It is not east to arrive at definitions that are commonly agreed upon in the substance abuse field. This is because the pharmacological actions of drugs on the human system are very complex and not yet fully understood. Moreover, individuals will experience different drug effects depending on physical and psychological make-up. The wide range of substances used and society's changing attitudes towards various substances also create challenges in this area. Nonetheless, research and practice in this field are leading to greater agreement on drug definitions.

Drug
A drug is any substance, natural or synthetic, which when taken into the body, is intended to bring a change in medical, behavioral or perceptual states for either therapeutic or non-medical purposes(17). The substances of concern in this booklet are called psychoactive drugs, i.e., they are capable of modifying the user's mood by way of their action on different brain centres. The either depress (e.g., narcotics, barbiturates, and tranquilizers); stimulate (cocaine, and the amphetamines); or they transform in a fundamental way neurochemical activity (e.g., LSD, and the other major hallucinogens). Psychoactive drugs have the potential to be abused and to affect various areas of a person's life.

Drug Abuse
The World Health Organization (WHO) proposes the term drug abuse or harmful use to mean a pattern of psychoactive drug use that causes damage to health, either mental or physical. The WHO notes that harmful use of drugs by an individual often has adverse effects on the drug user's family, the community and society in general(18). It should be noted that in the case of illicit or "street" drugs, where purity and dose are unknown factors, any use, even first time use, may well constitute abuse.

Tolerance
There are different types of tolerance to drugs, but basically they all mean that dosage must be increased, or the drug must be taken more often, to maintain the same level of effect. The World Health Organization defines tolerance as a reduction in the sensitivity to a drug following it's repeated administration, in which increased doses are required to produce the same magnitude of effect previously produced by a smaller dose(19). Tolerance may develop much more rapidly in some individuals than in others.

Dependence
There are three components involved in the concept of drug dependence:

Physical - The user's body has become so accustomed to the presence of the drug that when it is no longer used, withdrawal symptoms occur. These may be mild, such as sneezing and a runny nose, to very severe, such as potentially fatal convulsions. The severity of withdrawal increases with the level of the drug taken and the duration of abuse.

Psychological - Users, though not experiencing withdrawal symptoms upon cessation of use, nonetheless believe that they cannot function without the drug and crave it.

Addiction - Traditionally, this term has been synonymous with physical dependence and full-fledged withdrawal symptoms. Though the term is still widely used, most specialists prefer the term "drug dependency." What is important to remember is that contrary to popular opinion, it does not matter a great deal whether a user is physically or psychologically dependent. Both forms of dependency indicate a serious loss of control.

Factors Governing the Intensity of Effects

Drugs in the same category have similar effects, but the potency of the drug varies with the particular compound. For instance, heroin is stronger than morphine and morphine is stronger than codeine though they are all derived from the opium poppy. The symptoms and the effects of using a given drug can vary considerably with the dose taken; this is especially true of short-term effects.

Concentration in the Body
This factor depends on the dose and the pharmacological properties of the drug. The latter determine how the substance is absorbed, distributed, metabolized (chemically transformed), and eliminated from the body. Drugs are either fat soluble (e.g., cannabis) or water soluble (e.g., alcohol). Fat-soluble drugs are absorbed through the mucous membranes of the nose, throat, intestine, rectum, and small air cells of the lungs (alveoli). Water soluble drugs are absorbed principally through the walls of the small intestine and the stomach.

The rate of absorption depends on the concentration of the drug (dose and purity), its degree of fat solubility, the surface area of absorption, and the diffusion distance, i.e., the number of membranes it must cross before reaching the bloodstream and the central nervous system (principally, the brain).

Administration of the Drug
There are several ways a person can take a drug, depending on personal preference, the level of dependence, the nature of the drug, and the setting in which the drug is being taken.

(1) Oral: This is the most common method. It can be used for pills, capsules, liquids, tablets, and powders. Drugs taken by mouth are absorbed principally through the small intestine, less so through the stomach walls.

Drugs taken by mouth tend to be absorbed slowly, in part because they can be diluted by the presence of food in the stomach. Food can also coat the drug so that it will pass out of the body through the feces without having been absorbed. Oral administration usually means a less intense drug effect, particularly for major depressants or stimulates of the central nervous system.

(2) Across Mucous Membranes: The mucous membranes are the moist surfaces of the nose, sinus cavities, mouth, throat, rectum, and vagina. The rate of absorption tends to be rapid because mucous membranes are thin and have a greater blood supply than the skin. There are two major ways a drug can enter the body through the mucous membranes. Drugs such as cocaine, amyl nitrate ("poppers"), and tobacco snuff can be sniffed ("snorted"). This leads to rapid and effective absorption across the mucous membranes of the nose.

Inhalation of a drug also means the drug enters the body rapidly and effectively, this time across the mucous membranes of the alveoli, the tiny cavities in the lung where the exchange of gasses takes place. The drug must be in the form of a gas (such as the vapours of glue or solvents), fine liquid drops, or fine particles of matter suspended in a gas (such as tobacco or cannabis smoke). It should be noted that glue vapours are inhaled and are, therefore, absorbed through the lungs; technically, the term "glue sniffing" is incorrect.

(3) Parenteral (injection): There are three methods of injecting a drug, and all lead generally to more rapid absorption and intense effects than other forms of drug administration. They also mean a much more serious risk of infection due to the sharing of needles. Two infections often associated with the injection of drugs due to the sharing of needles are HIV and hepatitis B.

Subcutaneous injections ("skin popping") involve injecting the drug just under the skin. This is normally seen among beginning injection users because it is not difficult to do and is less traumatizing psychologically.

Intramuscular injections involve a deeper injection into tissue mass. Localized pain is the major drawback to this type of injection, though there is the advantage that the needle can be inserted through the clothing and the injection can therefore be given rapidly. Intramuscular injection is a common method of administration by users of anabolic steroids.

Intravenous injections ("mainlining") lead to extremely rapid absorption and intense effects because the drug is injected directly into the bloodstream through a vein. It is often the preferred form of drug administration for experienced users.

Distribution in the Body
Once a drug is administered, the bloodstream distributes it throughout the body. The distribution is not even, because some drugs dissolve more readily in fatty tissues, others prefer bone marrow, and yet others bind more easily with blood elements. A drug must be highly fat soluble to enter the brain (e.g., cannabis, heroin).

Elimination from the Body
Excretion in the urine is the major route of elimination for most drugs. The blood passes through the kidney, which acts as a filter. In the case of fat-soluble drugs, however, some of the substance is reabsorbed as it continues to pass through the kidney.

Volatile drugs, such as solvents, are excreted through the breath. In the case of alcohol, however, the breath is a very minor method of elimination.

Drugs can also be metabolized. The drug is transformed by enzymes into by-products called "metabolites." Most drug metabolism occurs in the liver and is a very complex process. In the case of THC (the main psychoactive ingredient of cannabis), for instance, which is highly fat soluble, the substance must be broken down into 25 metabolites.

It should be noted that repeated use of drugs metabolized by the liver leads to more rapid metabolism. This is a major factor in bringing about drug tolerance

Multiple-drug Use
While the principles of concentration, administration, distribution and elimination govern the intensity of the effects of a particular drug, the use of two or more drugs at the same time gives rise to effects that are less predictable. When they interact, some drugs may combine to produce an additive or intensified response, others may reduce or cancel some effects, while still others may magnify the effect to a point greater than an additive effect.

Drug Use and Drug Dependency

There are many patterns of drug use and it is difficult to predict the course of a person's drug use. A small proportion of users will become drug dependent; however, the actual course followed, and the outcome, will depend on many factors, including:

drug used
dosage administered
route of administration
frequency of use
personality of the user
genetic predisposition
extent of social support for drug use
availability of the drug(s)
Following is a schema that outlines three patterns or phases of drug use.

First phase: experimentation
Experimentors do not tend to differ a great deal psychologically from those who do not use. Whether an experimenter continues to use or not depends on such factors as availability of the drug, having a place perceived as relatively safe and friends who use or approve of use. Initially, users do not generally experience problems and can rarely see that their drinking or drug use might cause problems. Basically, they use drugs in moderate amounts, choose when and where to use them, and so on. The user feels more relaxed, less inhibited, and may experience moments of euphoria. During this first phase, users may feel resentment towards family, friends, and society who warn them against drug use because they cannot see anything wrong with what they are doing; in fact, everything seems very positive. Alternatively, some observers, such as friends, co-workers, and possibly even family members who do not see any negative effects, may reinforce the drug use, believing it to be harmless.

It is during this first phase that intervention is most timely, before problems emerge. Unfortunately, it is also during the first phase that intervention is most difficult, because the risks of drug use are often not apparent to the user.

Second phase: the emergence of dependency
The second phase, during which a pattern of use develops, is characterized by personal and social adaptation to more frequent drug use. Users subtly move away from family members, friends and social situations that do not support their drug use. Users must avoid any potential conflicts between their new lifestyle, which they still perceive as harmless, and their non-drug using past.

Users may easily convince themselves that everything is still fine, that they are not physically ill, depressed, or otherwise psychologically troubled. They may even still be producing relatively well at work or at school. This phase, depending on the factors listed above, can last indefinitely. Many "second-phase users" can be found in the workplace, where they may seem to be relatively immune to any ill effects.

Third phase: dependence syndrome
The user has become drug dependent; he or she must continue to use the drug to avoid either physical withdrawal or the extreme anxiety associated with craving. Users may show marked deterioration in physical health, and intellectual, emotional and social functioning. Their values may be radically different from those held prior to using drugs (e.g., engaging in prostitution and criminal activities, exhibiting lack of hygiene). The longer this phase persists, the more difficult cessation of drug use will be. By the time users have reached the third phase, increasing problems in a number of life areas, including work, will be evident. If untreated, dependence syndrome will often result in job loss and serious family, social, financial and legal problems.

Popular Myths

There are many myths and fantasies that encourage people to experiment with drugs. Here are some of the most popular.

"It's only alcohol, I don't do drugs"
Because alcohol use is very common (79% of Canadians over the age of 15 years report that they drink(20)), there is a tendency to consider it a benign substance and not a potentially harmful drug. Many who use alcohol, use it in a responsible manner and there is a tendency not to see the problems that can develop - accidents, absenteeism, lost productivity, violence, family conflict - and to ignore the very considerable costs to society that result.

"It's an aphrodisiac"
Though many substances have laid claim to this much sought-after label, such as MDA, the so-called "love drug", there are no aphrodisiacs. Many psychoactive drugs are capable of lowering inhibitions because of their action on specific brain centres, particularly the older part of the brain called the limbic area, which controls mood and emotional states. This is what accounts for the aphrodisiac myth.

The evidence is quite strong that regular drug users are far more preoccupied with obtaining a steady supply of drugs than with a healthy sex life. The drugs that are used generally have such a powerful effect on the brain that they replace the sex drive with an artificial desire based on craving the drug.

"I Just want to try it out"
Possible outcomes to experimentation include: the user won't like the effects and will stop use; the user will like the effects and will continue using; the user, not knowing anything about the drug's purity or dose, will have a very unpleasant experience, possibly even a fatal overdose.

Street drugs are notorious for being diluted with chemicals that can be extremely dangerous. Drug sellers are not concerned with the health of users. Another problem with experimentation is that users are convinced they will never become dependent. Addicted people, no doubt, start off "just trying it out."

"This is the only stuff I'm using"
It is very difficult to predict the course of one's relationship with a drug. While present use may pose few risks, the circumstances in a person's life may change and result in more harmful use. Few dependent users limit themselves to one drug. A wide range of substances are now available, in part because supplies are unpredictable and also because illicit laboratories are very inventive.

In using an illicit drug on an experimental basis, the user may come into contact with other people who use drugs and be offered other substances. Drug involvement that begins with the use of tobacco and alcohol may go on to illicit substances such as marihuana and cocaine. This is particularly true for users who start at a young age.

"It will never happen to me"
This variant of the "I just want to try it out" myth has special appeal to well-educated managers and executives. Executives accustomed to a "liquid lunch" or who have a drug habit, such as using cocaine, can do great harm to themselves and their company. Poor judgement and lost productivity may be harder to detect with a manager than with the line employee who is responsible for an accident, but can mean enormous costs, nevertheless. Education and a high paying position do not make one immune to drug dependence and its harmful consequences.

"Impaired driving = drinking and driving"
Many people associate impaired driving with drinking only without considering the impairing effects of other drugs. Alcohol consumption can have serious impairing effects; nevertheless, impairment by other drugs is also dangerous and illegal. Serious driving impairment by marihuana use is well documented(21). The use of stimulants as well as various over-the-counter medications while driving present serious problems, as well.

Drugs of Concern

Alcohol

The use of alcohol before and during the workday has been documented in an earlier section. Many skills and cognitive* processes begin to deteriorate at a Blood Alcohol Content (BAC) of 50 mg of alcohol per 100 ml of blood. (In America, a driver is considered to be legally impaired at a BAC of 80 mg of alcohol per 100 ml of blood). In practical terms, this means that an occasional drinker weighing 160-180 pounds (73-82 kilograms) who has two drinks within one hour on an empty stomach would be at least mildly impaired.

Major functional effects
(at a BAC of 80 mg of alcohol per 100 ml of blood)
impaired hand-eye coordination and hand steadiness
increased complex reaction time
impaired visual search and tracking
impaired transfer from immediate recall to long-term storage
prolonged glare recovery
contraction of visual field (tunnel vision)
difficulty in processing information
impaired performance of multiple tasks
Hand-eye coordination, reaction time, and other motor-sensory functions are still impaired on the morning and afternoon following the previous evening's alcohol intoxication. Even 34 hours after ingestion of alcohol, professional pilots still show impairment in their reactions(22).

*Cognition is a term widely used in psychology and generally means the process of knowing, or understanding, what one perceives.

Signs of use
flushed skin
slurred speech
impaired fine motor dexterity
poor concentration and reduced attention span
impaired recent memory
mood swings
absenteeism

Cannabis

(marihuana, hashish)
Cannabis has two principal forms: marihuana ("grass,""pot") and hashish ("hash"). Cannabis produces a more rapid effect than alcohol and is more easily concealed at the worksite. The potency of cannabis available to Canadians has increased dramatically over the years. While 20 years ago, a THC (the active ingredient) level of 1% was typical in a joint, levels of 3-5% are now typical, with some marihuana significantly exceeding those levels. When combined with alcohol, as it often is, the deleterious affects of both are increased.

Major functional effects
poor immediate recall
prolonged glare recovery
visual distortion
distorted perception of time and space
possibility of hallucinations
poor performance of complex tasks
poor tracking ability
impaired hand steadiness
increased complex reaction time
apathy and lethargy
Signs of use
giddiness
poor concentration and reduced attention span
impaired ability to understand abstract thought
loss of interest in surroundings
poor short-term memory
fluctuations in appetite

Cocaine

Though the coca leaf, and its extract cocaine hydrochloride, have been used for more than four thousand years, abuse in the workplace in North America is relatively recent. Partly because of its very high cost and alleged popularity among high-profile personalities, the use of cocaine in the workplace was at one time associated with the affluent, executive-level positions. The use of cocaine has, in the past decade, spread to other white collar, blue collar and student populations. The principal danger with cocaine is that its effects are intense but of short duration; over time, use becomes very frequent and psychological dependency extreme.

"Crack" is the street name for a more purified form of cocaine that is smoked. It is extremely addictive, and because it is prevalent in various centres in America, there is considerable concern about this form of the drug.

Major functional effects
exaggerated feeling of competency and power
hyper vigilance
excitability
poor judgement and decision-making
irritability
erratic, aggressive behaviour
impaired fine motor dexterity
impaired ability to estimate time and distance
Major functional effects
a dilation of pupils
exaggerated sociability and physical activity
absenteeism
hostile, withdrawn behaviour
irritability
flushed skin
a twitchy nose
slurred speech
impaired learning
increased reaction time
impaired psycho-motor coordination

Stimulants Other than Cocaine

(amphetamines, methamphetamine, methylenedioxymethamphetamine, Methedrine, Dexedrine, Ritalin, etc.)
The amphetamines ("speed") were first prescribed as appetite suppressants; it took several years before it was discovered that their repeated use leads to serious dependence and emotional disorders. Abuse has been documented among truck drivers and other individuals who must often work during prolonged periods. Though the use of speed-type drugs do not lead to physical dependency, it can lead to pyschological dependency and severe depression upon cessation of use.

"Ice" is a crystal form of a methamphetamine that can be smoked. The availability of a smokeable form increases the risk of abuse because it is delivered to the brain so rapidly and efficiently. MDMA, methylenedioxymethamphetamine, ("Ecstasy") is another amphetamine derivative.

Major functional effects
euphoria
insomnia
wild imagination
hallucinations
paranoia
irritability and aggressivity
Signs of use
excitability
grandiose ideas
erratic, aggressive behaviour
rapid, disconnected flow of ideas
needle marks
glassy look

Narcotics

(morphine, heroin, codeine, methadone, Demerol*, Dilaudid*, etc.)
* Drug names beginning with a capital letter indicate a proprietary name
Narcotics are major depressants of the central nervous system. Their repeated use, even over a period as short as two months, can lead to severe psychological and physical dependency. Tolerance develops quickly and withdrawal is very difficult.

Major functional effects
reduced nervous tension and anxiety
indifference to physical and emotional pain
reduced visual activity
poor concentration
possible pyschosis over time
Signs of use
needle marks on arms, hands, and legs
ulcerated veins
drooping eyelids
exaggerated calm and well-being
loss of motor coordination
Hallucinogens

(LSD, STP, MDA, DMT, psilocybin, mescaline, phencyclidine, etc.)
There are a great number of hallucinogenic drugs. These are substances that neither stimulate nor depress the central nervous system; rather, they greatly modify neurochemical activity in the brain such that the user experiences marked sensory distortion, particularly in the perception of time and space. The repeated use of hallucinogens leads to psychological dependency, but not to physical dependency. Tolerance is very high, so the user must stop taking the drug for a period of time before again experiencing its effects. Hallucinogens generally cost little to buy on the street. One danger they represent in industry is that the user may experience a severe type of flashback, which is unpredictable and may include visual and auditory hallucinations.

Major functional effects
severely distorted perception of time and space
bizarre ideation
depression and possible suicidal gestures
severely impaired memory
flashbacks
possible psychosis
Signs of use
excitability
mental confusion
mystical and magical ideation
infantile emotions

Barbiturates

(Nembutal, Seconal, phenobarbital, Tuinal, Dexamel, Mandrax, Quaalude, etc.)
The barbiturates are major depressants of the central nervous system. They were first prescribed to control epileptic seizures and in psychiatry. Their use in medicine now has fallen dramatically as repeated use of barbiturates leads quickly to severe pyschological and physical dependency. Tolerance is high and withdrawal is difficult and dangerous.

Major functional effects
drowsiness
depression
marked increased in reaction time
poor judgement
emotional instability
mental confusion
blurred vision
vertigo
Signs of use
drowsiness
weight loss
aggressivity
mood swings
staggered walk and slurred speech (user appears drunk)

Solvents

(cleaning fluids, nail polish remover, gasoline, household cement, lacquer thinners, lighter fluids, plastic cements, [naphtha, acetone, toluene, benzene], etc.)
The abuse of solvents is found principally among young teenagers. Repeated use leads to severe pyschological dependency and to moderate physical dependency. Tolerance is high, and there is a possibility of significant organic damage to the lungs, liver, kidneys, and heart. Withdrawal can lead to depression and a type of delirium tremens. In any work setting where solvents are used, it is important that the room be well-ventilated. In any cases of accidental intoxication, the company doctor should be consulted.

Major functional effects
poor motor coordination
mental confusion
double vision
mood swings
chronic apathy
Signs of use
giddiness
slurred speech
drowsiness
pupillary dilation
ethylene-type smell on breath
blood in urine and feces
glassy eyes

Tranquillizers

(Librium, Valium, Mogadon, Tranxene, etc.)
The widespread abuse of so-called "minor" tranquilizers is due to their easy availability on the street and to their being over prescribed. It has been firmly established that repeated use leads to both psychological and physical dependency. Tolerance is high and withdrawal difficult.

Major functional effects
relief from anxiety
mild motor incoordination
poor short-term memory
irritability
chronic lethargy
depression
double vision
dizziness
Signs of use
aggressivity
stuttering
tremors
flushed skin
dry mouth
drowsiness
nausea and fatigue
slurred speech

Performance Enhancing Drugs

Anabolic/androgenic steroids (Anvar, Deca Durabolin testosterone, Winstrol-V, etc.) are chemically manufactured derivatives of the male sex hormone, testosterone. No steroid is purely androgenic (masculinizing) or purely anabolic (growing or building). Therefore steroid use results in some combination of these effects.

Anabolic steroids comprise one group of these hormonal drugs. Anabolic steroids are designed to mimic the body-building traits of testosterone to build up the body to perform better in sports and to change the muscular appearance of the body. These drugs are also used to increase muscle mass in occupations where physical size contributes to job performance (23). On the psychological side, many users report "feeling good" about themselves while on anabolic steroids. When the drugs are stopped there are reported wide mood swings ranging from periods of violent episodes known as " 'roid rages " to depression.

Other drugs abused by athletes include stimulants, diuretics, beta blockers and pain killers. While in the past, the use of performance-enhancing drugs was limited to elite athletes, it is now understood to be a social problem involving a range of athletes as well as those interested in body image. In a recent national study of 11 to 18 years old, only 4% had never heard of anabolic steroids; 50% of females and 67% of males believed that anabolic steroids would enhance performance; and 1.5% of females and 4.1% of males have used steroids.

Major functional effects for males
reduced sperm count
shrinking of the testicles
impotence
difficulty or pain in urinating
development of breasts
enlarged prostate
For females
growth of facial hair
changes in or cessation of the menstrual cycle
enlargement of the clitoris
deepened voice
breast reduction
For males and females
acne
jaundice
trembling
swelling of feet or ankles
bad breath
high blood pressure
liver damage and cancers
aching joints
increased chance of injury to tendons, ligaments and muscles
rapid weight gain
can halt growth prematurely in adolescents
Signs of use
increased irritability
increased acne
increased aggressiveness
rapid "bulk up"

Other Drugs of Concern
(tobacco, caffeine, over-the-counter medications)

All these common substances can present health problems. Tobacco products, while legal depending on the age of the user and the restrictions on public use, present definite and well documented health hazards. The health impact of caffeine, found in coffee, tea, chocolate and some medications, is the subject of continuing research. The range of over-the-counter medications is extensive and like other substances there is potential for negative impacts, especially if combined with other substances. For example, the combination of a cold medication and alcohol may present safety risks.

Cost Of Drug Use In America

Employed drug abusers cost their employers about twice as much in medical and worker compensation claims as their drug-free coworkers. A study prepared by The Lewin Group for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism estimated the total economic cost of alcohol and drug abuse to be $245.7 billion for 1992. Of this cost, $97.7 billion* was due to drug abuse. This estimate includes substance abuse treatment and prevention costs as well as other healthcare costs, costs associated with reduced job productivity or lost earnings, and other costs to society such as crime and social welfare. The study also determined that these costs are borne primarily by governments (46 percent), followed by those who abuse drugs and members of their households (44 percent).

The 1992 cost estimate has increased 50 percent over the cost estimate from 1985 data. The four primary contributors to this increase were (1) the epidemic of heavy cocaine use (2) the HIV epidemic (3) an eightfold increase in state and Federal incarcerations for drug offenses, and (4) a threefold increase in crimes attributed to drugs.

More than half of the estimated costs of drug abuse were associated with drug-related crime. These costs included lost productivity of victims and incarcerated perpetrators of drug- related crime (20.4 percent); lost legitimate production due to drug-related crime careers (19.7 percent); and other costs of drug-related crime, including Federal drug traffic control, property damage, and police, legal, and corrections services (18.4 percent). Most of the remaining costs resulted from premature deaths (14.9 percent), lost productivity due to drug-related illness (14.5 percent), and healthcare expenditures (10.2 percent).

The White House Office of National Drug Control Policy (ONDCP)** conducted a study to determine how much money is spent on illegal drugs that otherwise would support legitimate spending or savings by the user in the overall economy. ONDCP found that, between 1988 and 1995, Americans spent $57.3 billion on drugs, broken down as follows: $38 billion on cocaine, $9.6 billion on heroin, $7 billion on marijuana, and $2.7 billion on other illegal drugs and on the misuse of legal drugs

* This estimate includes illicit drugs and other drugs taken for non-medical purposes. It does not include nicotine.

--------------------------------------------------------------------------------

1995 Drug Control Strategy

The White House Office of National Drug Control Policy.A study prepared by The Lewin Group for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism estimated the total economic cost of alcohol and drug abuse to be $245.7 billion for 1992. Of this cost, $97.7 billion* was due to drug abuse. This estimate includes substance abuse treatment and prevention costs as well as other healthcare costs, costs associated with reduced job productivity or lost earnings, and other costs to society such as crime and social welfare. The study also determined that these costs are borne primarily by governments (46 percent), followed by those who abuse drugs and members of their households (44 percent).

The 1992 cost estimate has increased 50 percent over the cost estimate from 1985 data. The four primary contributors to this increase were (1) the epidemic of heavy cocaine use (2) the HIV epidemic (3) an eightfold increase in state and Federal incarcerations for drug offenses, and (4) a threefold increase in crimes attributed to drugs.

More than half of the estimated costs of drug abuse were associated with drug-related crime. These costs included lost productivity of victims and incarcerated perpetrators of drug- related crime (20.4 percent); lost legitimate production due to drug-related crime careers (19.7 percent); and other costs of drug-related crime, including Federal drug traffic control, property damage, and police, legal, and corrections services (18.4 percent). Most of the remaining costs resulted from premature deaths (14.9 percent), lost productivity due to drug-related illness (14.5 percent), and healthcare expenditures (10.2 percent).

The White House Office of National Drug Control Policy (ONDCP)** conducted a study to determine how much money is spent on illegal drugs that otherwise would support legitimate spending or savings by the user in the overall economy. ONDCP found that, between 1988 and 1995, Americans spent $57.3 billion on drugs, broken down as follows: $38 billion on cocaine, $9.6 billion on heroin, $7 billion on marijuana, and $2.7 billion on other illegal drugs and on the misuse of legal drugs

* This estimate includes illicit drugs and other drugs taken for non-medical purposes. It does not include nicotine.

--------------------------------------------------------------------------------

** 1995 Drug Control Strategy, The White House Office of National Drug Control Policy.

U.S. Department of Health and Human Services ·National Institutes of Health.

Resource Links:

http://165.112.78.61/Infofax/treatmenttrends.html

http://165.112.78.61/DrugPages/Stats.html

Return Back