DSMDerived Definitions

In contrast to the 2001 consensus definition of addiction is the approach taken by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, or DSM,34 which is considered by many to be the bible of mental health diagnoses. Specifically, the DSM describes a pair of distinct but related substance use disorders that have become ubiquitous concepts within the mental health and substance-abuse communities. The two descriptions involve both terminological and...

Illegal Recreational Drugs

In the United States, the origins of modern drug criminalization stretch back over a century and a half, to a point when many currently banned substances were legal and widely available. Opium, one of the first popular narcotics, was commonly used in eighteenth-century America for a variety of medicinal purposes, from dysentery and rheumatism to cholera and lockjaw. The drug was liberally recommended by doctors, who described opium as God's Own Medicine, something that the Creator himself seems...

Case 1 Opioid Drugs for PainIs the Solution Worse Than the Problem

Jones is an eighty-four-year-old nursing home patient with metastatic breast cancer complicated by osteoporosis that has resulted in several vertebral compression fractures. During the times she is lucid, Mrs. Jones says she suffers from severe pain. The pain service recommends changing her medications from ibuprofen alone to ibuprofen plus morphine, an opioid typically used in such a setting. Mrs. Jones's daughter has legal power of attorney to make healthcare decisions for her mother....

Case 11 Is Ignorance a Defense The Case of the Olympic Swimmerand the Rower the Thief and the Cyclist

Consider the case of Brian, a junior elite swimmer who hopes to one day compete in the Olympics. His coach recommended the use of a dietary supplement because it was advertised to enhance the loss of body fat and facilitate the development of lean muscle, thinking that it would help Brian's swimming form. The coach was not worried that it would contain banned anabolic steroids, since they had recently become controlled by the 2004 Amendment to the Controlled Substance Act and presumably had...

Case 9 Self Medication for Depression Antidepressants Legal and Illegal

Janice and Karen are both in their early thirties. Both suffer from chronic depression. Janice is employed but Karen is not. Janice has had years of psychotherapy as well as medical treatment. She has been prescribed lithium, Valium, Elavil, Prozac, Wellbutrin, and now Cymbalta. She says that with this new drug she has finally got it right, more or less, and that her depression is relatively under control for the first time in her life. Karen, on the other hand, is not insured and has access...

What Counts as a Drug and Where Does a Drug Count A Policy View

Not only does talk about drugs vary widely from one sphere or silo to another, but the definition of drug, especially as used in policy contexts, itself may exhibit inconsistencies. The term is often value laden and means different things to different people and within different professional spheres, for example, law and medicine.9 The origin of the word is from the Old French drogue, which came from the Middle Dutch druge vate, dried or dry-vat, perhaps referring to dried plant medicinals....

Complementary and Alternative Medicines Dietary Supplements

Legally known as dietary supplements, herbal drugs are part of complementary and alternative medicine (which also includes other more regulated practices 20. It might be noted that the bill's co-sponsor, Sen. Hubert Humphrey, was a pharmacist. such as chiropractic). The path that has led to the virtually unregulated approach to herbal drugs traces back to the heyday of medicine shows and snake-oil salesmen around the turn of the previous century. This period was marked by unsupported,...

Case 8 What Do the Brain Scans Show Should Parkinsons Disease Obesity and Methamphetamine Use Be Considered Alike

Andrew has Parkinson's Disease, Bob is obese, and Charlie uses methamphetamines. Neuroimaging studies of all three show changes in brain morphology that substantially influence their behavior. Yet the three are regarded differently Andrew as the victim of a disease, Bob as irresponsible for failing to exercise and control his diet, and Charlie as an addict. As far as current neuroscience can tell, changes in brain biology largely account for their patterns of behavior. Does modern...

Case 6 Religious Drugs Peyote and Beyond

Red Eagle, a Native American, and John, of European ancestry, are members of the Native American Church and the Peyote Way Church of God, respectively, and both use peyote as a religious practice. Diego is from Brazil he is a member of the Uniao do Vegetal Church, and uses ayahuasca as a religious practice. Isaac is a recent immigrant to the United States from West Africa he is a follower of the Bwiti religion, which uses iboga root as a sacrament. Mustafa is an immigrant from the opposite...