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UNIT 1: Drugs and Public Policy
Issue: 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: 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" (U.S. Department of State, 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 10 years earlier and that cocaine and heroin are purer and cheaper because producers have become more efficient.
Issue: Should Big Pharma Be Permitted to Discourage Access to Generic Drugs?
Yes: Agnes Shanley, from “Legitimate Concerns over Patent Protection, Profits and Shareholder Value Are Being Balanced by Ethics and Humanism,” PharmaManufacturing.com (2005)
No: Arthur Caplan and Zachary Caplan, from “How Big Pharma Rips You Off,” CNN Opinion (2013)
Agnes Shanley argues that the enormous cost of developing a new drug justifies attempts to protect its exclusive access to the market after the patent has expired. Arthur Caplan and Zachary Caplan are skeptical of the "staggering cost" claims, and argue that consumers should have access to the generic version of the drug as soon as possible.
Issue: Should the Legal Drinking Age Stay at 21 to Decrease Underage Alcohol Use?
Yes: National Institute on Alcohol Abuse and Alcoholism, from “Underage Drinking,” National Institute on Alcohol Abuse and Alcoholism Research Report (2017)
No: Jeffrey A. Tucker, from “Lower the Drinking Age!” Foundation for Economic Education (2015)
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) considers underage drinking to be a serious health problem in the United States. Drinking by young people has numerous health and safety risks including injuries, impaired judgment, increased risk of assault, and death. The NIAAA makes recommendations for steps to decrease alcohol use by young people and to treat drinking problems. Jeffrey Tucker argues that despite “draconian” laws against alcohol use in the United States, many teens and young adults still drink. A legal drinking age of 21 years is not realistic and accomplishes nothing to actually stop drinking, according to Tucker. Moreover, the age probation encourages risk drinking behaviors.
Issue: 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 Magazine (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.
Issue: 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 Magazine (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.
Issue: 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: Does China Have an Effective Approach to Combat Drug Addiction?
Yes: Sheldon X. Zhang and Ko-lin Chin, from “A People’s War: China’s Struggle to Contain Its Illicit Drug Problem,” Foreign Policy at Brookings (2016)
No: Yingxi Bi, from “On the Death Penalty for Drug-related Crime in China,” Human Rights and Drugs (2012)
Sheldon X. Zhang and Ko-lin Chin provide an overview of China’s approaches and its successes and failures in combating illicit drugs, including the use of capital punishment for severe offenses. Yingxi Bi examines the factors that have led to a relatively large number of Chinese citizens and noncitizens being subject to the death penalty.
UNIT 2: Drugs and Social Policy
Issue: 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 M. 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: 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: 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: Can Ecstasy or Molly (3,4-Methylenedioxy-Methamphetamine, MDMA) Effectively Treat Psychological Disorders?
Yes: Kelley McMillan, from “Is Ecstasy the Key to Treating Women with PTSD?” Marie Claire (2015)
No: Rachel Patel and Daniel Titheradge, from “MDMA for the Treatment of Mood Disorder: All Talk No Substance?” Therapeutic Advances in Psychopharmacology (2015)
3,4-Methylenedioxy-methamphetamine (MDMA) is a synthetic drug that is similar to both stimu¬lants and hallucinogens and is associated with the club scene where it is known as “Ecstasy” and “Molly”. Kelley McMillan in “Is Ecstasy the Key to Treating Women with PTSD?” notes the potential clinical benefits of MDMA to help those with the anxiety disorder and post-traumatic stress disorder. Rachel Patel and Daniel Titheradge reviewed preclinical and clinical literature on MDMA and conclude that, “the pharmacology of MDMA offers a promising target as a rapid-onset agent”; however, they note neurotoxicity and safety concerns for MDMA. These limit its wide adoption to help manage the symptoms of psychological disorders.
UNIT 3: Drug Prevention and Treatment
Issue: Should Addiction to Drugs Be Labeled a Brain Disease?
Yes: Alan I. Leshner, from “Addiction Is a Brain Disease,” The Addiction Recovery Guide (2016)
No: Steven Slate, from “Addiction Is Not a Brain Disease, It Is a Choice,” The Clean Slate (2016)
Alan I. Leshner, director of the National Institute on Drug Abuse at the National Institutes of Health, believes that addiction to drugs and alcohol is not a behavioral condition but a treatable disease. Addition Theorist Steven Slate counters that addiction is not a true disease since there is no physical malfunction and the brains of addicts are normal.
Issue: 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: Can One Become Addicted to the Internet and Social Media?
Yes: Elias Aboujaoude, from “Problematic Internet Use: An Overview,” World Psychiatry (2010)
No: Antonius J. Van Rooij and Nicole Prause, from “A Critical Review of “Internet Addiction” Criteria with Suggestions for the Future,” Journal of Behavioral Addictions (2014)
Internet access provides opportunities to learn and connect to others; however, excessive Internet use can become almost compulsive with feelings of dysphoria when one is offline. Can someone be “addicted” to the Internet as they might be addicted to drugs? Elias Aboujaoude describes behavioral addictions and the clinical scales that are used to assess Internet addiction. Antonius J. Van Rooij and Nicole Prause critically review addiction models and the limited research on Internet addiction. Their assessment is that there is not yet sufficient evidence to support an Internet addic¬tion disorder, similar to that observed with drugs.
Issue: 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.
Issue: Is Advertising Responsible for Alcohol Use by Young People?
Yes: Timothy S. Naimi, et al., from “Amount of Televised Alcohol Advertising Exposure and the Quantity of Alcohol Consumed by Youth,” Journal of Studies on Alcohol and Drugs (2016)
No: National Institute on Alcohol Abuse and Alcoholism, from “Parenting to Prevent Childhood Alcohol Use,” National Institute on Alcohol Abuse and Alcoholism Research Report (2017)
Alcohol advertisements stabilize alcohol use to cultural norms and associate it with fun and success. Companies spend on marketing because advertisements increase the likelihood of purchase of specific brands. Dr. Timothy S. Naimi and colleagues examined the relationship between the amount of exposure to alcohol advertising and alcohol consumption in underage youth. Their findings revealed that advertising has an effect on drinking behavior. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) notes that parenting style has an important impact on a child’s alcohol use and attitudes toward drinking.
Issue: Does Drug Abuse Treatment Work?
Yes: National Institute on Drug Abuse, from "Principles of Drug Addiction Treatment: A Research-based Guide," National Institute on Drug Abuse (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.
