Lesson 1: TIMELINE IN THE HISTORY OF DRUGS

While the use of opium for dulling pain was well known by physicians worldwide ,
the real problem began with the isolation of morphine from opium in 1804.
Introduced commercially in 1827, morphine quickly became the drug of choice,
particularly after the advent of the hypodermic syringe in 1853. With few effective
controls on its production and sale, it rapidly reached epidemic levels in the United
States thanks to the American Civil War. Around 45,000 soldiers came home from
this war unable to function without morphine, according to Time's The Civil War: An
Illustrated History. A similar effect was observed in the Franco-Prussian wars between
France and Germany.

In the late half of the 19th century, drug abuse was so widespread that Britain
went to war twice with China to keep opium trade routes open, and these naturally
became known as the Opium Wars. Cocaine was isolated in 1884 and quickly became
yet another widespread drug of abuse. Heroin and other opiates were synthesized
and marketed as none-addictive alternatives to morphine. Of course, heroin did turn
out to be very addictive, causing more people to abuse the drug.

Thanks to increased chemical and drug development in the 20th century, more

drugs with abuse potential became available. LSD, methamphetamine and synthetic
opiates are all relatively recent drugs. To counter the growing tide of addiction, drug
laws became stricter, and drug addiction started to carry a serious social stigma.

 5000 B.C. The Sumerians use opium, suggested by the fact that they have an
ideogram for it which has been translated as HUL, meaning “joy” or “rejoicing.”

 2500 B.C. Earliest historical evidence of the eating of poppy seeds among the
Lake Dwellers on Switzerland.

 300 B.C. Theophrastus (371-287 B.C.), Greek naturalist and philosopher,

records what has remained as the earliest undisputed reference to the use of
poppy juice.

 c. 1525 Paracelsus (1490-1541) introduces laudanum, or tincture of opium, into

the practice of medicine.

 1680 Thomas Syndenham (1625-80): “Among the remedies which it has pleased

the Almighty God to give to man to relieve his sufferings, none is so universal
and efficacious as opium.”

 1762. Thomas Dover, and English physician, introduces his prescription for a
diaphoretic powder,” which he recommends mainly for the treatment of gout.
Soon named “Dover’s powder,” this compound becomes the most widely
used opium preparation during the next 150 years.
 1792 The first prohibitory laws against opium in China are promulgated. The
punishment decreed for keepers of opium shops is strangulation.

 1800. Napoleon’s army, returning from Egypt, introduces cannibis (hashish,

marijuana) into France. Avante-garde artists and writers in Paris develop their
own cannabis ritual, leading, in 1844, to the establishment of *Le Club de
Haschischins.

 1805 Friedrich Wilhelm Adam Serturner, a German chemist, isolates and

describes morphine.

 1822 Thomas De Quincey’s *Confessions of an English Opium Eater* is

published. He notes that the opium habit, like any other habit, must be learned:
“Making allowance for constitutional differences, I should say that *in less than
120 days* no habit of opium-eating could be formed strong enough to call for any
extraordinary self-conquest in renouncing it, even suddenly renouncing it. On
Saturday you are an opium eater, on Sunday no longer such.”

 1839-42 The first Opium War. The British force upon China the trade in opium, a
trade the Chinese had declared illegal.

 1841 Dr. Jacques Joseph Moreau uses hashish in treatment of mental patients at

the Bicetre.

 1856 The Second Opium War. The British, with help from the French, extend
their powers to distribute opium in China.

 1864 Adolf von Baeyer, a twenty-nine-year-old assistant of Friedrich August

Kekule (the discoverer of the molecular structure of benzene) in Ghent,
synthesizes barbituric acid, the first barbiturate.

 1868 Dr. George Wood, a professor of the theory and practice of medicine at the
University of Pennsylvania, president of the American Philosophical Society, and
the author of a leading American test, *Treatise on Therapeutics*, describes the
pharmacological effects of opium.

 1883 Dr. Theodor Aschenbrandt, a German army physician, secures a supply of

pure cocaine from the pharmaceutical firm of Merck, issues it to Bavarian
soldiers during their maneuvers, and reports on the beneficial effects of the drug
in increasing the soldiers’ ability to endure fatigue.

 1884 Sigmund Freud treats his depression with cocaine, and reports feeling
“exhilaration and lasting euphoria, which is in no way differs from the normal
euphoria of the healthy person. . . You perceive an increase in self-control and
possess more vitality and capacity for work. . . . In other words, you are simply
 more normal, and it is soon hard to believe that you are under the influence of a
drug.”

 1885 The Report of the Royal Commission on Opium concludes that opium is

more like the Westerner’s liquor than a substance to be feared and abhorred.

 1889 The John Hopkins Hospital, in Baltimore, Maryland, is opened. One of its

world-famous founders, Dr. William Stewart Halsted, is a morphine addict. He
continues to use morphine in large doses throughout his phenomenally
successful surgical career lasting until his death in 1922.

 1894 The Report of the Indian Hemp Drug Comission, running to over three
thousand pages in seven volumes, is published. This inquiry, commissioned by
the British government, concluded: “There is no evidence of any weight regarding
the mental and moral injuries from the moderate use of these drugs.

 1898 Diacetylmorphine (heroin) is synthesized in Germany. It is widely lauded as

a “safe preparation free from addiction-forming properties.”

 1900 James R. L. Daly, writing in the *Boston Medical and Surgical Journal*,

declares: “It [heroin] possesses many advantages over morphine. . . . It is not
hypnotic; and there is no danger of acquiring the habit.

 1901 The Senate adopts a resolution, introduced by Henry Cabot Lodge, to

forbid the sale by American traders of opium and alcohol “to aboriginal tribes and
uncivilized races.”

 1903The composition of Coca-Cola is changed, caffeine replacing the cocaine it

contained until this time.

 1904 Charles Lyman, president of the International Reform Bureau, petitions the

President of the United States “to induce Great Britain to release China from the
enforced opium traffic. We need not recall in detail that China prohibited the sale
of opium except as a medicine, until the sale was forced upon that country by
Great Britian in the opium war of 1840.

 1906 The first Pure Food and Drug Act becomes law; until its enactment, it was
possible to buy, in stores or by mail order medicines containing morphine,
cocaine, or heroin, and without their being so labeled.

 1906 *Squibb’s Materia Medical* lists heroin as “a remedy of much value . . . is

also used as a mild anodyne and as a substitute for morphine in combatting the
morphine habit.
 1909 The United States prohibits the importation of smoking opium.

 1910 Dr. Hamilton Wright, considered by some the father of U.S. anti-narcotics

laws, reports that American contractors give cocaine to their Negro employees to
get more work out of them.

 1912 A writer in *Century* magazine proclaims: “The relation of tobacco,

especially in the form of cigarettes, and alcohol and opium is a very close
one. . . . Morphine is the legitimate consequence of alcohol, and alcohol is the
legitimate consequence of tobacco. Cigarettes, drink, opium, is the logical and
regular series.” And a physician warns: “[There is] no energy more destructive of
soul, mind, and body, or more subversive of good morals than the cigarette. The
fight against the cigarette is a fight for civilization.”

 1912 The first international Opium Convention meets at the Hague, and

recommends various measures for the international control of the trade in opium.
Subsequent Opium Conventions are held in 1913 and 1914.

 1914 Dr. Edward H Williams cites Dr. Christopher Kochs “Most of the attack upon
white women of the South are the direct result of the cocaine crazed Negro
brain.” Dr. Williams concluded that” Negro cocaine fiends are now a known
Southern menace.”

 1924 The manufacture of heroin is prohibited in the United States.

 1928 It is estimated that in Germany one out of every hundred physicians is a

morphine addict, consuming 0.1 grams of the alkaloid or more per day. [Eric
Hesse,

 1938 Dr. Albert Hoffman, a chemist at Sandoz Laboratories in Basle,

Switzerland, synthesizes LSD. Five years later he inadvertently ingests a small
amount of it, and observes and reports effects on himself.

 1941 Generalissimo Chiang Kai-shek orders the complete suppression of the

poppy; laws are enacted providing the death penalty for anyone guilty of
cultivating the poppy, manufacturing opium, or offering it for sale.

 1943 Colonel J.M. Phalen, editor of the *Military Surgeon*, declares in an

editorial entitled “The Marijuana Bugaboo”: “The smoking of the leaves, flowers,
and seeds of Cannibis sativa is no more harmful than the smoking of tobacco.

 1946 According to some estimates there are 40,000,000 opium smokers in

China.

 1949 Ludwig von Mises, leading modern free-market economist and social

philosopher: “Opium and morphine are certainly dangerous, habit-forming drugs.
 But once the principle is admitted that is the duty of government to protect the
individual against his own foolishness, no serious objections can be advanced
against further encroachments.

 1951 According to United Nations estimates, there are approximately 200 million

marijuana users in the world, the major places being India, Egypt, North Africa,
Mexico, and the United States.

 1951 Twenty thousand pound of opium, three hundred pounds of heroin, and

various opium-smoking devices are publicly burned in Canton China. Thirty-
seven opium addicts are executed in the southwest of China.

 1955 The Prasidium des Deutschen Arztetages declares: “Treatment of the drug

addict should be effected in the closed sector of a psychiatric institution.
Ambulatory treatment is useless and in conflict, moreover, with principles of
medical ethics.” The view is quoted approvingly, as representative of the opinion
of “most of the authors recommending commitment to an institution,” by the
World Health Organization in 1962

 1955 The Shah of Iran prohibits the cultivation and use of opium, used in the
country for thousands of years; the prohibition creates a flourishing illicit market
in opium. In 1969 the prohibition is lifted, opium growing is resumed under state
inspection, and more than 110,000 persons receive opium from physicians and
pharmacies as “registered addicts.” [Henry Kamm, they shoot opium smugglers
in Iran.

 1956 The Narcotics Control Act in enacted; it provides the death penalty, if

recommended by the jury, for the sale of heroin to a person under eighteen by
one over eighteen.

 1984 U.S. busts 10,000 pounds of marijuana on farms in Mexico. The seizures,

made on five farms in an isolated section of Chihuahua state, suggest a 70
percent increase in estimates that total U.S. consumption was 13,000 to 14,000
tons in 1982. Furthermore, the seizures add up to nearly eight times the 1300
tons that official had calculated Mexico produced in 1983. [the San Francisco
Chronicle, Saturday, November 24, 1984]
 Lesson 2. GENERAL CONCEPT OF MEDICINAL AND DANGEROUS DRUGS

A. IMPORTANT TERMS OF MEDICINE AND DANGEROUS DRUGS

Medicinal Drugs
 A substance which when taken into the human body cures illness and/or relieves
signs/symptoms of disease.

 A medication (also referred to as medicine, pharmaceutical drug, or

simply drug) is a drug used to diagnose, cure, treat, or prevent disease.[1][2][3] Drug
therapy (pharmacotherapy) is an important part of the medical field and relies on
the science of pharmacology for continual advancement and on pharmacy for
appropriate management.

 Any substance or combination of substances presented as having properties for

treating or preventing disease in human beings;

 Any substance or combination of substances which may be used in or

administered to human beings either with a view to restoring, correcting or
modifying physiological functions by exerting a pharmacological, immunological or
metabolic action, or to making a medical diagnosis.

Dangerous Drugs
 A substance affecting the central nervous system which when taken into the
human body brings about physical, emotional, or behavioral changes in a person
taking it.

Over The Counter Drugs (OTC)

 These drugs are non-prescription medicines, which may be purchased from any
pharmacy or drugstore without written authorization from a doctor.

Prescripted Drugs
 These drugs required written authorization from a doctor to allow a purchase.

DRUG ABUSE
 Any non-medical use of drugs that cause physical, psychological, legal,
economic, or social damage to the user or to people affected by the user’s
behavior.
  Abuse usually refers to illegal drugs but may also be applicable to drugs that are
available legally, such as prescribed medications and certain over the counter
medications.

Drug Habituation
 It is a condition resulting from the repeated consumption of a drug.

Drug Dependence?
 It is a state of psychic or physical dependence or both on a drug arising in a
person following administration of drug on a periodic or continuous basis.

Psychological Dependence
 It refers to a state in which individual has a compulsion to take a drug, but one in
which there may not be a physical dependence.

Physical Dependence
 It is a result when a drug has been used for a long period of time. It is only
identified when a characteristic of withdrawal or abstinence syndrome occurs
after its use is discontinued.

Self – Medication Syndrome

 The “self-medication” syndrome is found in users and would be users of drugs
whose sources of information are people or literature other than doctors,
pharmacists and health workers.
 These could be members of the family, relatives and/or neighbors, all of whom
may be previously used the drug for their specific disease or disorder. Self –
medication may work against the good of the user because it can lead to
intoxication and other adverse reactions.

B COMMON REASONS WHY PEOPLE TURN TO DRUG ABUSE

Drug use is a dynamic issue that begins in different ways for different individuals.
There are countless reasons why people begin to abuse drugs, whether they’re illicit
drugs or prescription medications. The range of reasons why people take drugs is as
broad as the types of people who use them. Drug addiction can affect anyone, of any
background, and of any socio-economic status.

Contrary to popular belief, drug use doesn’t solely fall under the category of
mental illness, homelessness, or even poor family upbringing. Educated individuals with
high-paying jobs, families, and seemingly perfect or sought-after lives can be vulnerable
to drug abuse, as well.

In general, there are three primary causes of drug use. Within these main
causes, there stems a myriad of reasons as to why people start to use drugs. Certain
people may face several different factors, which are each, on their own, a reason to use
drugs. But these reasons are all the result of some sort of emotional, psychological, or
physical categorization of the causes for drug use.

1. Emotional: Feeling they need drugs to fill a void in their lives (whether it’s stress,
trauma, relationship issues or more)
2. Physical: Feeling like they need the physical effects of a high or low to physically
feel better
3. Psychological: General feelings of inadequacy towards themselves or the
world, so they use drugs to boost their confidence and self-esteem and ability to
make sense of things

Triggering and Common Causes of Drug Abuse

While there are emotional, psychological, and physical reasons why people may
choose to abuse drugs in the first place, there are several triggers that fall within these
reasons.

Emotional stress can develop due to a number of reasons. It can be the result of
a loss such as a job, a death, a divorce, or finances. Even health issues and medical
conditions can cause severe emotional damage. Physically, many people use drugs to
boost their endurance, improve their focus, or enhance their appearance in some
capacity. Finally, drug use is also the result of psychological factors such as mental
illness, mental trauma, or even just general attitude and beliefs.

Regardless of the triggers for drug use, it’s important to learn how to cope in
healthy and productive ways. Unfortunately, many people turn to substances as an easy
or perceived helpful way to cope.

Here are some of the most common causes of drug abuse and why substance
use occurs in different people:

1. Grieving: The death of a loved one, such as a close friend or family member, or

even a mentor who positively influenced a person, is emotionally devastating for
people. Different people handle grief in different ways. Some people are able to
seek counseling or work through grief on their own in healthy ways. Other people
really struggle with emotional or physical loss, so they use drugs as a way of coping
with grief in the short-term. However, this short-term coping mechanism may
transition into a long-term dependence for some people.
2. End of a Relationship: The end of a relationship is one of the most emotionally
destructive events in a person’s life. When a relationship ends through a breakup or
divorce, it can negatively impact self-confidence. This goes on to affect other areas
of life including career, friendships, families, and even one’s ability to find a
purpose. If the person doesn’t have appropriate emotional support available to
them, they may use drugs as a way of grieving the loss of their relationship.

3. Mental Illness: A complex trigger of substance abuse is mental illness. There are

several varieties of mental illness that manifest themselves in different ways. Some
people who face mental health challenges are vulnerable to using drugs as a way
of rationalizing or making sense of their illness. Others who face depression or
anxiety disorders may use drugs to help lift them out of these low mental states.

4. Environmental Influences: The environment that a person has been exposed to

can influence and trigger drug use. Growing up in poverty or in households with
drug addiction, abuse, crime or other negative factors can create a high risk for
substance abuse in those exposed to these conditions. They may perceive drug
use as normal or acceptable. Or, they may psychologically believe this to be a
pattern they can fall into.

5. Relaxation: The average adult faces typical life obligations such as bills, family,
and work. Because of this, many people look for outlets to help relax and find a
balance between responsibilities and having fun. Unfortunately, some people may
use drugs as an outlet to help relax and unwind on evenings and weekends. If left
unaddressed, this pattern can develop into a dependence or addiction.

6. Self-Medication: When people face physical or emotional pain, they may use

drugs to self-medicate. This means they use drugs that aren’t prescribed to them by
a doctor. Instead, they use drugs such as painkillers to administer pain relief to
themselves. Certain painkillers have highly addictive properties, which often leads
to developing an addiction to them.

7. Financial Stress: The burden of financial stress can be intolerable for many

people. Money pressures can cause people to feel trapped, desperate, and out of
control. These feelings lead to emotional and psychological conditions that trigger
drug use. Drugs can often help people to forget about their financial responsibilities
or avoid dealing with them altogether.

8. Career Pressures: It is common in today’s society to have your identity tied to

your career. For many people, their career places a lot of pressure on them to
perform, which is often reflected in their idea of their own self-worth. This type of
pressure can cause emotional and psychological stress. To help perform better or
alleviate work stress, it’s possible to turn to drugs to help cope, forget failures, or
boost performance.
9. School Pressures: Similar to career pressures, school pressure is another one
of the common reasons people abuse drugs. Many people face large workloads
with classes and homework, financial stress from student loans, balancing family
and work while going to school and the pressure to perform academically. These
stressful conditions make it easy for some people to be more susceptible to drug
use as a way of coping.

Additionally, professional educational programs such as medical or law school have

even greater standards of academic achievement, coupled with higher financial
costs. It is not uncommon for students in graduate programs to use stimulants and
other drugs as a means of boosting their cognitive performance.

10. Family Demands: Typical family demands include balancing work with raising
kids, as well as financial obligations towards family members. But, when those
demands become overwhelming, it can be difficult to manage. This may be
especially true for young mothers who can face feelings of isolation, loneliness, and
anxiety. Drug use, especially through prescription pills, can become an easy way
for parents to help cope with family demands.

11. Peer and Social Pressure: One of the most well-known ways for people —
especially teens and young adults — to start using drugs is through external
pressures from other people. Commonly known as peer pressure, people may
begin using drugs because of the influence of their peers. For them, it becomes
something they all share in common, and so they feel pressured to continue to use
drugs even if they understand the dire consequences.

Additionally, younger people may experience social pressure to use drugs from
television, social media, and other celebrity influences. It’s possible that people see
drug use being glorified in the media, and so they feel pressured to participate as
well.

12. Trauma and Abuse: Past or current traumas such as abuse, accidents,

emergencies and other events can negatively impact people psychologically.
Traumatic events can imprint in memory, making it difficult to move past them. Even
traumas that occurred during childhood can resurface in adult years, bringing up
new thoughts and feelings. Instead of seeking professional help to address trauma
in a healthy way, people may use drugs as a means to help them forget these
memories.

Present traumas, such as living in an abusive environment, can also trigger

substance use as a means of forgetting the pain and suffering. Often, abuse is
faced on a regular or even daily basis, and so drug use can quickly turn into an
addiction in this case.
13. Enjoyment of Getting High: Many people try drugs once as an experiment and
end up finding euphoric sensations from these substances. The chemical reactions
between the drug and the brain cause a release of dopamine, which is pleasurable
to many people. When this happens, people will continue to chase that same
euphoria and release because they like how it makes them feel. It may make them
feel more relaxed, self-confident, in control, or any number of other outcomes.

14. Boredom: Teens and young adults often face feelings of boredom or monotony,
as many of them don’t yet have adult responsibilities such as careers, bills, higher
education, families, and more. Drug use may seem like a convenient or entertaining
way to pass the time. While this may not always lead to a full addiction, it can often
become a go-to way of alleviating boredom instead of choosing other positive
activities.

15. Wanting to Fit In: Because human beings are social creatures, it’s important for
us to feel like we belong or fit in. This can affect people of any age but is most
influential during teenage and early adult years. If others around them are using
drugs, they may fear feeling left out, or that they won’t fit in. As a result, they place
pressure on themselves to use drugs as well.

16. Curiosity and Experimentation: For those who are around drugs, but haven’t
yet used them, they may hear positive feedback about certain drugs. They may
become intrigued or interested in their friends’ experiences, and so they try certain
drugs as well. This isn’t necessarily the result of the pressure of fear of not fitting in,
but rather genuine curiosity and a desire to try something new.

17. Rebellion: Certain personalities are more prone to rebellion or going against the
grain. This occurs in teens and even in adults. Because drug use is illicit or not
socially acceptable, it actually drives certain people to want to use them in order to
rebel, stand out or be different. For some people, this may simply be a phase of
rebellion and experimentation, or it may develop into an addiction.

18. Being in Control: When stressful periods of time occur with relationships, job
loss, health scares, or other tragedies, many people lose a sense of being in control
of their own lives. Drug use provides a false sense of being in control of health,
emotions or behaviors that many people find appealing. They may feel as though
when everything else around them is falling apart, they can rely on their substance
use to give them stability.

19. Enhance Performance: Certain drugs may help to temporarily enhance cognitive

function, memory, and focus. They may also help to alleviate fatigue and lethargy.
These are usually stimulants and other prescription drugs. For students or busy
professionals, these types of drugs can seem like a viable solution.

Other drugs, such as anabolic steroids, human growth hormones or stimulants, are
used to improve physical performance in athletes or those who are extremely
 physically active. People often choose to use these types of drugs in order to
compete or look a certain way.

20. Prescription Medications: Prescription drug abuse is becoming an increasingly

concerning issue that affects many people. Doctors may prescribe opioid painkillers
to patients who are recovering from surgery and facing injuries or other medical
situations. Left unmonitored, some people are susceptible to abusing these
prescription medications because of the high they provide. They may end up getting
hooked unintentionally and begin finding ways to keep obtaining their prescription
pills.

21. Isolation: Despite being more connected than ever, many people suffer from
feelings of isolation. If they feel as though they can’t relate to others or that they
aren’t understood by their peers, they may feel out of place. These feelings can
lead to low self-esteem or even depression over time. This only further exacerbates
a state of isolation. In order to numb this loneliness or emptiness, they use drugs to
feel alive and forget about feeling isolated. Using drugs may also give them a sense
of satisfaction and purpose.

22. Misinformation or Ignorance: Drug use and dependence have a number of

consequences. Physical, emotional, social, financial, and psychological
repercussions stop many people from continuing to use drugs or from using drugs
in the first place. Unfortunately, despite the amount of awareness surround the risks
of drug use, there is still a lot of misinformation about it. This misinformation may
especially impact young or undereducated people who don’t have the life
experience or ability to understand the dangers of drug use. Additionally, many
people may see others use drugs and not face any health or other concerns, and so
they think that it won’t hurt them either.

23. Instant Gratification: Many individuals have personality types that desire instant
gratification. This means they look for ways to be satisfied immediately and in the
short-term, as opposed to being satisfied by delayed gratification. This may be
especially true in young people who are conditioned today to expect that things
happen on-demand. Drug use delivers instant gratification in terms of physical,
psychological, and emotional sensations. It’s also often a social act, which further
enhances feelings of gratification.

24. Availability of Drugs: With the increased convenience of the internet and modern
communications, it’s relatively easy for people to obtain drugs today. When it
comes to prescription medications specifically, these drugs are now being
distributed as street drugs. They can also easily be obtained from friends, family
members, and colleagues who have prescriptions of their own. Prescription drugs
are also fairly easy to obtain with a prescription from a doctor, provided there are no
clear signs of a risk for abuse and dependence.
NOTE: Please prepare for a Quiz next meeting. Thank you and Happy weekend