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Recreational drug use is the use of one or more psychoactive drugs to induce an altered state of consciousness, either for pleasure or for some other casual purpose or pastime. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Generally, recreational drugs are divided into three categories: depressants, stimulants, and hallucinogens.
Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.
A drug overdose is the ingestion or application of a drug or other substance in quantities much greater than are recommended. Typically it is used for cases when a risk to health will potentially result. An overdose may result in a toxic state or death.
Polysubstance use or poly drug use refers to the use of combined psychoactive substances. Polysubstance use may be used for entheogenic, recreational, or off-label indications, with both legal and illegal substances. In many cases one drug is used as a base or primary drug, with additional drugs to leaven or compensate for the side effects, or tolerance, of the primary drug and make the experience more enjoyable with drug synergy effects, or to supplement for primary drug when supply is low.
The drug policy in the United States is the activity of the federal government relating to the regulation of drugs. Starting in the early 1900s, the United States government began enforcing drug policies. These policies criminalized drugs such as opium, morphine, heroin, and cocaine outside of medical use. The drug policies put into place are enforced by the Food and Drug Administration and the Drug Enforcement Administration. Classification of Drugs are defined and enforced using the Controlled Substance Act, which lists different drugs into their respective substances based on its potential of abuse and potential for medical use. Four different categories of drugs are Alcohol, Cannabis, Opioids, and Stimulants.
Substance abuse prevention, also known as drug abuse prevention, is a process that attempts to prevent the onset of substance use or limit the development of problems associated with using psychoactive substances. Prevention efforts may focus on the individual or their surroundings. A concept that is known as "environmental prevention" focuses on changing community conditions or policies so that the availability of substances is reduced as well as the demand. Individual Substance Abuse Prevention, also known as drug abuse prevention involves numerous different sessions depending on the individual to help cease or reduce the use of substances. The time period to help a specific individual can vary based upon many aspects of an individual. The type of Prevention efforts should be based upon the individual's necessities which can also vary. Substance use prevention efforts typically focus on minors and young adults – especially between 12–35 years of age. Substances typically targeted by preventive efforts include alcohol, tobacco, marijuana, inhalants, coke, methamphetamine, steroids, club drugs, and opioids. Community advocacy against substance use is imperative due to the significant increase in opioid overdoses in the United States alone. It has been estimated that about one hundred and thirty individuals continue to lose their lives daily due to opioid overdoses alone.
The Joseph L. Mailman School of Public Health is the public health graduate school of Columbia University. Located on the Columbia University Irving Medical Center campus in the Washington Heights neighborhood of Manhattan, New York City, the school is accredited by the Council on Education for Public Health.
An opioid overdose is toxicity due to excessive consumption of opioids, such as morphine, codeine, heroin, fentanyl, tramadol, and methadone. This preventable pathology can be fatal if it leads to respiratory depression, a lethal condition that can cause hypoxia from slow and shallow breathing. Other symptoms include small pupils, and unconsciousness, however its onset can depend on the method of ingestion, the dosage and individual risk factors. Although there were over 110,000 deaths in 2017 due to opioids, individuals who survived also faced adverse complications, including permanent brain damage.
Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences as a result of their use. The National Institute of Mental Health (NIMH) states that "Substance use disorder (SUD) is a treatable mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD". Substance use disorders (SUD) are considered to be a serious mental illness that fluctuates with the age that symptoms first start appearing in an individual, the time during which it exists and the type of substance that is used. It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms. Drug classes that are commonly involved in SUD include: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics or anxiolytics, stimulants, tobacco
In the United States, prescription monitoring programs (PMPs) or prescription drug monitoring programs (PDMPs) are state-run programs which collect and distribute data about the prescription and dispensation of federally controlled substances and, depending on state requirements, other potentially abusable prescription drugs. PMPs are meant to help prevent adverse drug-related events such as opioid overdoses, drug diversion, and substance abuse by decreasing the amount and/or frequency of opioid prescribing, and by identifying those patients who are obtaining prescriptions from multiple providers or those physicians overprescribing opioids.
Sandro Galea is a physician, epidemiologist, and author. He is the Robert A. Knox professor and dean at the Boston University School of Public Health. He is the former Chair of Epidemiology at the Columbia University Mailman School of Public Health. Dr. Galea is past president of the Society for Epidemiologic Research and an elected member of the American Epidemiological Society. He was elected to the National Academy of Medicine in 2012, chairing two of the organization's reports on mental health in the military. He formerly served as chair of the New York City Department of Health and Mental Hygiene's Community Services Board and as a member of its Health Board.
Mary Travis Bassett is an American physician and public health researcher who was the 17th Health Commissioner of the New York State Department of Health, being appointed to the position by Governor Kathy Hochul on September 29, 2021, until December 31, 2022. From 2014 to 2018, she was the commissioner of the New York City Department of Health and Mental Hygiene. Bassett is the Director of the FXB Center for Health and Human Rights at Harvard University and the FXB Professor of the Practice of Health and Human Rights at the Harvard School of Public Health. She is also an associate professor of clinical epidemiology at the Columbia University Mailman School of Public Health.
In the United States, the opioid epidemic is an extensive, ongoing overuse of opioid medications, both from medical prescriptions and illegal sources. The epidemic began in the United States in the late 1990s, according to the Centers for Disease Control and Prevention (CDC), when opioids were increasingly prescribed for pain management, resulting in a rise in overall opioid use throughout subsequent years. The great majority of Americans who use prescription opioids do not believe that they are misusing them.
The opioid epidemic, also referred to as the opioid crisis, is the rapid increase in the overuse, misuse/abuse, and overdose deaths attributed either in part or in whole to the class of drugs called opiates/opioids since the 1990s. It includes the significant medical, social, psychological, demographic and economic consequences of the medical, non-medical, and recreational abuse of these medications.
Chinazo D. Opia Cunningham is a physician, researcher, and Professor of Medicine at Albert Einstein College of Medicine in New York City. She is also the Director of Diversity Affairs for the Department of Medicine. She worked on the frontlines during the HIV/AIDS crisis in San Francisco and in 2020 began working on the frontlines of the Coronavirus disease 2019 (COVID-19) pandemic in New York City. She also specializes in treating patients with addiction, overseeing a network using buprenorphine to treat people with opioid addiction.
Melodie Winawer is a board certified neurologist and the director of clinical neuroscience education at the Columbia University College of Physicians and Surgeons. Her primary research is the genetics of epilepsy, in which she examines how certain genes are risk factors for epilepsy. She is also a published author.
Katherine Margaret Keyes is an American epidemiologist. She is a professor of epidemiology at the Columbia University Mailman School of Public Health. Her research focuses on psychiatric and substance use epidemiology across the lifecourse, including early origins of child and adult health and cross-generational cohort effects on substance use, mental health, and injury outcomes including suicide and overdose.
Dustin Troy Duncan is an American public health researcher who is an Associate Dean for Health Equity Research at Columbia University Mailman School of Public Health. Their research considers how environmental factors influence population health and health disparities. In particular, Duncan has focused on the health of sexual minority men and transgender women of color in New York City and the Deep South. Duncan serves as Founder and President of the Dustin Duncan Research Foundation.
Ayana Jordan is an American addiction psychiatrist and immunopathologist. She researches treatments for substance use disorders in marginalized communities. She is the Barbara Wilson Associate Professor of Psychiatry at NYU Langone Health and was a professor at Yale School of Medicine. She served as an attending psychiatrist in the Yale University Department of Psychiatry. She was elected to the Board of Trustees of the American Psychiatric Association in 2018. She attended Hampton University and received her MD and PhD from the Albert Einstein College of Medicine.
In response to the surging opioid prescription rates by health care providers that contributed to the opioid epidemic in the United States, US states began passing legislation to stifle high-risk prescribing practices. These new laws fell primarily into one of the following four categories:
- Prescription Drug Monitoring Program (PDMP) enrollment laws: prescribers must enroll in their state's PDMP, an electronic database containing a record of all patients' controlled substance prescriptions
- PDMP query laws: prescribers must check the PDMP before prescribing an opioid
- Opioid prescribing cap laws: opioid prescriptions cannot exceed designated doses or durations
- Pill mill laws: pain clinics are closely regulated and monitored to minimize the prescription of opioids non-medically
References
- 1 2 "Silvia Martins | Johns Hopkins | Bloomberg School of Public Health". publichealth.jhu.edu. Retrieved 2023-11-27.
- 1 2 Howard, Jesse. "CPDD Announces New President-Elect and Board of Directors Members | College on Problems of Drug Dependence – CPDD" . Retrieved 2023-11-27.
- ↑ "When the Stakes Turn Toxic". NIH News in Health. 2017-07-06. Retrieved 2023-11-27.
- ↑ "Silvia S Martins | Columbia | CPRC". cprc.columbia.edu. Retrieved 2023-11-27.
- ↑ "Pregnancy and overdose: The roles of harm redux, healthcare and criminalization". IDPC. Retrieved 2023-11-27.
- ↑ "Mentor of the Year Award". Irving Institute for Clinical and Translational Research. 2018-10-22. Retrieved 2023-11-27.
- ↑ "Silvia Martins". The Data Science Institute at Columbia University. Retrieved 2023-11-27.
- ↑ "IAPHS Honors Silvia Martins with Its 2021 Mentoring Award". Columbia University Mailman School of Public Health. 2021-06-21. Retrieved 2023-11-27.
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