<CHAP NUM="9" ID="CH.00.009">chapter 9
<FM><TTL>Drugs</TTL>
<KTSET><TTL>Key Terms</TTL>
<KT>anabolic steriods</KT>
<KT>analgesic</KT>
<KT>confirmation</KT>
<KT>depressant</KT>
<KT>hallucinogen</KT>
<KT>microcrystalline tests</KT>
<KT>narcotic</KT>
<KT>physical dependence</KT>
<KT>psychological dependence</KT>
<KT>screening test</KT>
<KT>stimulant</KT></KTSET>
<OBJSET><TTL>Learning Objectives</TTL>
<P>After studying this chapter you should be able to:
<OBJ><P><INST>< </INST>Compare and contrast psychological and physical dependence</P></OBJ>
<OBJ><P><INST>< </INST>Name and classify the commonly abused drugs</P></OBJ>
<OBJ><P><INST>< </INST>List and define the schedules of the Controlled Substances Act</P></OBJ>
<OBJ><P><INST>< </INST>Describe the laboratory tests normally used to perform a routine drug identification analysis</P></OBJ>
<OBJ><P><INST>< </INST>Explain the testing procedures used for forensic identification of marijuana</P></OBJ>
<OBJ><P><INST>< </INST>Understand the proper collection and preservation of drug evidence</P></OBJ></P></OBJSET></FM>
<CASE NUM="1" TY="CS"><TTL>Pablo Escobar, Drug Lord</TTL>
<P>In 1989, <ITAL>Forbes</ITAL> magazine listed Pablo Escobar as the seventh richest man in the world. Escobar began his climb to wealth as a teenage car thief in the streets of Medellin, Colombia. He eventually moved into the cocaine-smuggling business. At the peak of his power in the mid-1980s, he was shipping as much as eleven tons of cocaine per flight in jetliners to the United States. Estimates are that the Medellin cartel controlled 80 percent of the world’s cocaine market and was taking in about $25 billion annually. Escobar ruthlessly ruled by the gun: murdering, assassinating, and kidnapping. He was responsible for killing three presidential candidates in Colombia, as well as the storming of the Colombian Supreme Court, which resulted in the murder of half the justices. All the while, Escobar curried favor with the Colombian general public by cultivating a Robin Hood image and distributing money to the poor. In 1991, hoping to avoid extradition to the United States, Escobar turned himself in to the Colombian government and agreed to be sent to prison. However, the prison compound could easily be mistaken for a country club. There he continued his high-flying lifestyle, trafficking by telephone and even murdering a few associates. When the Colombian government attempted to move Escobar to another jail, he escaped, again fearing extradition to the United States. Pressured by the U.S. government, Colombia organized a task force dedicated to apprehending Escobar. The manhunt for Escobar ended on December 2, 1993, when he was cornered on the roof of one of his hideouts. A shootout ensued and Escobar was fatally wounded by a bullet behind his ear.</P></CASE>
<BM><P>A <ITAL>drug</ITAL> can be defined as a natural or synthetic substance that is used to produce physiological or psychological effects in humans or other higher order animals. However, this colorless clinical definition does not really tell us what drugs are; in their modern context, drugs mean something different to each person. To some, drugs are a necessity for sustaining and prolonging life; to others, drugs provide an escape from the pressures of life; to still others, they are a means of ending it.</P>
<P>Considering the wide application and acceptance of drugs in our society, it was perhaps inevitable that a segment of our population would abuse them. During the 1960s, succeeding waves of hallucinogens, amphetamines, and barbiturates found their way out of laboratories, pharmacies, and medicine chests and into the streets. During this decade, marijuana became the most widely used illicit drug in the United States, and alcohol consumption continued to rise—today 90 million Americans drink alcohol regularly, and 10 million of these are hopelessly addicted or have severe problems in coping with their drinking habits. In the 1970s, heroin addiction emerged as a national problem, and today the United States is in the midst of an epidemic of cocaine abuse.</P>
<P>Drug abuse has grown from a problem generally associated with members of the lower end of the socioeconomic ladder to one that cuts across all social and ethnic classes of society. Today, approximately 23 million people in the United States use illicit drugs, including about a half million heroin addicts and nearly six million users of cocaine.</P>
<P>In the United States, more than 75 percent of the evidence evaluated in crime laboratories is drug related. The deluge of drug specimens has forced the expansion of existing crime laboratories and the creation of new ones. For many concerned forensic scientists, the crime laboratory’s preoccupation with drug evidence represents a serious distraction from time that could be devoted to evaluating evidence related to homicides and other types of serious crimes. However, the increasing caseloads associated with drug evidence have justified the expansion of forensic laboratory services. This expansion has increased the overall analytical capabilities of crime laboratories.</P>
<H1>Drug Dependence</H1>
<P>In assessing the potential danger of drugs, society has become particularly conscious of their effects on human behavior. In fact, the first drugs to be regulated by law in the early years of the twentieth century were those deemed to have “habit-forming” properties. The early laws were aimed primarily at controlling opium and its derivatives, cocaine, and later marijuana. Today, it is known that the ability of a drug to induce dependence after repeated use is submerged in a complex array of physiological and social factors.</P>
<P>Dependence on drugs exists in numerous patterns and in all degrees of intensity, depending on the nature of the drug, the route of administration, the dose, the frequency of administration, and the individual’s rate of metabolism. Furthermore, nondrug factors play an equally crucial role in determining the behavioral patterns associated with drug use. The personal characteristics of the user, his or her expectations about the drug experience, society’s attitudes and possible responses, and the setting in which the drug is used are all major determinants of drug dependence.</P>
<P>The question of how to define and measure a drug’s influence on the individual and its danger to society is difficult to assess. To this end, the nature and significance of drug dependence must be considered from two overlapping points of view: the interaction of the drug with the individual, and the drug’s impact on society. It will be useful when discussing the nature of the drug experience to approach the problem from two distinctly different aspects of human behavior—<KT>psychological dependence</KT> and <KT>physical dependence</KT><SIDEIND NUM="1" ID="MN2.09.001"/><SIDEIND NUM="2" ID="MN2.09.002"/></P>.
<P>The common denominator that characterizes all types of repeated drug use is the creation of a psychological dependence for continued use of the drug. It is important to discard the unrealistic image that all drug users are hopeless “addicts” who are social dropouts. Most users present quite a normal appearance and remain both socially and economically integrated in the life of the community.</P>
<P>The reasons why some people abstain from drugs while others become moderately or heavily involved are difficult if not impossible to delineate. Psychological needs arise from numerous personal and social factors that stem from the individual’s desire to create a sense of well-being and to escape from reality. In some cases, the individual may be seeking relief from personal problems or stressful situations, or he or she may be trying to sustain a physical and emotional state that permits an improved level of performance. Whatever the reasons, the underlying psychological needs and the desire to fulfill them create a conditioned pattern of drug abuse.</P>
<P>The intensity of the psychological dependence associated with a drug’s use is difficult to define and largely depends on the nature of the drug used. For drugs such as alcohol, heroin, amphetamines, barbiturates, and cocaine, there is a significant likelihood that continued use will result in a high degree of involvement. Other drugs, such as marijuana and codeine, appear to have a considerably lower potential for the development of psychological dependence. However, this does not imply that repeated abuse of drugs deemed to have a low potential for psychological dependency is safe or will always produce low psychological dependence. We have no precise way of measuring or predicting the impact of drug abuse on the individual. Even if a system could be devised for controlling the many possible variables affecting a user’s response, the unpredictability of the human personality would still have to be considered; the personal inadequacies of the drug user represent the underlying motivation for drug use.</P>
<P>Our general knowledge of alcohol consumption should warn us of the fallacy of generalizing when attempting to describe the danger of drug abuse. Obviously, not all alcohol drinkers are psychologically addicted to the drug; most are “social” drinkers who drink in reasonable amounts and on an irregular basis. Many people have progressed beyond this stage and consider alcohol a necessary crutch for dealing with life’s stresses and anxieties. However, a wide range of behavioral patterns exists among alcohol abusers, and to a large extent the degree of psychological dependency must be determined on an individual basis. Likewise, it would be fallacious to generalize that all users of marijuana can at worst develop a low degree of dependency on the drug. A wide range of factors also influence marijuana’s effect, and heavy users of the drug expose themselves to the danger of developing a high degree of psychological dependency.</P>
<P>Where emotional well-being is the primary motive leading to repeated and intensive use of a drug, certain drugs, when taken in sufficient dose and frequency, are capable of producing physiological changes that encourage their continued use. Once the user abstains from such a drug, severe physical illness follows. The desire to avoid this <ITAL>withdrawal sickness</ITAL> or <ITAL>abstinence syndrome</ITAL> ultimately causes physical dependence, or addiction. Hence, for the addict who is accustomed to receiving large doses of heroin, the thought of abstaining and encountering body chills, vomiting, stomach cramps, convulsions, insomnia, pain, and hallucinations is a powerful inducement for continued drug use.</P>
<P>Interestingly, some of the more widely abused drugs have little or no potential for creating physical dependence. Drugs such as marijuana, LSD, and cocaine create strong anxieties when their repeated use is discontinued; however, no medical evidence attributes these discomforts to physiological reactions that accompany withdrawal sickness. On the other hand, use of alcohol, heroin, and barbiturates can result in development of physical dependency.</P>
<P>Physical dependency develops only when the drug user adheres to a regular schedule of drug intake; that is, the interval between doses must be short enough so that the effects of the drug never wear off completely. For example, the interval between injections of heroin for the drug addict probably does not exceed six to eight hours. Beyond this time the addict begins to experience the uncomfortable symptoms of withdrawal. Many users of heroin avoid taking the drug on a regular basis for fear of becoming physically addicted to its use. Similarly, the risk of developing physical dependence on alcohol becomes greatest when the consumption is characterized by a continuing pattern of daily use in large quantities.</P>
<P><LINK LINKEND="TB.09.001">Table <TBLIND NUM="1" ID="TB.09.001"/>9–1</LINK> categorizes some of the more commonly abused drugs according to their effect on the body and summarizes their tendency to produce psychological dependency and to induce physical dependency with repeated use.</P>
<P>The social impact of drug dependence is directly related to the extent to which the user has become preoccupied with the drug. Here, the most important element is the extent to which drug use has become interwoven in the fabric of the user’s life. The more frequently the drug satisfies the person’s need, the greater the likelihood that he or she will become preoccupied with its use, with a consequent neglect of individual and social responsibilities. Personal health, economic relationships, and family obligations may all suffer as the drug-seeking behavior increases in frequency and intensity and dominates the individual’s life. The extreme of drug dependence may lead to behavior that has serious implications for the public’s safety, health, and welfare.</P>
<P>Drug dependence in its broadest sense involves much of the world’s population. As a result, a complex array of individual, social, cultural, legal, and medical factors ultimately influence society’s decision to prohibit or to impose strict controls on a drug’s distribution and use. Invariably, society must weigh the beneficial aspects of the drug against the ultimate harm its abuse will do to the individual and to society as a whole. Obviously, many forms of drug dependence do not carry sufficient adverse social consequences to warrant their prohibition, as illustrated by the widespread use of such drug-containing substances as tobacco and coffee. Although heavy and prolonged use of these drugs may eventually damage body organs and injure an individual’s health, there is no evidence that they result in antisocial behavior, even with prolonged or excessive use. Hence, society is willing to accept widespread use of these substances.</P>
<TBL NUM="1" ID="TB.09.001"><TTL><P><INST>Table 9–1 </INST>The Potential of Some Commonly Abused Drugs to Produce Dependency with Regular Use</P></TTL>
<COLHD>Drug
Psychological Dependence
Physical Dependence</COLHD>
<TB>Narcotics
Morphine
High
Yes
Heroin
Methadone
Codeine
Low
Depressants
Barbiturates (short-acting)
Barbiturates (long-acting)
Alcohol
Methaqualone (Quaalude)
Meprobamate (Miltown, Equanil)
...
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