ANTH106 Notes

Anthropology Lecture 1introduction Common Misconceptions with Drugs - The effect of a drug is caused solely by its pharmacological properties and effects. - Some drugs are instantly addictive - The gateway/ stepping stone theory - the use of 1 drug leads to the use of other more dangerous drugs What are drugs ? Krivanek's definition : Drugs are substances that are introduced into the body knowingly but not as food. Therefore illicit drugs, legal recreational drugs and legal but regulated pharmaceutical drugs that aren't recreational at all. - Whether if a drug is considered bad and is prohibited depends on the culture of the society in a particular period. What is culture ? The definition of culture = Through Roger keesing and Andrew Strathern's definition it is a system of shared ideas, rules and meanings that underlie and are expressed in the ways that human live. - This includes : law, beliefs, political economy, media and popular culture - this perceives ideas about what is normal and abnormal to society. " Culture is always changing and contested, not unified" Enthography as a method for studying drug use It is a process of observing, recoding and describing other peoples way of life through intimate participation the community being studied". - Participation observation, involving yourself in the life of the community , taking up the life of the other person, observing their actions, asking questions and learning what questions to ask. Zinberg's theory of drug use Effect of drug use is due to three variables and their interaction: - DRUG : The pharmacological action of the substance itself - SET : The attitude of the person at time of use, including his or her personality structure, and what they expectation the drug to do. ( Individual attitudes are significantly influenced by social values and social expectations. - SETTING : The influence of the physical and social setting in which it occurs. There are 2 dimensions regarding this : - social sanctions - the informal and informal values and conducts used around drug use - example ( defines when it is appropriate to do something, a social influence ) - social rituals Both shape how drugs are used. The myth that drugs are defined and determined by their pharmacological properties - NOTE NOT IMPORTANT. - The choice between legal and illegal drugs is done by socially and historically determined and not based on its dangers. - Drug and its effect can be understood by taking into account the particular social, cultural, political and economic contexts as well their pharmacological properties. A portrait of drug addiction- and NOT addiction : Meth - Drug is never 100 percent addictive - drugs are not always bad Post- Propaganda approach to studying drugs - how drugs work in bodies - (neuropharmacology) - how addictions work - (psychology) - how experiences with drugs are mediated by 1 . culture symbolism ( anthropology) 2. the social organisation ( subculture) of users ( anthro and sociology) 3. drug law and international markets ( political science and economics) - the history of drug use ( history) - drugs in popular culture and media ( media/ culture studies) - how drugs are pleasurable for many ( philosophy and literature) In short : AN INTERDISCIPLINARY APPROACH. Drug branding and symbolism - "The diversity of the branding demonstrates the vigour of the business and dynamism of the market" - many different names for it , it is recognised widely. Comparing between laws and use prevalence in the European union, what conclusion we can make between illicit drug use and countries drug laws is that - the more restrictive the law, the more drugs are used. Moral of the story -Illegal drug tree and the pharmaceutical market are massive. - Enormous economics implications where there are large profits made " Wars against drugs" - profits and criminality associated with drug trafficking - Temper the horror stories we hear of drug use : for every addict with a ruined life there are more people who do not become part of these stories . Basic categories of illicit drugs Narcotics - Qualities : it relieves pain, induces euphoria , create physical dependency Hypnotics - Qualities: habit- forming, causing sleep and stupor. Tranquilisers are similar but recede anxiety without causing sleep Stimulants - Qualities : cause excitement, increase mental and physical energy, create dependency, may cause psychotic disturbance Inebriants Hallucinogens- Qualities: causes complex changes in visual, auditory and other perfections and may cause acute psychotic disturbance. lecture 2 What has cannabis research mostly focused on? psychedelics/ Hallucinogens - its medial uses or the harmful health consequences of heavy and uncontrolled used. Why no scientific research on spiritual/ mystical/ pleasurable effects of drugs ? -Dichotomy of mind and body in western trough , emphasis on the primary reason of it - "Aesthetic horror" of drug use in mainstream society Pervasive puritan ethic, fear of hedonism and of Dionysian pleasure - Manderson Natural hallucinogenic drugs in pre-industrial Europe - Belladonna ( deadly nightshade) - Datura ( Jimson Weed, thorn apple) - Mandragora ( Mandrake) Used in Europe mainly for ritualistic purposes e.g witches ' sabbath. New world and hallucinogens The New world has the highest concentration of plant hallucinogens of any region in the world Mckenna " The new world subtropical and tropical zones are phenomenally rich in hallucinogenic plants - for religious purposes The cults and religious orders that use hallucinogens for ritual ,religious and healing purposes also cluster in the tropical new world. Some new world hallucinogens Ayahuasca - Harmaline - western Amazon Datura - Scopolamine - america ( as examples ) Shamanism Shamans who play a dominant role in their societies Definition - a religious and ritual specialist who gains control/ power over supernatural force. They have a ability to enter visionary trance - states ( altered states of consciousness, including visions) Shamanic trance can be induced by - tobacoo - hallucinogenic drugs - fasting -mediation, hypnosis - music, dancing - controlled breathing functions of shamanic trances community functions - shamans as mediator between supernatural and the community. Shaman communicates with spirits uses spiritual power to gain control over supernatural forces for the benefit of the community. Healing: the shaman uses visionary trances to dig nose illness. Shaman can 'see' or visualise the cause of an illness and fight the battle against evil and harmful supernatural forces causing illness. Effect of changing the mental state of the patient- a form of faith healing or psychotherapy Personal spiritual functions - hallucinogens may contribute to the development of religious awareness. Common religious theme in shamanic trances. Andrew Weil on hallucinogens and social controls Weil applies Zinberg's theory to use of hallucinogens by Amazonian indians and apply that the indians have no problems with this : 1. The drugs are used in their natural forms, not refined drugs 2. They consider the human desire to periodically experience altered states of conscicious to be normal, not deviant. 3. The taking of hallucinogens is usually under the supervision of an experienced user, such as a shaman 4. The use of hallucinogens is highly ritualised. Avoids negative effects by ' establishing a framework of order around their work. 5. Hallucinogens are not taken for negative reasons but for positive reasons. - Weil argues that indian do not appear to have any problems with hallucinogens A critique of weil : weil claims that drug use is not linked to antisocial behaviour and is therefore a romantic view of the absence of social conflict in amazonian tribal societies. Shamans are seen as key figures and use their magical power in conflicts - Timothy krab ; War of witches. Hallucinogens in the west Lyserigic Acid Diethylamide ( LSD) first synthesised from ergot by Dr. Albert Hofmann From Hoffman to Hubbard to Huxley - He ingested some LSD and experienced vivid hallucinations and started it on himself and volunteers - It was claimed that it could be used to investigate schizophrenia - Dr. Ronald Sandison gave some LSD to Alfred M hubbard - former intelligence officer and millionaire - Hubbard gave Aldous Huxley his first LSD experience . Hubbard ordered 43 Cases of LSD from sandoz and became a LSD missionary ( 1955) CIA AND LSD 1942 - General Bill Donovan, launched a speech inducing drug - Initial OSS experiments showed it was too inconsistent for use in interrogation : OSS volunteers had to be weaned off it. Marijuana extract referred to as Truth Drug - 1951 - CIA launched a new secret program in search of a miracle drug operation called antichoke. Psychoactive properties for looked for. LSD was chosen as promising 1950s research fianced by CIA found that LSD produced transitory psychoses and symptoms that were similar to schizophrenia called a "psychotomimetic drug" - CIA also financed 15 experiments in 15 prisons and mental institutions using inmates as guinea pigs. 1953 : Artichoke program by new CIA secret drug and mind control program called MK-ULTRA. Went through normal experiments and LSD would cause people to act strangely in public; in normal lives e.g in CIA annual party ( LSD in the punch) . George hunter white would slip LSD to observe their behaviour. 1955 : white initiated operation midnight climax. Prostitutes hired to pick up men and bring them back to CIA- financed brothel. Fed drinks laced with LSD while white watched behind two- way mirror, sipping martinis - continued until 1963. Army testing of LSD on soldiers - LSD found to be more useful for interrogation as an anxiety producing drug. LSD used as an interrogation aid from 1950s to 1960s. - Late 1950s US army considered LSD in aerosol form as a madness gas which could disorient enemy populations. Moral entrepreneurs : Huxley Aldous Huxley experimented with mescaline under supervision of psychiatrist Osmond. Describing experience in The doors of perception - perception of flowers, books and furniture described in terms of " a sacramental vision of reality" and "inner light" Huxley's theory and the function of the brain was eliminative - it acts as a screening mechanism " to protect us from being overwhelmed and confused by the mass of largely useless and irrelevant knowledge". Hallucinogens by-passed this screening process, intensifying visual impressions, heightened the perception of colour, dissolving the ego. Huxley and osmond on terminology Huxley and Osmond argued that terms "hallucinogen" and "psychotomimetic" were inappropriate because it implied negative states. Osmond coined the term "psychedelic" as " mind - manifesting" implying that the drug elicits whatever is latent in the unconscious. Moral Entrepreneurs : Leary and Ginsberg Dr Timothy Leary 1954- 1959 - director of clinical research 1959- appointed to harvard where he experimented with psilocybun and conduced experiment with theology students who reported to experience religious experiences when taken shrooms. 1960 - leary introduced sacred mushrooms to poet Allen Ginsberg. - Huxley made this research quietly , in contrast to that leary and Ginsberg wanted to take it to masses. Utopian fantasy of biochemical world revolution. Arthur Koestler on sacred mushrooms: "i solved the secret of the universe last night but this morning i forgot what it was" . - Leary and Alpert were accused of conducting research outside the medical model and were dismissed from harvard in 1963. But notoriety helped popularise leary and psychedelics. Leary coined phrase " Tune on, tune in and drop out" . After leaving Harvard, leary and Alpert retreated to a mansion called Millbrook. Psychedelic commune with 30 other people, it had a fairy tale atmosphere. Millbrooke atmosphere was important to leary as it had proper "set" and "setting" to achieve euphoric, religious experience with the aid of Pyschedelics, where as CIA labelled LSD as a psychotomotic drug. LSD is neither inherently transcendental nor anxiety - producing. It simply amplifies existing psychic and social proclivities within the individual . LSD banned - Black Market boom In 1963 - LSD classified by FDA as "experimental drug" - 1966 - led became illegal in the USA - Last LSD research project ended in 1975. - Making it illegal only made it popular and the black market developed an intensive demand for LSD. Moral Entrepreneurs : Kesey - First experience LSD as MK-ULTRA subject - assessed psychedelics in mental asylum where is worked. - Band of LSD heads called the "Merry pranksters" toured US in a psychedelically decorated bus. Politicisation of LSD - In 1964: Kesey's scene began to attract people from Berkley Free speech Movement. The start of politicisation of US campuses, and politicisation of LSD. LSD and marijuana became a form of protest against authority and therefore increased tension between the activist and hippies. Leary - " The choice is between being rebellious and being religious". Psychedelics and Counter- culture aesthetics - Haight - ashbury in San Francisco as centre of psychedelic lifestyle- LSD was sold on a mass scale. - Beatles expressed the psychedelic ideals and aesthetics. Timothy leary claimed the beatles " prototypes of revolutionary agents sent by GOD with a mysterious power to create a new species". 1969 - Woodstock music festival as apogee of the psychedelic revolution and counterculture. The decline of Psychedelics - New drugs hit the market and the hippies were coming in with a different attitude more focused on sex and the rebellion but didn't share religious ideas of peace, love and transcendence of bourgeois ideals. - LSD on the black market: tainted supplies, controlled by mafia - Manson murders attributed to LSD. - the events had undermined the psychedelic subculture. The symbols had remained of their lifestyle as commercial exploitation of the symbols. Key points from the lecture. • The relevance of Zinberg's theory of set and setting determining experience of drugs. - Himmelstein's theory of moral entrepreneuers in shaping the way a drug is seen in society. - Different approaches to describing drugs in society - psychedelic drugs in west compared to anthropological accounts of shamanic use of hallucinogens. - The scientific approach we use to studying drugs determines what we look for and, to some extent, what we find. Research that looks only for public health harm or biomedical benefits associated with drugs will never capture religious , spiritual, transcendental striving that many people ae looking for they use drugs and it was this scientific bias that researches like Hukley, leary and Alpert were trying to rebel against. Lecture 3 - Cannabis - Botanical names - cannabis saliva and Cannabis Indica - Main forms - Marijuana, sincemila , hashish, hashish oil ( high potency) and hemp. History of Cannabis - originated in central Asia - Mentioned in ancient medical and religious chinese and indian texts. - In the west cannbis was initially used for practical purposes - as hemp fibre ( for sails and ropes) - W.B.O Shaughnessy is credited with introduction of medical use of cannabis. Between 1842 - 1900 over 100 reports published on therapeutic qualities of cannabis. - Recreational use in the west: a. French Hashish club ( Baudelaire and Gautier, 1843) b. Hashish bars in Europe and USA ( 2nd half century). Symbolic Dimensions of Cannabis Legislation Himmelstein ( From killer weed to Drop- Out Drug): -" Moral entrepreneurs" : Moral crusaders who play a key role in drug legislation by influencing public images of a drug (e.g Harry Anslinger) - Social locus : the social position (e.g. class, ethnic, generational) position of the drug users - "Symbolic politics" - drugs and drug prohibition as "symbolic counters in wider social conflicts". Drugs as political scapegoats. Cannabis (ganja) in jamaica and class conflict : - Introduced by indian labourers in 1830s and quickly spread to black population. - Ganja : a scapegoat for elite and middle - class anxieties about deviant behaviour ( crime, violence, laziness) of poor working class - In 1937 Anslinger pressured British colonial authorities in jamaica to introduce mandatory minimum sentences for cannabis possession. Rastafarianism - Founded by Marcus Garvey: political activist and black rights in Jamaica, England and USA. - Belief in black messiah: Emperor Haile Selassie ( Ras Tafari Makonnen) strict rules of conduct ( no alcohol, gambling, cutting of hair). - Cannabis ( kaya) as a sacred herb. - Symbolic politics : a colonial authorities considered: Rastafarianism dissident movement and a threat to social stability. - The suppression of cannabis was synonymous with keeping down Rastafarians. Cannabis and inter-generational conflict ( Himmelstein) - In USA the public image of cannabis/ marijuana had changed from a drug violence to a "drop out" drug linked to "amotivational syndrome" - " Social locus" - of use changed to middle class youth. " Symbolic politics" - cannabis a symbol of conflict between generations. - The social characteristics of the counterculture, as perceived by the dominant society, were projected on to marijuana and then claimed to be the psychological effect inherent in the drug". Cannabis Legislation Prohibition: Moves made in the 20th century to prohibit cannabis as a dangerous narcotic: 1 . Geneva convention Dangerous Drugs act 1925. 2. Individual country legislation : Great britain, 1928; Australia 1928; USA 1937. 3. Single convention on narcotic Drugs, 1961. Legal Status of Cannabis in the U.S. Since 1970 twelve states in the US have decriminalised cannabis. 18+ Washington, D.C. have legalised " medial marijuana" use. - November 2012 : 2 states ( colorado, washington) legalised cannabis for recreational use… but this is at odds with federal laws and will be bought out in the court. Cannabis Legalisation : Australia - Since 1987 all Australian states have decriminalised cannabis ( for possession of small amounts) through systems of fines or cautioning. Cannabis Legalisation : Netherlands - "De facto legalisation" since 1976. Non- enforcement policy for sale in coffee shops. ( Dutch police were more likely to enforce anti- smoking bans than cannabis bans)? Gateway theory Theory that cannabis use in adolescence leads to the use of more dangerous "hard" drugs ( e.g heroin) David Fergusson and John Horwood: Classic articulation of the Gateway theory in 2000. " Does cannabis use encourage other forms of illicit drug use" Processes independent of socio- economic background: - Cannabis provides a blueprint for experimentation with other illicit drugs, reducing inhibition for further illicit drug use. - Existence of factors and processes that encourage both cannabis and other illicit drug use "common factor" explanation. - Availability - common or correlated genetic factors that may increase the risk of various forms of illicit drug use ( " neurochemical" explanation - genetics) Gateway theory often used as argument against decriminalisation or legalisation of cannabis. BUT critiques of Gateway Theory point out: - Almost all hard drug users first used cannabis however temporal precedence cannot be equated with casualty. - Research shows only small proportion of those who use cannabis go on to use heroin. - There is a " reasonably strong association between regular and early cannabis use and other illicit drug use" ( Hall and Lynsky). Major Adverse health and psychological effect of Cannabis use. - Anxiety, dysphoria, panic and paranoia. - Psychomotor impairment and risk of injury. - Increased risk of low weight babies during pregnancy - Respiratory diseases - Cancer link - Cannabis dependence syndrome - Cognitive impairment - Psychosis ( including Schizophrenia). Cannabis and Psychosis -Cannabis use exacerbates the symptoms of schizophrenia - Cannabis use precipitates schizophrenia in people who already have a history of personal or family history of schizophrenia. - Young cannabis users who begin use at an early age and subsequently use cannabis regular expose themselves to an increased risk of experiencing psychotic symptoms. Can you overdose on Cannabis? short answer - it is nearly impossible as the acute toxicity of cannabinoids is very low. -BUT that does not mean that cannabis users do not end up in emergency rooms due to - psychomotor impairment while driving - Heart attack ( cannabis raises heart rate 25% - 50% and raises blood pressure - not a problem for young healthy users but potential danger to at risk populations). Philippe Bourgois on U.S political economy of cannabis - The mystery of why marijuana is so severely repressed by law enforcement should be especially humbling for public health researches in the US and for the field of science studies more broadly. - " Objective scientific evidence" - does NOT shape drug policy , media coverage and popular opinions. - Medical, epidemiological and scientific evidence that cannabis consumption is less risky than alcohol use. - Yet in the 2000s, U.S spent over $4 billion a year arresting people on marijuana charges - Despite ( or perhaps because of ) law enforcements efforts, hip-hop culture defiantly celebrates marijuana and this probably represents a public health boon. - Bourgois says that hip hop cultures celebration of cannabis is a public health boon because there is a good possibility that increasing marjiuana use has decreased use of more dangerous drugs, particularly crack cocaine and heroin. - ' The greatest harm caused by marijuana comes form the collateral damage of its illegality"' Criminalization leads to an increase in profitability of marijuana - criminalisation also leads to an increase in the violence surrounding trafficking. - prison terms for sellers punish the poorest members of the society, who then have a hard time getting jobs after prison. Legalisation of Cannabis? rubbing over skin or enema.make you pass out. . anxious.Blood vessel constriction .Nicotine stimulates production of neurotransmitters : .Measure is by seeing how many people give up a drug and are still clean after a year. now more dominant .local species of Nicotiana .used for shamanistic purposes to achieve altered state of consciousness .Also somewhat relieves the symptoms of Parkinsons.Rustica tobacco produced largely for insectide and "Turkish cigarettes" . making the heart work harder and COHb is very stable and takes a long time to break it down. -Drinking the juice cases body trembles. How Native americans used it . Pharmacology . .alkali ash used to enhance action of the drug. heroin addicts are more often clean The problem with this way of measuring is that ? .high doses : Severe stimulant effect.Dopamine. but because of rituals.Extreme high doses .containing plant called Duboisia hopwoodii . peru and Ecuador .cigarettes are less stigmatised than heroin . vomiting.effects ranging from euphoria to stupor and catalepsy.calm relaxation .main tobacco ingredient . tobacco chewing. .Tobacco inhibits the production of enzyme MAOB which breaks down dopamine . serotonin and noradrenaline.Reduces weight loss .Originated from wild species in Boliva. environmental conditions. A single drop is fatal.Promotes alertness . . . How is it prepared ? . Measuring addictiveness of nicotine .Columbus found the natives used it for healing by blowing it over body parts Other techniques .Drug made from it called "pituri" . Another way of measuring is : The addiction severity index. .European culture : intent on trade and colonising new worlds. Result : huge increase to mortality from heart attacks amongst smokers.increases concentration of triglycerides and cholesterol in the blood .although MacCoun and Reuters predict that legislation would increase prevalence and possibly intensity of use and encourage aggressive commercial promotion. native americans dried tobacco leaves over the fire. leading to hyperactivity. only 7 percent are still clean after a year . peanuts.blowing smoke.It is a lot easier to buy tobacco than heroin . Effects on hearts . vomiting and then sleep or semi unconsciousness. .it is more addictive than heroin . . Lecture 4 . Europeans took tobaccos and made a commercial product out of it.Used in different contexts in Europe and Native America .Native Americans: Domesticated tobacco and made a sacred drug out of it. .Have to smoke about 400 cigarettes all together to get a fatal dose ( Nick Modjeska's calculation).Reduces anxiety and stress . more widely used.Traditionally the use was mainly to put the smoker or drinker into a deep sleep.thus dopamine levels rises. Withdrawal symptoms include : uptight . vanilla and tobacco have pituri common.the removal of criminal penalties for personal possession does not increase use of marijuana or more dangerous drugs . All plants in including corn. South American Varieties of tobacco that became dominant: . trembling and convusions.Sacred Tabacco Tabacco . -Indian shamans also achieved this by smoking large cigars . Tobacco and Shamanism .Tabacum is milder than Rustica . Reduces oxygen carrying capacity of blood.Pure nicotine : a clear oily liquid. .some used a nicotine. Nicotine . Alzheimers and Tourettes.high nicotine content.Cured and fermented and aged before smoking . and mood and personality of user. Possible benefits of smoking . Pituri Aboriginal people used nicotine prior to European discovery. over 50 wild species.Indians of south america domesticated the tobacco and grew it.Key varieties of tobacco came from south america. fidgety.Relieves discomfort and pain . Range of reactions for smokers: .stimulation and euphoria .Aids in sociability : not because of the drug . Two main types of tobacco : Nicotiana tabacum and Nicotiana rustica .Carbon monoxide combines with haemoglobin to form Carboxyhaemoglobin.Stimulates components of the blood clotting process . irritable. some tribes : men take turns blowing dust up each others nose and drinking the juice.Reaction depends on dose. Tobacco is not a true hallucinogen.Direct observation of subjects in natural settings .he estimates 15.After about 1700. .20. . but long indigenous "cigars" used only by shamans .Do not start from the assumption that the behaviour of drug users is determined by the chemical properties of the drug.smoked throughout the Newworld for ritual purposes .dark part of the spirit world sends out a blood siphon at night .Everyone smokes. . .Etymology of Shaman: from Russian.000 people speaking the Warao language in Venezula.'Sanctions' a. you hallucinate while unconscious. ' formal laws and policies regulating drug use' b.Priests or shamans in the Warao visit the spirit world regularly. Lecture 5 : Ethnographies of Drug use. . Shamanism and tobacco among the Warao . Zinberg's critique of " Pharmacomythology" According to zinberg.Parallels between shamanism in the Americas and Siberia are so numerous and extensive that Wilbert believes it must have been a single intellectual tradition that spread and travelled over the continent and across the Bering Straits. . .to live in the area . which cause most illness .Shamans of siberia didn't have tobacco . .Wilbert proposes that for a tradition to spread so far it would have to be very old and to have spread for a very long time.tobacco to native americans: equivalent of grapes to christianity as without it there could be no communion with the divine. the effect of a drug on an individual depends on the interaction of pharmacological psychological and social variables. -" Light" shamans maintain a bridge of tobacco. How do ethnographies of drug use differ from other social science approaches ? . tobacco was mostly smoked for medical and magical purposes.this is a term coined by Carlos Castaneda to speak of things that other people see and which are real to them. Russians got it from indigenous people Siberia. The Warao -Warao Indians of the Orinoco Delta in eastern Venezula . . . smoke with the bright part of the spirit realm.Not a hallucinogen buts its role in shamanism in the Americans is very similar to that of hallucinogenic/ psychotrophic plantts.in the natural setting of the drug user. Downbeat conclusion : Between the missions and the traders.buying drugs from a known dealer . with tobacco. recording and describing another peoples way of life ( culture) through " participant observation" of the community studied. the chances of the Warao keeping their traditions and continuing to smoke tobacco in this sacred way are pretty minimal. and proper seance medicine to see the bad spirits. . 'informal and often unspoken values or rules of conduct shared by a group' Social Sanctions among illicit drug users in Perth ."Set" 'the attitude of the person at the time of use including his personality structure' .Tribes who knew of real hallucinogens sometimes mixed it with tobacco to get a combined effect. and smoking for trance and spirit communication purposes became less and less commons. Enthnographic account of a Shaman's use of tobacco from Wilbert This is not a pleasurable drug. in post columbian American. but one that is necessary for obtaining knowledge about the spirit world.15. but which may not be seen and perceived by others who are not trained to se and perceive them. puffed on the peace pipe and passed it around.columbian).Residence in the community .Have three different kinds of Shaman who use tobacco for both curing an causing sickness ..ordinary reality" . regarded as a sacred drug and act.got their high through controlled breathing. all the way down to Patagonia and Tierra del Fuego.Plains indians did NOT smoke themselves into unconsciousness.Establishments of relationships of trust with informants. Suriname.Very isolated people at the time that Wilbert was there in the 1950s. .But shamanistic idea of getting into the spirit world and fixing things up DID spread from siberia down into the Americas. . who had a a well established magical tradition of shamans who entered the spirit world to find out why people were sick.000 years for tobacco being domesticated and spread throughout the americas. Wilbert's Conclusions : . What is Shaman? Wilbert uses the expression " Shamanistic ecstasy" .Before columbus ( pre.seek advice from a experienced drug user when in doubt .a people called the Tungas. Difference is that with more psychotrophic drugs you are hallucinating while awake.don't use drugs during the week . ." Setting" : 'the influence of the physical and social setting within which the use occurs' Zinberg on " controlled drug use" "Setting" and social controls .Tobacco essential in inducing ecstatic trance experiences. . They use no other drug substances than tobacco. smoking for pleasure because more and more the norm for Native Americans. .Participation in everyday activities and frequent interaction with informants within the community over a long period. Shamans used " tobacco narcosis" to reach the spirit world .What the shamans sees is a " non." Drug" : the pharmacological action of the substance itself. unstructured interviews with a small number of informants.Ability to communicate in the local language .Focus on informal.tobacco smoke : proper food to give to good spirits. bridge must be constantly renewed by shamans smoking . Virginia tobacco was smoked increasingly for pleasure. What is meant by " participant observation" . What is Enthography Definition: The process of observing."Rituals" " 'Stylized . Guygana.don't use drugs with strangers .Tobacco smoke used both healing and sorcery ( both good and bad) in many Native American Cultures . prescribed behaviour surrounding the use of a drug'.Novices become shamans by becoming culturally conditioned for a specific ecstatic experience. . Manderson (1995) on the double meaning of drugs and drug objects (e. . which enable the researcher to: . The drug attaches itself to a person. How do ethnographies of drug use differ from other social science approaches ? .definitions by different authors. .class anxieties about deviant youth behaviour. " David moore" social controls.19th cent. clinical samples are restricted to drug users in treatment or picked up by the legal system b. .Drugs are invested with a powerful agency.Drug Symbolism Manderson's Analysis of drug symbols .Meth : a scapegoat for elite and middle. from a 'diligent drug' to a crazy 'crazy drug'.Medicine . .Don't start from the assumption that drug use in itself is an expression of psychopathology or mental illness . (Sexed work. Drugs and fetishism. . . motivations and behaviours of drug users. Drugs : the irrational and the ecstatic . or indeed the chinese opium pusher. Drugs and pollution . Primacy of reason and rationality. In the 'symbolic politics' of marijuana the drug was a scapegoat for: a.Grund et al : symbolic dimension of front loading ritual ( Rotterdam heroin and cocaine users). Drugs and the loss of human rationality and autonomy . .e to consider ' the sensory reaction ( emotional reaction) provoked by drug images and the symbolic meaning of that imagery'.Catholic Inquisition : proving the existence of the Devil to contest growing influence of empiricism and scientific rationality .Prohibition and absolutism : fear of loss of human agency and autonomy. " youth culture and identity " Lecture 7 : From Tears to Hope. Manderson : needle is 'metal out of place'.Are critical of the assumption that the behaviour of drug users can be understood through a clinical setting : a. -Hypodermic syringe (needle) and aesthetic aversion . Drug fetishism: the law and the addict -Both the law and the addict share a common obsession. like the drug. hypodermic syringe). Drugs become convenient scapegoat to displace these fears. on.Davenport .Religion .the good and bad side of it rather than just negative.We need to move away from the reasons for drug laws towards aesthetics i.Making serendipitous discoveries of unanticipated forms of drug use and dealing. Opium as a cause of racial pollution.Agar: rituals have 'special meaning' for the drug user . How do enthographies of drug use differ from other social science approaches? Participant observation enables the researcher to have extended. Lecture 6 .Modern Western thought : protecting the mind/body dichotomy.Methamphetamines in Thailand. harm minimisation and interactive outreach . ' The crime of possession is the crime of being possessed' Seductive power of drugs -Chinese immigrants in 19th century. clinical research. .D. witchcraft and belief' . Manderson ' Metamorphoses : Clashing symbols in the social construction of drugs' . middle. . . Drug rituals . .the view on hypodermic syringe (needle) a emotional response. .woman who had been seduced and possessed by the devil and believed to be a 'addicted' to the sexual pleasure. Drugs as Scapegoats for social anxieties and conflicts .Uncover the meaning of drug use in social context. -Witches .Criminal laws of drug ' possession': mere proximity establishes a presumptive crime. ' Double . based on formal surveys. .Throw light on the diversity of contexts and day-to-day variability of drug use. Drugs used for three purposes . . ' Influence of anthropologist Mary Douglas: pollution as 'matter out of place'.Theory and laws of property: ' possession' assumes humans actively appropriate and use passive things..The needle as 'boundary violation' and pollution.Manderson" ' The devil. removes drugs from their social context and tells us little about the everyday life. the peace that comes from oblivion'. .'Literalization the symbolic' .g.Drugs challenge boundaries erected between mind and body and between rationality and irrationality.Have access to "real" people and their "lived experience". the yearning for the perfect moment. fears about immigrant Mexicans (1920s and 1930s). . Gender . Australia : seductive power of opium. seduces and destroys the will'.sideness' of drug symbolism .Hines : prohibition is the 'policy of idealist who cannot appreciate that the use drugs often reflects other sets of human ideals: Human perfectibility. . .consume only a small amount of a drug in case of first users.Parallel with witchcraft beliefs of 16th and 17th century Europe. when trying a new batch of a drug or when buying from a new dealer." Pursuit of oblivion " A social History of drugs 2001. Australia : Anxiety about safeguarding the purity of Western ('White') identity. Humans as autonomous agents.class fears about Counterculture and passivity of youths (1960s and 1970s). Drugs and possession .D. By thus giving them a 'voice' anthropology humanises drug users and prevents their demonisation.drugs were seen as the magical reason to cause all this. and b. Manderson 'possessed: drug policy.Zinberg: definition of drug rituals encompasses only functional aspects of drug use.Himmelstein ' from killer weed to drop out drug'. allowing drug users to tell their own stories in their own words. race and in Drug market).going interaction with drug user over along period of time.Recreational reasons Lecture 8 : How and why Drugs work . .sharing ritual between users. .Prohibitionist legislation: drugs as symbols of certain fears are treated as if they were the cause of those fears. keep below this dose Drug Potency .little margin for dosing. SIDE EFFECTS . Drug Information . treatment.transdermal and eye . such as a narcotic or hallucinogen.Therapetic (intended) dosing LD50: Dose at which 50 percent of the population found to be Lethal . A substance used in the diagnosis .good for insoluble suspensions and solid pellets.Pharmacokinetics determined by chemical properties of the drug e.not used for drugs that are poorly soluble.Metabolism ( biotransformation ) .Herbal medicines ? .good for pulmonary disease ( asthma) . Rectal . Intramuscular .blood flow.50 percent will bypass liver. Subcutaneous . However patient co-operation is needed .Excretion .subcutaneous ( under the skin. unstable .very fast access to the circulation . slow release from repository preps .liver. HALF LIFE.USE ( Main effect) : what disorder it is used to treat ( how it works) .Intraperitoneall . .large margin for dosing. Absorption Drug pass into blood circulation Bioavailability .routes of administration) . tissue permeability . There is irregular absorption and many drugs irritate rectal mucosa. difficult to harm patient. such a substance as recognised or defined by Food and drug Administration.unwanted effects for one treatment yet may be wanted for another ( e.first pass metabolism through the liver -Pulmonary absorption (inhalants) .Absorption ( bioavailability .very good when patient can not take drugs orally ( vomiting.limitations reduced of absorption .Tropical applications .g lipophilicity ( soluble in lipids (fats) all cell membranes)).DOSE .What is a drug ? 1.ability for drug to take effect ( how much is needed) Drug toxicity .intravenous Drug absorption Oral administration ( Enteral) Absorption pattern is variable .Distribution . INTERACTIONS . . diabetes) .good for high lipophilic drugs .increased risk of adverse effects and overdose. Inhalants .Emesis due to irritation of gastric mucosa Sublingual . 3.poisons or excessive amount of any substance Each drug as a 'Therapeutic index ( margin of safety) .local effect.they dissolve quickly through mucosa to vena cava.potential to do irreversible harm to body functions . PRECAUTIONS: take care when using drugs ADVERSE REACTIONS : unwanted effects. lungs. High therapeutic index .use of gas exchange at lungs . or extensively metabolised by the liver. that effects the CNS.permits titration of dose .drugs or disorders that this drug should not be prescribed with/for. Therapetic Vs Lethal dosing ED50 : Dose at which 50 percent of population found drug to be effective . . unconscious).Difference between LD50 and ED50.immediate and accurate effects .g sedative effects of antihistamines).good for moderate volumes . causing changes in behaviour and often addiction Problems : .prompt action from solutions.can't use with large volumes.time to remove half of the active drug amount. slow release from repository preps .how the drug is packaged. Low therapeutic index .Oral . Human physiology : Pharmacokinetics Pharmacokinetics : what happens to the drug once it has entered the body (fate) Drug effect is modulated by .what drug interactions will occur PACK. it is convenient and economical and safe.kidneys. enzymes in tissue .fractional extend of drug which reaches its site of action routes of drug administration . . Injections ( Parenteral) Intravenous .prompt action from solutions. may cause necrosis.avoid hepatic first pass .intramuscular . .can alter distribution by changing blood flow to area ( massaging of the arm) and is not ideal in obese patient.what dose to prescribe depending on what it is used to treat -CONTRAINDICATIONS . or prevention of a disease or as a component of a medication 2. A chemical substance. easier to overdose. slowly absorbed.Food that alter neurotransmitter levels " there is not a legal or commonly accepted definition for drug". Affinity Vs Efficacy . Bound NT causes a change in post.astrocytes and oliogdendrocytes .Brain capillary endothelial cells have continuous tight junctions only high lipophilic drugs can cross ( phospholipid membrane) from blood capillaries to cerebrospinal fluid (CSF) -.dendrites .for local effects ( e.Noradenaline . modulator of many processes . reward and movement -Acetylcholine . urethra . NT binds to receptor on post synaptic cells 3. Dendrites receives and passes cell body or soma and sends a electrical signal down which is called a action potential and the neurotransmitter is released.sends information from one end to another . vaginal.memory .Release of a neurotransmitter binds to a receptor to tell the next neurone what to do.the ability for a drug to induce a response once bound to the receptor site Agonists have affinity and efficacy Antagonist have affinity but not efficacy Negative Drug Interaction : Antagonism . decongestants) Directly into cerebrospinal fluid ( brain and spinal cord) Intrathecal ( epidurals) .houses nucleus . . Contains neurotransmitters -Axon + dendrites = Neurites.synaptic cleft ( chemical synapses) Chemical communication = neurotransmission.intrathecal/ or intercerebroventricular) .produce euphoria! There are heaps of receptors ! allows fine-tuning of cell communication Receptor Pharmacology .support neurones Ependymal cells .Allows for sophisticated ( and quite complex) transfer of information .Major inhibitory NT . Neurons . Crossing the Blood Brain barrier .They communicate via receptors .soma ( cell body) .Affinity .to another neurone. strategy and planning. movement and REM sleep .line the CSF.short term memory.improve disorders .remove dead or generating neurones or glia ( phagocytosis) Neurons 4 main parts to a neuron .Dopamine . perceptual learning.synaptic dendrite 4. hugh network for communication and complex processing.All drugs that reach the brain effect the rest of the body ( unless locally applied . Neuron network .Electrical communication : Gap junction (electrical synapses between cells) .they receive information -points out like tree branches axon . colon.Activation of some receptors stimulate neurones .Glutamate . Types of Brain Cells.They act like the neurotransmitters to open the door Antagonist are drug 'keys' that fit the lock but can't open the 'door' .human brain starts with approx 100 billion neurones .GABA .inject directly into the subarachnoid space ( spinal ages) Intracerebroventricular ( intraventricular) .presynaptic terminals .Serotonin .learning and memory ( Neuroplasticity and excitotoxicity) .Nasal.Appropriate behavioural output to an environmental stimulus We can use drugs to change this transfer of information .Activation of other receptors inhabit neurones Agonist are drug 'keys' that unlock the receptor 'door' . fight/ flight and sleep.attention.Efficacy . How to neurotransmitters communicate with the next neurone? . emotion and reward .Mucous membrane application .this can benefit if no centreal effect is desired . .They compete with neurotransmitters for the keyhole.main cells that coordinate brain function Glial cells .filled ventricles ( neurogenesis) Microglia .cognition.many drugs used ( or abused) in pyschopharmacology increase or reduce communication in the brain . NT released from receptor 5. Neuron communication .Chemical communication . Neurotransmission 1.Brain cells communicate with other brain cells by NEUROTRANSMISSION.major excitatory NT .stop pain .g.inject directly into ventricles (brain tumours) Drug Absorption From blood to brain .the attraction that a drug has for a receptor site .lots of branches with swells at base of axon. NT transported back into pre-synaptic cell or metabolised in synapse. Action potential triggers release of neurotransmitter from presynaptic terminal 2. Major roles . measured on elevated plus Maze .Synergism .ingest both alcohol and meth .inactivates) .increased self confidence .Drugs are substances introduced to the body that change regular functioning. Chemical Antagonism Two substances may mix in solution before administration .ALSO needs alcohol dehydrogenase Physiological Antagonism The physiological effect of two administrated drugs counteract each other .chemical antagonism .Quick to cross BBB .ingest alcohol .stimulates the brain .broken down by gut and liver enzymes . meth.Liver : CYP1.Acetylcholine .alcoholic stupor requires greater alcohol consumption .increased energy Ecstasy (MDMA) & Mephedrone (Miaow) are also ENTACTOGENS (touchy feely) promotes closeness to others Cocaine and Amphetamine . meth combination with alcohol . Positive Drug interactions : Agonism .Nicotine ( tobacco) .increased alterness .stereotypy (repetitive movemet) Nicotine .narcotics .Mepedrone . .ingest meth . -Brain communicates via a process of neurotransmission -Some drugs act as AGONISTS and magnify normal effects -Some drugs act as ANTAGONISTS and prevent normal functions -Mixing drugs can have positive or negative interactions (eg: Meth + Alcohol) lecture 9 drugs of Abuse Many substances are abused by humans including : .consciousness .cytochrome P450 cycle .neuroleptics .depressants .Amphetamines affect similar regions to cocaine .interaction with other medication/ ingested compound .Striatum .The effect of one drug ( or neurotransmitter) minimised or abolished by another .Both increase dopamine transmission in the nucleus accumbens (NAc) .altering drugs . alcohol .Long term anxiety in rats after binge treatment of Saline ( control) .meth derivaties . it is reversible and irreversible .Caffeine Psychostimulant .euphoria and well being .Methylphenidate .Amphetamine derivaties .Nicotinic receptors .oxidises drug ( adds an oxygen atom to drug .pharmacokinetic antagonism .pharmaceuticals stimulants . CYP3 enzymes -CYP1A2 oxidises caffeine • CYP2C9 oxidises ibuprofen • CYP2E1 oxidises alcohol .Receptor block 'competition' antagonism ( most common) .amphetamine . ( meth and alcohol) KEY POINTS.MA/EtOH treated animals show synergistic effect. not at receptor site) .competitive antagonism ( block occurs IN neurone or cell.uncommon Pharmacokinetic Antagonism Once drug has entered the body its activity is reduced .Half .one drug potentiates the effect of another ( more than addictive) Example of synergism .cocaine . meth counteracts the effect of alcohol.Non.The effect of one drug ( or neurotransmitter) increased by another -Additive : sum of the effect of each drug to get the double effect .increases motor activation .leads to stupor at high doses . Major effects of stimulants short term .Activity of drug is lost .reaches brain in about 20 secs . CYP2. The effect of the drug is modulated by – Absorption – Distribution – Metabolism – Excretion -Most drugs increase or decrease communication within the brain.life is about 2 hours .Increase dopamine release in the NAc Caffeine .physiological antagonism.Fast pass metabolism .Arouses or accelerates activities .. Side effects of Depressants .Alcohol ( stimulant at low doses) Effects of Depressents Used to treat .coma/ death due to mix with depressants. Neuroleptics Neuroleptic/ Antipsychotic : literally to seize neurons. methadone.muscle relaxation Facilitate GABA Reduce Glutamate.cingulate cortex : judgment .Tolerance and withdrawal .anxiety .opium.paranoia .Chronic constipation . Side effects of opiate use .Depression and anxiety . PCP.Euphoria and well being .to control abnormal neuron activity .seizures .coma / death from OD due to low tolerance . magic mushrooms.Water and lipid soluble .these interact with the dopaminergic system Metabolised in the liver by the cytochrome P450 enzymes Variable half life .LSD. ( tricyclic's like imipramine) Depressants Depressant .Decreased BP and Heart Rate . marijuana.peaks in blood stream within 1 hour caffeine is a competitive antagonist for Adenosine receptors .depressants.insomnia .hippocampus .cortex : movement / sensory .g chlorpormazine -Anti.cerebellum .analgesia. Consciousness.Anandamide is the natural 'endogenous' ligand for receptors. Side effects of stimulant use Acute ( short term) .9hrs to 15 hours.sleep or stupor = numbing . judgement .4.active constituent of cannabis is D9 Tetrahydrocannibional ( THC) .Aggression.altering Hallucinogens/ psychedelics . heroin . . .Cognitive impairment .anxiety .Neurotoxicity Nacrotics : induces narcosis .drowsiness .pain relief .schizophrenic e. Opiates . DOI.Benzodiazepines . -Cannabinoid receptors : CB1and CB2.blunts memory . Effects of cannabis .depression -psychosis . Pharmacology of Cannabis .produce hallucincations .thalamus and spinal cord: pain centre .blunts motor coordination.Respiratory depression .cortex : motor / sensory .Memory impairment .relief of pain.Anti.depresses activity .Psychosis Chronic ( Long term) .Activation of mu opiate receptors directly act in the NAc AND indirectly stimulate dopamine release in the NAc by cells in the VTA (mu and delta opiate receptors) Opiates stimulate opiate receptors and increase dopamine in NAc Opiates ( Morphine) opiates bind to : . morphine .THC binds to cannabinoid receptors to increase DA release in the NAc.Dissociation . codeine.symptoms and stop use .cingulate cortex .Barbituates . Major effects of opiates . VTA.nucleus accumbens .Rats will self .NMDA glutamate receptor antagonist .Dopamine antagonist. 1.compulsive drug seeking vs normal side effects of medication . Problems with DSM-IV . use alcohol or recover from its effects. Tolerance. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work. Nucleus accumbens .Modulates opioid peptide systems .Increased DA in the NAc makes a substance rewarding . or a strong desire to use alcohol 5.Lateral Hypothalamus.Reward and drugs Reward = positive reinforcement initial exposure to certain drugs will produce feelings of reward .route of administration . Self.physical dependence vs 'drug dependence' . There is a persistent desire or unsuccessful efforts to cut down or control alcohol use 3.all drugs increase dopamine but only a small percent of people become addicts Diagnostic and statistical Manual of Mental disorders ( DSM-IV) . tailpinch or aggressive attacks in animals increase dopamine neurotransmission. or recreational activities are given up or reduced because of alcohol use.Speed and magnitude of increased dopamine in the nucleus accumbens RUSH which is determined by .natural rewards ( sex.all drugs of abuse increase dopamine here Reward and Dopamine .Relaxation Usage reinforced . A need for markedly increased amounts of alcohol to achieve intoxication or desired effect. Reward pathway : Dopamine (DA) The mesolimbic dopamine system Ventral Tegmental area . electric footshock. A great deal of time is spent in activities necessary to obtain alcohol.change back to term 'addiction' . Dopamine and addiction .Different sub-types based on drug .potency of the drug . occupational. Alcohol use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by alcohol. as defined by either of the following: a.stimulation and Drug self administration Rats will self stimulate ( electrically) .had categories for substance Abuse and substance dependence. Recurrent alcohol use in situations in which it is physically hazardous 9.Excitement .oral ( less potent) .able to rate severity of the addiction . school or home.Mice lacking the dopamine transporter will still self.like gambling . 10. however there are now diagnostic criteria for intoxication and withdrawal.NAc .heroin is less toxic at 36 percent deaths Rewarding effect of cocaine is blocked by: . Important social. Other limitation of dopamine theory of addiction .problematic pattern of alcohol use leading to clinically significant impairment or stress by at least two of the following occurring within a 12 month period. .alcohol and cannabis use disorder .administer cocaine .Removal of substance abuse category.Until last year DSM-IV.individual differences . 4. 6.What makes a substance addictive ? . .adverse stimuli such as stress of handling.GABA-A receptor agonist . Lecture 10 .addiction and related disorders . Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by alcohol.pharmacology of Alcohol . 8. subcutaneous. inhalation intravenous ( most potent) Dopamine = reward .becomes a drug of abuse.lead to the hypothesis that if dopamine causes the sensation of reward then it is responsible for addiction to abused substances " Dopamine Theory of addiction".Median forebrain bundle ( dopamine fibres of passage) . Alcohol is often taken in larger amounts or over a longer period than was intended 2.administer cocaine until death ( 90%) .pharmacological addictions. Craving. 7. intranasal . A markedly diminished effect with continued use of the .Evidence for 'substance abuse category . intramuscular.Elation . DSM-V Example alcohol use disorder .Increases Dopamine release in the Nucleus accumbens. nurturing) also increase dopamine in the NAc.Inclusion of caffeine in intoxication and withdrawal categories. DSM-V .Non. food.inclusion of a behavioural category . One limitation ( of several) of the Dopamine theory of addiction . b. psychotic episodes High incidence of relapse . or shortly after. convulsions.drug induced.intense cravings. cue.conditioned place preference Withdrawal/ negative affect . Psychomotor agitation 7.increase in crime rates to support habit . Transient visual. Autonomic hyperactivity (e. C. sensation . Impairment in attention or memory 6.Drug / alcohol self administration . Incoordination 3.Significant problematic behavioural or psychological changes e.craving of the drug during abstinence.The increased response to a drug following repeated administration . tactile. including intoxication with another substance. Anxiety 8.the state characterised by : 1. Unsteady gait 4.Alcohol and benzodiazepines ( valium) . stressed induced. Nystagmus 5. anxiety. developing within several hours to a few days after the cessation of alcohol use described in A.Neuroadaptive processes to counter the acute effects of the drug A key element in the drug dependence is sensitisation : .loss of effect of a drug with repeated administration Withdrawal . Reinforcement theories . 1.Reinstatement ( replase) . A compulsion to seek and take the drug continuously or periodically 2. two ( or more) of the following. diarrohea .g. including intoxication or withdrawal from another substance.Withdrawal negative effect. coma and even occasionally death ( if withdrawal is too abrupt) Pyschological dependence .Recent ingestion of alcohol .. or auditory hallucinations or illusions 6.preoccupied with obtaining drugs/ persistent problem -. paranoia. Physiological components of dependence Tolerance .same amount of alcohol.elevated reward thresholds Preoccupation/ Anticipation( Craving) . Increased hand tremor 3. Slurred speech 2.relationships breakdown . One (or more) of the following signs or symptoms developed during.Binge intoxication tolerance .anxiety like responses . occupational.heroin . visual or tactile illusions occur in the absence of a delirium Drug dependence physical dependence .stop taking the drug produces withdrawal symptoms .appearance of symptoms associated with termination of chronic drug use . alcohol use: 1.LONG TERM ( chronic) neuroadaptions which are manifested after repeated drug administration Long term use includes : anxiety. family and friends .work. Insomnia 4. mood liability etc C. Negative emotional state when access to the drug is denied Often failure to function in society .hyper sensitivity to sound and light. Nausea or vomiting 5. goosepimples. Generalised tonic-clonic seizures.g inappropriate sexual or aggressive behaviour . or auditory. inability to control intake 3. Addiction . as manifested by either of the following Alcohol intoxication .preoccupation / Anticipation Animal model of addiction Binge intoxication . or other important areas of functioning D. Alcohol withdrawal A.induced. Specify if: With perceptual disturbances: This specifier applies in the rare instance when hallucinations (usually visual or tactile) occur with intact reality testing.social/ occupational activities compromised .abrupt cessation causes sweating. The signs or symptoms in Criterion B cause clinically significant distress or impairment in social.big socio-economic problem Addiction has both positive and negative reinforcement processes 3 part cycle of Addiction . 11. Withdrawal. Stupor or coma D. The signs of symptoms are not attributable to another medical condition and are not better explained by another mental disorder. sweating or pulse rate greater than 100 bpm) 2. The signs of symptoms are not attributable to another medical condition and are not better explained by another mental disorder. cessation of ( or reduction in) alcohol use that has been heavy and prolonged B. Methamphetamine Decreases DAT binding . .Similar to the 'frozen addicts ' who took MPTP by mistake.Abstinent cocaine users shown video of either Nature ( neutral) or crack paraphernalia ( drug taking).Genetics ( alcoholism.Drugs produce long.depression .chronic drug use also appears to alter the brain at a genetic level ( epigenetics).positron emission Tomography (PET) scan.process theory and incentive.Transforms ordinary 'wanting' to obessive craving.anxiety .reduced serotonin transporters .g increased anxiety) .Transition of drug use to drug dependence is the result of tolerance to the positive rewarding effects of the drug ( hedonic tolerance) and the development of negative states ( withdrawal e.response in a situation becomes more common in future if it is rewarded .inability to maintain homeostasis prompts impulsive behaviour .. .Neurotoxicity of dopamine neurones ( Nigrostriatal) .shared and unique .loss of serotonin . Hedonic homeostatic dysregulation . Repeated Ecstasy use . the experiment showed that glutamate neurotransmission triggers craving in humans.Reduced dopamine increases the filter of the basal ganglia . preventing relapse to drug use.failure to self.information for movement cannot get through .Damage is long.taking environment.worlds most comprehensive tobacco control legislation . Addiction . .sensitisation theory.ecstasy cause degeneration of serotonin nerve terminals. Methamphetamine and Neurotoxicity . (PET studies). . heroin but not cocaine).Anterior cingulate cortex and amydala neurones contain glutamate which signals to neurones in the nucleus accumbens .plain packs in 2012. serotonin metabolites and transporters .environment .glutamate in the nucleus accumbens triggers craving in abstinent individuals . Associations with drug.future treatments may involve specific glutamate receptor antagonists to stop flow of information to the nucleus accumbens.sensitisation theory. .Meth may also produce depletions in serotonin to produce depressive and anxiety symptoms . psychosis conduct disorder.lasting changes ( neuroadaptations) in the brain . ADHD) . BUT.depleted stores of serotonin in the brain or neurotoxicity of serotonin neurones .process theory .Glutamate appears to be the main neurotransmitter involved in craving . .Glutamate is involved with learned associations with the drug. Opponent .problem with theory : not all addictive substances are pleasurable to begin with ( nicotine.Repeat behaviour to escape unpleasant side effects .sets up 'spiralling distress ." Prevention" similar to opponent.the systems that are changed are involved in motivation and reward .combination of opponent.regulate leads to emotional distress .abstinent users DAT = dopamine transporter .existing mental health conditions ( depression.Globalisation of Tobacco Why tobacco .most available pharmacotherapies are 'replacement' therapies ( methadone) Neurotransmitters and Craving .Meth has great effect on Dopamine neurones .sensitisation of the dopamine system leads to incentive salience of drugs .in monkeys who have been treated with ecstasy generation of serotonin cells is very slow. Incentive . Addiction symptoms arising from drug addiction .taking of drugs removes the negative state.Ads Australia .Positive reinforcement theory : .helps to clear dopamine from the synapse loss of DAT shows that the dopamine neurones are not functioning well or are injured.ecstasy reverses the serotonin transporter and causes serotonin depletion in neurons.treatments can be treated with available pharmacotherapies .process theory .sensation theory . Lecture 11 . caffeine). .addiction cycle' .psychosis Risk factors .Problem with theory : not all drugs that produce tolerance and withdrawal symptoms but don't have the compulsive pattern of use seen in other substances.induced neurotoxicity MDMA . Effective treatment for addiction .Cases of parkinson-like symptoms have been reported.term. Negative reinforcement theory: .chronic depressive and or anxiety states.taking stimulates glutamate transmission to nucleus accumbens . marijuana.cell bodies are still intact but function abnormally . ECTASAY . .similar to incentive. Ecstasy . canada . china . consumption and mortality has not always been in LMICs 1901.the cigarette century .the new intensive techniques for modern advertising BAT and Global Growth by 1910 : .shipping cigarettes to some forty countries and territories . 1927 takeover of brown and williamson .5 percent growth in raw tobacco exports . men and almost everyone through propaganda.600.000 deaths per year (excluding second hand smoke exposure health) exceeds combined tolls from .hand smoke.skin cancer etc.leading manufacturer in australia . Smoking is a habit of lower working class people Lung disease .health warnings From 1970s : steady downward trend in smoking prevalence and sales in US and other traditional markets By 1980s : TTC considering exit from tobacco business .aimed at woman. Globalisation's rescue of the tobacco industry What is globalisation .cigarettes accounted for less than 3 percent of total tobacco consumption by weight in USA.3 mn smokers 18th between 2007/2010 15. How did we get to this point 20c .safe.12.1880s : the american tobacco company.road accidents . following decades of negligible growth Uruguay round of WTO negotiations = rapid expansion in trade in tobacco : 1994 .4 million deaths annually .most production.96 growth in cig exports 5 percent growth in global cigarette consumption during this same period.not only is the burden of smoking there but there is also burden to do with production where the land is used for this purposes. Impact . Dukes response was 'aggressive solication of new smokers' in US and abroad Coincidental developments . Mechanisation led to overcapacity .neo-liberal/market .cigarette exports increased at increasing rate . Mechanisation first adopted by James Duke of North carolina .movement of capital . 1993.compression of time and distance .sales of 10 billion + cigs by 1920s . Indonesia .1980s . respiratory diseases ( pneumonia) etc etc.Number of smokers have been dropping a lot Yet smoking remains the ' largest single preventable cause of death and disease in australia" 3.india .technology .000 non smokers exposed to second .97 .by 2030s . portable matches in the late 1880s .2000 .introduction of modernised production into china and india . Decline of traditional tobacco markets 1950s : first US significant decline in US cigarettes sales .approx one death every 6 secs due to tobacco .21century 8m deaths annually by 2030 1 billion deaths attributed an imbalanced burden of disease .driven Key components A) trade liberalisation ' free trade is likely to improve health if what if being traded is harmful' .roughly even spilt between low and middle income countries .us presence .alcohol .range of processes ( not simply economic ) . malaysia . since the mid . Fertility and reproductive effects Tobacco production and consumption : a global health crisis that requires global solutions Currently : 5.tobacco market saturation .diversification ( real estate/ insurance / retail/ food).East africa. Associated economic costs ( tangible and intangible) AUS 31bn.acceleration of communication .accounts for one in 10 adult deaths .75-80 percent will be LMICs massive rise predicted among woman in LMICs Globally smoking is increasing .garner and Mckee. projections . Patrick O kefee. Democratic Republic of Congo 14%.TTCs motivated by first declines in number of US smokers post wwii . thailand 1990 . How globalisation rescued the industry industry .:westernisation" / consumerism .BAT. south korea 1988 . FSU • leader in 50 markets • 52 cigarette factories in 44 countries -55. Bi-partisan support / connections “Tobacco exports should be expanded aggressively because Americans are smoking less.america .US .japan.pressure on health services . B) rise of the transnational cooperation (TNC) .United states trade representative (USTR) . •biggest increases among youth and women: -smoking among Tokyo women 20-29 increase -10% (1986) to 23% (1991) •Korea 1987-1988 -massive rise among teen smokers: males 18% to 29%.united states cigarettes export association ( USCEA) .ira shapiro Trade liberalisation .supported denationalisation in the 1960s allowed TTCs to entrench their place in latin American markets TTCs " aggressive promotional campaigns has had to some 100 million current smokers" .state monopolies .aggressive marketing and pricing policies . the uneducated and the young PMI ( Philip morris international) •employs over 80.foreign direct investment in overseas markets / joint venturers / licensing agreements/ merges / takeovers .trade liberalisation ( WTO/ Regional/ bilateral free trade agreements? .mounting trade deficits with all 4 countries. thailand . Gallaher.support of governments of industrialised countries for leading TTCs.000 people • uniformity of marketing strategies • Dunhill.late 1980s .Blanco 2. Lucky Strike.regime change in FSU and Eastern Europe .japan and taiwan 1986.'301 countries ' . JTI. 555 .acquisition of existing firms . taiwan. Because of court cases in the US we know more about the tobacco industry and globalisation .privatisation / deregulation .pressure on national sovereignty .trade liberalisation across key Asian markets ." the expansion of trade in tobacco products has worked in much the way that the economics textbooks would predict" . korea. 4 Waves of TI expansion 1. Imperial) By 2000. Asia.local manufacturers unable to compete .firms that own/ control production facilities in more than one country through direct foreign investment.caused tobacco moving quickly having the most impact on low income countries.eclipse of local culture . females 1. unregulated entry of TTCs (PM. Pall Mall. 1990 High-profile support from (R) Robert Dole /Howard Baker/Jesse Helms (D) George Mitchell / Ann Richards / Al Gore US embassy staff Impact: consumption increase in 301 countries •per capita cigarette consumption 10% higher in ‘301 countries’ in 1991 than predicted without bilateral trade agreements. Kent. and throughout North Africa -2003 built a US$150 million factory in Nigeria PMI:15% of the market across North Africa / 10% elsewhere -new factory in Senegal Selling and marketing single sticks aimed at the poor.000 people worldwide •brands sold in 160 countries •50 factories around the world • leader in 11 of 30 biggest markets/2nd in 8 others • Marlboro largest selling private brand BAT-the most global company • sells 900 billion cigarettes pa in 180 countries ( British american tobacco) • 70% of sales in Africa.6% to 8.” -Vice President Dan Quayle.forced to drop restrictions on imported cigarettes under the threat of trade sanctions .7% •attributed to lower prices -aggressive TTC advertising -Japan: cigarettes 40th to 2nd most heavily advertised product on television iii) Former Soviet Union -1990s • 1991 -collapse of the Soviet Union / emergence of deregulated market economy • privatisation of state owned tobacco monopolies and rapid.1940s / 1950s .1980s . often targeted at women and young people iv) sub-Saharan Africa 12% of global population 4% of global tobacco users -low smoking rates due to widespread poverty Selected male smoking rates: Ghana 10%. almost US$3 billion in FDI had been poured into ten countries to take over privatised monopolies and modernise production • consumer demand for TTC brands been ensured through aggressive promotion. SE ASIA . Latin .exacerbated disparities between and within countries. Latin America.first significant competition for BAT . Impact of globalisation on public health .transformation in future prospects: . Nigeria 12% Increasing TTC activity BAT:South Africa to Congo and west to Ghana. •circumvent regulation Philanthropy Charitable contributions have been a part of this company's culture for more than 40 years. E. Black american people were documented to see what the disease does to the body but they were lied that they would be treated.Harm from not receiving drug being tested . A convincing placebo treatment is too dangerous to be to ethically possible is a case where trials cannot be blinded.mostly on black poor people -should have voluntary informed consent from research participants -only proper trained scientists should carry out the research . Open trial .can't blackmail them . how it’s promoted.) • introduction of new smoother brands that are more attractive to smokers and easier for new smokers • powerful political lobby vs.” sponsorship •aspirational western imagery. problems . placebo . exploration. evasion and revision Be Marlboro Campaign 201250+ countries associates Marlboro with risk-taking. •cost effective. and we're doing our best to meet those expectations.they will know if they are not doing anything The Ethics of International Drug trials and Placebo Use .g. e. controls for placebo affect. •broad range: from global reach to grassroots.Brief history of medical research ethics Nazi human experimentation ( Nuremberg trials and the Nuremberg code) . Society expects a company our size to be socially responsible.blind trial . single . 1964 . •political influence.controlled trials a. researches must stop if outcomes harmful Alabama experiment . it was good to inform but not enough to stop the tragedies . freedom and defying authority advertising features attractive young people sponsorships -Music events in Saudi Arabia -beach tours in Tunisia and Latin American countries -online promotional videos and-interactive promotional booths at shopping malls in Ukraine Summary impact of the globalised tobacco industry -trade liberalisation and FDI(legal and illicit trade) -aggressive global marketing -beyond regulatory capacity of many individual states What to expect: ~ 5 mn deaths annually -1 bn this century Regulating a global industry Framework Convention on Tobacco Control (FCTC) -an explicit response to the globalised tobacco epidemic The FCTC recognises: -limits of national governance -political and economic obstacles to regulation -global industry.both the patient and researcher are unaware of the treatment . And the result is the creation of new demand.no coercion to participate in research . transborder effects Lecture 12 Pharmaceutiical Drug trials and ethics causation vs correlation Causation .when it is shown that one thing definitely affects another.Experiments were donated to find a vaccine for typhus to treat burns caused by mustard gas.the researcher and patient are aware of the details of the treatment.g.minimise risk and suffering .g Surgery Phsyiotheraphy . correlation .TTC success in LMIC markets Increased consumption result of: • price competition • aggressive promotional strategies targeted at groups with previously low levels of consumption (women SE Asia e. dieting and exercise where people are forced to do the negative . tobacco control measures Advertising/promotion TTCs radically alter “how tobacco is presented.Harm from the receiving drug being tested .bias and placebo effect 2. how it’s advertised.only the researcher is aware of the treatment details and not the patient b.it is most accurate as there are no bias.participants can end experiment at any time. especially among women and young people.withholding a drug that would provide benefits Drug trials need to stopped whenever even during the trial it is found that the drug trials are actually providing a negative effect. Double blind trial . Helsinki Declaration : World medical Association . Blind .when 2 things happen and they aren't neccearily linked Ethical considerations need to be taken into account before experimenting on people . 2010 Value of influence in policy process: -keep tobacco control off policy agenda -pre-empt legislation via ‘self-regulation’ -block or dilute proposed legislation -annulment. -Philip Morris website. •comparatively uncontroversial.the risks must be outweighed by human benefits .syphilis cure was not there before but there was no " effective" treatments. obstruction. Estrogen and heart attack How drug trials work 1. • if ineffective the placebo should be immediately withdrawn.E.the populations in which the research is carried out must stand to benefit from research results. -Essentially a reminder of when placebo use can be unethical Example 1 .the problem would be that it involves deception and the ethics of medication if informed consent. " Disclosing to a patient that he is receiving a placebo will not necessarily diminish its effectiveness".placebo effect is about meaning. • The placebo.as an Elaboration of Numerburg code . professional.blood oxygen level dependent activity in medial orbitofrontal cortex ( pleasure associated area) Bottom line : if you think wine is more expensive you enjoy it more.e. The morphine content of opium is about 10 percent .Treatment regimen ( ACT6 076) was found to be effective but it was expensive and required many interventions. or is in a situation where standard treatment does not exist. Example 2 .’s guidelines for the ethical use of placebo in clinical practice • The intentions of the physician must be benevolent: her only concern the wellbeing of the patient. Lecture 13 opium It is the sap of a particular kind of poppy . when offered. No economical.aceti anhydride.thinking they are getting the treatment Placebo effect has high rates of effectiveness ..heroin addicts can get high from injecting what they know is saline . Afganistan and iran ) Columbia . turkey. placebo effect is really a meaning effect 2. Helsinki Declaration and controversy over ART trials in africa -In the early 1990s.if unequal distribution to drugs and ethical drug trials then drug countries are given a incentive to use poor people as guinea pigs .the patient wants a treatment but receives a placebo . . Steven Levitt on wine and sensory perception . -NEJM editorial . must be given in the spirit of assuaging the patient’s suffering. would be unethical. but it also undermines the subsequent effectiveness of medication by undoing the patient’s conditioned response and expectation of being helped. different ethical standards in poor countries.chanes in the price of a product can influence neural computations associated with experienced pleasantness".Lichtenberg . and it is possible to enjoy cheap wine as long as a) . Placebo effect as meaning effect Their argument : placebos do not cause placebo effects .limitations on placebo use when there is known effective treatment . political economy of placebo use. Three aspects of ethics of placebo use : . i. On these grounds some have maintained that placebo treatment will always be unethical.subjective reports of flavour pleasantness . discontinuing the placebo. in absence of a more effective treatment. or otherwise failing to address his distress. japan. The placebo effect ( or meaning response) : whats happening in the brain ? subjects told " cheap wine vs expsenive wine hypothesis .it stated that no one group or society should disproportionately bear the costs of.Heroin is a synthesis of morphine and the industrial acid .nocebo Potential for therapeutic use . a violation of the patients right to be honestly and fully informed about the treatment. or emotional interest should interfere with her decision. • If the patient is helped by the placebo. as illustrated in debate over the ART trials .Most trials used a placebo as the justification was that it was too expensive to provide the proper regimen but in the US all HIV positive patients had access to the actual ART and not the placebo. -Lurie and Wolf . suffers from its side effects.Golden Triangle ( N.lecture room . Can therapeutic use of placebos be ethical ? .argued that most of the trials are unethical and lead to hundreds of preventable HIV infections in infants. . Mexico opium is cultivated legally for pharceutials in 19 countries including india. silencing him. and not merely mollifying him. Meaning has physiological action in our brain 3. Areas of cultivation . Administration of placebo should be considered when a patient is refractory to standard treatment. there were clinical trials to test anti. china. meaning responses elicited after the use of inert of sham treatment may be called ' placebo effect ' when they are desirable and 'nocebo effect' when they are undesirable'.you don't think your drinking cheap wine b) you aren't a wine expert.increasing the price of a wine increases : . Placebo effect is not about placebos . • The placebo cannot be given in place of another medication that the physician reasonably expects to be more effective. Lichtenberg et al. Findings . or reap the benefits of research.stimulant vs depressant whereby all pill was a placebo.no effect .laos) .Morphine is one of the 23 alkaloids found in opium. Key points to remember 1. Burma/ Myanmar . Moerman and Jonas argue that we should look at the placebo effect as the meaning effect because placebo cannot do anything but their meaning can Definition of the 'meaning response' . N. UK and australia ( Tassie) .conclusion taken from it was that fancy people with lots of training can tell cheap wine from expensive wine but regular people cannot. In these circumstances. • The physician should not hesitate to respond honestly when asked about the nature and anticipated effects of the placebo treatment he is offering. This phenomena reflects the lingering effect of conditioning but Sustained disclosure overtime will extinct the conditioned behaviour and therefore extinct the placebo effect. .Golden Crescent ( parts of pakistan .people naturally get better when they have a placebo effect . Placebos are inert and don't cause anything.deception in therapeutic use of placebos 4.Any research participant should receive the best treatment available . N.distribution of placebo use in international drug trials . france. not only is the placebo useless.retroviral therapy (ART) for reducing mother to child transmission of hit .Thailand.the physiologic or psychological effects of meaning in the origins or treatment of illness. opium cultivated. Highland household opium uses . following British colonisation . .Decline in opium cultivation in India. Opium addiction and mass consumer markets . • Ethnic (minority) armies increase drug production (opium/heroin/ meth. Middle East and China.fire agreements with most rebel armies. Though supply reduction takes precedence.the development of capitalism in Europe was linked to the expansion of drugs and drug economics.42 and 1856-58) to maintain lucrative trade .E Asia due to famines in south china ( migration of chinese) .000 ha in 2007 to 209.But local cultivation encouraged during WW2 due to problems of obtaining supplies from india and middle east.40 million opium addicts in china by 1890. Opium and Demand Reduction Demand Reduction It has been a part of the UN drug control policy since creation of UNDCP in 1991.000 ha in 2013 though volume has declined to 5.Drug provided the first mass consumer markets due to their addictive qualities .Burma's military government (SLORC) unable to gain political control over N. • Area of cultivation has increased from 193. CIA support for Chinese Nationalist Army to seal China. : a ) . Causes of rapid increase in opium production in Golden Triangle . .) to purchase armaments.prior to ww2 = 80 tons late 1950 . . . • Pro.700 tons early 1970 .Local opium cultivation at first discouraged by opium monopolies as threats to profits. Opium monopolies sold opium imported from india to licensed chinese merchants. • Ethnic insurgents and criminal syndicates created new trafficking routes for distribution of heroin to Russia and Europe.000 .Mass market development in S. • Drug traffickers diversify into methamphetamines and opiates. .40.Spread of heroin use by U.15 million chinese opium addicts by 1830s . • 1996-2000: Taliban expanded opium.the problem of the tea trade with china : drain on European sliver supplies . there is a assumption that continuing local consumption of opium will encourage local cultivation.W. KMT expanded opium production in Burma to finance food and arms. china by hill tribes .for cash . Burma until mid 1990s.By 1930 there were more than 6.E Asia.E Asia supplying about 500.500 tons (73% of world production).Colonial govt established opium dens for chinese addicts. Now heroin also smuggled into Pakistan and Iran from Taliban strongholds in southern Afghanistan. production by 20% tax on drug shipments by traffickers. Most armies trafficked in opium to finance rebellion.000 govt opium dens in S.mass produced and with a mass consumer market. • 2009: cease-fire agreements break down as Burma’s military pressure cease-fire ethnic armies to become Border Guard Forces. . .Chinese opium merchants formed interconnected syndicates which then allowed rapid accumulation of capital and investment in commodity production and first Asian Banks. .By 1990s there were 16 armed ehtnic groups in rebellion against central government . pricing and quality control c? The mass market was china and S.The trocki thesis .opium wars fought ( 1839. 'cold war' strategy of containing Communist china. Opium cultivation in the Golden Triangle . Heroin set up labs in GT. . under strict control.1000 tons mid 1990s = 2700 tons.In 1773 the east india company was granted a monopoly over production and sale of opium.opium as the solution to trade deficit with china. Opium in Afgan 1982 = 250 1988 = 750 1991 = 2000 1999 = 4600 Causes of rapid increase in opium production in Afghanistan • Islamic guerrilla groups (mujaheddin) financed war against Soviet Union by collecting taxes in opium.Opium became a fully capitalised commodity . . • Taliban have renewed dependence on opium to fund guerrilla war and win support from local farmers. .Ethnic insurgency and warlordism. Post war in opium cultivation in golden triangle .government warlords also invest heavily in opium cultivation and trafficking.S troops in vietnam in late 1960s.000 registered addicts. Production reduced to 80 tons in 2001. following cease.legalisation of opium imports (1860) encouraged local cultivation in S. in Bengal by more than a million farmers b) .trafficking armies.Changing alliances between opium. . • 1989-1996: Rival mujaheddin factions financed fighting in civil war with profits from opiates.Ethnic minority revolts in response to uncompromising centralist policies of Burma's military government . storage . Diversification: methamphetamines and opiates • Warlord Khun Sa surrenders in 1996 and promotes methamphetamine production.000 tons by 1906. .400 tons in 2007 (93% of world’s illicit supply).E. Ethnic insurgency and warlordism in Burma .opium production in china reached 30. Taliban bans opium cultivation in July 2000.EIC created a well organised system of packaging. Taliban traffickers supply poppy seeds and fertilizer to farmers and pre-purchase opium crop.Opium cultived in GT region by hill tribes who fled from china in repines to chinese military campaigns . • This has led to a surge in opium production to 4100 tons in 2005 and 7.U.burma border.S. g.closing ceremony 3.Martin . and weak village leadership. Lisu).However .CBDAC : strategy ( developed in N thailand by NGOs) based on a 'participatory' model and includes medical detoxification.14-21 days in school rooms or camp built by villagers . Laos participatory in name only.Labelling process often becomes internalised with addicts expressing feeling of 'shame'. CBDAC deco . village factionalism.Medical support * herbs.T.High rates of relapse of detoxed addicts . voluntary drug dependency treatment. Preparation . thailand and N.rites and ceremonies .By 2003 there were 800 meth users in sing district ( a third were Akha). raising awareness of community. Addicts are passive recipients of treatment and subjected to enforcement and punishment.crop cultivators e.exchange for goods and livestock. Thailand.lectures by local officials . ..Traditional use a as medicine . • Opium and opium addicts viewed as obstacles to ‘development’. vietnam. Beyond Silk Road . Lyttleton .g.N agencies jointly called for the closure of drug detention centres and expansion of access to community based.medicine for physical ailments . Creation of an ‘addict identity’ • in the Demand-reduction campaigns in N. ‘Opium-reduction programmes. leading to stigmatisation and marginalisation of addicts and relapsed addicts (see P.Laos) was quite successful : only 19 villages. Detoxification . Medical checks . good follow up and low relapse rates.Availability . Follow up .intended to facilitate anonymous communications between political dissidents living under authoritarian regimes.distributed approximately 1 million USD worth of drugs to 3000 people in 35 different countries . little genuine participation of villagers or 'dialogue' between villagers and government/ agency workers . surveillance and stigmatisation pressures addicts to smoke secretively and to turn to other more dangerous drugs ( e. Community .Laos (Akha. Addiction rates of upto 10 percent of population What are the causes of opium addiction ? .in the middle ages .Health checks.Laos (Sing district) created an ‘addict identity’.000 meth addicts in laos. . Very very bad conditions are suffered. village location on trafficking routes and wage labour. active village headmen.farmers market in operation from 2006.type stimulants) that are easier to conceal and consume furtively.Encrypted electronic currency launched in 2009 . paracetmol and valium ) .Increasing distinction between addicts and non-addicts and new category of the 'degenerate addict'.led transnational investigation . . in the modesn world woman are imprisoned to save them and lucky ones are detoxified. problem of drug addiction among drug. Bitcoin made its easier to be untraceable .CBDAC : process of labelling. .2 year DEA. china and cambodia.40. Manderson on detoxficiaiton .Lecture 14 Digital frontier silk road was a illicit drug website Enter the dark net .Village data collection. Signing of form agreements and destruction of smoking equipment. discourses of addiction and gender in northwest Laos’ (Course Reader). In 2012 11 U. Problem of RELAPSE .used as tranquilliser to relieve anxiety . laos ): even community based can be punitive.Village social support .it is a online forum where goods and services are exchanged between parties who use digital encryption to conceal their identities .CBDAC programmes in N.medicine . CBDAC run by Norwegian Church Aid in Long district ( N. 2. Lahu.free encryption software .2012 .payments conducted via international wire transfer services. Thailand and Sing district (N. .volunteers are lucky compared to detainees of compulsory drug treatments and detention centres in laos. myths).Masks user identity and location . Cybercrime + cryptomarkets .Allowing financial transactions that are effectively untraceable . Contrast with traditional Akha values (e. • Opium was demonised in lectures and poster iconography. a lot of woman were burnt to save them from demons.recreational use NB rates of addiction vary from village to village depending on factors such as village leadership. hill tribes of N.extraordinarily difficult to 'crack' TOR encryption Proto sites . physical and occupational rehabilitation and prevention Phases of Detoxification Program 1.Reasons for high relapse : inadequate follow-up activities. .how to illicit drugs net operate TOR! The onion Router launched in 2002 .N.Wildly flluctuating 'floated ' value . with high relapse rates.g.Based Drug Abuse control . heroin. treatment and counselling. . addicts ' volunteer needed for detoxification'.Thailand and N. amphetamine. By 2008 : 35000 .Cohen and C. lucky ones were exorcised.used for a growing number of legitimate purposes. prices incase .Online reputation critical to vendor success . .drug bureaucracy.! Suppliers insulate themselves from law enforcement by including additional ‘intermediary’ nodes Network Inefficieny . and changing prison sentencing laws).They also share the following characteristics §! reliance on the TOR network §! use of cryptonyms to conceal user identity §! use of traditional postal systems to deliver goods §! third-party hosting and administration §! decentralized exchange networks §! use of encrypted electronic currency (e.a crypto market case study promotion . terms and conditions etc.drug policing strategies ( raids.organised crime groups use violence to settle disputes and establish control over trafficking routs and retail territory 'turf wars'.illicit drugs delivered cheaper and less opportunity for product adulteration .breaking capacities but at what cost ? Conclusions .crypto markets adapt quickly to law enforcement .elimination of intermediary and retail sections has the potential to significantly reduce market based violence.! Multiple layers of distribution – traffickers. .vendor ranking ensured 'good' suppliers rewarded with additional business .! ‘Stealth’ improved by: • competitive vendor rankings • leaked customs documents • online forum communications • online drug purchases typically small Evidence Gathering and resource allocation . Bitcoin).! Vast majority of goods not subject to inspection .! Connections between different groups facilitated by brokers .top sellers offer refunds. Drug War supply.g.Remarkable similarity to legitimate online business and trading platforms. .successful prosecutions end with consumers .need to develop and expand cyber investigation and code.Drug producers need to establish partnerships with organised crime groups for security and distribution .! Customs profile suspect items based on risk profiles .Extraordinarily high levels of user satisfaction Online vs. Cutting out the middlemen .user ' karma' .! Potential to render intermediary nodes redundant and reduce violence associated with the drugs trade .! Retail levels most exposed to detection and arrest ( most dangerous) . decentralised networks .successful trafficking techniques preliterate through competitive processes .more direct links between drug producers and consumers .Complex and large networks are resilient but also relatively inefficient .each distributing node has to be compensated for participation Outcomes .g. Silk Road . .goods detected through most are not enough to justify prosecution .product is altered Market.side strategy .Based Violence .! Large.presidents reagan and bush escalated drug war ( e. undercover ) unlikely to be successful in combating crytomarkets .! Cryptomarkets represent a small but expanding section of the global drug market .customs and postal interception .users share information and learn from previous mistakes . Conventional drug distribution Conventional distribution networks . feedback.He also extended drug war abroad to strike at sources of supply. Challenges for law enforcement . Drug quality chemical analysis Creating trust in an anonymous virtual environment .Major protagonists in modern war on drugs: US and UN drug control programme ( UNDCP) and united nations nations office of Drug control and crime prevention. wholesalers.! More research is necessary in order to better determine impacts and implications for all stakeholders involved with the global drugs trade.no capacity to follow up the chain of supply.Variety of systems used to create trust in a virtual environment .! Huge increases in volume of legitimate trade . . mid-level distributors and street retailers .information feedback system Shipping costs are included too Refund policy .Generally small quantities result in lower level possession charges .conventional anti.! Global illicit drug market estimated 322 billion USD (UNODC 2005) .! Cryptomarkets are complex and resource intensive targets for law enforcement .scare police resources put under increased pressure .reduced participation of intermediary nodes . complex. militarisation in SA. Dynamic and Hardening Targets . War on drugs -Nixon initiated modern war on drugs in early 1970s. He expanded the punitaitve approach to drugs through new laws.! Online drug distribution networks offer significant advantages to drug producers and consumers .extra evidence is resource intensive ( surveilance ) .online drug distribution networks will be significantly more efficient . increased funding and enlargement of anti. 2. and other Western countries. Long period of time without income for substitute crops ( e.Bertram 1.U.People participation and voluntary nature of alternative development is limited by the 'conditionality' of development aid. . Problems with alternative development Crop substitution ( Farrell. Coco cola.cocaine was first extracted from coca in 1860 by german chemist and promoted by pharmaceutical industry in U. colombia. drug war symbolism and obsessive concern and supply reduction targets.g..52 million 1995 . federal budget for drug law enforcement 1970 . c. drop then increase in heroin use with availability of non.Coca chewing was part of the indian culture before and during Inca Empire .eminence of coca production after WW2. . .Substitue crops ( e. fruit trees).drug agencies attempt to intercept illicit drugs en route or at the borders of the U. Political Economy of Coca and cocaine Traditional uses of coca in Andean Region. Failure abroad a. The drug war was raised the cost to traffickers of doing business and of the prices of drugs in Western countries. and Europe for tonic medicines and drinks e.12 years and over who have ever used illicit drugs : 2002 : 8. peru ) hill regions of south america .opium production in Pakistan and Afghanistan .expanding international demand for coca and cocaine encouraged cultivation of coca outside sOUTH america. -Success of crop substitution undermined by unrealistic eradication deadlines: a. U. "The profit Paradox" . cocoa leaf is indigenous to the indi ( ecudor.Alternative legal markets for illicit coca and opium as prohibition has actually stimulated global trafficking in illicit drug ( McCoy 2004).A gradualist approach that realistic eradication deadlines and requires AD to precede and succeed prior to illicit crop eradication.S.injectable versions.8.19 billion 2012 . Dutch East indies was the major producer of coca from 1911 to late 1920s. b.'Alternative development' ( AD) is the international aid component of supply-side policies.S.The precursors of AD are 'crop substitution' of the 1970s and 'integrated rural development' of the 1980s. 4.26 billion despite the costs there is Steady rates of illicit drug use in US . Marketing often a problem due to poor transport system and low profit-to weight ratio. coffee . 5. Vin Mariani.production of the drug trade / Balloon effect Examples: . politicians and institutions recommend alternative legal markets for illicit coca and opium.collapse of colombian marijuana industry by late 1970s .2 billion 2003 . c. b.S.Drug sellers will never be over. . Europe : restricted in 1886. etc).Anti.Assumption : Law enforcement measures will function to make it more dangerous and costly for growers.coca eradication in Bolivia and peru . coffee rarely possess economic advantages of illicit drug cropss: a. .7 % trends : suggest decline in numbers using cocaine but not in overall consumption. Alternative development . . refiners and traffickers to produce and sell illicit drugs.g. and Europe.increased demand from late 1970s for cocaine in the us and emergence of Medellin and Cali 'cartels' to supply us market.AD emphasises ' people participation'. .International demand for coca and cocaine began in 1860s with growth of market in U. . However. High profits provide an incentive for drug supplies to remain in the trade for new supplies to enter.drug agencies target illicit drugs at their source by pressuring foreign governments to target growers and destroy refining facilities.2005) allowed insufficient time for adequate alternative development. This will reduce production and availability. as well as a work stimulant and medicine. Global coca cultivation . Hellin) .has increased then decreased b. Colombia has also become a major coca producer. and discourage consumers.in bolivia and peru. Recreational consumption of cocaine also increased. Negative impact of rapid opium elimination in Laos: rice shortages and migration Limits to peoples participation . Rapid elimination of opium in Laos ( 2000 .g. methamphetamine.subsidies for substitute crops . . . the prices are not high enough to reduce demand by consumers 3.S. steady rise in cannabis. The paradox is that the raising of prices also inflates profits.Alternative development is implicitly punitive. drive up prices. Causes of post . Volatility of domestic and international markets.Bolivia and Peru regained pre.Economic crisis of 1970s and 1980s : decline in prices of agricultural exports and increased foreign debt. ( 1903 . therefore.Role of the state. coca continues to have religious significance. Growth of global market for coca and cocaine . acts as an effective price-support scheme for drug dealers.production gone down Drug war and hydra effect .a lot ( increased steadily) Coca . Global illicit opium production .opium production in Thailand and Burma ( also : rise in methamphetamine production) .S not until in 1900s.religious significance of coca for incas . Drug War failure .3 % 2007 : 8.no more coca in cocaa cola ) . .war expansion of Coca cultivation in Sliver triangle . . pineapples. The drug war.Some scholars.Anti. bananas. Alternatives to 'alternative development' . .Drug enforcement agents and police arrest drug dealers and seize drug supplies. . ( especially NY with a large Colombian population).buy their own supplies and use it controlled.to . . George shultz.increasing number of new drugs ( WODAK). ether. ) Weak state unable to control drug traffickers ('narco entrepreneurs') . Part 4 : Cocaine export .prices have declined . new system starts .Newberry. Fairness and justice: .cocaine export in 1980s dominated by Medellin and Cali " cartels" . . Cocaine as a transnational commodity chain ( Wilson and Zambarano ) Cocaine : five part transnational commodity chain part 1 . . paul volker. Colombias coca cultivation exceeds that of Bolivia and peru by 2000.punishment for risk to themselves ? what about cig smokers . 29 .the production .availability remains high .colombians play important role in distribution within the U. hcl. water.2012 : November CO. sire richard branson .collapse of Bolivias tin industry in 1985 and rise in unemployment .yields up to 4 harvest a year .Cocaine refinement requires considerable capital e.is it fair 2014 punish people who have minority taste drugs if they don't hurt others ? .take it if there is a opportunity to consume it Lecture 15 Drug law reform in australia Last 50 years drug markets have expanded and become more riskier . Part 5 : Distribution in Western Markets United states . Global drug law reform : .S.Cocaine hydrochloride is produced from coca paste.Traffickers have more money than law enforcements.g.Global commission Drug policy 2011 . Part 2 : Coca Paste production .Low susceptibility to disease . pruning.Oscar Wilde 1895 2 years hard labour sex another man . The alcohol prohibition in USA didn't work drug won't too.violence .undertaken by many small producers .growth by peasants on small family farms b) . .fair & just ? .profile trafficking organisations which also export heroin to U.prohibition have caused more crime .threats national security Does drug prohibition work ? .' the global war on drugs has failed with devastating consequences for individuals and societies'.Colombians have dominated cocaine exports due to : a ) . former presidents : Brazil . .Husak.crops can maintain high yields for upto 40 years without fertiliser.S.coca leaves are trampled by poor labourers.cocaine and addiction 14 . processing.Colombia : left.. WA states USA 55 percent : 45 percent voted tax.Kofi Annan .compulsively addicted 28 . Start global drug law reform: .S. low . Australia . . solo round world sailors ? . regulate cannabis. Drug policy outcomes . infequnt 29 . weeding.seedlings harvest after 1 year of growth .weight ratio. .cultivation a) . c. having cocaine related friends.large colombian population in U. switzerland . mountain climbers. According to Robson .wing ( FARC) and right wing armies promote coca cultivation to retain peasant support. expensive equipment and imported chemicals. b) .high profit .there is bigger and more dangerous markets with worse outcomes . Cocoa is good to produce because . lime.it tolerates extreme fluctuations in temperature. consumption . acetone .Australia : small market compared to U.corruption . mexico colombia. .methanol etc. .Cocaine imports increased during heroin 'drought' ( from 2001). .strategic geographic location of colombia. sodium bicarbonate and sulphuric acid.purity has increased . -2013 : uruguay legislature voted legalise cannabis 2013 : NZ parliament voted regulate some new drugs .labour intensive. Last 50 years spectacular increase : . Smaller quantities sent through mail or by courier.low perishability . Most refining is in colombia.coca is soaked in pits and treated with kerosene. .S.since 1990s these 'cartels' replaced by smaller. hand harvesting .deaths -disease .Govt colonisation programs for poor peasants in Bolivia and Peru. Part 3 : coca refining .Large quantities imported in bulk on ships from South America.prohibition will make the price heroin increase x 300.use the drug more frequently .crime . selected drugs commercial sale ? How can drug law reform be achieved ? -By incremental steps.documentary review . interviews.Government expenditure implications The mini debates include : .mather .why the debate ? .1984.combat related causes communicable and non-communicable diseases substance use as a underlying behaviour and determinant .methadone as a model prescription control .should cannabis be medically used ? .off licence . small quantities .MDMA .blackmarket Options for australia .what sort of punishments should be provided for possession . social issue and regulate . Options for regulation of drugs .000 .direct observation.how ? .should we have needle syringe programs ? what about prisons ? -herion assisted treatments ? .complex international spider web. Mae la Refugee camp Methods . Middle East .induced displacement Conflict important cause of global motility 45 million displaced by conflict .understanding social.Remain within those regions -camps/ collective settings or dispersed less than 1/2 of urban 2/3 internally displaced persons ( IDPS) 1/3 refugees ( under international law) with a average stay of around 20 years.threshold question Now primarily law enforcement .leaders medical profession .Africa.tax .rapidity . quantative analysis . economic and cultural context.Debate is over : drug prohibition an expensive .base policy on evidence and recognise diversity the world. Asia.Edible opium australia until 1906 .young people . Drugs.pharmacy -on licence .ongoing forced relocation .tax regulating cannabis.community opinion . Importance .community participation in all phases .Political rhetoric . .slowly . substance use disorders is being recognised.thailand has not signed to refugee convention .dilute .not clear yet what post prohibition arrangements will be .increased funding. comprehensive failure.burma border n = 150. Facts bout the camp . it is the largest of 9 camps along thai.Government spending .inductive thinking .health services and qualitative .around 3 million ( illegal) migrant workers in thailand. conflict and displacement ( Thai border) lecture Conflict .should we have safer injecting facilities near large drug markets ? . regulate cannabis . Evidence now strong many reforms .takes too long .recognise drugs a market : sellers and buyers increasing punishment also increases profits.it has a population of 40.what to do ? . many karen are stateless . respectfully.redefine as health .prescription .Mixed methods .failure current policy .when ? maybe another 30-50 years but started .consume on permesis . social response .Primarily ' health and social' OR ' law enforcement' ? . 1970s . .triangulation of data .The big drug policy debate : . carefully.unofficial settlements .intervention focus . Substance use among conflict displaced High death rates due to non.KNLA armed rebellion since 1948 . . This is through Rapid Assessment . Conclusions .move from criminal justice to predominately health.000 with 97 percent being karen . rigorous evaluation . political resistance struggle.irregular movement ( illegal work in thailand and other places) Forced distinction of economic migrant and refugee . there were a lot of rural communities.1/3 population mobile. Sometimes. 33 man who arrived a year ago) Social controls ‘Small amounts of alcohol were considered ‘good to eat rice’ (improve appetite) and ‘like medicine’ (improve health). . 43-year-old man 17 year resident) Intoxication proscribed. Slide 22 has statistics. Ya ba ( metamphetamine + caffeine ' crazy pill' ) opium/ heroin Dizephem Inhalants ( glue) Population concerns. carbonated wine drinks bought in shops and bars nearby .Multimillion dollar aid budget Fear of 'refugee warrior' communities . psychosocial stressors of life in displacement. . powerlessness and confinement.alcohol from different refrugee camps was considered bad as they were suspicious of how they made it.communist activities) seeking containment. 2000s . physical assault. it is sold for survival . Ijust drink it in moderation’. 43-year-old man. If it is over the limit. mainly young men within thailand and the region Increasing cultural.villages were displaced across border intact . Artisanal alcohol ( distilled rice liquor . psychosocial stressors of life in displacement . . Deep mistrust of ' new arrivals' of non karen people and deep mistrust thinking that there are spies leading to more fighting.integral to ethno.97 to 83 percent karen. Alcohol use created important concerns and was recognised as a cause of insecurity . Refugees in UK drink more compared to Mae la. Burma has mostly homemade compared to thailand ( men and woman drink more) Mae la Data Antenatal clinic ( n=636) risky drinking . changing power structures and social hierarchies. .made locally) . it is cooked for religious purposes.partners left home as males came home drunk scared of partner violence. 1980s . Development of ' humanitarian enterprise' . Jobless and lack of identity.a lot of woman where drinking and men were drinking more.people do not know who to listen to as UN and thai authorities have power so people from outside were influencing them and people were not listening.forced distinction of combatants and civilians . a 42-year-old man 17 year resident of Mae La) Manufacturing skills brought from Burma ‘sometimes in the farm. it is like medicine. ( shameful) ‘[if alcohol is drunk] within limits.’ (Saw E. and prepared by the wife’ (Maung M. it is dangerous. the karen cultural percentage had dropped and the gradients of poverty was more than 20 times difference Common substances Alcohol .From sanctuary to cage ' Consolidation Camp' -Thai government had abandoned 'buffer zone' approach ( supporting anti. integration and resettlement . ‘I come back to eat after drinking but I do not continue to have more.family splitting .programme of 3rd country resettlement 2005. (Saw S. Gendered norms Use by women proscribed. changing in displacement Shift from celebratory to every day From traditional to dangerous rationales -economic imperatives.Mae la as transit station Refugee regime 'durable solutions' -Repatriation. described frequently as: ‘the theft of the buffalo is revealed’. abstinence associated with femininity Becoming dangerous .they felt confined and trapped so to release the tension they drunk alcohol. long term resident) One of these dangers was being loose tongued and indiscreet. there was some external support through autonomous village committees.Alcohol was creating problems and fighting and it would be frightening the lives of the people in the camp.abuse of alcohol caused diseases and led to dependence in comparison to people who didn't abuse it. Not for income. social structures and power structures were changing . Sometimes just for buying food. ethnic and economic diversity .used commonly and not permitted to be sold in the camp.. . ‘Traditional’ Established use in Karen culture Socialisation : often referred to in Karen as ‘happy water’ ‘it is like we drink alcohol in order to make us happy … I have a lot of friends sometimes we buy a bottle of alcohol and drink together with friends’ (Saw S.hopelessness.Resettled replaced by new arrivals Other options employed by population . " drinking to avoid thinking" social stressors .growing social complexity .. ( More different types of people more problems) .. Intimate partner violence ( IPV) . beer whisky. violence against women an suicide. economic imperatives. and the resultant change in social conditions. at 60 years old.Turinabol given to 10. increased gender equity associated with decreased gender differences in drinking and decreased alcohol related problems Alcohol on causal pathway between gender inequity with gender based violence in many refugee settings Conflict and social determinants • Conflict.british military used 72 million odes of amphetamines. Mark Mcguire hit the 70th home run.german athletics in the 1936 olympics were given amphetamines as was hitler .japanese swimmers in 1932 had unexpected victories after receiving pure O2 before races .he was accused of it and admitted. environment.we live in it The paradox is that we ask the athletics to strive as hard as they can but this one is reprehensible and it can destroy them. " fair play and health consequences are highlighted". • Social determinants of health include living conditions across the life course – such as education. harms and meanings and designing interventions Steroids Neuroanthropology . The east german olympic team -from 1960s to 1980s population 16 million ' the wonder girls' in montreal 1976 Oral. It is a steroid hormone produced in the adrenal gland precursor to sex hormones including testosterone.people try earn a livelihood by selling alcohol as they cannot get out of the camp to work. risks. gender differences. Thailand. and ignores benefits and underlying macro structural and economic influences (eg marketing) • Use ≠ harm EG Gender equity • Substance use norms deeply gendered • Globally. man boobs and woman gaining masculine features. Steriods causing balls reduction.the 2012 prohibited list international standard . 1998 . human growth hormones) . cultural and social transitions contributed to changes in alcohol use behaviours and norms. Thomas hicks . brain problems. for example.masking drugs ( epitestosterone) World anti doping agency states that doping is fundamentally against the ethos of spirit of the olympic games : the fair play. Androstenedione or andro was considered a dietary supplement .diuretics ( especially for weight graded sports) . General conclusion • Substance use among populations displaced by context is an important behaviour with social and health implications • More intervention-oriented research is required • Methodological challenges need to be acknowledged and explored • Importance of social and structural context when studying alcohol use behaviours. and increased the potential of alcohol related harm. methamphetamine) . ' performance enhancing drugs' . • Risky alcohol use was common among men but not women and warrants public health and clinical intervention. Many of the prohibited substances and methods are harmful to athletics' health and can cause short and long term damage. • Poor quality food and nutrition • limited social resources Conclusions – Mae La • Economic. it builds the body.Livelihood imperatives .It is anabolic . is an important social determinant of health. Implications Theoretical perspectives • ‘Social stress’ model : social stressors may promote community substance use culture (eg Galea 2007) • ‘Self medication’ hypothesis : substances are used to relieve individual suffering (Khanztian 1974. peptide induce anabolic steroid formation Sandor Earl was banned for peptide use and trafficking In 2007. .000 athletes who got 160 gold medals.to become abnormally calm . prevalence and distribution of substance-related harm among displaced populations -Access to cash can increase access to substances -Poor more likely than to experience harm from same pattern of use due to • Decreased access to health care • Differential policing patterns.painkillers ( over the counter .1904 gold medalist in marathon received strychnine injection. The steroid era .sedatives . during 6 day bicycle races. how training affects developments. Perfomance enhancing drugs . Sylvester stallone arrest at syndey interet airport with high vials of HGH ( human growth hormone) charged with importing controlled substance. Around WW2 .the year of the biggest baseball match .stimulants ( caffeine .lists the drugs that are all illegal -Lean mass builders ( anabolic steroids. rides sometimes hallucinated from fatigue campagne and nitrogglyercine tablets as PED. Social determinants -Influence the magnitude. Singer 2008) BUT • Too easy to paint substance use as an individual escape (Fitzgerald 2005) • Doesn’t explain. . and access to health care – and the underlying economic and political structures determining the distribution of resources and power. . narcotics ) . • The population may have been partially protected from rapid rises in problem alcohol use observed in the host country.there was very little moral concerns and authrories recommended different substances to make the performance better.relo between brain and culture . emergency contraception. . after steroids discontinued to avoid testing positive. humans will be able to perfect themselves. but in higher doses.ECPs ( =EC pills): contain same hormones in 'birth control pills'.Norlevo Mechanisms of action .studios are now aware of potential scandal. i think we see paradox: . ( referring to testosterone) Andropause . now being used by body-builders. . with technology. high stakes and massive technology and on the other hand higher standards than for the general public. police officers. Heidi Kreiger . including run risks. erectile dysfunction drugs. with support staff outnumbering coaches and centres of excellence taking on children at a younger and younger age.S. but the methodology remains worryingly familiar ( carlson 2002). . . Point is shifting expectations. about life itself: when does life begin ? what creates and ends life ? .in australia avail from pharmacists Brands in aus . Through shifting expectations bodies are forced to conform to distorted ideals. .class sport. Athletics are instilled fear in terms of the risks and on the other hand there is a assumption that athletics should do everything in their power to succeed .a paradoxical pharmacological puritanism .it is because of changing expectations of male bodies.it was a 'bridging drug' to maintain steroid . .woman bodies are a site of control where the politics of sexuality. Andro .reduce ( but not eliminate ) risk of pregnancy . Ewalds obituary in the Guardian . bouncers.the refusal to say ageing is normal. .Stem cell research. originally created to fight spread of HIV in addicts.they love it but it is illegal .postinor 1 .Postal seizures .can be taken upto 5 days after sex.few scruples about using technology for vanity .e the way that the drug works in the body to prevent pregnancy) 1.' a large.not just about health. the number has tripled since 2001. A expectation is faced and the shifting expectations is what causes the problems and pressure upon the actors to use PED. Communist coercive vs capitalist individual illegal ( both took andro) it was developed by E. . What is emergency contraception ? EC : methods of contraception used after sex . A preview of the theory . Plan B .S. postinor 2 . .recent news report on IV drug injection rooms in Gold Coast. sex and sexuality amongst moralised areas of private behaviour. also about sex. supplements.to our change in diet.never get drugs get into sporting space.Debate over EC in the U.EC methods include pills and copper IUD . EMP .Abraham Morgentaler.cause prevention before implantation not after and do not cause induced abortion.under went sex change later because the pills accelerated her transexual tendencies. Just because something isn't common doesn't mean it should not be treated .there are 3 theorised mechanisms of action for emergency contraception (ie.not just about life. discourses on public health. A 2012 study in Minnesota found 6% of teenage boys reported steroid use. Dwayne Johnson .on one hand a demand for constant improvement.use of steroids is normalising. cloning. preimplantation genetic testing.scale animal experiment on living people'.some people argue that.largest category of users: clinics 'now overrun with muscly young men'. Imagining American Sexuality in debates over access to emergency contraceptive pills New productive health technologies . in vitro fertilisation. workout and techniques to get shredded.induced growth until competition.if we 'listen to steroids'.levonelle -2 . . Rising prescription of testosterone to middle aged and older men one quarter of men prescribed testosterone had never been blood tested for natural testosterone level . the goal may have changed from the glorying state to making a profit.Most significantly scientific training regimens are now the norm in all world. medical abortion. a body builder from 1953 no longer looks like a bodybuilder to us . It is easy to say these users are illegitimate and their use is illegitimate . .puritanism around the notion of 'fair play' .users : bodybuilders. Steriod Use in Australia . by delaying ovulation 2.the brand of EC sold in the U. The athletes did not know what they were taking but it was controlled by Manfred Ewald. german doctors.paradox of a ' performance enhancing drug' with no performance ' fastest growing drug in interdiction in australia : 100% + increase last year. . and medical contractions of biological processes intersect. Situation today . by blocking the transport of either sperm or egg.Wold biermann . The paradoxes of Pharmacological purianism in sport . Female pituitary gland releases follicle growth hormone ( FSH) the follicle triggers ovulation and then dissolves and gets shredded away. Carol Ben Maimon . Microgynon 20.no contraceptive used in the first place .we all know that 2/3 of 12th grade of woman have had sex and that 3 to for million new std cases will be teens. Oral contraceptives used for EC/ progestin-estrogen combined . 2004.National organisation of woman ( NOW) Erin Mahoney .FDA hearing encapsulated activism of the main players in the public opinon. Loette . president of ACOG.Advisory committee for Reproductive health drugs .judie brown .first vaccining into the penis.3. non penetrative sex that off since this is debate about contraception .using woman in a committed relationship with an equally responsible man What kind of sexual encounters and possibilities are absent in this debate ? . 2.3 bush appointees voted against makning plan B available OTC .making around women's reproductive health . microval.In May . he or she will die.Non. not just people have social lives . . Over the counter decreases conversations and therefore EC is bad.take 4 pills within 120 hours after sex an 4 more pills 12 hours later : levlen. monofem.Research strongly supports the idea that the two poles of hypothetical sexuality potrayed in this debate (the two poles) are NOT the face of 'typical american sexuality or especially of unintended pregnancy.yourself cutting up pill packs in your bathroom) FDA hearing on Plan B people providing for and against arguments for pills to be available over the counter.voting at the end of day : .it was abortiion as she believed that human being begin at conception and not implantation so if a human zygote cannot implant. .hetrosexual. not do -it . it is hard to already get a appointment to get a appointment with a doctor and get the pill.EC position is revealed if we try a little thought exercise: can we imagine an alternative scenario in which the roles are switched? Woman as gatekeeper of sexuality image whereby EC was lobbied but not viagra as facilitating the sexual exploitation of women. nordette. . microlevlen.take 50 pills within 120 hours after unprotected sex : Microlut.medical authorities publicly condemned the FDA dickerson.take 2 pills within 120 hours after unprotected sex and 2 more pills 12 hours later . Dedicated ECPs: ' dedicated' means drugs that are packaged and labeled for EC use (ie.take 5 pills within 120 hours after unprotected sex and take 5 more pills 12 hours later.many of these same players have also been vocal participants in debates over other new reproductive technologies in the US including medical abortion. state legislator from Virginia said primary beneficiers will sell it to high school kids and it will cause more problems. Structure of FDA hearing FDA .nordiol . An exploitative male sexual predator . FDA memo from curtis Rosebraugh .catholic medical association . Outcome of FDA hearing .concerned woman for america -Nurse ( Jill Stanek ) .the highly gendenered portrayal of sexual encounters in the anti.john Bruchalski .planned parenthood federation of america .woman are cast in the role of weak sexual gatekeeper. Erectile dysfunction lecture . called the decision ' morally repugnat'.23 committee members voted yes to the nonprescription switch . . FDA hearing as a kay moment n the social life of this pharmaceutical produt . the FDA issues a 'not approvable' letter.human life international -Jennifer taylor .Non presception Drugs Advisory committee . Against expanded EC access : .plan B works like other progestin only oral contraceptive and only prevents ovulation. . A responsible condom. Yet it is most controverisal.that woman should control themselves and know their fertility circle Robert Marshall .getting ' caught up in the heat of the moment" .4 voting consultants 6.consensual sex under the influence of alcohol or .american life league . Open Public hearing FOR expanded EC access : .with wide majority most expected the FDA to approve the plan B application BUT .non voting FDA participants.things . stem cell research etc.national family planning and reproductive health association . microgynin-30. . citing lack of data on teen use of Plan B .if it is not over the counter . DIY emergency contraception in AU .that adult sexual predators will molest family members and wil feed them the pills after raping.The possibility that woman might be exploiters rather than men .a internal memo realised in 2006 says that 'urban legend' status that would lead adolescent to form sex based cults Imaginations of American Sexuality in FDA debate over nonprescription access to ECPs 1 . by preventing the implantation of a fertilised egg ( zygote/ blastocyst) .can cut up a regular pack of controlled pills . Vivian Dickerson says that Plan B meets the FDA citeria for over the counter status and that people need it.not anymore The last mechanism of action is considered least likely by scientist. and impotence was not so much associated with masculine shame – the real shame and fear was about revealing concern with sexual desire. a chief complaint was impotence. not pleasure: – Moral symptomatology in Mao era only justified seeking medical treatment for impotence for reproductive reasons.” • Post-Mao China: rise of consumer culture and diminishing ethic of collectivism. ivory wave and legal highs.online anonymous drug markets. more concern with sexual satisfaction.History of pharmacological treatments for erectile dysfunction Professor Giles Brindley presentation at 1983 annual meeting of the American Urological Association in Las Vegas. Working at ACC showed the profits from organised crimes. Moral symptomatology in post-Mao era • But by late 1990s: “nanke” (men’s medicine) clinics all over the country. • Impotence was scarcely recognized in China during the era of Maoist collectivism. 2011 . depending on power structure and larger social context.the officer pretends to be a drug dealer. more than just commodities: they have a special aura. thus increasing the visibility of impotence in post-Mao China by the 1990s when he did his research. Links between modern biomedicine and indigenous health benefits . virility and sexual potency. histórical association with the black market/ gift economy .Shame vs promise of exuberant sexuality . Sex supposed to be about reproduction. • Maoist period hostile to individual desire. cannabis crops . .This exercise : snapshot of young . Chinese anthropologist Everett Zhang on men's medicine ( nanke) in China. .” • a single illness may be accepted or rejected as diseases by the medical system. Zhang’s key points • Emergence of nanke (men’s medicine) in 1980s: response to changing political economy in China. • Less concern with reproduction. and practice concerning what illness symptoms qualify as disease and whether an illness deserves medical attention.injecting in his penis. Effects of drug use . National drug strategy Supply reduction . eradication When things go wrong . Demonstrated his research of the use of Phenotolamine for erectile dysfunction in most unusual way .more than just drugs. • Moral ethics of the country had shifted from seeing sex and masculinity in terms of reproduction to seeing these in terms of sexual pleasure and sexual satisfaction.middle class multicultural. different cultures have different ideas bout sexuality. masculinity and pharmaceutical products .” Annals of Internal Medicine136 (6):471-476.seeing what is unique about our culture by comparisons with other culture e.synthetic drugs .taking the notoriety of a global pharmaceutical product and using it to rebrand products that evoke indigenous beliefs about health. • What Zhang calls “the changing moral symptomatology” in China increasingly encouraged individual desire.bath salts.needles program and etc Drug law reformed debate . . -We define the meaning response as the physiologic or psychological effects of meaning in the origins or treatment of illness. “The body that desired was more shameful than the body that was impotent. • Male impotence recognized by Chinese medicine since 220 BC. knowledge. Readings for Week 3 Daniel Moerman and Wayne Jonas.g eygpt and china Different cultures have different ideas about sexuality.chemical hazards and fire/ explosions Emerging challenges . “Deconstructing the Placebo Effect and Finding the Meaning Response.placebos are inert and do not cause anything as they don't cause the placebo effect.the process that requires a lot of lawyers.there is a lot of unknowns on how to do it. urban australian ideas about relationship between sexuality and masculinity and pharmaceutical use.drug squad -2 main areas operational arm ( drug investigation ) -General drugs operation team . meaning responses elicited after the use of inert or sham treatment can be called the “placebo effect” when they are desirable and the “nocebo effect” -Placebo analgesia can elicit the production of endogenous opiates. masculinity and pharmaceutical products.in egypt. the prevalent moral symptomatology was hostile to sexual desire. Analgesia elicited with an injection of saline solution can be reversed with the opiate antagonist naloxone and enhanced with the opiate agonist proglumide . Ending up arresting and charging people who were conducting drug shootings. Drug supply and trade was a catalyst between organised and violent crime. A Law Enforcement Perspective on Drugs: shit load of drugs in cabramatta . “Moral symptomatology”: “a mixture of institutionalized judgment.legislation and law enforcement demand reduction . Under Mao.high level drug supplies -clandestine drug laboratory team -cannabis team Development and implementation of strategic policy. 2002.it stuffs you up. A lot of money was laundered in and out.  .new and emerging psychoactive substances .Ever changing and dynamic organised crime networks . – Medical cases published in journals of Chinese medicine in the 1960s and 1970s: men who had not yet fathered children constituted the majority of impotence patients.prevention and treatment strategies Harm minimisation . Cohesive hearing . New ideas about shame: shameful to not be able to have sex and pleasure one’s partner. comparative advantage and division of labour all came together. ••  use of cryptonyms to conceal user identity. Simply put.Manderson’s claim that drugs often ‘take on a malevolent life and character of their own’ (1995: 812) and. -It is in the creation of the opium trade that we can see the invisible hand of capitalism at work Week 4 readings Martin. indulgence or recreational intoxication. it may be more useful to view it rather as a specific type of OIM. Basic capitalist growth. -Traditionally opium was a highly valued commodity and drug for the Akha.1-17.ing this issue in terms of the meaning response rather than the placebo effect. Bitcoin). of failure to compete in the capi. or trade goods. J. (2013) ‘Lost on the Silk Road: Online drug distribution and the ‘cryptomarket’. Manderson draws a parallel with beliefs in sixteenth century Europe that female witches were sexually possessed by the Devil and indeed became ‘addicted’ to the sexual pleasure afforded them (2005: 43). ••  Decentralized exchange networks. pp. and coffee It was necessary to make it too a "commodity". travels.The article has two related aims: the first seeks to locate the offences associated with Silk Road within the realm of cybercrime. moreover. Ideal type crypto. "Because we can" (Gamarra. and the Bolivian Reality. Trocki. In this case. The political economy of opiates readings Cohen. the same drugs we take in the medicinal or ritual contexts. for rituals and ceremonies. cotton. they may engage in risky dealing methods to ‘sell on’ goods purchased online. -it was necessary to do to opium what had already been done to commodities such as sugar. particularly a cryptomarket. Criminology and Criminal Justice. That opium is a cause of poverty is not supported by anthropological and agronomic research either in northern Laos or elsewhere in the Golden Triangle region. we use drugs for "play. In MB Leons & H Sanabria (eds). Opium had manifold uses: for exchange for goods and livestock. in a recent analysis (1995) that applies a harm reduction measure to drug trafficking policies. Bolivians follow policies that are dictated by the U. 2-46. coughing. for the hiring of labour. or they may simply be unlucky and fall foul of random or unexpectedly rigorous inspections. for recreational use (including visiting guests). . tobacco. push poles that exact such a high price from bolivians ? In the words of one of Eduardo Gamarra's informants. ••  third-party hosting and administration. maintains that continuing the present course is probably the best option that Bolivia has" .sagepub. London: Routledge. 13-32. Coca.-Practitioners can benefit clinically by conceptualiz. it is difficult to perceive any broader social benefit offered by other cryptomarkets which deal in explicitly malicious goods or services. hunts or engages in warfare." vVe may use. -Generally speaking. civilisation and primitiveness. such as stolen credit cards. & H Sanabria (1997) ‘Coca and Cocaine in Bolivia: Reality and Policy Illusion’. luxury manufactures. http://crj. but with no "serious" intent -There was social pressure to dispose of drugs to reach trance states because of their unpredictability. traditional long-distance trade seems to have focused on four major types of products. The fixation on opium as a potent cause of deterioration – of the individual and social body – reflects the obsession in Laos with economic development and thepervasive anxiety.com/ content/early/2013/10/06/1748895813505234 Silk Road article . -drugs has been for healing. C. this volume) Tullis. -A third type of drug use involves the "healing" of the spirit.S that generally don't serve its best interest is that bolivians are cored to do so by their dependence on the US and their extremely unfavourable position in the world market Why does U. it was also. Cryptomarket is a colloquial term that originated on internet hacker forums. and human beings -The "profound changes" that Mintz sees here are the expansion of the market and the commensurate lowering of prices that came with the expansion of production. M.Eradication began in 1984 -It is apparent from this opium-causes-poverty discourse that poverty is caused both by opium as a drug that weakens the body and a drug-crop that is unproductive. (1999) ‘All the Drowsy Syrups of the World’. as Ducourtieux suggests. is the aim of pure enjoyment.talist world market. PT (2013) Symbolic dimensions of the anti-opium campaign in Laos. A. Online. malaria and other fevers. good and evil. to organize its production with a force of cheap and malleable labor. New York: State University of New York Press. More direct online distribution networks between drug producers and consumers may significantly curtail the involvement of narco-traffickers and street-level gangs in global and domestic drug distribution. " the danger of opium addiction" poster.nyms and have goods posted to addresses other than their place of residence -Buyers and sellers may be lazy or complacent and fail to conceal adequately their goods or protect their online anonymity. B. In Opium Empire and the Global Political Economy: A Study of Asian Opium Trade. pp.argues that the discourse of opium as a cause of poverty reflects the symbolic dimensions of the process of Laoisation in post-socialist Laos. The fast-tracked opium eradication campaign in Laos was more than a politically motivated ‘showcase’ to notch up an easy victory in the War on Drugs. precious metals and minerals. 1750-1950.ising opportunities to remove much of the violence associated with illicit drugs the potential of Silk Road to minimize the violence associ.g.ated with illicit drug distribution may become evident as the site continues to grow.markets may also share the following characteristics: ••  reliance on the TOR network. a ‘kabuki theatre’ that aimed to dramatise the absolute distinction between normal and abnormal. -The long-term implications of these changes have important implications for the global drugs industry. and the possibility that the information obtained in the trance might upset accepted orthodoxy. on land that was already controlled for as cheap a price as possible.S. TAJA 24:177-192  . and perhaps abuse. ••  use of traditional postal systems to deliver goods. or at least to remedy or alleviate some physical distress -work drugs": those substances which kill pain. and particularly as a medicine for ailments such as diarrhoea. Cocaine. are frequently perceived as agents of sexual seduction that destroy the will (2005: 43). to use Manderson’s analogy (2005: 58). -Given the limitations apparent to conceptualizing Silk Road as cybercrime. illustrated by the ‘discourse of lack’. Buyers using Silk Road are advised on discussion forums and seller Q&A pages to use pseudo. ••  use of encrypted electronic currency (e. pp. increase stamina and dull hunger while one labours. these were: exotic chemicals. economies of scale. . Leons. child pornography or contract killing. or at least changes our perceptions of "reality" and thus moves us to an "altered stat -Finally. physical pain and anxiety. Cryptomarket technology – of which Silk Road is just the largest iteration – therefore presents one of the most prom. 1987). government banned cocaine and coca from flee consumption and classified them as illegal narcotics in 1915. and by a variety of street names. CT: Praeger. In the international ar·ena. with Colombian drug organizations. . and white in the 1970s to being more heterogeneous in terms of race. meaning hemp) • Portions of the Cannabis sativa plant producing a resinous exudate secretion rich in specified terpenoid chemicals. By the 1920s. retail sellers. 1982. As a result o f this war. ethnicity. a South American plant. Standardisation of any plant material. but it has been able to provide better-paying jobs to the unskilled and skilled Our analysis has also shown that despite the fact that cocaine is an illegal commodity and that a regional. no taxation. S . On the domestic flont. resulting in "de facto" aid for counterinsurgency programs and repression of local populations In recent years. these are in fact ineffective strategies for achieving the goals ofthe policy. Coca. and peddlers sell it to the world's largest market of cocaine con. the mixers first add kerosene and SUlflIIic acid to the coca leaves Stompers. Not only has the cocaine tIade benefited from the decline in formal labor arrangements. and emphasis on punitive and repressive law enforcement. Like coca cultivation. Musto. in most parts of the world. a New South Wales Legislative Council multiparty committee recommended that medicinal cannabis should lawfully be made available for selected.opment as a way of getting international money into the country that might enter competitive. and Colombia for over a millennium The U. lower-priced heroin had largely replaced cocaine in the market and in drug. despite the fact that studies at the time showed that they were white. a major non-psychoactive component that attenuates the cognitive effects of THC and may have useful effects of its own.S.S. chemical components of cannabis other than cannabinoids probably contribute to the medicinal and other effects. wholesalers. called pisadores. dietary supplement and medicine (as a tincture). . 297-315. Rauwendaal. market oriented activities" Sanchez de Lozada's opci6n cero plan was a desperate attempt to up the ante in capturing such international resources for the country. and income by the 1990s Crack's appearance in the mid-1980s expanded the availability of cocaine. In Commodity Chains and Global Capitalism. it still shares similarities with other transnational commodities-profits remain within core countIies and the trade is tied to the global economy by links to legal industIies such as chemical and arms manufactuIing and the world's financial system. the U . and 5) doing away with the crime and violence associated with the drug trade. In order to produce coca paste. employing racist imagery to purport that the majority of users were blacks..S." we can depict cocaine as a five-part transnational commodity chain: coca cultivation. refining coca paste into cocaine. Crack's roots lie in smoking freebase. AD (2013) (Re)introducing medicinal cannabis.We would contend that however one measures the results. • The evidence indicates that cannabis has genuine medicinal utility in patients with certain neuropathic conditions. a pattern similar to today's (Courtwright et al. Medical Journal of Australia 199(11):759-762 • After considering extensive scientific and medical evidence. g.it is illegal in the U. cocaine export to consumer markets. wholesale distributors.based products to lower-income groups.. and distribute cocaine to the United States.control officials' concerns Two significant legacies horn this first war persist in today's war on cocaine. extract or blend for medicinal use is essential. The policy course the U. the cocaine trade binds Pemvians and Bolivians. . the U. LE. thus deprivingthe cocaine trade of its raw material. 3) consequently increasing the price of cocaine and crack to unaffordable levels. Cannabis terminology. ER.He concludes that Bolivia's best harm reduction package is probably its present prohibition regime and that "[t]he task is to pursue the present course of nominal crop eradication and more aggressive alternative devel. Mather. pp. sativa. In brief. has been cultivated in Peru. 4) resulting in lowering the consumption of cocaine. which resulted in soaring numbers of illegal dealers and skyrocketing cocaine prices (Courtwright. • Historical source of fibre. under the Bush administration. middlemen. • Principal botanical cannabinoids are tetrahydrocannabinol (THC) and cannabidiol (CBD). and the chemovar is the most reliable predictor of medicinal value. which refine. labor intensive. middle·class. We see these interrelated goals as the following: 1) reducing significantly the amount of coca grown.ceived to be caused by the cocaine trade is based on two keystone principles: disproportionate investment in control of supply rather than control of demand. drawing horn the flexible reserves of labor thereby created.Second. coca paste production. Wilson. transport.Changes in the global economy (e. who cultivate coca and process the coca paste. the trend toward increased militarization has accelerated Similarities . Westport.S engaged in its first war on cocaine. food. this procedure is very labor·intensive and does not require sophisticated equipment. with acceptable levels of risk from mostly mild side effects.giving it high market prices and high return. where US. then pound the mixture to fOIm the coca paste. being directed towards the hazards of its recreational use. 2) therefore reducing the flow of cocaine into the US. harvest and preparation. a "purer. • The NSW Government has since dismissed the unanimous and compassionate recommendations of their committee. and distribution within cocaine-importing countries. cocaine is not regulated in the same manner as other commodities. and low··level distributors Money laundering. with research and society’s attention. government started advocating international drug policies to control coca production at source countries The cocaine-consuming population also switched from being predominantly well-off. thus ties the illegal economy with the legal economy by recycling drug money into the legal financial system. Commodity Chains and Drug Politics: a Transnational Approach’. Moxham-Hall. 1989). dominant discourses on dmg abuse viewed cocaine use as a criminal activity. most narcotics aid has been given to the military. VL and Wodak. S & M Zambrano (1997) ‘Cocaine. Cannabinoids • Substances (regardless of chemical structure and whether they are natural or synthetic) that bind to biological receptors and produce the classical spectrum of pharmacological effects demonstrated by extracts of C.sumers Difference between cocaine and other commodity . and varietal names related to botanical cultivars. Bolivia. tIre main thrust of narcotics policy is directed toward arresting low-level street dealers and most domestic funding On the international front. There are no state policies. storage. has set to control the harm per. more solid form" of cocaine Using Hopkins and Wallerstein's (1986: 159) definition of a commodity chain as "a network of labor and production processes whose end result is a finished commodity. tIends toward less state intervention and the informal economy growth) have affected cocaine like other commodities. a key component of the trade.use pharmacotherapy. • The potential medical benefits of cannabis pharmacotherapy have largely been overlooked. substances and preparations Cannabis (Latin. Latin American elite controls production. • With all modes of administration... • Also known as marijuana or marihuana. • Concentrations of chemical constituents can vary by plant strain and conditions of growing. . or no tariffs to promote the trade and cocaine manufacturing On the domestic front. tion "on his own. the vast bulk of government funding has been allocated to law enforcement. erections were rein. Practitioners and policy makers need to under. Phase I is a clinical trial on a few persons to determine the safety of a new drug and its dosage or toxicity limits.THC:CBD. epidemiological. As described in the NIH Consensus State. • Whole-plant extract.theirdrug-companylogosgleaming in the sun.7 mg THC and 2. J. “Making Viagra: From Impotence to Erectile Dysfunction. Itishardtoimaginethattheywillnotturnto elite athletes. • Natural THC (Namisol. Programming efforts addressing problem alcohol use among long-term displaced populations in alcoholconsuming cultures need to be assessed on their impact on IPV against women.signing interventions. 2. This also marked the beginnings of the transformation of terminology from impotence to "erectile dysfunction" (ED) erections are dependent upon a complex interplay between vascu. 183-200. The Wilson Quarterly Vol. Although. In the 1990s. Fishman (2007). the few successes of Austraha's drug policy can be attributed to the harm reduction programs.ence" sponsored by the National Institutes of Health. including both vasoactive intestinal polypeptide (VIP) and prostaglandin El' Prostaglandin El does play a role in inducing erections. etc. inducing relaxation of the smooth muscle of blood vessels.macological Calvinismin thefaceof growing demands for the "therapeutic"benefits of enhanced Theelastic of performance. pharmacy-supplied for vaporisation or tea preparation. Preparations currently available • Synthetic THC (dronabinol [Marinol.. 19. Attracting drug users from the illicit supply system into drug treatment will improve the lives of drug users and their families as well as reducing crime for the entire community. 2:1 (Cannador. ineffective and counterproductive. and regardless of whether or not a man had any difficulty getting an erec. Drugs and Democracy.” Men had a choice of either accepting and adjusting to these changes or consuming morally and medically questionable elixirs or nostrums such as Brown. Hoberman.ating erections. (1995). erections are most often initiated by a central nervous system response to psychogenic stimuli (e.35-44 it is easy to endorse the medical wisdom of warnings against the widespread use of steroids and other potentiallydangerousdrugs. Australia now has the example of other more successful countries to emulate. 1.tions displaced by conflict is particularly warranted. Nitric oxide is released by both the caver. Meda Pharmaceuticals]): oral capsule.pharmacological effects may therefore be enhanced by synergies between constituents of cannabis not present in isolated or synthetic cannabinoid pharmaceuticals. which then activates the sympathetic and parasympathetic innervation of the penis.first rods inserted greater blood flow." a diverse group of clinicians. N (2013) It’s not just the alcohol: Gender. injections such as these could produce erections regardless of the etiology of the impotence. and a condition of the 0Id. At the 1925 Geneva Convention. violence against women.. import. Phase III is a large clinical trial of a drug that in phase I and phase II has been shown to be efficacious with . A fundamental review of drug policies is required that redefines the problem of illicit drugs as primarily a health and social issue Unless such a redefinition is accompanied by a major re-allocation of funding. while impotence in men over 45 was still considered a "normal" part of the physical decline of aging. Week 5 readings." As Marshall and Katz summarize. progress will not occur. The parasympathetic aspects of the arousal response were newer elements in the theory and ran counterintuitive to previous notions of sexual arousal. Listening to Steroids.lar and neurological events. Experience with more than seven decades of cannabis prohibition and almost five decades of heroin prohibition suggests that these policies are expensive. "impotence was still largely regarded as a disease of the young." perception. Australia agreed to enact laws to 'limit exclusively to medical and scientific purposes the manufacture. Indian hemp and heroin' In 1997. More research is required on the relationship between alcohol. oral tablet with novel emulsifying drug delivery technology. 2009.stand gendered roles and power relationships when de."26 In 1992. The most important step is to redefine illicit drug use as primarily a health and social issue rather than a criminal justice problem.12:<1(Bedrobinol). psychotherapy was recommended (and considered successful) for men under 45. it is the active compound in penile injections.). using the Delphi technique. Phase II of a clinical drug trial is when a drug is tested on human subjects to evaluate its fficacy and side effects. pp. It now appears that the reform of Australia's drug policies is more a question of 'when' than 'whether'. 'Fine tuning' of these policies or 'more of the same' is unlikely to achieve improved outcomes. distribution. 14:< 1 (Bedica): produced by Bedrocan BV for the Netherlands Ministry of Health.Sequard's "PoW's Spermine Preparations.5 mg CBD per 0. Further economic. • Synthetic analogue of THC (nabilone [Cesamet.g. • Botanical cannabis extract with minor cannabinoid and other plant-derived substances. concept therapywill help to legitimizehormonalma. Thailand. linedup atthestartof anOlympicfinalearlyin thenext century.It is interestingto speculateabouthow the advertisingexpertswill promotetheseproducts. Solvay Pharmaceuticals]): oral capsule.1 mL (nabiximols [Sativex. and gender in general. and social science research to improve understandings of common causal pathways is required as a basis for identi.Onecansee theathletesnow. Welfare and Sport. this shift of impotence from a psychological to a biomedical disorder was stabilized and codified by a "consensus development confer. researchers.19:1(Bedrocan). A (2000) ‘Developing More Effective Responses’.fying and implementing complex interventions. THC:CBD. Echo Pharmaceuticals): early development. IKF Berlin): oral capsule. Melbourne: Melbourne University Press. 6:75 (Bediol). Ezard.nipulationas a mass therapyof the future. "desire. Bayer]): oromucosal spray Wodak.nosal nerves and the epithelial cells of the corpus cavernosum. the historyof athleticdoping in this centuryshows that it has been very difficult to enforce such phar. pp. sale. enabling erections. Up to this time. P Chalk & K Gillen (eds). a number of neurotransmitters were considered responsible for cre. alcohol use and intimate partner violence in Mae La Refugee Camp. No.ment. Substance Use and Misuse: 1-10 This study from one long-established refugee camp describes how alcohol use and IPV are shaped by the specific social context and embedded within gendered power rela-tionships."7 Therefore. cocaine. intervention-oriented research among popula. In G Stokes. and those for heroin following international pressure. export and use of medicinal opium. nitric oxide as a messenger signal of the cardiovascular sys. morphine. he and Rajfer conducted some of the research identifying nitric oxide as the neurotransmitter responsible for smooth muscle dilation in the penis. . government officials and drug users estimated that there were currently 100000 regular injecting drug users with an additional 175000 occasional injecting drug users Australia's drug policies were originally adopted for cannabis on an almost arbitrary basis.portrayingthem as pharmacologicallyimprovedexamplesof supercharged health. Like implants. law enforcement officers.tem.terpreted as a function of blood flow. • Standardised plant matter in granular form. Desmond Manderson (2011). The available empirical evidence suggests that at the global level there have rarely been more than 10 percent of any one type of illicit crop eradicated in a given year. no matter how severe they might be. fears and desires.This autotoxin had effects opposite to opium. Apparently. psy. eds. addiction to refer exclusively to the excessive use of drugs and to replace terms such as intemperance and inebriety DSMIV does not say disease but disorder and does not day addiction but says substance dependence or substance abuse. psy.istered. such that it was no longer considered a component of normal aging. Jellinek suggested that alcoholism is a diease and people are born with it as if a alcoholic does not drink alcohol they will never have a problem.many reinforcing stimuli vt has long been known that if a neutral stimulus is paired with a reinforcing stimulus.tive stimulus. 2 theories . .cated impotence from a problem of the mind to a problem of the body. “Images of American Sexuality in Debates Over Nondescription Access to Emergency Contraceptive Pills” Obstetrical Gynecology 108(5):1272- Over the counter approach is the best to this contraceptive pills no matter what the situations are. Where eradication is implemented. and (b) the drug use has harmful consequences They proposed a hypothetical substance called an autotoxin-a metabolite of opium that stayed in the body after the drug was gone. It expanded the dependence model by assuming that drugs such as cocaine caused unobservable psychological withdrawal symptoms. New Jersey:Pearson Prentice Hall.chological.” In S Fraser and D Moore.92-127 (on eReserve).law is not just instrumental but also symbolic. McKim. . and sabotage. that is. Eventually. Food and Drug Administration (FDA).nations were developed to account for it The tenn physical dependence or physiological depen. withdrawal that caused a craving for a drug. repetitive predictable and destructive performance of a symptom.” Chapter 5 of Drugs and Behavior: An Introduction to Behavioral Pharmacology. This effect is known as the discounting delay Similarties between human and nonhuman animals . evidence relates primarily to two decades of United Nations programs and projects in 11 countries. farmers use a range of adaptive responses to minimize the impact.When a drug is admin. a positive reinforcer is any stimulus that increases the frequency ofa behavior it is contingent on . When punishing consequences occur infre-quently and after a considerable delay. a vehicle for the representation and organisation of our underlying anxieties.rate experiment of thomas and pickens. Crime and Society.way for erectile function. “Dependence. sixth edition. G (1998) ‘A Global Empirical View of Drug Crop Eradication and the United Nation’s Substitution and Alternative Development Strategies’. including popular opinion and public demonstrations. 28(2): 395-436.former sedative users will reuse the drug priming effect . The American Association for the Cure of Inebriates was established in 1870 and became the forerunner of the temperance movement. however. it will acquire reinforcing properties through classical condition. The drug crops in question were coca bush. The sickness that remained after the drug was gone became known as withdrawal or abstinence syndrome. definitions of addiction have two elements in common: Ca) The addicted individual has impaired control over the use of the drug. This model assumes that drugs are self-administered because they act as positive reinforcers and that the principles that govern behavior controlled by other positive rein. it seems likely to continue. pp.forcers apply to drug self-administration. What began as crop substitution in the 1970s became integrated rural development in the 1980s and emerged in the 1990s as alternative development. focusing attention on the penis as an "organ. farmers' risks are generally low. the empirical evidence regarding their effectiveness shows little reductions in illicit cultivation. the psychologization of impotence in the 1960s and 1970s pathologized impotence. positive reinforcement model. a company applies for formal approval from the U." Sildenafil in effect enhances the effect of the cGMP path. Melbourne: Cambridge University Press. as opposed to physical. they are less likely to exert as much control over behavior as will immediate gratification. A range of obstacles obstruct the implementation of eradication. however. but as a dysfunction in need of treatment. Journal of Drug Issues.tolerable side effects. it made the person very sick. or psychic. after successful conclusion of phase III clinical trials. .forcing properties can be demonstrated using a second-order schedule . and more accurate expla. the animal will learn to bar press just to make the light come on. such as a light. corruption. the light acquires reinforcing properties because of its association with the dmg.chological dependence presumed that there was some sort of psychological. previous experience . the most notable adaptive response is relocation and the new planting of crops. task demands. “Possessed: The unconscious law of drugs.S. stress a reason to use drugs. William A.ing.Addiction. that is.dence was used to describe the state in which the discontinuation or reduction of a drug would cause withdrawal symptoms.people born with the diease or people become addicted later on..the legal structure of law is not the solve the problem but to dramatise an ideology and to entrench an anxiety by the obsessive.suffers no ill effects on its discontinuance" the term psychological dependence became widely used. opium poppy. and when left in the body. The organicization of impotence beginning in the 1980s relo. Farrell." The idea that alcoholism was a disease was not based on any medical research at the time but was motivated strictly by humanitarian concerns. . despite efforts to tailor and improve the theoretical underpinnings of the approaches. pp.harm minimisation measures seek to improve the halt and longevity of drug users even if those measures lead to an overall increase in use .Zero tolerance measures seek to decrease drug use even if those measures worsen the health and longevity of those who use drugs. hence. and they can quickly resume cultivation. it is preceded or accompanied by a distinc.type of drug used and patterns of self admistriation. "Habituation is a condition in which the habitue desires a drug.225-239. The Drug Effect: Health. and the cannabis plant. Mid 1950s addictive behaviour was only related to humans as attempts to create addictions in animals was only through oral routes and because of taste this was normally rejected. Its first principle was. These rein. With respect to crop substitution and development work. dependence. and the Self-Administration of Drugs. and the risks to farmers of imprisonment are minimal. because development work is less punitive than eradication and far more politically acceptable within producer countries.for kids having the pills will not increase sexual vulnerability. but . Wynn & Trussell (2006). In short. The changes in terminology reflect refinements in methodology of the approach according to proponents and mark the failure of various policies according to critics. current eradication strategies hold little prospect for making substantial inroads into illicit cultivation. "Inebriety is a disease. Second order schedule . 2007. habituation (meaning "habit forming") should be used for drugs that do not create physical dependence. campus. The exceptions are most hallucinogens. • Most definitions of addiction describe drug use that is "out of control".enced stimuli and past actions and their outcomes.tem rather than a pleasure system. it is based on the presumption that the reinforcement caused by drugs is a result of pleasure created when drugs activate the nucleus accumbens and related structures they call the extended amygdala and the effect of withdrawal on that system.administration of particular drugs is similar. . • Experiments with nonhumans showed that physical dependence was not necessary for self-administration. Thus. and choice experiments have been used to assess the incentive value or reinforcing properties of drugs. incentive salience . This research shows that the effect of a price increase on demand for a commodity depends on the availability of competing commodities that dm act as substitutes.the finding that normally positive or rewarding events are discounted at a higher rate than losses or negative events of equal value.niques that have demonstrated this are (a) place conditioning and Cb) second-order schedules. • In the 1950s. Substance dependence is now officially a disorder in the DSM-IV .administer are used and abused by humans. • Despite explanations involving biochemical deficiency and allergies. which is composed A part of the brain important in motivation is the mesoIimblc dopamine system. an opponent process or compensatory response increases.drug controlling a addicts life Sign effect . • -Rate of responding. • A positive reinforcer is any stimulus that will increase the frequency of a response on which it is contingent. This is called conditioned tolerance. place conditioning. Pleasure is a subjective state that often accom.A part of the brain important in motivation is the mesoIimblc dopamine system. • Nearly all the drugs that nonhumans will self. but this is not necessary. spiral to addiction . exposure to the same or other drugs. It often is accompanied by the experi. the disease of addiction has never been identified. • The positive reinforcement explanation of drug use and addiction may seem to be circular. they will reduce the effect of the drug when they are presented along with the drug. relief of some unpleasant symptoms. people who abused drugs were thought to be deficient in willpower or morality. and exposure theories that say that excessive exposure to a drug will make you an addict. • In humans and nonhumans. The animal becomes more sensitive to the drug rather than less sensitive. This is not a pleasure system. • The physical dependence model suggests that exces. These techniques have shown that the following factors can alter the incentive value of drugs: type of drug. the reinforcing effects of a drug (incentive value) and related stimuli become sensitized. In addition. Later. This causes tolerance to the pleasurable effect of the drug. the set point of the pleasure system changes so that the person becomes increasingly insensitive to pleasure. it was viewed as an abnormal type of behavior that could not be explained by the same rules that govern normal behavior. which are part of a learning and m. and drug abuse was thought to be a problem for the clergy and the church to handle.emory system that holds the memory ofpreviollsly experi. genetics. • Originally. This system. that is.panies activation of the mesolimbic dopamine system.humans would give themselves drugs in the same manner as humans. these stimuli are easily noticed. The idea that addiction was a disease was proposed in the mid-1800s but did not become formally recognized as such until the 1950s. but it can be shown that the brain mechanisms of positive reinforcement are similar to those common to all drugs that are used and abused. It is now known that the cause of the animal's becoming more active is the increased sensitivity of the mesolimbic dopamine system to the drug.easily noticed. in conjunction with the motor loop and the learning and memory system. There are two types of dis. when it became known that non. which proposes that with repeated use of a drug. CHAPTER SUMMARY • Because drug abuse appeared to be particularly compulsive and self-destructive. the mesolimbic dopamine system and the nucleus accumbens in particular constitute a "wanting" sys. This means that the drug and related stimuli will have increased incentive salience. • Researchers came to realize that drug administra. physical/psychological dependence theory. Predisposition theories say that some people are born with a predisposition to become addicted. depriva. to some extent. dose. The incentive sensitization theol)' uses this change in sensitivity to explain addictive behavior. that is. physical dependence. and. As a result. historically. task demands. Another neurological theory is the hedonic dysregulation theory. the pattern of self. progressive ratio schedules. . Two tech. it was easily demonstrated that some assumptions of the disease model and the physical dependence model were not correct. • -The reinforcing effects of drugs can be conditioned to stimuli paired with drug administration.ease theories.tion. All drugs that are self-administered are known to cause a release of dopamine in the mesolimbic dopamine system. stress. Their theory is a hedonic. The problem with this is that there is no way of defining whether any behavior is controlled. the addict cannot stop using the drug. the medical profession became involved in attempts to treat people who were abusing opium and morphine because these substances were widely used as medicines. and animals will avoid infusions of these drugs.tions could control the behavior of organisms in the same way as more traditional positive reinforcers. The incentive sensitization theory proposes that with repeated administration.sive dmg use is motivated by a fear of the withdrawal symptoms that occur when a person stops using a drug. such as food and water. The moivation control system also receives sensory information about the environment. • Some drugs can act as negative reinforcers.If drug-related stimuli cause a compensatory effect. is responsible for positive reinforcement by giving stimuli incentive salience.dence by suggesting that these dlUgS cause psychological dependence. This information is processed by the thalamus and conex and then sent to the amygdala and the hippo. and we are attracted to them-we want them.ence of pleasure. which expresses itself as craving for the drug. Demand curve states that if anything else is positive one would take the alternative if they wish. that is. which is composed of cells in the ventral tegmental area that release dopamine in the nucleus accumbens. the person must take increasing amounts of the drug. Proponents of the dependence model explain the abuse of drugs that do not cause physical depen. all of the above. usually. the 'priming effect of drugs' is a phrase that McKim uses to refer to: Select one: a. The value of a reinforcer or a punisher decreases hyperbolically as the event becomes further and further away in time.forcers have been shown to act as alternatives for drug reinforcers. . the attitude of the person at the time of use. the shared style of drug use. - Both other drugs and a variety of nondrug rein. Pharmacokinetic tolerance results in the reduced bioavailability of the drug and. a 'crack pipe') can spark a relapse. There are various underlying causes of tolerance: pharmacodynamic tolerance reflects the changes in receptor activity which accompany repeated drug use. the demand is said to be elastic.standing operant behavior is called behavioral economics. b. . The effect of providing an alternative reinforcer is greatest when the cost of the drug is high. serotonin and noradrenaline. Mid semester Quiz question and answer All drugs . D-amphetamine stimulates the release of monoamines independently of the electrical activity of the neuron. on the extent of drug use. d. Reserpine inhibits the synaptic vesicular storage of the monoamines: dopamine. Organisms will distribute their behavior among a number of tasks in accordance with the rate of rein. This release leads to an increased concentration of monoamines in the synaptic cleft and. Manderson examines modern legal and cultural understandings of drugs with attention given to:  c. with the risk being particularly acute during: The correct answer is: the first three months of development..legal or illegal . thus. Feedback The correct answer is: all of the above. c. It can explain both choice to use drugs and the effect of economic factors. Addiction and the Self Administration of Drugs'.represent a potential threat to the well-being of a fetus.Providing an alternative reinforcer can greatly diminish the demand for a drug reinforcer. this is often caused by the enzymatic induction of cytochrome P-450 in the liver. the network of drug users surrounding an individual user. this means that we can alter the reinforcing value of drugs by increasing the other sources of reinforcement available in the environment. Question 5 In Zinberg's theory of drug use the term 'set' has the following meaning: Select one: a. including his/her personality structure Question 6 . an increase in receptor stimulation. involves changes in drug metabolism. the ways that stressful stimuli can trigger a relapse in addiction for abstinent former addicts. This can explain why people can make irrational decisions and often change their minds.The application of economic principles to under. psychomimetic is a term used to refer to a drug that The correct answer is: is 'madness inducing' The legal theorist D. c. spirit possession and witchcraft laws Question 4 In 'Dependence. the ways that stimuli previously associated with drug delivery (e.I f people spend less on a commodity when the price increases. thus starting a spiral of addiction. If they do not decrease spending on the drug (or increase spending). the influence of the physical and social context within which drug use occurs. Known as the matching law. thereby heightening the risk of relapse. a situation where a user is exposed to a drug to which they were previously addicted. the demand is said to be inelastic.forcement on each task. Parott article The half-life (tl/2) is the time required for the concentration of a drug to reach half its peak plasma concentration and provides a guide to the duration of action of the drug and the dosing interval required to maintain optimal therapeutic concentrations. Feedback The correct answer is: the attitude of the person at the time of use. Tolerance is defined as the need for an increasing dose of a drug to achieve the same psychopharmacological effect. • Some drugs can control behavior because the use of those drugs diminishes the availability of other reinforcers that could compete with them. b. For many drugs. Drug use can be understood in terms of behavioral economics.g. demand is inelastic up to a point at which it becomes elastic. including his/her personality structure d. such as price and availability. d. d. d. b. c. physiological agonism. mixing methamphetamine with alcohol is a good exmaple of: Select one: a. tobacco. The Himalayas b. Feedback The correct answer is: all previously mentioned answers are means by which shamans enter into trance states. b. c. a way of minimising harm associated with both drugs. Serotonin. Continental Europe c. generally uncommon. the social dynamics that encourage or discourage drug use d. the social position of drug users b. fasting. b. North Africa d. none of the above Feedback The correct answer is: the social position of drug users Question 10 Shamans are spiritual healers that enter trance like states for various community or personal functions. Feedback The correct answer is: Glutamate Question 7 According to Kraushaar. the perceivable social and material environment at the exact time of drug consumption c. controlled breathing. Please identify the following answer which is NOT a way that Shamans enter into trance in the new world:  Select one: a. physiological antagonism Feedback The correct answer is: physiological antagonism Question 8 we find the most natural hallucinogens in Select one: a. a fun night out.  music and dance. something only the lower class engages in. Dopamine. all previously mentioned answers are means by which shamans enter into trance states. Glutamate b. d. Question 11 In Jamaica cannabis consumption is: Select one: a. . Acetylcholine.Which neurotransmitter is most involved in craving: Select one: a. differently meaningful depending largely on who is consuming it c. c. the New World (the Americas) Feedback The correct answer is: the New World (the Americas) Question 9 social locus refers to Select one: a. e. something only the middle class engages in. being more or less dependent upon the unreliable views or narratives of people in altered states of consciousness. Feedback The correct answer is:  both the social sanctions and social rituals surrounding drug use Question 14 Why did cannabis/THC use fall out of favour in western medicine?  Select one: a. cross the blood brain barrier. c.  blocking serotonin receptors in the prefrontal cortex b. are seriously hampered by taking subjective approaches to drug use. social control refers to:  Select one: a. and alcohol create sensations of reward in the brain by: Select one: a. all of the above.  both the social sanctions and social rituals surrounding drug use d. b. medical professionals did not believe it to be an effective treatment of diseases and mental conditions. so medical professionals were fearful about overdosing Question 15 Ethnographic studies of drug use: Select one: a. b. are reliant solely on surveys and statistical quantification. Feedback The correct answer is:  it was not water soluble and dosages were hard to judge. are not characterised by any of the above statements.  stimulate specialist receptor sites. d. all of the above Feedback The correct answer is: all of the above Question 13 Zinberg argues that 'social controls' shape the effect of a drug. so medical professionals were fearful about overdosing d. b. c. the attitude of the person at the time of drug use and their personality structure. because it was illegal. the people using the drug with you. increasing dopamine release in the nucleus accumbens c.   Feedback The correct answer is: are not characterised by any of the above statements. c.   Question 16 Drugs like nicotine. cocaine. block specialist receptor sites  d. c.  increasing entactogen receptors in the cerebellum Feedback The correct answer is: increasing dopamine release in the nucleus accumbens Question 17 What are the main types of brain cells that co-ordinate brain function?   Select one: . because it was associated with crime and madness.Feedback The correct answer is: differently meaningful depending largely on who is consuming it Question 12  Drugs alter functioning in the central nervous system because they can: Select one: a. increasing blood flow to pleasure centers of the brain d. b.  it was not water soluble and dosages were hard to judge. start from the assumption that drug users are mentally ill or sociopathic. c. b.  drug users generally engage in behaviors that allow them to assert some control over their drug use. microglia. Feedback The correct answer is: ecstasy . d. Ecuador. Feedback The correct answer is: Hemp Question 21 Andrew Weil has argued that the Amazonian Indians have devised effective social controls pertaining to the use of hallucinogens. Bolivia.  the personalities of drug users are primarily responsible for their addiction. Feedback The correct answer is:  neurons Question 18 The suspected origin of tobacco is: Select one: a. drug users will do absolutely anything to get hold of drugs. heroin. c. glial cells. the use of hallucinogens is usually done under the supervision of an experienced user. please indicate which of the following claims are NOT one of Weil's explanations for this phenomena: Select one: a. Bolivia. ependymal cells. modern day Europe. Hashish d. such as a Shaman. Peru. e. the Himalayas or India d. b. modern day Canada. they do not use refined drugs. d. c.  neurons b. ecstasy d. c. d. they are not taken for negative reasons (such as to rebel) but for positive reasons. Feedback The correct answer is:  drug users generally engage in behaviors that allow them to assert some control over their drug use. c. Question 20 Which of the following is the least potent form of cannabis? Select one: a. Feedback The correct answer is:  they believe its ok to be deviant once in a while Question 22 MDMA is another name for:   Select one: a. Hemp b.  the use of hallucinogens is highly ritualised. Ecuador. Hashish oil. Question 19 Ethnographic studies of drug-using communities have revealed that: Select one: a.  they believe its ok to be deviant once in a while b. Feedback The correct answer is: Peru. drug use patterns can be explained solely by the pharmacological properties of drugs. Marijuana (leaves and tops) c. LSD. b. PCP.a. d.. Question 27 The medicinal uses of cannabis were introduced to Europe by:  Select one: a. d. tobacco d. Jamaican Rastafarianism Feedback The correct answer is: WB Oshaughnessy Question 28 the US military took an interest in LSD thinking it was Select one: . a person who uses drugs in social settings for spiritual or moral reasons (e. the communication between dopamine receptors. c. none of the above. to one that is increasingly popular amongst 'modern' Thai youth. b. electrical communication between neurons. utilising support from interest groups in society and the media. Feedback The correct answer is: tobacco Question 24 In Thailand perceptions about methamphetamine have shifted:  Select one: a. From being 'lethal' to being seen as 'harmless'.  from it being a drug used mainly by 'traditional' and backwards Thais.  a member of the elite classes in society who actively defends drug use (e. b. Shamans). Feedback The correct answer is:  from being a 'productive' drug to one that induces 'madness' and 'violence' Question 25 A 'moral entrepreneur' is:    Select one: a.all are true hallucinogens. none of the above .. datura c.  from being a 'productive' drug to one that induces 'madness' and 'violence' b. d. the absorption of drugs through inhalation. Timothy Leary). b. a crusader who influences laws by shaping public perceptions of drugs. Sir Joseph Banks d. chemical communication between neurons. c. c. Rastafarians. From being relatively 'non-addictive' to being 'highly addictive'. belladonna.g. e.Question 23 Which of the following substances is not a ‘true’ hallucinogen:  Select one: a.  san pedro cactus. WB Oshaughnessy b. utilising support from interest groups in society and the media. Feedback The correct answer is: a crusader who influences laws by shaping public perceptions of drugs.g. Feedback The correct answer is: chemical communication between neurons. Question 26 The term 'neurotransmission' refers to: Select one: a. Christopher Columbus c. drinking tobacco juice e. all of the above. The correct answer is: the native americans consumed tobacco in all the above ways Question 6 What is the suspected origin of cannabis?  Select one: a. LSD d. the native americans consumed tobacco in all the above ways Feedback Your answer is correct. The correct answer is: India Question 5 'Midnight Climax' was the name given to the CIA operation that experimented with Select one: a. false b. it is preferable to artists celebrating more dangerous drugs. d. c. The Americas Feedback Your answer is correct.a. it is a way that the underclass can gain an income and thus pay for health services. e. Opium b. b. the celebration of cannabis in hip hop culture is positive for public health because:  Select one: a. none of the above Feedback The correct answer is: a truth drug Question 29 According to Philippe Bourgois. a truth drug b. preventable cause of death and disease in Australia: Select one: a. c. a drug that terrorist and militant groups might use to attack the US and its allies d. India d. chewing b. it is a means by popular culture may lend legitimacy to the therapeutic effects of cannabis consumption. Viagra c. Question 30 true or false: smoking remains the largest single. a drug being used by the USSR to enhance the performance of soldiers in the battlefield. Feedback The correct answer is: it is preferable to artists celebrating more dangerous drugs. enemas c. North Africa c. Mexico b. true Feedback The correct answer is: true Question 7 Which one of the following is NOT a way that Native Americans consumed tobacco:  Select one: a.  it is likely to contribute to its decriminalization or legalization. Cannabis . blowing tobacco dust into the nose d. like crack and heroin . like crack and heroin . a fun night out. physiological antagonism d. a way of minimising harm associated with both drugs. LSD) Feedback Your answer is correct. The correct answer is: physiological antagonism . with the intended use being a madness gas? Select one: a. b. d. some drugs are highly addictive (e. b..g. nicotine) and others less so (e. people who are addicted to heroin are likely to have previously used cannabis c. mixing methamphetamine with alcohol is a good exmaple of: Select one: a. Opium c. Feedback Your answer is correct.Feedback Your answer is correct. c. there are genetic differences in tolerance to certain drugs: some genes act as a 'gateway' to drug abuse. The correct answer is: LSD Question 1 The 'gateway hypothesis' is used to explain why: Select one: a.. The correct answer is: LSD Question 3 According to Kraushaar. physiological agonism. The correct answer is: people who are addicted to heroin are likely to have previously used cannabis Question 2 what drug was developed into an aerosol form by the US military.g. Alcohol d. LSD b. Caffeine Feedback Your answer is correct. drug induced psychosis emerges in only some users.