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Major Studies of Drugs and Drug Policy
Drug Use In America: Problem in Perspective - US National Commission on Marihuana and Drug Abuse

The Report of the National Commission on Marihuana and Drug Abuse

Drug Use In America: Problem in Perspective

Commissioned by President Richard M. Nixon, March, 1972

 

Table of Contents

Letter of Transmittal

Introduction

Chapter One -- Defining the Issues

  • Definitional Confusion: What is Drug Abuse?
    • "Drug"-The All-Purpose Concept
    • Drug Abuse: Synonym for Social Disapproval
    • The Roots of a "Problem"
  • The Social Response: False Premises and the Perpetuation of a Problem
    • The Assumptions and Premises of Present Policy
    • Elimination of Non-Medical Drug Use
    • Risk-Taking and Health
    • Motivation for Mood Alteration
    • Drugs and Individual Responsibility
  • An Overview of the Present Response
    • Risk-Education
    • Coercion
    • Sickness
    • Perpetuating the Problem
  • Defining the Problem
    • The Meaning of Drug Use
      • The Incidence of Drug Use
      • Drug Using Behavior
      • Drug-Related Risk
        • Risks to Individual Health
        • Drug-Induced Behavior
        • Dependence Liability
    • Evaluating the Social Consequences of Drug Use
    • Defining America's Drug Problem
    • The Limits of Social Control
  • The Commission's Role

Chapter Two - Drug Using Behavior in the United States

  • I. Drug Use in the General Population
    • Tobacco and Alcohol
    • Use of Proprietary and Ethical Psychoactive Substances
      • Incidence and Prevalance
      • Demographic Characteristics
      • Motivations for Use
      • Multi-Drug Use
        • Alcohol, Ethical and Proprietary Psychoactive Drugs
        • Marihuana and Ethical and Proprietary Psychoactive Drugs
        • Concurrent Drug Usage
    • Illicit Drug Use in the General Population
      • Marihuana
      • LSD, Other Hallucinogens
      • Glue, Other Inhalants
      • Cocaine
      • Heroin
      • Multi-Drug Use
  • II. Drug Use Among Students
    • Survey Methodology
    • Comparative National Survey Student Data
    • Incidence of Student Drug Use
      • Alcohol
      • Marihuana
      • Inhalants
      • Hallucinogens
      • Stimulants
      • Depressants
      • Opiates
    • Patterns of Student Drug Use
      • Present and Future Drug Involvement
      • Frequency and Intensity of Drug Use
      • Duration of Student Drug Use
      • Multi-Drug Use
  • III. A Typology of Drug-Using Behavior
    • Experimental Use
    • Social-Recreational Use
    • Circumstantial-Situational Use
    • Intensified Drug Use
    • Compulsive Drug Use
  • IV. Psychosocial and Institutional Influences on Drug-Using Behavior
    • Broad Cultural Influences
    • Drugs and Youth
      • Experimentation, Availability and Need
      • Personal Dissatisfaction and the Search for "Something of Value"
      • Age and Responsibility
      • The Impact of Extended Education
      • Institutional Sources of Identity
    • Mood Alteration in America
    • Factors Bearing on Drug Dependence
    • A Final Note

Chapter Three The Social Impact of Drug Dependence and Drug-Induced Behavior

  • I. Drug Dependence
    • Terminological Confusion
      • Addiction
      • Habituation
      • The Search for Precision
      • Drug Dependence
      • Excising "Addiction"
    • Toward a Functional Understanding of Drug Dependence
      • Psychological Dependence: The Primary Reinforcer
      • The Pharmacological Component: Reinforcement Potential
      • Psycho-Social Components
      • The Development of Dependence: Conditioning
      • The Dependence Continuum
      • Measuring the Degree of Dependence: Psychological Components
      • Physical Dependence: The Secondary Reinforcer
      • Summary
    • Evaluating the Social Impact of Drug Dependence
      • Dependence, Health and Behavior
      • The Vulnerability Factor
      • The Relevance of Social Response
    • Present Social Impact
      • Alcohol
      • Heroin
      • Barbiturates
      • Amphetamines and Related Stimulants
      • Cocaine
      • Hallucinogens
      • Cannabis
  • II. Drug Induced Behavior
    • Impact on Perception
    • Impact on Memory
    • Alteration of Mental States
    • Impairment of Psychomotor Function
    • Summary
  • III.Impact on Public Safety
    • Drugs and Crime
      • Drugs and Their Criminogenic Effects
        • Alcohol
        • Marihuana
        • Barbiturates
        • Amphetamines
        • Opiates
        • Cocaine
        • Hallucinogens
        • Other Psychoactive Substances
        • Summary
    • Psychosocial Characteristics of Drug-Dependent Persons: Implications for Public Safety
    • Social and Demographic Characteristics
      • Age
      • Educational Status
      • Income, Occupation and Employment Status
      • Home Environment and Marital Status
      • Psychological Characteristics
    • Problems in Inferring Causation
    • The Costs of Heroin Dependence
      • Cost to the Heroin-Dependent Person
      • Cost to Society from Criminal Activity
      • Criminal Justice Costs: Processing the Drug-Dependent Person
    • The Effect of Drug Treatment on Crime
      • Current Research Findings
      • A Realistic Appraisal
    • Drugs and Driving
      • Research Limitations
      • Research Findings
        • Alcohol
        • Marihuana
        • Other Psychoactive Substances
  • IV. Impact on Public Health and Welfare
    • Public Health and Welfare: A Preventive Concept
    • Assessing the Public Health and Welfare Impact of Drug Use
      • The Population of Heavy Alcohol Users
      • Economic Loss
      • Death
        • Alcohol
        • Heroin
        • Barbiturates
      • Medical Complications of Chronic Drug Use
      • Impact on the Family Structure
      • Compensatory Social Costs
    • Framing a Public Health Response

Chapter Four - Toward a Coherent Social Policy

  • Introduction
    • The Process
    • Goals and Premises
      • Drugs and Social Responsibility
      • Irresponsible Use
      • Discouragement and Social Tolerance
      • Responsible Decision Making
      • Risks and Perceived Advantages
      • Designing a Differential Response to Drug Use
  • I. The Availability Decision
    • Models of Availability
    • The Calculus: An Overview
      • Relative Social Cost
      • Efficacy of Controls
      • Cost of Controls
      • The Social Context of the Availability Decision
    • The Present System
      • Availability Not Limited As To Purpose of Consumption
      • Availability Limited As To Purpose of Consumption
      • Substances Not Available For Consumption
    • Specific Recommendations
      • Opiates
      • Cocaine
      • Amphetamines
      • Barbiturates
      • Non-Barbiturate Sedatives
      • Minor Tranquilizers
      • Hallucinogens
      • Marihuana
      • Alcohol
    • Implementing Restrictions on Availability
      • The Role of International Agreements
      • Federal Enforcement Policy
      • State Enforcement Policy
  • II. The Consumption-Intervention Decision
    • An Overview of the Possession Offense
    • Deviance, Deterrence and Symbolism
      • Philosophical Conflict
      • Constitutionality
      • Functional Overview
      • Deterrence
      • Social Costs of Enforcement
      • Possession and Supply
      • Symbolism
    • Sickness and Treatment
      • Origins of the Cult of Curability
      • Addiction and Treatment: The Early Days
      • The Therapeutic Premise Takes Hold
      • Therapeutic Intervention Comes Under Attack
      • Harnessing the Therapeutic Response
      • Involuntary "Civil" Commitment: The Problems of a Therapeutic Response
      • Therapy and the Criminal Process
    • Dangerousness and Prevention
      • Crime and the Public Safety
      • Contagion and the Public Health and Welfare
      • The Appropriate Role of Preventive Intervention
    • Conclusion: The Possession Offense and Its Enforcement
      • Functional Enforcement
      • Role of the Police
  • III. Defining the Government's Role
    • Governmental Competence
    • General Guidelines
    • Analyzing the Government Response
      • An Overview of the Government Response
      • The Special Action Office: A Stopgap
      • Failures of the Present System
        • Identification of the Nature and Extent of Drug Use
        • Definition of goals and objectives for drug-related functions
        • Effective planning
        • Affective control of resource allocation
        • Coordination among federal agencies
        • Drug-related functions within agencies whose primary mission is not solving drug problems
        • Evaluation of programs in terms of their effectiveness
        • Evaluation of programs in terms of efficiency
        • Separation of drug and alcohol activities
    • Reorganizing the Governmental Response
      • Bringing the Drug Effort Under Control
      • The Structure of the Unified Approach
      • Organization of Response at the Community Level
  • IV. Treatment and Rehabilitation
    • An Overview of the Present Response
      • Uncertainty About the Illness
      • Uncertainty About the Objective of Treatment
      • Diversity of Method
    • History of the Treatment of Opiate Dependence
      • 1870-1900: The Early Years
      • 1900-1915: Years of Optimism
      • 1915-1930: Confidence Wanes
      • 1930-1960: The Dry Years
      • The Sixties: Society Turns to Therapy Again
    • Present Methods and Models of Treatment
      • Hospitalization
      • Ambulatory Drug-Free Treatment
      • Therapeutic Communities
      • Methadone Maintenance
      • Antagonist Treatment
      • Multi-Modality Programs
      • Treatment for Non-Opiate Drug Dependence
    • The Role of the Law in Treatment
      • Legal Controls as Therapy
        • Civil Procedures
        • Criminal Procedures
    • Legal Control of the Treatment Process
    • Heroin Maintenance
    • Conclusions and Recommendations on Treatment of Dependence
      • Federal Funding and Services
      • Federal Evaluation
      • State Treatment Programs
      • The Role of the Legal System in State Programs
      • Uniformity of State Law
      • Emergency Treatment of Drug Users
  • V. Prevention
    • The Information-Education Explosion
    • Goals of Information-Education Prevention
    • Information Policy
    • Education
    • Training
    • The Media and Drug Use Prevention
    • Other Prevention Strategies and Techniques
    • Summary and Conclusion
  • VI. Research
    • A New Interest in Research
    • The Need for a Directed Research Plan
      • Incidence, Frequency and Intensity of Drug Use
      • Etiology and Consequences of Drug Use
      • The Role of the Criminal Justice System
      • Efficacy of Treatment
      • Other Areas
  • VII. The Private Response
    • The Health Professions
    • Pharmaceutical Industry
    • Alcohol Industry
    • Legal Profession
    • Industry
    • Colleges and Universities
    • Mass Media
    • The Religious Community
    • The Family

Chapter Five - Looking Ahead

  • The Immediate Future: The Goal of the Commission's Recommendations
    • Changing Attitudes
    • Filling the Informational Gaps
    • Unifying the Government Response
    • Developing the Private Response
    • Improving Controls on Availability
    • Rationalizing Consumption Controls
    • Expanding Treatment, Rehabilitation and Prevention Services
  • The Immediate Future
  • Policy Making Over the Long Term
    • Confronting the Basic Question
    • Reappraisal: The Need for Evaluation

Sources

Bibliography

Consultants

Contractors and Contributors

Research Papers Prepared for Commission

Recommendations

Index of First Year Recommendations

Index of Second Year Recommendations
Library Highlights

Drug Information Articles

Drug Rehab