Pharmacology of the drugs of abuse and the development of public policy. 1991

R B Millman
Department of Public Health, Cornell University Medical College, New York, NY 10021.

It is fascinating that the morality, ethics, and effectiveness of current drug prohibition policies are being criticized in an era when drug use is declining in most segments of society. The current era is also marked by increasingly restrictive policies against drug use and users, including much enhanced interdiction efforts, calls for tougher penalties and more jails, and extensive drug screening programs at the work site. Summary dismissal of workers or students who use drugs is increasingly advocated. Two distinct and opposing currents advocating policy change have emerged, one for legalization, the other for greater restriction. The current inner-city rise in drug use, particularly of cocaine and "crack," and the remarkable increase in drug-related crime is probably providing the impetus for both lines of thinking. Yet both views appear extreme and neither seems to offer a promising social policy. It is critical that we continue to attempt to develop effective strategies for reducing the impact of drug taking on the individual and society. Whereas I am sensitive to the ethical and legal perspectives of the proponents of legalization, pharmacologic and social issues persuade me that legalization of heroin and cocaine would lead to a marked increase in drug dependence and an increase in drug-related disability and crime. In response to the idea that the legalization and taxation of drug use would provide resources for more effective research, prevention, and treatment, my sense is that we should not wait for legalization but should embark on that long and expensive course immediately.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D004335 Drug and Narcotic Control Control of drug and narcotic use by international agreement, or by institutional systems for handling prescribed drugs. This includes regulations concerned with the manufacturing, dispensing, approval (DRUG APPROVAL), and marketing of drugs. Drug Regulations,Narcotic Control,Pharmaceutical Policy,Drug Control,Narcotic and Drug Control,Pharmaceutic Policy,Control, Drug,Control, Narcotic,Controls, Drug,Controls, Narcotic,Drug Controls,Drug Regulation,Narcotic Controls,Pharmaceutical Policies,Policies, Pharmaceutical,Policy, Pharmaceutical,Regulation, Drug,Regulations, Drug
D006291 Health Policy Decisions, usually developed by government policymakers, for determining present and future objectives pertaining to the health care system. Health Care Policies,Health Policies,Healthcare Policy,National Health Policy,Care Policies, Health,Health Care Policy,Health Policy, National,Healthcare Policies,National Health Policies,Policies, Health,Policies, Health Care,Policies, Healthcare,Policy, Health,Policy, Health Care,Policy, Healthcare
D006556 Heroin Dependence Strong dependence or addiction, both physiological and emotional, upon HEROIN. Heroin Abuse,Heroin Addiction,Heroin Smoking,Abuse, Heroin,Addiction, Heroin,Dependence, Heroin,Heroin Smokings,Smoking, Heroin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001143 Arousal Cortical vigilance or readiness of tone, presumed to be in response to sensory stimulation via the reticular activating system. Vigilance, Cortical,Arousals,Cortical Vigilance
D013287 Illicit Drugs Drugs that are manufactured, obtained, or sold illegally. They include prescription drugs obtained or sold without prescription and non-prescription drugs. Illicit drugs are widely distributed, tend to be grossly impure and may cause unexpected toxicity. Club Drug,Drugs, Illegal,Illegal Drug,Illegal Drugs,Illicit Drug,Recreational Drug,Recreational Drugs,Street Drug,Street Drugs,Club Drugs,Drug, Club,Drug, Illegal,Drug, Illicit,Drug, Recreational,Drug, Street,Drugs, Club,Drugs, Illicit,Drugs, Recreational,Drugs, Street
D013375 Substance Withdrawal Syndrome Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug. Drug Withdrawal Symptoms,Withdrawal Symptoms,Drug Withdrawal Symptom,Substance Withdrawal Syndromes,Symptom, Drug Withdrawal,Symptom, Withdrawal,Symptoms, Drug Withdrawal,Symptoms, Withdrawal,Syndrome, Substance Withdrawal,Syndromes, Substance Withdrawal,Withdrawal Symptom,Withdrawal Symptom, Drug,Withdrawal Symptoms, Drug,Withdrawal Syndrome, Substance,Withdrawal Syndromes, Substance
D019966 Substance-Related Disorders Disorders related to substance use or abuse. Chemical Dependence,Drug Abuse,Drug Addiction,Drug Dependence,Drug Habituation,Drug Use Disorder,Drug Use Disorders,Organic Mental Disorders, Substance-Induced,Substance Abuse,Substance Dependence,Substance Related Disorder,Substance Use,Substance Use Disorder,Substance Use Disorders,Prescription Drug Abuse,Substance Addiction,Abuse, Drug,Abuse, Prescription Drug,Abuse, Substance,Addiction, Drug,Addiction, Substance,Chemical Dependences,Dependence, Chemical,Dependence, Drug,Dependence, Substance,Dependences, Chemical,Disorder, Drug Use,Disorder, Substance Related,Disorder, Substance Use,Disorders, Substance Related,Drug Abuse, Prescription,Habituation, Drug,Organic Mental Disorders, Substance Induced,Related Disorder, Substance,Related Disorders, Substance,Substance Abuses,Substance Uses,Use, Substance

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