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7.2: Drugs and Drug Use Today

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    Learning Objectives

    1. Summarize the different types of drugs.
    2. Explain the various harms caused by alcohol and tobacco.
    3. Understand the effects of marijuana, cocaine, and other illegal drugs.

    A drug may be defined as any substance other than food that, when taken into the body, affects the structure and/or functioning of the body. Defined this way, many common substances contain drugs or are drugs: coffee, No-Doz, and other products to keep us alert; aspirin, acetaminophen, ibuprofen, and other pain relievers; Tums, Rolaids, and other products that reduce heartburn; Metamucil and other products that reduce constipation; Robitussin, Sudafed, and other cold medicines; and so forth. If you have ever used one of these products, you are technically a drug user, however silly that might sound.

    Many prescription drugs also certainly exist: Prozac and other antidepressants; Valium and other tranquilizers; Lipitor and other cholesterol drugs; Yasmin, Yaz and other birth control pills; Viagra and other products that relieve erectile dysfunction; and so forth. Sales of these prescription drugs amount to tens of billions of dollars annually.

    The following substances are also drugs: alcohol, ecstasy, cocaine, heroin, marijuana, LSD, methamphetamine, PCP, and tobacco. Much has been written about these drugs, and we will discuss them further later in this section. But note that two of these drugs, alcohol and tobacco, are legal after a certain age, while the remaining drugs are illegal.

    One of the problems in deciding how to think about and deal with drugs is that this distinction between legal drugs and illegal drugs has no logical basis. It makes sense to assume that the illegal drugs should be the ones that are the most dangerous and cause the most physical and social harm, but that is not true. Rather, alcohol and tobacco cause the most harm even though they are legal. As Kleiman et al. (2011, p. xviii) note about alcohol, “When we read that one in twelve adults suffers from a substance abuse disorder or that 8 million children are living with an addicted parent, it is important to remember that alcohol abuse drives those numbers to a much greater extent than does dependence on illegal drugs.” Tobacco kills about 435,000 Americans annually by causing premature death, and alcohol kills about 85,000 annually through its effects on the liver and other body organs (Mokdad, Marks, Stroup, & Gerberding, 2004).

    Putting these numbers together, some 520,000 Americans die annually from alcohol and tobacco use. Meanwhile, the physiological effects of all illegal drugs combined kill an estimated 17,000 Americans annually (Mokdad et al., 2004), a number that is only just above the number of annual deaths (16,500) from nonsteroidal inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Frech & Go, 2009). Figure 7.1 “Annual Deaths from Legal and Illegal Drugs” depicts the huge difference between deaths from alcohol and tobacco as legal drugs and from illegal drugs.

    Figure 7.1 Annual Deaths from Legal and Illegal Drugs


    Source: Mokdad, A. H., Marks, J. S., Stroup, D. F., & Gerberding, J. L. (2004). Actual causes of death in the United States, 2000. Journal of the American Medical Association, 291(10), 1238–1245.