Sign the Resolution for a Federal Commission on Drug Policy
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by the National Clearinghouse for Alcohol and Drug Information
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The history of nonmedical drug use, and the development of policies in response to drug use, also extends back to the early settlement of the country. Like alcohol, the classification of certain drugs as legal, or illegal, has changed over time. These changes sometimes had racial and class overtones.
According to Mosher and Yanagisako, for example, Prohibition was in part a response to the drinking practices of European immigrants, who became the new lower class. Cocaine and opium were legal during the 19th century, and were favored drugs among the middle and upper classes. Cocaine became illegal after it became associated with African Americans following Reconstruction. Opium was first restricted in California in 1875 when it became associated with Chinese immigrant workers. Marijuana was legal until the 1930s when it became associated with Mexicans. LSD, legal in the 1950s, became illegal in 1967 when it became associated with the counterculture.
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Historical Overview of Prevention
Alcoholic beverages have been a part of the Nation's past since the landing of the Pilgrims. According to Alcohol and Public Policy: Beyond the Shadow of Prohibition, a publication commissioned by NIAAA and prepared by the National Academy of Sciences, the colonists brought with them from Europe a high regard for alcoholic beverages, which were considered an important part of their diet. Drinking was pervasive because alcohol was regarded primarily as a healthy substance with preventive and curative powers, not as an intoxicant. Alcohol was also believed to be conducive to social as well as personal health. It played an essential role in rituals of conviviality and collective activity, such as barn raisings. While drunkenness was condemned and punished, it was viewed only as an abuse of a God-given gift.
The first temperance movement began in the early 1800s in response to dramatic increases in production and consumption of alcoholic beverages, which also coincided with rapid demographic changes. Agitation against ardent spirits and the public disorder they spawned gradually increased during the 1820s. In addition, inspired by the writings of Benjamin Rush, the concept that alcohol was addicting, and that this addiction was capable of corrupting the mind and the body, took hold. The American Society of Temperance, created in 1826 by clergymen, spread the anti-drinking gospel. By 1835, out of a total population of 13 million citizens, 1.5 million had taken the pledge to refrain from distilled spirits. The first wave of the temperance movement (1825 to 1855) resulted in dramatic reductions in the consumption of distilled spirits, although beer drinking increased sharply after 1850.
The second wave of the temperance movement occurred in the late 1800s with the emergence of the Women's Christian Temperance Movement, which, unlike the first wave, embraced the concept of prohibition. It was marked both by the recruitment of women into the movement and the mobilization of crusades to close down saloons. The movement set out to remove the destructive substance, and the industries that promoted its use, from the country. The movement held that while some drinkers may escape problems of alcohol use, even moderate drinkers flirted with danger.
The culmination of this second wave was the passage of the 18th Amendment and the Volstead Act, which took effect in 1920. While Prohibition was successful in reducing per capita consumption and some problems related to drinking, its social turmoil resulted in its repeal in 1933.
Since the repeal of Prohibition, the dominant view of alcohol problems has been that alcoholism is the principal problem. With its focus on treatment, the rise of the alcoholism movement depoliticized alcohol problems as the object of attention, as the alcoholic was considered a deviant from the predominant styles of life of either abstinence or "normal" drinking. The alcoholism movement is based on the belief that chronic or addictive drinking is limited to a few, highly susceptible individuals suffering from the disease of alcoholism. The disease concept of alcoholism focuses on individual vulnerability, be it genetic, biochemical, psychological, or social/cultural in nature. Under this view if the collective problems of each alcoholic are solved, it follows that society's alcohol problem will be solved.
Nevertheless, the pre-Prohibition view of alcohol as a special commodity has persisted in American society and is an accepted legacy of alcohol control policies. Following Repeal, all States restricted the sale of alcoholic beverages in one way or another in order to prevent or reduce certain alcohol problems. In general, however, alcohol control policies disappeared from the public agenda as both the alcoholism movement and the alcoholic beverage industry embraced the view, "the fault is in the man and not in the bottle."
This view of alcoholism problems has also been the dominant force in contemporary alcohol problem prevention. Until recently the principal prevention strategies focused on education and early treatment. Within this view education is intended to inform society about the disease and to teach people about the early warning signs so that they can initiate treatment as soon as possible. Efforts focus on "high risk" populations and attempt to correct a suspect process or flaw in the individual, such as low self esteem or lack of social skills. The belief is that the success of education and treatment efforts in solving each alcoholic's problem will solve society's alcohol problem as well.
Contemporary alcohol problem prevention began in the 1970s as new information on the nature, magnitude, and incidence of alcohol problems raised public awareness that alcohol can be problematic when used by any drinker, depending upon the situation. There was a renewed emphasis on the diverse consequences of alcohol use--particularly trauma associated with drinking driving, fires, and violence, as well as long term health consequences.
The history of nonmedical drug use, and the development of policies in response to drug use, also extends back to the early settlement of the country. Like alcohol, the classification of certain drugs as legal, or illegal, has changed over time. These changes sometimes had racial and class overtones. According to Mosher and Yanagisako, for example, Prohibition was in part a response to the drinking practices of European immigrants, who became the new lower class. Cocaine and opium were legal during the 19th century, and were favored drugs among the middle and upper classes. Cocaine became illegal after it became associated with African Americans following Reconstruction. Opium was first restricted in California in 1875 when it became associated with Chinese immigrant workers. Marijuana was legal until the 1930s when it became associated with Mexicans. LSD, legal in the 1950s, became illegal in 1967 when it became associated with the counterculture.
By the end of the 19th century concern had grown over the indiscriminate use of these drugs, especially the addicting patent medicines. Cocaine, opium, and morphine were common ingredients in various potions sold over the counter. Until 1903, cocaine was an ingredient of Coca-Cola(R). Heroin, which was isolated in 1868, was hailed as a nonaddicting treatment for morphine addiction and alcoholism. States began to enact control and prescription laws and, in 1906, Congress passed the Pure Food and Drug Act. It was designed to control opiate addiction by requiring labels on the amount of drugs contained in products, including opium, morphine, and heroin. It also required accurate labeling of products containing alcohol, marijuana, and cocaine.
The Harrison Act (1914) imposed a system of taxes on opium and coca products with registration and record-keeping requirements in an effort to control their sale or distribution. However, it did not prohibit the legal supply of certain drugs, especially opiates.
Current drug laws are rooted in the 1970 Controlled Substances Act. Under this measure drugs are classified according to their medical use, their potential for abuse, and their likelihood of producing dependence. The Act contains provisions for adding drugs to the schedule, and rescheduling drugs. It also establishes maximum penalties for the criminal manufacture or distribution of scheduled drugs.
Increases in per capita alcohol consumption as well as increased use of illegal drugs during the 1960s raised public concern regarding alcohol and other drug problems. Prevention issues gained prominence on the national level with the creation of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in 1971 and the National Institute on Drug Abuse (NIDA) in 1974. In addition to mandates for research and the management of national programs for treatment, both Institutes included prevention components.
To further prevention initiatives at the Federal level, the Anti-Drug Abuse Act of 1986 created the U.S. Office for Substance Abuse Prevention (OSAP), which consolidated alcohol and other drug prevention activities under the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA). The ADAMHA block grant mandate called for States to set aside 21 percent of the alcohol and drug funds for prevention. In a 1992 reorganization, OSAP was changed to the Center for Substance Abuse Prevention (CSAP), part of the new SAMHSA, retaining its major program areas, while the research institutes of NIAAA and NIDA transferred to NIH.
The Office of National Drug Control Policy (ONDCP) was established by the Anti-Drug Abuse Act of 1988. Its primary objective was to develop a drug control policy that included roles for the public and private sector to "restore order and security to American neighborhoods, to dismantle drug trafficking organizations, to help people break the habit of drug use, and to prevent those who have never used illegal drugs from starting." In early 1992 underage alcohol use was included among the drugs to be addressed by ONDCP.
While Federal, State, and local governments play a substantial role in promoting prevention agendas, much of the activity takes place at grass roots community levels. In addition to funding from CSAP's "Community Partnerships" grant program, groups receive support from private sources, such as The Robert Wood Johnson "Fighting Back" program.
While alcohol and other drug problems continue to plague the Nation at intolerably high levels, progress is being made. National surveys document a decline in illicit drug use and a leveling off of alcohol consumption. And indicators of problem levels, such as alcohol-involved traffic crashes, show significant declines.
References
A Promising Future: Alcohol and Other Drug Problem Prevention Services Improvement. CSAP Prevention Monograph 10 (1992) BK191
National Household Survey on Drug Abuse: Main Findings 1990 (1991) BKD67
Mosher, J.F. and Yanagisako, K.L. "Public Health, Not Social Warfare: A Public
Health Approach to Illegal Drug Policy," Journal of Public Health Policy
12(3):278-322, 1991
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