TAKING SIDES: Clashing Views in Drugs and Society, Eighth Edition
Unit 1 DRUGS AND PUBLIC POLICY
Issue 1. Should Laws Against Drug Use Remain Restrictive? New! YES: Herbert Kleber and Joseph A. Califano Jr., from “Legalization: Panacea or Pandora's Box,” World and I (January 2006) New! NO: Peter Gorman, from “Veteran Cops Against the Drug War,” World and I (January 2006)
Herbert Kleber, the executive vice president of the Center on Addiction and Substance Abuse (CASA), and Joseph Califano, founder of CASA, maintain that drug laws should remain restrictive because legalization would result in increased use, especially by children. Kleber and Califano contend that drug legalization would not eliminate drug-related violence and harms caused by drugs. Author Peter Gorman states that restrictive drug laws have been ineffective. He notes that drug use and drug addiction have increased since drug laws became more stringent. Despite the crackdown on drug use, the availability of drugs has increased while the cost of drugs has decreased. In addition, restrictive drug laws, says Gorman, are racist and endanger civil liberties.
Issue 2. Should the United States Put More Emphasis on Stopping the Importation of Drugs? New! YES: Office of National Drug Control Policy, from The National Drug Control Strategy (February 2007) NO: Cathy Inouye, from “The DEA, CIA, DoD, & Narcotrafficking,” Z Magazine (July/August 2004)
The Office of National Drug Control Policy (ONDCP) argues that the importation of drugs must be stopped to reduce drug use and abuse. If the supply of drugs being trafficked across American borders is reduced, then there would be fewer drug-related problems. The ONDCP maintains that a coordinated international effort is needed to combat the increased production of heroin, cocaine, and marijuana. Cathy Inouye, a human rights volunteer for NGO SEDEM (Seguridad en Democracia), feels that the corroboration of numerous United States with leaders in foreign governments has resulted in continued human rights abuses and has enriched those leaders in countries where the drug trade is prominent. Inouye notes that the federal government should reexamine its role of cooperation with other governments, especially those involved in the drug trade.
Issue 3. Are Drinking Age Laws Effective? New! YES: Judith G. McMullen, from “Underage Drinking: Does Current Policy Make Sense?” Lewis and Clark Law Review (Summer 2006) New! NO: U.S. Department of Health and Human Services, from “Why Do Adolescents Drink, What Are the Risks, and How Can Underage Drinking Be Prevented?” Alcohol Alert (January 2006)
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. The United States Department of Health and Human Services maintains that underage drinking is fraught with numerous problems ranging from motor vehicle crashes to homicide and suicide. Also, underage drinking is related to unhealthy risk-taking behaviors and poor academic performance. Rather than tolerate underage drinking, more effort should be placed on enforcing underage drinking laws.
Issue 4. Are the Dangers of Ecstasy (MDMA) Overstated? YES: Jacob Sullum, from “Sex, Drugs and Techno Music,” Reason (January 2002) New! NO: U.S. Department of Health and Human and Services, from “MDMA (Ecstasy) Abuse,” National Institute on Drug Abuse Research Report (March 2006)
Jacob Sullum, a senior editor at Reason magazine, contends that the effects of drugs such as Ecstasy, particularly in regard to sexual behavior, are exaggerated. Sullum refers to the history of marijuana and how it was deemed a drug that would make people engage in behaviors that they would not typically engage in. Sullum feels that the public’s reaction is unjustified. Club drugs such as Ecstasy allow partygoers to dance and remain active for long periods of time according to the National Institute on Drug Abuse (NIDA). However, Ecstasy may produce a number of adverse effects such as high blood pressure, panic attacks, loss of consciousness, seizures, and death. Moreover, Ecstasy can produce negative effects on the brain, resulting in confusion, depression, memory impairment, and attention difficulties.
Issue 5. Should Pregnant Drug Users Be Prosecuted? YES: Paul A. Logli, from “Drugs in the Womb: The Newest Battlefield in the War on Drugs,” Criminal Justice Ethics (Winter/Spring 1990) NO: Carolyn S. Carter, from “Perinatal Care for Women Who Are Addicted: Implications for Empowerment,” Health and Social Work (August 2002)
Paul A. Logli, an Illinois prosecuting attorney, argues that it is the government’s duty to enforce every child’s right to begin life with a healthy, drug-free mind and body. Logli maintains that pregnant women who use drugs should be prosecuted because they harm the life of their unborn children. He feels that it is the state’s responsibility to ensure that every baby is born as healthy as possible. Carolyn Carter, a social work professor at Howard University, argues that the stigma of drug use during pregnancy has resulted in the avoidance of treatment. Carter asserts that the prosecution of pregnant drug users is unfair because poor women are more likely to be the targets of such prosecution. To enable pregnant women who use drugs to receive perinatal care, it is necessary to define their drug use as a health problem rather than as a legal problem.
Issue 6. Should Drug Addiction Be Considered a Disease? YES: Lisa N. Legrand, William G. Iacono, and Matt McGue, from “Predicting Addiction,” American Scientist (March–April 2005) NO: Jacob Sullum, from “H: The Surprising Truth About Heroin and Addiction,” Reason (June 2003)
Psychologists Lisa LeGrand, William Iacono, and Matt McGue maintain that certain personality characteristics, such as hyperactivity, acting-out behavior, and sensation-seeking may have their bases in genetics. LeGrand, Iacono, and McGue acknowledge the role of environment, but they feel that genes play a substantial role in drug-taking behavior. Jacob Sullum, a senior editor with Reason magazine, contends that drug addiction should not be considered a disease, a condition over which one has no control. Numerous individuals who have used drugs extensively have been able to stop drug use. Sullum maintains that drug use is a matter of behavior, not addiction. Classifying behavior as socially unacceptable does not prove that it is a disease.
Issue 7. Should the Federal Government Play a Larger Role in Regulating Steroid Use? New! YES: National Institute on Drug Abuse, from “Anabolic Steroid Abuse,” National Institute on Drug Abuse Research Report (August 2006) New! NO: Matthew J. Mitten, from “Drug Testing of Athletes—An Internal, Not External, Matter,” The New England Law Review (Spring 2006)
The National Institute on Drug Abuse (NIDA) warns that anabolic steroids produce numerous harmful side effects that can lead to stunted growth, breast development in males, excessive hair growth on women, acne, complications of the liver, and infections from nonsterile needles. Behaviorally, anabolic steroids have been associated with rage and aggression. According to NIDA, simply teaching about steroids does not deter their use. Matthew J. Mitten, a professor with the Marquette University Law School, feels that the federal government should not try to regulate the use of anabolic steroids. Rather, the various sports-governing bodies should be the regulators. Also, if athletes are aware of the risks of using anabolic steroids, then they could make the decision about whether to use these drugs. Allowing steroid use would essentially level the playing field for all athletes.
UNIT 2 DRUGS AND SOCIAL POLICY
Issue 8. Are the Adverse Effects of Smoking Exaggerated? YES: Robert A. Levy and Rosalind B. Marimont, from “Lies, Damned Lies, and 400,000 Smoking-Related Deaths,” Regulation (vol. 21, no. 4, 1998) NO: Centers for Disease Control, from The Health Consequences of Smoking: A Report of the Surgeon General (2004)
Robert A. Levy, a senior fellow at the Cato Institute, and Rosalind B. Marimont, a mathematician and scientist who retired from the National Institute of Standards and Technology, claim that the government distorts and exaggerates the dangers associated with cigarette smoking. Levy and Marimont state that factors such as poor nutrition and obesity are overlooked as causes of death among smokers. They note that cigarette smoking is harmful, but the misapplication of statistics should be regarded as “junk science.” The 2004 Surgeon General’s report on smoking states that the evidence pointing to the dangers of smoking is overwhelming. The report clearly links cigarette smoking to various forms of cancer, cardiovascular diseases, respiratory diseases, reproductive problems, and a host of other medical conditions.
Issue 9. Should Laws Prohibiting Marijuana Use Be Relaxed? YES: Ethan A. Nadelmann, from “An End to Marijuana Prohibition” National Review (July 12, 2004) NO: Office of National Drug Control Policy, from Marijuana Myths and Facts: The Truth Behind 10 Popular Misconceptions (2004)
Ethan Nadelmann, founder and executive director of the Drug Policy Foundation, argues that law enforcement officials are overzealous in prosecuting individuals for marijuana possession. Eighty-seven percent of marijuana arrests are for possession of small amounts of the drug. The cost of marijuana enforcement to U.S. taxpayers ranges from $10–15 billion. In addition, punishments are unjust in that they vary greatly. The Office of National Drug Control Policy (ONDCP) contends that marijuana is not a harmless drug. Besides causing physical problems, marijuana affects academic performance and emotional adjustment. Moreover, dealers who grow and sell marijuana may become violent to protect their commodity.
Issue 10. Are Psychotherapeutic Drugs Overprescribed for Treating Mental Illness? New! YES: Leemon McHenry, from “Ethical Issues in Psychopharmacology,” Journal of Medical Ethics (2006) NO: Bruce M. Cohen, from “Mind and Medicine: Drug Treatments for Psychiatric Illnesses,” Social Research (Fall 2001)
Professor Leemon McHenry, a professor with the Philosophy Department at the California State University at Northridge, questions the effectiveness of psychiatric drugs, especially antidepressant drugs known as selective serotonin reuptake inhibitors (SSRIs). McHenry maintains that the increase in the prescribing of antidepressant drugs results from their promotion by the pharmaceutical industry. McHenry also argues that pharmaceutical companies should be more forthright in the efficacy of these drugs. Medical doctor Bruce M. Cohen maintains that psychiatric medicines are very beneficial in enabling individuals with a variety of illnesses to return to normal aspects of consciousness. Cohen points out that people with conditions such as anxiety, depression, and psychosis respond very well to medications. These types of drugs have been utilized successfully for hundreds of years.
Issue 11. Do the Consequences of Caffeine Outweigh Its Benefits? YES: James Thornton, from “Start Me Up,” Men's Health (October 2004) New! NO: Sally Satel, from “Is Caffeine Addictive?” American Journal of Drug and Alcohol Abuse (November 2006)
James Thornton from Men’s Health describes caffeine as an addictive substance that results in withdrawal symptoms. The stimulating effects of caffeine are muted by tolerance that develops to the drug. One downside to caffeine is that it impedes one’s ability to get to sleep. The lack of sleep may result in jitteriness and arrhythmias in adults. In large amounts caffeine can cause anxiety and panic attacks. According to medical doctor Sally Satel, caffeine may have addictive qualities but its dangers are overstated. Caffeine’s addictive qualities are modest. Most caffeine users are able to moderate their consumption of caffeine. Headaches are one by-product of caffeine cessation. Very few people consume caffeine compulsively. Moreover, individuals who have difficulty moderating their caffeine use often have other psychiatric problems.
Issue 12. 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 (February 3, 2003) New! NO: Lawrence Diller, from “Ritalin and the Growing Influence of Big Pharma,” Psychotherapy Networker (January/February 2005)
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. Pediatrician and family therapist Lawrence Diller contends that Ritalin is overused because diagnosing ADHD is imprecise. Symptoms such as distractibility, inattention, and impulsivity are typical behaviors of many children. Moreover, it is unclear whether the use of Ritalin and other stimulants carry over to long-term academic success. Diller argues that the proliferation in the use of Ritalin stems from its promotion by the pharmaceutical industry.
Issue 13. Do Consumers Benefit When Prescription Drugs Are Advertised? YES: Merrill Matthews Jr., from “Advertising Drugs Is Good for Patients,” Consumers Research Magazine (August 2001) New! NO: Robert Langreth and Matthew Herper, from “Pill Pushers: How the Drug Industry Abandoned Science for Salesmanship,” Forbes (May 8, 2006)
Merrill Matthews, a health policy advisor with the American Legislative Exchange Council, argues that the advertising of prescription drugs directly to consumers will result in better-informed consumers. Additionally, communication between doctors and patients may improve because patients will be more knowledgeable about drugs. Writers Robert Langreth and Matthew Herper contend that the pharmaceutical industry spends much more money promoting drugs that are similar to existing drugs rather than researching how to develop new and better drugs. The top ten pharmaceutical companies spend twice as much money on marketing and administration as on research. Too often, claim Langreth and Herper, the excessive marketing of drugs creates demand even when the demand is not present.
UNIT 3 DRUG PREVENTION AND TREATMENT
Issue 14. Does Secondhand Smoke Endanger the Health of Nonsmokers? New! YES: U.S. Department of Health and Human Services, from The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General (2006) NO: J. B. Copas and J. Q. Shi, from “Reanalysis of Epidemiological Evidence on Lung Cancer and Passive Smoking,” British Medical Journal (February 12, 2000)
According to the Surgeon General’s report on secondhand smoke, in 2005 more than 3,000 adult nonsmokers died from lung cancer, 46,000 from coronary heart disease, and about 430 newborns from sudden infant death syndrome. In addition, children exposed to secondhand smoke have an increased risk of acute respiratory infections, ear problems, and severe asthma. Simply separating smokers from nonsmokers or having separately ventilated areas for smoking is ineffective. Statisticians J. B. Copas and J. Q. Shi argue that research demonstrating that secondhand smoke is harmful is biased. They contend that many journals are more likely to publish articles if secondhand smoke is shown to be deleterious and that the findings of many studies exaggerate the adverse effects of secondhand smoke.
Issue 15. Is Alcoholism Hereditary? YES: National Institute on Alcohol Abuse and Alcoholism, from “The Genetics of Alcoholism,” Alcohol Alert (July 2003) NO: Grazyna Zajdow, from “Alcoholism's Unnatural History: Alcoholism Is Not a Health Issue, But One of Personal and Existential Pain. Recognizing This Would Force Us to Acknowledge One of the Most Successful Methods of Dealing With Alcohol Addiction,” Arena Magazine (April–May 2004)
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) contends that heredity plays a large role in the development of alcoholism. Family environment may play a role in whether one becomes an alcoholic but individuals inherit characteristics that increase the possibility of developing alcoholism. The NIAAA notes that identical twins are twice as likely to become alcoholic as fraternal twins. Grazyna Zajdow, a lecturer in sociology at Deakin University, maintains that the concept of alcoholism results from a social construct of what it means to be alcoholic. Because alcoholism is a social stigma, it is viewed as a disease rather than as a condition caused by personal and existential pain. Environmental conditions, especially consumerism, says Zajdow, are the root cause of alcoholism.
Issue 16. Should Marijuana Be Approved for Medical Use? New! YES: Sherwood O. Cole, from “An Update on the Effects of Marijuana and Its Potential Medical Use: Forensic Focus” The Forensic Examiner (Fall 2005) New! NO: Drug Enforcement Administration, from The DEA Position on Marijuana (May 2006)
Sherwood O. Cole, a professor emeritus of psychology at Rutgers University, argues in favor of allowing marijuana for medicinal purposes despite the fact that it has some adverse effects, especially on cognition and mental health and on the respiratory and cardiovascular systems. Some of the potential medical uses of marijuana include reducing fluid pressure in the eyes of glaucoma patients, reducing nausea associated with cancer treatment, stimulating appetite in AIDS patients, and reducing convulsions of epileptic patients. The Drug Enforcement Administration (DEA) states that marijuana has not been proven to have medical utility. The DEA cites the positions of the American Medical Association, the American Cancer Society, the American Academy of Pediatrics, and the National Multiple Sclerosis Society to support its position. The DEA feels that any benefits of medicinal marijuana are outweighed by its drawbacks.
Issue 17. Should Schools Drug Test Students? New! YES: Office of National Drug Control Policy, from Strategies for Success: New Pathways to Drug Abuse Prevention (Fall/Winter 2006) New! NO: Jennifer Kern, Fatema Gunja, Alexandra Cox, Marsha Rosenbaum, Judith Appel, and Anjuli Verma, from Making Sense of Student Drug Testing: Why Educators Are Saying No (January 2006)
The Office of National Drug Control Policy (ONDCP), an agency of the federal government, maintains that it is important to test students for illicit drugs because testing reduces drug use and improves the learning environment in schools. The ONDCP purports that the majority of students support drug testing. In addition, drug testing does not decrease participation in extracurricular activities. 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? New! YES: Susan L. Ettner , David Huang, Elizabeth Evans, Danielle Rose Ash, Mary Hardy, Mickel Jourabchi, and Yih-Ing Hser, from “Benefit-Cost in the California Treatment Outcome Project: Does Substance Abuse Treatment ‘Pay for Itself’?” Health Services Research (February 2006) NO: United Nations, from Investing in Drug Abuse Treatment (2003)
Author Susan L. Ettner and associates maintain that not only do people in substance abuse treatment benefit, but that taxpayers also benefit. They estimate that about seven dollars is saved for every dollar spent on treatment. Individuals in treatment are less likely to engage in criminal activity and they are more likely to be employed. The report from the United Nations Office on Drugs and Crime argues that drug abuse treatment does not cure drug abuse. Most people who go through drug treatment relapse. Drug abuse treatment does not get at the root causes of drug abuse: crime, family disruption, loss of economic productivity, and social decay. At best, treatment may minimize drug abuse.
Issue 19. Is Abstinence an Effective Strategy for Drug Education? New! YES: Tracy J. Evans-Whipp, Lyndal Bond, John W. Toumbourou, and Richard F. Catalano, from “School, Parent, and Student Perspectives of School Drug Policies,” Journal of School Health (March 2007) New! NO: Marsha Rosenbaum, from Safety First: A Reality-Based Approach to Teens, Drugs, and Drug Education,” Safety First (Drug Policy Alliance, 2004)
Tracy J. Evans-Whipp, of the Murdoch Children’s Research Institute in Melbourne, Australia, and her colleagues maintain that an abstinence message coupled with harsh penalties is more effective at reducing drug use than a message aimed at minimizing the harms of drugs. They contend that an abstinence message is clear and that a harm reduction message may give a mixed message. Drug researcher Marsha Rosenbaum states that because many teens experiment with drugs, a message to reduce the harms associated with drugs is necessary. Rosenbaum believes that scare tactics and misinformation about drugs increases the likelihood that teens may have problems if or when they experiment with drugs. Also, a problem with the abstinence-only message is that teens have no one to turn to if they experience problems with drugs.