, Calif.: Mayfield.

Justice Department. Bureau of Justice Statistics. 1993. Sentencing in the Federal Courts: Does Race Matter? The Transition to Sentencing Guidelines, 1986–1990. December.

Lowney, Knoll D. 1994. "Smoked Not Snorted: Is Racism Inherent in Our Crack Cocaine Laws?" Washington University Journal of Urban and Contemporary Law 45 (winter).

Lusane, Clarence. 1991. Pipe Dream Blues. Boston: South End Press.

National Clearinghouse for Alcohol and Drug Information. 1992. A Short History of the Drug Laws.

Powell, John A., and Eileen Hershenov. 1991. "Hostage to the Drug War: The National Purse, the Constitution, and the Black Community." University of California at Davis Law Review 24.

"Report of the Special Committee on Race and Ethnicity to the D.C. Circuit Task Force on Gender, Race, and Ethnic Bias." 1996. George Washington Law Review 64 (January).

U.S. Sentencing Commission. 1992. Monitoring Data Files, April 1–July 1, 1992.

White House Conference for a Drug Free America. 1988. Final report. Washington, D.C.: U.S. Government Printing Office.

cross-references

Criminal Law; Criminal Procedure; Education Law; Employment Law; Privacy; Schools and School Districts; Sports Law.

Drugs

Drug use by children and adolescents periodically comes under state and social scrutiny, fueled both by actual incidence of increased drug use and popular and parental fears about it. Prior to the twentieth century "soothing syrups" consisting of paregoric and laudanum (both dilute opiates) were among the few effective medications available to treat cholera and childhood diseases by physicians, lay healers, and family members responsible for health care. Criticisms of their use in infants and children were present from the earliest days of the United States. Early campaigns against infant "doping" by mothers and nursemaids were led by nineteenth-century "regular" physicians who employed such warnings as part of their bid to consolidate professional control over pharmaceutical opiates.

Clinicians observed congenital addiction to opiates as early as the 1830s. Restlessness, moral and mental weakness, and "blue baby" (cyanosis) were attributed to maternal opiate use. An 1832 dissertation by William G. Smith criticized the "youthful, inconsiderate mother and the idle nurse" who quieted infants with opiate-laced proprietary medicines "rather than forego the pleasures of a crowded assembly, or the gaudy charms of a dramatic scene, a single evening." Nineteenth-century physicians practiced gradual withdrawal techniques. However, the American Textbook of Applied Therapeutics (1896) applauded the poor prognosis of "infants born of mothers who are morphinists" because "the moral and mental strength of these children is so far below par as to make them liable to much subsequent suffering." Under the influence of the Women's Christian Temperance Union (WCTU), all states required physiology and hygiene instruction in public schools that emphasized the dangerous effects of alcohol, tobacco, and other drugs by the turn of the twentieth century. Mothers who "drugged" their children came under public scrutiny during the Progressive campaigns to regulate patent medicines. These campaigns took place in the context of broader concerns about widespread popular use of proprietary medicines, adulteration of them, and exaggerated advertising of them, which ultimately led to their regulation under the Pure Food and Drug Act (1906).

"Morphinist mothers" were depicted as direct threats to their babies when in 1913 a physician found that babies' blood was "as much saturated with the drug as the blood of the mother," thus confirming that narcotics crossed the placenta. "Morphinist fathers" were also thought to impair their offspring: "How could it be otherwise, since every influence within the body tells in the upbuilding of protoplasm, and since the composite protoplasm of the germ borrows its qualities from every form of protoplasm in the parental organism?" (Terry and Pellens, p. 416). The first congressional attention to narcotics use among schoolchildren occurred in 1910 in Philadelphia. States such as New York, which had the highest number of addicts, regulated opiates prior to the federal Harrison Act of 1914, which effectively ended the administration of narcotics by physicians once its constitutionality was ascertained through United States v. Jin Fuey Moy (1916) and Webb v. United States (1918). With Prohibition enacted, reformers turned to organizations such as the World Narcotic Defense Association (WNDA), headed by Spanish-American war hero and temperance reformer Richmond Pearson Hobson. The WNDA held a conference on narcotics education in 1925 at which a speaker maintained that addiction was spread through "intergenerational transmission": "Babies are born in drug addiction and, horrible as it may seem, they actually begin life under the influence of narcotics…. what can society expect of children whose father and mother, or both, are criminal addicts? What will be the children's attitude toward society?" Claims concerning high numbers of child addicts were also made by public officials who ran the New York City Clinic, operated by the City of New York Department of Health and administered by the state, which served over 7,000 addicted persons from 1919 to 1920.

Addiction among children was rarely mentioned until the mid-twentieth century and there were long periods when most physicians knew little about how to treat it. When Charles Terry and Mildred Pellens surveyed physicians in the 1920s for The Opium Problem they concluded that most lacked accurate and rational knowledge about congenital addiction. A 1924 questionnaire with a response rate over 50 percent that was administered to 687 schools in New York State failed to turn up any cases of drug addiction despite popular press reports. The same survey sent to juvenilecourt judges and chiefs of police only yielded a handful of cases throughout the state. During World War II few opiates were available as the U.S. government stockpiled them as strategic materials, thus keeping the numbers of addicted persons low until the postwar period.

Warnings that a "frightening wave" of narcotics addiction was about to engulf New York City youth fueled a statewide popular panic that spurred officials to action after the war's end. The first televised congressional hearings before the Senate Crime Investigating Committee and the Sub-committee to Investigate Juvenile Delinquency, stimulated intense fervor among an estimated 20 to 30 million viewers. Chaired by Senator Estes Kefauver, the hearings lasted from May 1950 to August 1951. Mention of teenage drug addiction aided November 2, 1951 passage of the Boggs Act, which mandated the first minimum sentences for drug offenders. New York hearings on teenage narcotic addiction held by State Attorney Gen Nathaniel L. Goldstein in the summer of 1951 in Buffalo and Albany helped establish the first state institution dedicated to the treatment and rehabilitation of female drug addicts at Westfield State Farm in Bedford Hills, New York.

New York City and state became a locus for public discussion of teenage addiction. The prestigious New York Academy of Medicine held conferences titled "Drug Addiction among Adolescents" in 1951 and 1952. The Research Center for Human Relations at New York University conducted the classic addiction research of the 1950s. Their social-psychiatric study of heroin use among adolescents in three boroughs of New York City between 1949 and 1954 was published as The Road to H (1964). Considered the definitive study on the topic for decades, it criticized federal drug policy for confusing a minor symptom with a major epidemic–a view shared by many treatment professionals who worked directly with drug users.

The heightened attention to adolescent narcotics use in the 1950s focused on the increased availability of drugs to teenagers and the role of parenting, especially mothering, in producing it. Postwar addicts were depicted as racial and ethnic "others," and sometimes as sexual "deviants" in the steady trickle of films depicting narcotic use that began to appear in the late 1940s. The press played up the lurid and novel aspects of the 1950s epidemic, but professionals who remembered the aftermath of the Harrison Act referred to it as the "second peak of an old problem." Until this point, opiates, especially heroin, were the real concern and the basis for policy.

Drug control officials were taken aback by the explosion of widespread popular youthful experimentation with illicit drugs that took place in the 1960s. The emergence of adolescent medicine and neonatology as clinical specialties; the expansion of the federal and state treatment and research apparatus; and the movement of community mental health into the substance abuse area paralleled the explosion of youth participation in the counterculture that developed in the second half of the twentieth century. As youthful users' "drug of choice" changed from LSD to marijuana to heroin to crack-cocaine to methamphetamines to Ecstasy specific drug-using subcultures emerged among younger users. The social context in which drugs are used continues to determine which subpopulations gravitate towards specific substances. Peer influence plays a role, as do high levels of undiagnosed depression among teenagers, suggesting that youthful drug use may represent a form of "self-medication." Due to the United States' commitment to incarceration for drug offenses, juveniles began to experience higher levels of involvement with the criminal justice system in the later twentieth century. Some states and municipalities began experimenting with alternative justice systems called "drug courts" to respond more appropriately to youth drug use by diverting some young offenders to treatment and rehabilitation programs.

The National Institute of Drug Abuse (NIDA), a component of the National Institutes of Health, has funded a nationwide survey of the extent of drug use among high school seniors called "Monitoring the Future" since 1975. In 1991 the survey was expanded to include eighth and tenth graders. A decade later, the 2002 survey showed not only an overall decline in illicit drug use but a significant decline in the proportion of children who had used any illicit drug for the sixth year in a row. Following cyclic trends similar to those seen in adults, drug use among children tends to follow the cycles of social learning demonstrated by historians Courtwright and Musto rather than the notions of "intergenerational transmission." For instance, children who observed adult crack-cocaine use tended not to become crack-cocaine users themselves. As the crack-cocaine epidemic subsided, the nation's concern about "intergenerational transmission" seemed to have been largely unwarranted. Longitudinal studies show that cognitive abilities and other "outcomes" measures differ little between children who were exposed to cocaine in utero, and those whose basic needs go unmet for reasons of economic deprivation.

See also: Smoking; Teen Drinking; Youth Culture.

bibliography

Campbell, Nancy D. 2000. Using Women: Gender, Drug Policy, and Social Justice. New York: Routledge.

Courtwright, David T. 2001. Dark Paradise: A History of Opiate Addiction in America. Enlarged edition. Cambridge, MA: Harvard University Press.

Goldstein, Nathaniel L. 1952. Narcotics: A Growing Problem, A Public Challenge, A Plan for Action, Report to the Legislature Pursuant to Chapter 528 of the Laws of 1951, 175th Session. No. 3. Albany, New York.

Kandall, Stephen R. 1996. Substance and Shadow: Women and Addiction in the United States. Cambridge, MA: Harvard University Press.

Musto, David F. 1999. The American Disease: Origins of Narcotic Control Policy. 3rd edition. New York: Oxford University Press.

Prescott, Heather Munro. 1998. A Doctor of Their Own: The History of Adolescent Medicine. Cambridge, MA: Harvard University Press.

Terry, Charles, and Mildred Pellens. 1970 [1928]. The Opium Problem. Montclair, NJ: Patterson Smith.

White, William L. 1998. Slaying the Dragon: The History of Addiction Treatment and Recovery in America. Bloomington, IL: Lighthouse Institute.

Nancy Campbell

DRUGS AND NARCOTICS

Drugs have long played a prominent role in the affairs of the Middle East.

The Middle East is ideally suited to profit from all phases of the drug trade. Climate, geography, and, more recently, politics have combined to make the region an important source and transit point of drugs destined for Europe, the United States, and many of the countries of the Middle East itself. Traditionally, the most important drugs in the Middle East have been opium and marijuana, which provide the raw material for the heroin and hashish that form the staple of the illicit drug trade in the region. Both the opium poppy (Papaver somniferum) and marijuana (Cannabis sativa) grow easily in many parts of the Middle East and North Africa, and the centuries-old trade routes that crisscross the region give illicit drug producers ready access to the major international drug markets. Although the drug trade is driven largely by the profits inherent in any lucrative criminal activity, in the Middle East it has taken on an important political dimension as rival groups have used enormous drug revenues to pay for the arms necessary to pursue their political ambitions. With a metric ton of heroin worth between $100 million and $600 million, retail, on the streets of the United States, drug sales are an appealing source of immediate, vast revenues for clandestine or criminal activities.

The importance of the Middle East in the international drug trade has varied according to the demand for certain illicit drugs. The taste for drugs is cyclical, alternating between periods of demand for stimulants such as cocaine and amphetamines, and times when the drug-abusing public seeks depressants such as opiates (e.g., morphine, heroin, and other opium derivatives) and hashish. Because the Middle East primarily produces depressants, its importance as a drug source increases when opiates are in demand, as in the 1930s, 1970s, and 1990s.

Opiates

Because Papaver somniferum grows best at higher altitudes, Turkey, Afghanistan, Iran, and more recently Lebanon, have at different times been major sources of heroin and other opiates. In the late 1960s and early 1970s, Turkey gained international notoriety as the principal source of the heroin that fed an epidemic of drug abuse in the United States and Europe. In 1973, as part of an agreement with the United States, Turkey first banned, then allowed only very restricted cultivation of opium poppies for medicinal purposes. This is still the only successful drug crop-control program of its kind, with virtually no leakage into illicit channels.

With Turkey effectively eliminated as a source in the mid-1970s, the center of illicit opiate production shifted eastward to Afghanistan, Lebanon, and, to a lesser extent, Iran. In both Afghanistan and Lebanon, the chaos created by civil war, coupled with the absence of a strong central government and rival combatants' desire for a source of revenue for arms purchases, led to an explosion of opium cultivation. By 1992, Afghanistan had become second only to Myanmar (Burma) in the production of illicit opium. The U.S. government estimated that at the end of 1992, Afghanistan had over 48,000 acres (nearly 19,500 ha) of opium poppy under cultivation, capable of producing 705 tons (640 metric tons) of opium or 70 tons (64 metric tons) of heroin. This would be enough to satisfy estimated heroin needs in the United States six times over and to pump between $6.4 billion and $38.4 billion into the underworld economy. While a large percentage of these opiates is probably consumed by addicts in Afghanistan, Iran, and Pakistan, the remainder flows into the international drug trade through Iran for transshipment to heroin refineries in Turkey and Lebanon. There is also evidence that Afghan opium is flowing northward into new routes opened in central Asia following the collapse of the Soviet Union in 1991.

Although not an opium producer on the scale of Afghanistan, Lebanon is an important country in the international heroin trade. Following Syria's occupation of the Biqa valley in 1976, eastern Lebanon became a center of opium cultivation and heroin refining. The Lebanese government has blamed the Syrian military for the Biqa valley drug trade, which in 1991 had the capacity to produce an estimated 37 tons (34 metric tons) of opium (or 3.7 tons [3.4 metric tons] of heroin) from an estimated nearly 8,400 acres (3,400 ha). Subsequently, a combination of harsh weather and joint Syrian–Lebanese eradication efforts have reduced cultivation to an estimated nearly 1,100 acres (440 ha) in late 1993, though clandestine laboratories may be refining more than 5.5 tons (5 metric tons) a year of heroin from Afghan opium.

Despite Iranian government efforts to ban the opium poppy in 1980, Iran in 1992 was still an important potential source of opium. The U.S. government estimated that nearly 8,650 acres (3,500 ha) of Papaver somniferum were under cultivation at the end of the year. There are indications, however, that Iran's addicts consume most domestic opium production. Iran continues to be a conduit for Afghan and Pakistani opiates moving to Turkey and onward along the Balkan route into Europe.

Hashish

Although there is cannabis cultivation in nearly every country of the Middle East, only Morocco and Lebanon are significant hashish producers and exporters. Hashish is simple to manufacture, requiring little of the intensive labor and none of the chemicals needed to refine opiates. And while it does not generate profits on the same scale as opiates, hashish production is a multimillion-dollar criminal enterprise. In 1992, Morocco's nearly 74,000 acres (30,000 ha) of cannabis potentially yielded nearly 9,918 tons (9,000 metric tons) of hashish, most of which was destined for Europe. Lebanon, with an estimated nearly 38,800 acres (15,700 ha) of cannabis under cultivation in 1993, potentially had 623 tons (565 metric tons) of hashish available for export. Cannabis may be sold and used legally in many countries so most governments accord cannabis control a relatively low priority. The hashish trade is likely to remain steady therefore, even as the governments of the Middle East intensify efforts to suppress illicit opiates and stimulants.

See also Biqa Valley; Climate; Geography.

Bibliography

Ehrenfeld, Rachel. Narco-Terrorism. New York: Basic Books, 1990.

U.S. Congress. Senate. Committee on the Judiciary. Poppy Politics. Hearings before the Subcommittee to Investigate Juvenile Delinquency. Washington, DC: U.S. Government Printing Office, 1975.

U.S. Department of Justice. Drug Enforcement Administration. Illegal Drug Price/Purity Report: January 1989–December 1992. Washington, DC: U.S. Government Printing Office, 1993.

U.S. Department of Justice. Drug Enforcement Administration. Illicit Drug Trafficking and Use in the United States. Washington, DC: U.S. Government Printing Office, 1993.

U.S. Department of Justice. Drug Enforcement Administration. The NNICC Report 1992: The Supply of Illicit Drugs to the United States. Washington, DC: U.S. Government Printing Office, 1993.

U.S. Department of State. International Narcotics Control Strategy Report, April 1993. Washington, DC: U.S. Government Printing Office, 1993.

w. kenneth thompson

130. Drugs

See also 122. DISEASE and ILLNESS ; 350. REMEDIES .

adjuvant

Medicine. a substance added to a medicinal preparation to assist the action of the principal ingredient.

alcoholomania

an obsession with alcohol.

apothecary

1 . apharmacy.

2 . a pharmacist.

barbiturism

a condition of chronic poisoning caused by excessive use of barbiturates.

cannabism

1 . addiction to marijuana.

2 . a toxic condition caused by excessive use of marijuana.

cataphoresis

the introduction of drugs into the body by means of an electric current.

chloroformism

a condition caused by the habitual use of chloroform.

cinchonism

a toxic condition owing to excessive use of cinchona and marked by headache, dizziness, and ringing in the ears. Also called quininism , quinism .

cinchonology

a branch of pharmacology that studies cinchona and its derivatives, as quinine and quinidine. Also called quinology .

cocainism

the condition of being addicted to cocaine.

cubebism

a toxic condition caused by smoking cubeb or Java pepper, formerly dried and crushed for medicinal purposes.

diatesseron

Obsolete Pharmacy. a mixture of four medicines in syrup or honey.

dosimetry

dosiology. See also 264. MEASUREMENT ; 342. RADIATION . —dosimetrist , n. —dosimetric , dosimetrical , adj.

dosiology, dosology

the study and determination of the doses in which medicines should be administered. Also called dosimetry .

electuary

a preparation consisting of pulverized medication mixed with honey.

etheromania

a mania for ether.

formulary

a book or Hst of medicines, with formulas and instructions for their preparation.

galactopoietic

any substance that stimulates the production and flow of milk. —galactopoietic , adj.

hallucinogen

a substance that induces hallucinations. —hallucinogenic , adj.

laudanum

tincture of opium or any preparation, especially in liquid form, in which opium is the main ingredient.

lethomania

a mania for narcotics.

magma

a pharmaceutical preparation in which precipitated matter is suspended in a watery substance. See also 179. GEOLOGY . —magmatic , adj.

meconism

an addiction to opium; opium eating. Also called meconophagism .

meconology

Rare. a treatise on the opium poppy.

morphinism

the condition produced by the excessive use of morphine. —morphinist , n.

morphiomania

an addiction to and intense craving for morphine. Also morphinmania .

narcohypnosis

hypnosis with the aid of drugs.

narcomania

an abnormal desire for drugs.

narcosis, narcoma

a condition of stupor or unconsciousness induced by drugs.

narcosynthesis

a form of treatment for mental illness that involves placing the patient under the influence of a narcotic.

narcoticism, narcotism

1 . the narcosis or narcoma induced by drugs.

2 . an addiction to drugs.

opiomania

an addiction to opium.

opiophagism, opiophagy

the habitual use of opium.

opiumism

the excessive and habitual use of opium.

pharmaceutics

the science of pharmacy or pharmacology.

pharmacodynamics

the division of pharmacology concerned with the action and breakdown of drugs in the body. —pharmacodynamic , pharmacodynamical , adj.

pharmacognosy, pharmacognosia, pharmacognosis, pharmacognostics

the branch of pharmacology that studies the composition, use, and history of drugs. —pharmacognosist , n. —pharmacognostic , adj.

pharmacography

the description of drugs and their effects.

pharmacology, pharmacologia

the branch of medical science that studies the preparation, uses, and effects of drugs. —pharmacologist , n. —pharmacologic , pharmacological , adj.

pharmacopedics, pharmacopedia

the branch of medical science that studies drugs and medicinal preparations. —parmacopedic , adj.

pharmacophobia

an abnormal fear of drugs.

pharmacopoeia

a book, usually of an official nature, containing a list of approved drugs and medicines, with information regarding their properties, preparation, and use. Also called antidotary .

2 . a pharmacist’s stock of drugs.

pharmacopolist

an apothecary or pharmacist.

pharmacy

1 . the art of preparing drugs and medicines, especially the discovery of new varieties.

2 . the place where drugs are prepared, dispensed, or sold. Also called apothecary .

3 . a drug therapy. —pharmacist , n.

potomania

1 . an excessive tendency to drink alcoholic beverages.

2 . delirium tremens. Also called tromomania.

quininism, quinism

cinchonism.

sudorific

a medicine or other substance that causes or stimulates sweating. Also called diaphoretic, hidrotic. —sudorific , adj.

synergism, synergy

the joint action of agents, as drugs, that, taken together, produce a greater effect than the sum of their individual effects. —synergistic , adj.

tabacism, tabagism

addietion to tobacco; poisoning from excessive use of tobacco. Also tobaccoism .

teaism

the habitual use of tea.

theriac, theriaca

a compound of sixty-four drugs made into an electuary, formerly used as an antidote for poison. Also called Venice Treacle . —theriac , theriacal , therial , adj.

tincture

Pharmacy. a medicinal substance in soluble form, especially in a solution of alcohol.

toxicomania

an addietion to drugs, especially opium or cocaine.

drugs substances used in medicine either externally or internally for curing, alleviating, or preventing a disease or deficiency. At the turn of the century only a few medically effective substances were widely used scientifically, among them ether , morphine , digitalis , diphtheria antitoxin, smallpox vaccine, iron , quinine , iodine , alcohol, and mercury . Since then, and particularly since World War II, many important new drugs have been developed, making chemotherapy an important part of medical practice. Such drugs include the antibiotics , which act against bacteria and fungi; quinacrine and other synthetics that act against malaria and other parasitic infections; cardiovascular drugs, including beta-blockers and ACE inhibitors ; diuretics , which increase the rate of urine flow; whole blood, plasma, and blood derivatives; anticoagulants such as heparin and coumarin; various smooth-muscle relaxants such as papaverine , used in heart and vascular diseases; smooth-muscle stimulants; immunologic agents, which protect against many diseases and allergenic substances; hormones such as thyroxine , insulin , and estrogen and other sex hormones; psychotherapeutics such as antianxiety drugs and antidepressant drugs ; cortisone and synthetic corticosteroid drugs used in treating inflammatory diseases such as arthritis; vitamins and dietary minerals; antidotes for poisons; and various drugs that act as stimulants or depressants on all or various parts of the nervous system, including analgesics , narcotics , amphetamines , and barbiturates (see also anesthesia ; psychopharmacology ; hallucinogenic drug ).

See also drug resistance ; drug poisoning ; drug addiction and drug abuse .

Sources of Drugs

Drugs are obtained from many sources. Many inorganic materials, such as metals, are chemotherapeutic; hormones, alkaloids, vaccines, and antibiotics come from living organisms; and other drugs are synthetic or semisynthetic. Synthetics are often more effective and less toxic than the naturally obtained substances and are easier to prepare in standardized units. The techniques of genetic engineering are being applied to the production of drugs, and genetically engineered livestock that incorporate human genes are being developed for the production of scarce human enzymes and other proteins (see pharming ).

Pharmacopoeia and Drug Safeguards

Standards for drugs and tests for their identity, quality, and purity are given in the U.S. pharmacopoeia , first published in 1820 and at first revised every 10 years, later every 5 years. The British publish a similar pharmacopoeia. The National Formulary published by the American Pharmaceutical Association gives the composition, description, method of preparation, and dosage for drugs; the Physician's Desk Reference is a privately published compilation of information supplied by drug companies about their drug products, published yearly. The scientific study of drugs, their actions and effects, is pharmacology .

Legislation to safeguard drug purchasers began in the United States with the Pure Food and Drugs Act of 1906; this was superseded by the more inclusive and more stringent federal Food, Drug, and Cosmetic Act of 1938. Such laws are enforced by the Food and Drug Administration. The 1962 Kefauver-Harris amendments to the Food, Drug, and Cosmetic Act increased the authority of the Food and Drug Administration to regulate testing and marketing of new drugs. There are two marketing classes of drugs: ethical drugs, for which prescriptions are needed, and proprietary drugs, which are sold over the counter without prescription. Many of the latter, such as mouthwashes, gargles, and cold preparations, are only slightly, if at all, effective in curing ailments.

Bibliography

See B. Barber, Drugs and Society (1967); C. B. Clayman, ed., American Medical Association Guide to Prescription and Over-the-Counter Drugs (1988); A. Burger, Drugs and People: Medications, Their History and Origins, and the Way They Act (rev. 1988); United States Pharmacopeial Staff, The Complete Drug Reference (1995).

DRUG

As a therapeutic agent, a drug is any substance, other than food, used in the prevention, diagnosis, alleviation, treatment, or cure of disease. It is also a general term for any substance, stimulating or depressing, that can be habituating. According to the U.S. Food, Drug, and Cosmetic Act, a drug is (1) a substance recognized in an official pharmacopoeia or formulary; (2) a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease; (3) a substance other than food intended to affect the structure or function of the body; (4) a substance intended for use as a component of a medicine but not a device or a component, part, or accessory of a device.

Pharmacologists consider a drug to be any molecule that, when introduced into the body, affects living processes through interactions at the molecular level. Hormones can be considered to be drugs, whether they are administered from outside the body or their release is stimulated endogenously. Although drug molecules vary in size, the molecular weight of most drugs falls within the range of 100-1,000, since to be a drug it must be absorbed and distributed to a target organ. Efficient absorption and distribution may be more difficult when drugs have a molecular weight greater than 1,000. The drug's molecular shape is also important, since most drugs interact with specific Receptors to produce their biological effects. The shape of the receptor determines which drug molecules are capable of binding. The shape of the drug molecule must be complementary to that of the receptor to produce an optimal fit and, therefore, a physiological response.

Within this general definition, most Poisons would be considered to be drugs. Although water and oxygen technically fit this general definition and are used therapeutically and discussed in pharmacology textbooks, they are rarely considered to be drugs. Efforts have been made to develop a more restricted definition, but because so many molecules and substances can affect living tissue, it is difficult to draw a sharp line.

(See also: Inhalants ; Plants, Drugs from ; Vitamins )

BIBLIOGRAPHY

Hardman, J. G., et al. (Eds.). (1996). The pharmacological basis of theraupeutics, 9th ed. New York: Mcgraw-Hill.

Stedman ' Medical Dictionary. (1992). 27th ed. Baltimore, MD: Lippincott, Williams, & Wilkins.

Nick E. Goeders