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UNIT: Drugs and Public Policy
Issue 1. Should Laws Against Drug Use Remain Restrictive?
Yes: Drug Enforcement Administration, from "Speaking Out Against Drug Legalization", (2010).
No: U.S. Department of Health and Human Services, from "Youth Prevention-Related Measures", Results from the 2009 National Survey on Drug Use and Health: Volume 1 (2010).
The Drug Enforcement Administration (DEA) is charged with enforcing the controlled substances laws and regulations of the United States. In “Speaking Out Against Drug Legalization” the DEA argues that enforcement of drug laws is not the cause of violence; drug legalization will not reduce crime and increase government revenue; and prohibition actions can be successful at decreasing drug use. The report from the U.S. Department of Health and Human Services points out that a number of factors affect drug use by young people. One of the most important factors is perception of risk. If young people perceive that drugs are harmful, they are less likely to engage in drug use. Other relevant factors include the perception of drug use by peers, religious beliefs, and parental involvement. Legal sanctions are not noted as a deterrent to drug use.
Issue 2. Should the United States Put More Emphasis on Stopping the Importation of Drugs?
Yes: Bureau of International Narcotics and Law Enforcement Affairs, from "2009 INCSR: Policy and Program Developments", (2009).
No: Ethan Nadelmann, from "The Global War on Drugs Can Be Won", Foreign Policy (2007).
The U.S. State Department maintains that more effort is needed to interdict drugs coming into the United States because the trafficking of drugs represents a direct threat to national security. Better cooperation with countries in Latin America, the Caribbean, Africa, and Asia, where drugs are grown and exported, is essential. Ethan Nadelmann, the executive director of the Drug Policy Alliance, contends that attempts to stem the flow of drugs are futile and that it is unrealistic to believe that the world can be made free of drugs. Nadelmann points out that global production is about the same as it was ten years earlier and that cocaine and heroin are purer and cheaper because producers have become more efficient.
Issue 3. Should the United States Drinking Age Remain at 21?
Yes: Carla T. Main, from "Underage Drinking and the Drinking Age", Policy Review (2009).
No: Judith G. McMullen, from "Underage Drinking: Does Current Policy Make Sense?", Lewis and Clark Law Review (2006).
Carla Main contends that the drinking age should remain at 21. Underage drinking has been linked to sexual assaults, violent behavior, unprotected consensual sex, and numerous automobile accidents. Although one can serve in the military before age 21, alcohol use among that age group contributes to poor morale and productivity according to Main. Rather than tolerating underage drinking, more effort should be placed on enforcing underage drinking laws. Judith McMullen, a law professor at Marquette University, argues that laws prohibiting underage drinking have been ineffective. Young adults between the ages of 18 and 21 who do not live at home have opportunities to drink alcohol without parental interference. In addition, this same age group has other legal rights, such as the right to marry, drive a car, or join the military. Enforcement of underage drinking laws, says McMullen, is destined for failure.
Issue 4. Are Opiates Overprescribed?
Yes: Graeme Wood, from "Drug Dealers Aren’t to Blame for the Heroin Boom. Doctors Are", The New Republic (2014).
No: Carol M. Ostrom, from "New Pain-Management Rules Leave Patients Hurting", The Seattle Times (2011).
Graeme Wood, a contributing editor at The New Republic, draws on his personal experience using potent opiates after dental surgery to explain the prevalence of opiate addiction. He describes an American medical system that precipitates opiate abuse and dependence. Carol Ostrom, who writes for The Seattle Times, acknowledges that prescription opiate addiction and drug diversion are important concerns; however, these concerns could be inflated. As a consequence, those who need opiates are denied appropriate management of their pain.
Issue 5. Should Health Care Plans Cover Naturopathic Remedies?
Yes: Mary Flynn, from "Naturopathic Doctors Fighting for Inclusion Under Health Reform Insurance Policies", California Health Report (2014).
No: Brian Palmer, from "Quacking All the Way to the Bank", Slate (2014).
Naturopathy, or naturopathic medicine, emphasizes prevention, treatment, and optimal health via methods that stimulate self-healing processes. Mary Flynn, a reporter for California Health Report, describes efforts in California to have visits to naturopathic doctors covered in her state’s new insurance marketplace. Brian Palmer, who writes for Slate, is concerned that taxpayers are forced to support, through state and federal public medical plans, alternative approaches that have little efficacy.
Issue 6. Is Drugs Addiction a Brain Disease?
Yes: National Institute on Drug Abuse, from "The Science of Addiction", (2007).
No: Gene M. Heyman, from "Addiction: A Disorder of Choice", Harvard University Press (2009).
Because there are biological and chemical changes in the brain following drug abuse, the National Institute on Drug Abuse (NIDA) claims that drug addiction is a disease of the brain. One may initially use drugs voluntarily, but addiction occurs after repeated drug use. NIDA acknowledges that environment plays a role in the development of drug addiction, but one’s genes play a major role as well. Writer Gene M. Heyman maintains that drug addiction, including alcoholism, runs in families. There is no doubt that genes are hereditary. However, Heyman argues that behaviors are not hereditary. Whether an individual engages in drug use or abuse is a choice made by the individual. Claiming that drug addiction is a disease removes the stigma of drug addiction because one can assert that it is the disease that causes one’s addiction, not one’s behavior.
Issue 7. Should There Be More Regulation of Performance-Enhancing Drugs?
Yes: National Institute on Drug Abuse, from "Anabolic Steroid Abuse", National Institute on Drug Abuse Research Report (2006).
No: Laura K. Egendorf, from "Is the Use of Performance-Enhancing Drugs Cheating?", Performance-Enhancing Drugs (2007).
Anabolic steroids are synthetic substances related to the male sex hormone testosterone. They are used and abused to improve athletic performance and gain a “fit and toned” physical appearance. However, they are also associated with a wide range of adverse side effects ranging from some that are physically unattractive to others that are life threatening, such as heart attacks and liver cancer. The National Institute on Drug Abuse describes the pharmacology of steroids and the risks associated with their use. In her book, author Laura Egendorf cites individuals who feel that athletes are aware of the risks of taking steroids and other performance-enhancing drugs (PEDs). Competition and the desire to succeed drive individuals to improve their athletic performance. Allowing steroid use would essentially level the playing field for all athletes. In addition, some experts believe that the negative consequences are exaggerated.
Issue 8. Should Smoking Be Banned from Public Places?
Yes: Sheelah A. Feinberg, from "No-Smoking, Please", Huffington Post (2013).
No: John Stossel, from "Control Freaks Still Targeting Tobacco", Reason (2014).
Environmental tobacco smoke (a.k.a., “secondhand smoke”) is classified as a carcinogen and government agencies declared that there are no safe exposure levels. Many communities have banned smoking in public areas (e.g., bars, restaurants, and parks) to minimize secondhand smoke exposure, including New York. Sheelah A. Feinberg, director of New York’s Coalition for a Smoke-Free City, reports that her city’s ban on public smoking has improved health and quality of life. Journalist John Stossel disagrees with this position in his opinion piece in Reason Magazine and believes that bans on public smoking are indicative of increased government control over American’s lives.
UNIT: Drugs and Social Policy
Issue 9. Should "Smart Drugs" Be Used to Enhance Cognitive Functioning?
Yes: Barbara J. Sahakian and Sharon Morein-Zamir, from "Neuroethical Issues in Cognitive Enhancement", Journal of Psychopharmacology (2011).
No: Helia Garrido Hull, from "Regression by Progression: Unleveling the Classroom Playing Field Through Cosmetic Neurology", University of Hawaii Law Review (2010).
Professor Barbara J. Sahakian and Dr. Sharon Morein-Zamir note that cognitive enhancing medications provide considerable benefits to individuals with cognitive disabilities, and can also serve as “smart drugs” for healthy individuals for the purpose of cognitive enhancement. While more research is needed into the long-term effects of these drugs on healthy individuals, responsible use of these drugs is recommended in order to gain maximum benefits with minimal harm to the individual and to society as a whole. Attorney and Professor Helia Garrido Hull explains that the use of cognitive enhancing drugs by healthy individuals can have a negative impact on individuals with disabilities. The use of such drugs in competitive environments such as classrooms creates an imbalance between students without cognitive disabilities and those with disabilities for whom the drugs were originally intended. She asserts that the government has a responsibility to enforce the law in order to maintain the integrity of decades of legal precedent intended to protect individuals with disabilities from becoming disadvantaged again. Although many of these drugs are listed as controlled substances, their use without a prescription has become widespread and viewed as morally acceptable.
Issue 10. Should Laws Prohibiting Marijuana Use Be Relaxed?
Yes: Kevin Drum, from "The Patriot's Guide to Legalization", Mother Jones (2009).
No: National Institute on Drug Abuse, from "Marijuana Abuse", National Institute on Drug Abuse Research Report (2010).
Political columnist Kevin Drum contends that medical marijuana is now legal in more than a dozen states without any major serious problems or increased usage. The research report from the National Institute on Drug Abuse identifies various deleterious effects associated with marijuana. For example, marijuana alters perception and time, impairs memory and learning, and compromises academic performance. This report also notes that long-term marijuana use can lead to addiction and negatively affect the fetuses of women who used marijuana while pregnant.
Issue 11. Is Opiate Addiction Truly Debilitating?
Yes: Heather Lynn Peters, from "Young Father Details Heroin-Addiction Nightmare: ‘It’s the Worst Sickness You Can Imagine", Michigan Live Media Group (2015).
No: Theodore Dalrymple, from "Withdrawal from Heroin Is a Trivial Matter", The Spectator (2009).
A heroin addict stays a heroin addict to avoid the misery of withdrawal, a sickness where the addict is unable to function: This is the experience of young man in Michigan who is dependent on opiates. The article by Heath Lynn Peters describes how addiction to heroin and other opiates has torn apart a community. Theodore Dalrymple is the pen name of Anthony Daniels, a retired prison doctor and psychiatrist. He reports that opiate withdrawal is medically trivial and the withdrawal symptoms are overstated. Dalrymple states, “the great majority, though not quite all, of the suffering caused by withdrawal from opiates, insofar as it is real and not feigned, is psychological in origin and caused by the mythology surrounding it.”
Issue 12. Is Caffeine a Health Risk?
Yes: Carrie Ruxton, from "Health Aspects of Caffeine: Benefits and Risks", Nursing Standards (2009).
No: Peter J. Rogers, from "Caffeine--Our Favourite Drug", Biologist (2009).
Carrie Ruxton, a dietician in Scotland, maintains that certain sources of caffeine and the extent of caffeine intake have been linked to health-related problems. For example, tea has been linked to reduced iron absorption; high levels of coffee have been associated with hypertension; cola has been shown to increase the likelihood of dental cavities and dental erosion; and chocolate has high amounts of calories, sugar, and fat. Carrie Ruxton states that caffeinated products should be used carefully. Peter Rogers, a professor of biological psychology at Bristol University, acknowledges that caffeine is a stimulant but that it offers some positive effects. Caffeine, says Rogers, which is the most popular drug worldwide, increases alertness and mental performance. Rogers believes that claims regarding caffeine’s negative effects on hypertension and cardiovascular disease are overstated. Moreover, its potential for addiction is low.
Issue 13. Should School-Age Children with Attention Deficit/Hyperactivity Disorder (ADHD) Be Treated with Ritalin and Other Stimulants?
Yes: Michael Fumento, from "Trick Question", The New Republic (2003).
No: Lawrence H. Diller, from "The Last Normal Child: Essays on the Intersection of Kids, Culture, and Psychiatric Drugs", Praeger (2006).
Writer Michael Fumento disputes the idea that Ritalin is overprescribed. He notes that there are many myths associated with Ritalin. It does not lead to abuse and addiction. Fumento argues that Ritalin is an excellent medication for ADHD. One reason it is not as accepted is because it has been demonized by various groups. It is possible that the drug is underutilized. Fumento contends that more students would benefit from Ritalin and other stimulants. Behavioral pediatrician Lawrence Diller contends that Ritalin is overused and that, while Ritalin can moderate behavior, many school districts advocate the use of Ritalin and other stimulants so that they do not have to provide other services, and does not overcome learning disabilities.
Issue 14. Are Energy Drinks with Alcohol Dangerous Enough to Ban?
Yes: Don Troop, from "Four Loko Does Its Job with Efficiency and Economy, Students Say", The Chronicle of Higher Education (2010).
No: Jacob Sullum, from "Loco Over Four Loko", Reason (2011).
The Chronicle of Higher Education journalist Don Troop argues that the combination of caffeine and alcohol is extremely dangerous and should not be sold or marketed to college students and young people. Journalist and editor of Reason Magazine Jacob Sullum disagrees and claims that alcoholic energy drinks should not have been targeted and banned since many other products are far more dangerous.
UNIT: Drug Prevention and Treatment
Issue 15. Is Alcoholism Hereditary?
Yes: Markus Heilig, from "Triggering Addiction", The Scientist (2008).
No: Rajita Sinha, from "How Does Stress Lead to Risk of Alcohol Relapse", Alcohol Research: Current Reviews (2012).
Markus Heilig, Clinical Director of the National Institute on Alcohol Abuse and Alcoholism, argues that molecular changes in the brain result in positive reinforcement from alcohol. Heilig notes that alcoholism has a behavioral component, but certain genes may be responsible in individuals who abuse alcohol despite its adverse consequences. Research by Rajita Sinha indicates that alcohol use disorders are associated with dysfunction in emotion and stress responses and that these dysfunctional responses contribute to the motivation to drink. Stress levels and mechanisms to manage stress are key factors for the desire to use alcohol and relapse to alcoholism.
Issue 16. Should Marijuana Be Approved for Medical Use?
Yes: Jennifer Welsh and Kevin Loria, from "23 Health Benefits of Marijuana", Business Insider (2014).
No: John Cooke, from "The Medical Marijuana Debate: Con", Denver Post (2007).
Jennifer Welsh and Kevin Loria compiled a comprehensive list of the putative medical benefits of marijuana and cannabinoid-like drugs. While there are negative effects of smoking too much or using it for nonmedicinal purposes, it can be effective to minimize the symptoms of a variety of disorders from glaucoma to Alzheimer’s disease. John Cooke is a sheriff in Greely, Colorado, and is concerned that proponents of medical marijuana play upon people’s compassions and emotions and not scientific medical research. Groups that support medical marijuana are the same groups that push for marijuana legalization.
Issue 17. Should Schools Drug Test Students?
Yes: Susanne James-Burdumy, et al., from "The Effectiveness of Mandatory-Random Student Drug Testing: Executive Summary", National Center for Education Evaluation and Regional Assistance, Institute of Education Services, U.S. Department of Education (2010).
No: Jennifer Kern, et al., from "Making Sense of Student Drug Testing: Why Educators Are Saying No", (2006).
Susanne James-Burdumy of Mathematica Policy Research and her colleagues report that schools which implemented mandatory random drug testing had less substance use. Moreover, random drug testing did not have a negative impact on the number of students engaging in school activities. Likewise, drug testing did not affect how students feel about their schools. Jennifer Kern and associates maintain that drug testing is ineffective and that the threat of drug testing may dissuade students from participating in extracurricular activities. Moreover, drug testing is costly, it may make schools susceptible to litigation, and it undermines relationships of trust between students and teachers. Drug testing, according to Kern, does not effectively identify students who may have serious drug problems.
Issue 18. Does Drug Abuse Treatment Work?
Yes: National Institute on Drug Abuse, from "Principles of Drug Addiction Treatment: A Research-Based Guide", (2009).
No: Sacha Z. Scoblic, from "The Dogma of AA Has Taken Over", The New Republic (2013).
The National Institute on Drug Abuse report acknowledges that drug addiction is difficult to overcome but that treatment can be effective and works best when individuals are committed to remain in treatment for an extended time. Sacha Z. Scoblic, a Carter fellow for mental health journalism, argues that anti-addiction programs, such as Alcoholics Anonymous, can be ineffective and are misused. Popular programs might not adhere to the vast body of research on addiction treatment.
Issue 19. Is Drug Addiction a Problem of Youth?
Yes: National Institute on Drug Abuse, from "Drugs, Brains, and Behavior: The Science of Addiction", National Institute on Drug Abuse Research Report (2014).
No: Olivera Bogunovic, from "Substance Abuse in Aging and Elderly Adults", Psychiatric Times (2012).
The National Institute on Drug Abuse (NIDA) is charged with bringing the power of science to bear on drug abuse and addiction. In its publication Drugs, Brains, and Behavior: The Science of Addiction, NIDA provides an overview—based on the scientific literature—of the drug addiction problem. A strong focus of this research has been in preventing drug addiction in young people. Psychiatrist and author Olivera Bogunovic indicates that drug addiction is a formidable problem for older adults. In her article “Substance Abuse in Aging and Elderly Adults,” she describes the unique challenges faced by older people.
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