TAKING SIDES: Clashing Views in Drugs and Society, Ninth Edition
Unit 1 Drugs and Public Policy
Issue 1. Should Laws Against Drug Use Remain Restrictive? YES: Herbert Kleber and Joseph A. Califano Jr., from “Legalization: Panacea or Pandora’s Box?” The World & I Online ( January 2006) NO: Peter Gorman, from “Veteran Cops Against the Drug War,” The World and I Online ( 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 harm 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? 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 (October 2007)
Because the trafficking of drugs represents a direct threat to national security, the U.S. State Department maintains that more effort is needed to interdict drugs coming into the United States. 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: Kenneth P. Moritsugu, from The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking (U.S. Department of Health and Human Services, 2007)NO: Judith G. McMullen, from “Underage Drinking: Does Current Policy Make Sense?” Lewis & Clark Law Review (Summer 2006)
Kenneth Moritsugu, the previous United States Surgeon General, maintains that underage drinking is fraught with numerous problems ranging from motor vehicle crashes to homicide and suicide. Underage drinking is also 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. 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 the Dangers of Ecstasy (MDMA) Overstated? YES: Leslie Iversen, from Speed, ecstasy, Ritalin: The Science of Amphetamines (Oxford University Press, 2006)NO: National Institute on Drug Abuse, from “MDMA (ecstasy) Abuse,” National Institute on Drug Abuse Research Report (March 2006)
Author Leslie Iversen contends that ecstasy can result in adverse effects but that the drug has been unfairly demonized. Moreover, Iversen states that its negative consequences on the brain have not been proven conclusively. Iversen acknowledges that ecstasy may produce profound effects, although those effects are subject to an individual’s perception. 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. Is Drug Addiction a Brain Disease? YES: National Institute on Drug Abuse, from The Science of Addiction (April 2007) NO: Sally Satel, from “The Human Factor,” The American (July/ August 2007)
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 plays a major role as well. Psychiatrist Sally Satel maintains that drug addiction is not a disease of the brain. Satel asserts that there are individuals who are capable of stopping their drug addiction without medical intervention. Moreover, diseases have distinct characteristics, and drug addiction does not share these characteristics. Satel feels that addicts are done a disservice by calling addiction a brain disease.
Issue 7. Should the Federal Government Play a Larger Role in Regulating Steroid Use? YES: National Institute on Drug Abuse, from “Anabolic Steroid Abuse,” National Institute on Drug Abuse Research Report (August 2006) NO: Laura K. Egendorf, from Performance Enhancing Drugs (Reference Point Press, 2007)
The National Institute on Drug Abuse (NIDA) warns that anabolic steroids produce numerous harmful side effects which 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. 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. 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.Unit 2 Drugs and Social Policy
Issue 8. Should Employers Limit Secondhand Smoke? YES: Leslie Zellers, Meliah A. Thomas, and Marice Ashe, from “Legal Risks to Employers Who Allow Smoking in the Workplace,” American Journal of Public Health (August 2007)NO: Robert A. Levy and Rosalind B. Marimont, from “Lies, Damned Lies, and 400,000 Smoking-Related Deaths,” Regulation (vol. 21, no. 4, 1998)
Leslie Zellers and Marice Ashe, attorneys with Public Health Law and Policy of the Public Health Institute, and attorney Meliah Thomas maintain that employers should want to reduce their employees’ exposure to secondhand smoke to reduce the risk of litigation and to decrease their premiums for workers’ compensation. Moreover, eliminating secondhand smoke protects their employees from deleterious effects. 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 like 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.”
Issue 9. Should Marijuana be Legalized? YES: Peter Cohen, from “The Culture of the Ban on Cannabis: Is It Political Laziness and Lack of Interest That Keeps This Farcical Blunder Afloat?” Drugs and Alcohol Today ( June 2008)NO: Office of National Drug Control Policy, from Marijuana Myths and Facts: The Truth Behind 10 Popular Misconceptions (2004)
Author Peter Cohen argues that many assumptions about the effects of marijuana are untrue. Cohen indicates that research supports his claim but that there is little interest by public officials in the research. Cohen maintains that marijuana does not lead to the use of other drugs, nor does it result in mental illness or addiction. He also asserts that certain groups, such as police departments, benefit from the perpetuation of myths surrounding the use of marijuana. 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? YES: Leemon McHenry, from “Ethical Issues in Psychopharmacology,” Journal of Medical Ethics (July 2006) NO: Bruce M. Cohen, from “Mind and Medicine: Drug Treatments for Psychiatric Illness,” 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. Is Caffeine a Health Risk? YES: Nancy Shute, from “Over the Limit? Americans Young and Old Crave High-Octane Fuel, and Doctors Are Jittery,” U.S. News and World Report (April 23, 2007)NO: Sally Satel, from “Is Caffeine Addictive? A Review of the Literature.” American Journal of Drug and Alcohol Abuse (November 2006)
Writer Nancy Shute contends that many individuals, especially young people, are consuming high levels of caffeine to make up for their lack of rest. Although Shute acknowledges that caffeine has some benefits, she also notes that caffeine may cause anxiety, jitteriness, and heart palpitations as well as increase the risk of miscarriages and low–birth-weight babies. 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 byproduct 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)NO: Lawrence H. Diller, from The Last Normal Child: Essays on the Intersection of Kids, Culture and Psychiatric Drugs (Prager, 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 many school districts advocate the use of Ritalin and other stimulants so that they do not have to provide other services. Diller acknowledges that Ritalin can moderate behavior, but that the drug does not help youngsters overcome learning problems. Another concern, states Diller, is that legal stimulants like Ritalin are being used illegally.
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)NO: Dominick L. Frosch, Patrick M. Krueger, Robert C. Hornik, Peter F. Cronholm and Frances K. Barg, from “Creating Demand for Prescription Drugs: A Content Analysis of Television Direct-to-Consumer Advertising,” Annals of Family Medicine (January/February 2007)
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. Dominic Frosch of the UCLA School of Medicine and his colleagues maintain that direct-to-consumer drug advertisements provide limited educational value to consumers. Moreover, the benefits of some prescription drugs are exaggerated. Frosch and associates feel that the drug advertisements dissuade individuals from engaging in health-promoting activities.Unit 3 Drug Prevention and Treatment
Issue 14. Should Smokeless Tobacco Be Promoted as an Alternative to Cigarette Smoking? YES: John Britton and Richard Edwards, from “Tobacco Smoking, Harm Reduction, and Nicotine Product Regulation,” The Lancet (February 2, 2008) NO: David A. Savitz, Roger E. Meyer, Jason M. Tanzer, Sidney S. Mirvish, and Freddi Lewin, from “Public Health Implications of Smokeless Tobacco as a Harm Reduction Strategy,” American Journal of Public Health (November 2006)
Professors John Britton and Richard Adwards advocate the use of smokeless tobacco as an alternative to tobacco smoking because the harm from tobacco is rooted more in the act of smoking than from nicotine. They recognize that smokeless tobacco carries certain risks, although they note that nicotine is not a known carcinogen nor does it reduce birthweight as much as tobacco smoking. David Savitz of the Mount Sinai School of Medicine and his colleagues raise concerns about the promotion of smokeless tobacco in lieu of tobacco smoking because there are numerous health concerns associated with smokeless tobacco. They are concerned about the products used in smokeless tobacco as well as the effects of smokeless tobacco on oral health, cardiovascular disease, and reproductive health.
Issue 15. Is Alcoholism Hereditary? YES: Markus Heilig, from “Triggering Addiction,” The Scientist (December 2008)NO: Grazyna Zajdow, from “Alcoholism’s Unnatural History: Alcoholism Is Not a Health Issue, But One of Personal and Existential Pain. Recognising This Would Force Us to Acknowledge One of the Most Successful Methods of Dealing With Alcohol Addiction,” Arena Magazine (April–May 2004)
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 for individuals who abuse alcohol despite its adverse consequences. 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? YES: Peter J. Cohen, from “Medical Marijauna, Compassionate Use, and Public Policy: Expert Opinion and Vox Populi?” Hastings Center Report (May/June 2006)NO: Drug Enforcement Administration, from The DEA Position on Marijuana (May 2006)
Peter J. Cohen, an adjunct law professor at Georgetown University and a medical doctor, notes that marijuana has a long history of medicinal use. Cohen supports research to verify whether marijuana is a safe and effective therapeutic agent for various maladies. However, the federal government has presented barriers to conducting the necessary research. 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? YES: Office of National Drug Control Policy, from Strategies for Success: New Pathways to Drug Abuse Prevention (Fall/ Winter 2006)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? 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 are 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? 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)NO: Rodney Skager, from “Beyond Zero Tolerance: A Reality-Based Approach to Drug Education and School Discipline” (Drug Policy Alliance, 2007)
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. Rodney Skager, formerly a professor at UCLA, argues that a zero tolerance drug policy does not change drug-taking behavior among young people. Instead of merely punishing drug offenders, Skager suggests that effective drug education is needed. Instances in which drug use presents a significant problem for the user may require intervention and treatment. Again, zero tolerance does very little to rectify behavior.
