DOING YOUR OWN RESEARCH

DOING YOUR OWN RESEARCH

If reading this book has raised your level of interest and you want more specific information, or you want the straight story about a new develop­ment, there is no substitute for doing your own research.

Reading both scholarly review articles and original research papers is much easier than most people believe. In fact, one of the first steps in writing this book was gathering such research. Much of the library work for the first edition was done by two college students, neither of whom had any previous experience using a medical library. Should you decide to investigate for yourself, here are some suggestions about where to begin.

Public libraries are not likely to have the sorts of journals and books you will need. Because there is such a vast amount of medical literature pub­lished, most universities with a medical school have a separate library just to house all this information. Find a medical library at a nearby medical school. If for some reason you cannot get to a medical school, check to sec if there is a college or university biology department nearby and use the

library they use.

Next, go to the library and make friends with the reference librarian, because you will need his or her help until you are familiar with the library and the search mechanisms. The most efficient way of searching the literature is to use MEDLINE or PubMed, databases of the National Library of Medicine, a US government institution that allows you  

search almost all the published medical literature on any subject you can think of related to health. You can search by author, title, subject, key­word, institution, and many other descriptors.

In most cases you will find far more information than you need. A good place to start is with reviews. Reviews are documents that consoli­date and summarize the research and literature available in a given area, and they are usually written in less technical language. Reading several recent reviews about the topic you are researching will help you form a base of knowledge about the subject. Practice using MEDLINE by start­ing out with simple concepts; for example, search for marijuana articles. There are hundreds of them, and many of the titles will be so technical that they might seem indecipherable. So tell the computer to select mari­juana review articles. This will reduce the number markedly.

If you have read Buzzed, then you know that one of the active ingredi­ents in marijuana is THC. Try searching for THC and you will get more articles. Refine your search by asking for reviews of THC and you will get articles different from those you did when you searched for marijuana in general. Play with the database and have fun. Search for all kinds of com­binations of keywords, like THC and learning, or THC and adolescent. You will soon have an idea of the enormous amount of information there is about just this chemical. Understand, though, that no one study tells the whole story.

As a final note, we caution you not to accept everything you read as directly applicable to the human condition. Often scientists employ very high levels of a chemical to test for toxic effects in animals, and sometimes the chemical levels they use in/on animals are hundreds or thousands of times higher than a human would ever use, taking into account the weight of the human compared to the animal. Consequently, some of the toxic effects seen in animals may not apply to humans. On the other hand, ani­mal experiments cannot reveal many subtle effects of chemicals, particu­larly psychological ones, and thus animal studies almost certainly miss some important effects that humans will experience. So, as you read a sci­entific paper, remember that it is just a small part of the literature about a drug, and while the data may be true, it is important to understand that data in the context of everything else known about the drug.

WHERE DO WE GO FROM HERE?

WHERE DO WE GO FROM HERE?

There is an ongoing debate in the United States about the legalization or decriminalization of drugs by society. Several states have either passed laws or are considering laws that allow the use of marijuana for medical and possibly recreational purposes, but these laws are still controversial, and there is the additional problem that these state laws can be in conflict with federal laws. As a result, no one knows what the outcome will be even though it appears that federal officials are beginning to limit some prosecutions.

A number of prominent Americans—including the conservative Repub­lican senator Rand Paul—have concluded that the War on Drugs is leading to injustices. As this is being written, Senator Paul and Democratic senator Patrick Leahy want to change the law and have introduced the justice Safety Valve Act, which will allow judges more discretion in sentencing.

On the other side, many people believe that any effort to reduce the pressure on drug users and dealers will result in a flood of illegal sub­stances that, in their worst nightmares, will become readily available to children. Unfortunately, drugs are already readily available to anyone, including children, from all economic levels. So that nightmare is here right now.

To reduce demand, we need to increase education. As we have said elsewhere in this book, effective drug education is not just a matter of exhortations to refuse all drugs, because many individuals believe that the drugs they use are harmless. It is a matter of teaching the basic science that can help us appreciate what complex and delicate organisms our brains are, how body chemistry may vary from person to person, and how little we know about the many ways, both positive and negative, short-term and long-term, that the powerful chemicals we call "drugs" can affect us. Good education is expensive, but with it we will be healthier, and as a society, we will save the enormous costs of lost wages, law enforcement, and prisons that drugs have brought us.

GETTING CONVICTED: THE PENALTY BOX

GETTING CONVICTED: THE PENALTY BOX

The penalty laws of most states and countries are built on a series of leg­islative acts that happened over a long period of time, and thus, they are complicated and not easily summarized. Possession of modest amounts of marijuana can result in a slap on the wrist in some places and serious jail time in others. The same is true for other drugs, although they are usually taken more seriously, even in very small amounts. Often the prosecuting attorney has some leeway about the level of crime with which to charge an individual. The problem is that it is difficult to be sure of (1) the latest changes in the law, (2) the attitude that the prosecu­tor is taking toward drug crimes, and (3) whether that individual will be charged under state or federal statutes. Thus, conviction for the posses­sion of a small, recreational amount of heroin or cocaine could result in either a modest sentence or a huge fine and a long prison term, depend‑

ing on the exact circumstances and the mood of the legal officials over­seeing the case.

It is important to recall that in some states and in the federal system there is structured, or guideline, sentencing. That means that once an individual is convicted of some drug crimes, the sentence is regulated by law and might not be alterable by the judge no matter what the circum­stances. Coupled with the fact that there is no parole in the federal system (and increasingly in the state systems), a conviction can mean long prison time, even if the prosecutor and judge wish it were otherwise.

Here's an example of how things can go terribly wrong as a conse­quence of alcohol, a prescription drug, and harsh laws. One of us (WW) testifies as an expert in legal cases, and a recent one illustrates how the law, the prosecutor, and the courts can interact to ruin the life of an indi­vidual. A man was at a party with his neighbors outside of his home. He consumed a modest amount of alcohol throughout the evening, but at some point he decided to go to bed and took his nightly medicine, which included the sleeping pill zolpidem (generic for Ambien). Before going to bed, he came back to the party but soon appeared intoxicated. He then prepared for bed and went to sleep. Shortly thereafter, he awoke and came out of the house without his shoes, false teeth, or hearing aid, clearly hav­ing just awakened. But he had a gun, which he had retrieved from his bedside where he kept it. He fired twice as he yelled an obscenity to the individuals at the party. No one was hurt. The police were called, and he was arrested.

The man was charged with aggravated assault, and everyone thought he was intoxicated with alcohol. In the law of most states, that is consid­ered "voluntary intoxication" and thus is not a defense against any charges. His defense team argued that he was not intoxicated with alco­hol, but with his prescribed zolpidem, which is known to produce odd behaviors such as sleep driving, sleep sex, sleep shopping, sleep eating, and so forth. If it were the zolpidem, that would be "involuntary intoxica­tion," and that is a defense against such charges.

The jury heard the case and decided that he was intoxicated by alcohol and was therefore guilty. Now, here is where the disaster occurred. In that state, commission of many crimes (such as aggravated assault) with a gun is a mandatory ten-year sentence. If the gun is fired, the mandatory sen­tence is twenty years. In this case the prosecutor chose to charge the man for each of the six people present at the party, and the law requires that the mandatory sentences apply to each charge and be served consecu­tively. This means the man (who has not been sentenced at this writing)

must, by law, be sentenced to 120 years in prison. The judge has no discre­tion in this case.

This is a terrible example of the interaction of intoxication, harsh laws, vigorous prosecution, and finally, the presence of a gun where a sleepy, intoxicated person could access it and fire it. This man had no history of behavior like this and was a decorated soldier. It is very likely that the zolpidem produced the bizarre behavior, but the prosecutor and jury did not see it that way.

The lesson from this is that if a person chooses to intoxicate himself and then commits a crime, that intoxication is usually not a defense against any crime he committed, no matter how impaired he was at the time of the crime.

GETTING CAUGHT

GETTING CAUGHT

Most people believe that they will not get caught. Teenagers, in particular, have the feeling that they are "beyond the law" But it does happen. It hap­pens to grandmothers, teenagers, lawyers, doctors, and the most ordinary people on the face of the earth.

Many drug arrests come from the most random events imaginable. In Virginia, an officer stopped a car for having something hanging off the rearview mirror. He became suspicious, legally searched the car, and found major quantities of cocaine. Another drug transporter thought he had the perfect scheme and filled fruit juice cans with cocaine, then resealed them. It is a regular practice for tourists to bring back food from vacation in the Caribbean, and he expected to walk right through customs. What he did not realize was that customs officials knew there was no reason to bring

canned fruit juice from the Caribbean, where it is expensive, to the United States, where it is cheap. He was arrested and convicted for transporting millions of dollars' worth of cocaine.

Even grandmothers are not immune to arrest. A pair of DEA agents working a bus station in North Carolina noticed an elderly woman behav­ing oddly. When they approached her, she moved away and they became suspicious. They conducted a legal search and found a large quantity of cocaine in her luggage.

A college student came back to her dorm room to find the place crawl­ing with campus and city police. While she had absolutely no role in any illegal activity, a friend of her roommate had come to town from another college with a shipment of drugs. Another student, obeying the honor code, had called the campus police. Fortunately, the innocent student was not arrested because the roommate cleared her, but it was a very close call.

The law-enforcement community is actually quite sophisticated in its drug-enforcement efforts. DEA agents work all over the world trying to prevent the transport of drugs into the United States. They have agents working major and minor airports, and even bus stations. The highway patrols of most states have drug interdiction units looking for suspi­cious vehicles. This is not a trivial effort, and it results in so many con­victions that both the state and federal prison populations have grown dramatically.

Yet everyone realizes that most countries are overrun with drugs. It is usually easy to buy the most common illegal drugs in many areas of cit­ies and on college campuses. So why is the legal interdiction effort per­ceived as failing? It is not exactly failing, but rather it is being overwhelmed. Many, many people are caught in the legal system, but there is always someone else to replace each person caught. Routine usage of cocaine, crack, or heroin can be a very expensive habit, and the only way that most people can maintain such expensive behavior is to turn to dealing. As we say elsewhere in this book, cocaine and opiates can be extremely reinforcing, and they are also expensive in the quanti­ties that habitual users consume. The combination of dependence and expense often leads users to become dealers until they are stopped by medical intervention, arrest, or death.

What does this have to do with the average reader of this book? Any­one who can read this book no doubt has the ability to do honest and legal work and have a successful life. Such a reader might feel that she is above being caught, or just not in the "wrong" circle of friends. This

naiveté might be the most dangerous attitude of all, because, like most jobs, illegal drug dealing depends on knowledge, skills, and having a network of people. Most casual dealers do not have the knowledge or, fortunately, are not willing to do what is necessary to involve themselves fully in the drug culture. Thus, they approach the whole issue as ama­teurs, and like many amateurs in anything, they fail miserably. Only in this case, the stakes are much higher. They can get caught, lose a lot of

money, become victims of criminal violence, or become heavily depen­dent on the substance they are dealing.

As we all know, some people think they have few opportunities and only a short time to live. They will deal drugs no matter what anyone says. In their lives they see jail time as just the cost of doing business. However, a district attorney who has prosecuted thousands of drug cases had just one bit of advice: people with families, an opportunity for education, and a supportive network of friends have so much to lose from being on the wrong side of the legal system that they should never become involved with it. A felony conviction can strip a person of so many opportunities in this society and can cost families so much in

pain, suffering, and financial loss that no amount of money or drug experience is worth the risk.

ILLEGAL ACTS

The drug laws are complicated, and the states differ from each other and from the federal system. So, there is no easy way to explain them in detail. However, there are a few very powerful and relatively unknown aspects of the law that should be explained to everyone.

First is the difference between a felony and a misdemeanor. A misde­meanor is a minor crime that might result in a fine, public service, or a short prison sentence—typically less than one year (in the federal sys­tem)—and usually is associated with traffic violations, minor theft, or sometimes possession of a very small amount of an illegal drug. A felony (murder, armed robbery, sale of drugs) usually carries a sentence in excess of one year and is considered such a serious crime that convicted individ­uals lose many rights that ordinary citizens enjoy. This includes the right to hold many kinds of highly paid jobs. A felony conviction is truly a life-changing event. Understanding this is important for drug users because possession of some amounts of some drugs can be considered a misdemeanor, while larger amounts are always felonies.

The law always sets the level of punishment based on the amount of a drug that one possesses or distributes, and in this case size counts a lot.

For example, there is a current public controversy because the federal laws are terribly tough for possession of even a few grams of crack cocaine, but one would have to possess much more powdered cocaine to receive the same punishment. Anyone who contemplates drug usage should under­stand the severity of the penalties that various levels of drug possession invoke. (As we write this, the US Department of Justice has decided to modify the way US attorneys may charge cocaine/crack dealers. Now they can make the charge without stating the amount of drug, so that the pen­alties are more consistent between crack and powdered cocaine. The problem is that this is an executive decision and can be reversed in any case and at any time. The actual law regulating possession and distribu­tion of these drugs has not been changed.)

Most people know that conviction for selling drugs (distribution) results in stiffer penalties than for possession. What they don't know is that sim­ply possessing certain amounts of a drug can be considered an "intent to distribute" and thus may subject a person to the much stiffer distribution penalties. Moreover, money may not have to change hands for distribution to take place from a legal perspective. Simply handing a package of a drug from one person to another can be considered distribution.

Another obscure criminal area is conspiracy. In drug cases, there are many convictions for conspiracy to commit a crime because very often a drug deal involves much more than the simple transfer of money and drugs. The conspiracy laws are broad and powerful, and even people peripheral to the planning of a crime, who may not have participated in the crime itself, are often charged under these laws, sometimes in the hope that they will cooperate with the court officials to convict others. Anyone hanging around individuals involved in drug possession and dis­tribution should be aware of the risk of being charged with conspiracy for seemingly innocent acts, such as lending a boyfriend a car, cashing a check, or allowing a friend who is a dealer to use a telephone if it can be proven that in doing any of these seemingly innocent acts you knew why the person wanted you to do them. From the standpoint of law enforce­ment, drug dealing is considered a business (although it is illegal), and just as in a legal business, different people play different roles and have different levels of importance. In general, being around drug dealing is legally very risky.

Finally, there is the issue of the confiscation of property. Most of us have heard about auctions where the property of drug dealers is sold. This hap‑

pens because of forfeiture laws that allow property used in drug dealing to be confiscated and sold by the government. The particularly devastating aspect of this is that the property of a more or less innocent individual might be confiscated because it was being used in violation of drug laws. Imagine, for example, a student distributing cocaine from his father's home and car. Suppose the father knew something about this and told the student to stop it. If the prosecutor could prove that the father knew some­thing and allowed it to continue, it is possible that both the home and the car could be confiscated as part of the criminal prosecution.

What about marijuana? It's now legal, right? Some states have "legal­ized" marijuana possession for medicinal purposes; others have made the possession of small amounts for recreational use either legal or punish­able as a misdemeanor. But the US federal law makes it a crime in all fifty states. In general, federal law overrules state law, so you might well be in a state in which possession is legal but prosecuted under federal law. As we are writing this new edition, President Obama has asked the Department of justice to refrain from enforcing the marijuana laws in certain circum­stances for states that permit its possession. But that is an executive deci­sion that can he reversed at any time. Moreover, the specific conditions under which the federal law might be enforced may not be crystal clear. So, be aware that no matter what a state law says, federal law still has this drug illegal everywhere in the United States.

DRUG LAWS

DRUG LAWS

The drugs in this book are subjected to a variety of laws. Tobacco and alcohol are legal to possess and use in the United States, as long as you are at least eighteen years old (for tobacco) or twenty-one years old (for alco­hol). The same pertains for many of the over-the-counter cold medica­tions that can be used as precursors of methamphetamine and for dextromethorphan—if you show identification and are at least eighteen years old, you can possess amounts for personal use. Most herbal drugs we discuss (except ephedrine) can legally be purchased and possessed by anyone.

Most of the other drugs are covered by the Controlled Substances Act. According to this federal law, some substances cannot be purchased or possessed by anyone, while others can be used if they have a prescription from a doctor. There are different "schedules" that are based on the dan­ger of abuse, and the medical use. These are described in what follows. These drugs can be purchased and possessed only with an appropriate

license from the Drug Enforcement Administration (DEA) or a prescrip­tion from a physician.

· Schedule I: Drugs in this class have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse. They cannot be purchased or possessed by anyone. Some of the drugs in this category are all forms of marijuana (natural and synthetic), heroin, all serotonin­related hallucinogens (LSD, psilocybin, and all their derivatives), MDMA and all its congeners, and all cathinone derivatives (bath salts). These can be possessed only for research purposes with an appropriate license.

Schedule II: Substances in this schedule have appropriate medical use but a high potential for abuse that may lead to severe psychologi­cal or physical dependence. This includes many opiates, such as methadone, morphine, opium, oxycodone, fentanyl, meperidine, and codeine; some sedatives like pentobarbital; and stimulants that are used clinically, including amphetamine, methamphetamine, and methylphenidate.

· Schedule III: Substances in this schedule have a potential for abuse less than substances in Schedules I or II, and abuse may lead to mod­erate or low physical dependence or high psychological dependence. Drugs in this class include combination products containing some opiates like hydrocodone with acetaminophen; buprenorphine for­mulated with naloxone (Suboxone), which is used to treat opiate addiction; the anesthetic ketamine; and testosterone.

·  Schedule IV: Substances in this schedule have a low potential for abuse relative to substances in Schedule III. Drugs in this category include many benzodiazepine sedatives, including diazepam (Valium), alprazolam (Xanax), and triazolam (Halcion).

·  Schedule V: Substances in this schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.

This list is not comprehensive, but it provides enough examples. The penalties that result from purchasing or possessing them vary by the schedule and by how much you have in your possession, so you should consider this only as an introductory guideline. You need to understand that if you purchase or possess anything in these schedules without a doc‑

tor's prescription, you are breaking the law. In addition, state laws may differ from federal laws. For example, marijuana is scheduled much lower by most states, but many states have broadly liberalized availability for medical purposes (although it is not completely legal in any state).

We have a word of caution about the scheduling of drugs. While this list describes the various schedules for drugs, placement at a given level in the list does not necessarily represent the degree of safety of the drug. For example, marijuana is a Schedule I drug, but it is almost impossible to die from it acutely. On the other hand, benzodiazepines are Schedule IV drugs, and with regular use over a period of time, an individual can become very tolerant to them. At that point, stopping their use can be almost impossible without medical help. If you take one of these drugs, get good information about it and don't depend on the level of scheduling to keep you safe.

Not all psychoactive drugs are controlled substances and, therefore, are on these schedules, but they do require a prescription. In most situations, you are breaking the law if you possess these drugs without a prescription and particularly if you give or sell them to another person.

GETTING SEARCHED

There's this joke about a very large canary: Where does an eight-hundred­pound canary sit? Anywhere he wants to! Likewise, a law-enforcement officer will search just about anywhere if he really wants to do it. Eventu­ally the courts could decide whether the search was legal, but if an officer has reason to believe that a crime is being committed, he may well initiate the search process and let the lawyers settle the issue later.

Laws in the United States on the subject of a search are extremely com­plicated, in part because the legal rights of individuals have been defined over the years by many different court cases. However, there are a few general principles that govern when someone can legally be detained and searched.

First is the "expectation of privacy." The expression "A man's home is his castle" applies here. To search a residence usually requires more strin­gent legal prerequisites than searching elsewhere. Often a search warrant signed by a judge is required, unless there is evidence of a major and immediate threat to public safety.

Next is the automobile. This is the place where most individuals con‑

front the law. An officer will see a traffic violation in progress, stop the vehicle, and then come to suspect that illegal drug activity is being car­ried out. If an officer reasonably believes that a crime is being committed, then he probably has the right to detain the occupants of the car until a legally proper investigation can be carried out. Remember, this officer can stop and hold someone if he believes that a crime is being committed, even if he is wrong!

A court official gave us an extreme example: Say a murder has been committed in the course of a bank robbery and the killer is driving away in a 2007 blue four-door sedan. In the heat of the moment, an incompe­tent 911 operator becomes confused and broadcasts that the killer is leav­ing the scene in a 2003 red pickup truck. An officer down the road sees a 2003 red pickup truck and stops it, removes the occupants, and searches the truck for weapons. He finds illegal substances. Was the search legal? Probably, because the officer had reason to suspect that the occupants were criminals. He was wrong, but with good reason, and the occupants may well be convicted for whatever offense they committed.

There are equally odd outcomes in which convictions are not possible because the officer was found to have no reason to search a vehicle. That is why most officers ask permission to search a car before doing so. That permission usually makes the search legal and any evidence is thus legally obtained. If permission is not given, then the officer may choose to detain the individuals further and call for a drug dog or other assistance to examine the vehicle. This issue then gets very complicated.

The practical side of all this is that a law officer has quite a lot of power to detain and arrest, because the lawmakers have decided it is in the pub­lic good to be able to temporarily detain potential criminals and, to some extent, to ask questions later. Even if an officer is eventually found in court to be wrong, the suspected individuals would have suffered loss of time and perhaps arrest, legal bills, and considerable life discomfort.

Finally, there is the situation when a person is out in public and walk­ing about. This is the least "private" act, and so there is the least expecta­tion of privacy. In this case a law officer has much more leeway in searching a person for the protection of the officer herself and for that of the general public. For example, imagine that an officer sees a person walking down the street in and out of traffic, in an erratic manner. She has the right to stop and talk to that person to ensure that he and the driving public are safe. If in the process of that stop the officer suspects

 that the individual may be carrying a weapon, she could search him by doing a pat down. If in the course of that search the officer feels some­thing she recognizes to be an illicit drug, the officer can seize the drug. Can the person be convicted of a drug-law violation? It is very likely that he can because the search was legal.

The same rules might apply at a concert. Let's say that two students are obviously intoxicated and fighting. An officer moves to stop the fight, the students resist, they are appropriately searched for weapons, and illicit substances are discovered. If the officer chooses to charge them, there is a good probability that the charges will stick.

Do law-enforcement officers have a pathological agenda to harass driv­ers and students at a concert, looking for drugs everywhere? Rarely. Most law officers see their work as a job, not a mission. Think of all the traffic laws that are broken every day and how seldom stops occur. Think of how seldom someone who is innocent of any law violation is stopped in a car or interdicted at a concert. By and large, the legal community just does its job.

LEGAL ISSUES

IT IS SAID that your life can change forever in a matter of seconds. When a person mixes alcohol or other drugs and the legal system, the combina­tion can easily become life-changing. For a variety of reasons, the law­making bodies of most countries, especially the United States, have decided to suppress illegal drug use by making drug laws harsh and cer­tain. All who deal with drugs in an illegal manner are thus at risk for penalties that can disrupt their own lives and those of their families.

The use of almost all the drugs discussed in this book could involve violations of the law, depending on the circumstances. Many of these drugs are illegal in all circumstances—manufacturing, distribution, and possession. Others are legal when prescribed, but not for recreational use. Still others, such as alcohol, can be legal for adults, but their use is prohib­ited for underage individuals and for activities such as driving a car or operating a boat.

This chapter is written to inform readers about very basic laws and principles that come into play around drug issues. It is not intended to give advice about dealing with the law-enforcement community or the judicial system. If you feel that you need that advice, find a good lawyer and ask her all of your questions before you become legally involved.

THE PRINCIPLES

I While laws exist regarding the rights of a law officer to search some­one's car or home, this very complicated issue is often decided in the courts in individual cases. Generally you have the greatest "expecta­tion of privacy" in your home. There is less expectation of privacy in a car, and the least when you are out in public.

2. If a law-enforcement officer suspects you of a crime and really wants to search you or your car, you will be searched, whether or not you give permission. If you give your permission, the search will almost certainly be considered legal. If you refuse permission, the search may or may not be legal, but it may happen anyway. The debate over whether the search was permitted and legal will begin in the court system. The easiest way to avoid trouble is to avoid situations in which a random and unexpected search will yield anything illegal.

3. A person who is innocent of any crime but is with someone arrested for possessing drugs may become involved with the legal system until her innocence is proven. By that time, she may have incurred large financial burdens (e.g., an expensive lawyer), terrified her family, and spent some time under arrest.

4. 'the penalties for drug-related activities can be horrendous, especially in the United States federal judicial system, and particularly for selling drugs. Many casual drug users do not realize that simple possession of a modest amount of a drug can automatically be considered "intent to distribute," whether or not they actually plan to sell the drug.

5. You do not have to be on government property to be in violation of federal law. The federal drug laws apply everywhere in the United States and US territories at all times.

6. State and federal laws can be extremely strict about the use of guns in the commission of crimes. The possession of a gun—even just having one in the vicinity of a drug-law violation canadd many years onto the sentence for the original crime.

Many people believe that they are "safe" from serious legal consequences because they know the local officials, or because they believe the penal­ties are not serious. They are wrong. First, it a local official were to inter­fere with a prosecution, she could be prosecuted for obstruction of justice or public corruption. Second, an arrest by a state or local officer can eas­ily be referred to federal prosecutors not subject to local political influ­ence. Third, in many states and in the federal system there is no parole. Even worse, in some cases "minimum mandatory" sentencing laws give the judges practically no leeway for reduced sentences.

8. Your rights as a US citizen do not apply in foreign countries, and the legal consequences of drug-law violations in some places can literally mean death.

FAMILY SESSION

FIRST (FAMILY) SESSION

Once the guardians arrived, Jim's conduct turned out to be more fomented and he raised another subject not already examined. Jim started to make dangers toward a meeting extraordinary auntie, saying that he had a sawed-off shotgun and that he would go home and "shoot the old bitch.- The close relative was on the father's side of the family, a sister to the grandma. She had come to visit the family around seven days sooner. There was some specify by the grandma that maybe the auntie could remain for all time. Mrs. Galvani (Jim's mom) needed her better half to talk with the grandma and close relative and attempt to clarify that there essentially wasn't room in the house for the auntie to remain for all time. Mr. Galvani felt that he should - not encroach into this sensitive circumstance,- as he clarified it. The auntie was dozing in Jim's room. Jim was thinking about the lounge chair. As the session proceeded with, Jim turned out to be progressively fomented, undermining to murder the close relative - right when the majority of this doltish squabbling stops.- The specialist took the position that he barely knew Jim and that the guardians ought to choose what was to be done to deal with this circumstance. Inside a brief timeframe, the guardians chose that Jim ought to go to Redtown a nom de plume an adjacent doctor's facility with an inpatient program). The session finished with an understanding that the whole family would meet again once Jim returned home from Redtown Hospital. This was Jim's second trek to Redtown in a month. 

In this family the healing facility resembled a weight valve and the specialist came to see hospitalization as a basic component in the fixation cycle. Mounting family pressure would set off debilitating conduct by the someone who is addicted. This would be trailed by a refocus of all family consideration on him and the family would push for him to be hospitalized, along these lines redirecting consideration from their unique clash. It was very apparent how Jim's conduct played a defensive capacity in the family, particularly in relationship to his dad: Mr. Galvani did not need to talk with the grandma and the close relative; regardless, the circumstance was settled. While Jim was checking in at the doctor's facility, he called home to advise the close relative that she was in charge of his going into the clinic and influencing him to go insane. When he was released 6 days after the fact, the close relative was no more. This cooperation gave vital demonstrative data to the advisor in mostly under-standing the Galvani family. The association proposed that Jim was engaged with a defensive coalition with his dad; additionally, Mr. Galvani was associated with a defensive coalition with his own particular mother. 

In view of this experience, the specialist knew from the earliest starting point the vital capacity the healing center played in this family and that no doubt he would again be confronted with a looming hospitalization once another unpleasant circumstance introduced itself. An individual-situated specialist may have neglected this bigger cycli-cal process, which included the whole family and the doctor's facility, and rather have centered his consideration solely upon the individual conduct of the fanatic. In doing as such, he would have missed the operation portunity to mediate all the more adequately, for example, in altering the interprotective cooperations among relatives—and might un-intentionally have progressed toward becoming piece of the intersystem cycle himself. 

SECOND (FAMILY) SESSION 

So far the specialist had no working contract with either the family or the someone who is addicted. They had not settled upon the objectives of treatment, nor had they settled upon who was to be associated with the treatment. In the second session these two issues were deliberately promotion dressed. The specialist took the position that he just worked with addicts who needed to get off medications—all medications, including methadone. The guardians concurred this was without a doubt a splendid objective, and the fiend moreover concurred. At the point when there was some repeating articulation of uncertainty in the matter of whether such an objective was - sensible,- the advisor guaranteed them that it was practical and that he had effectively worked with different cases similarly as troublesome as Jim's. With respect to the second inquiry of who ought to be engaged with the treatment, the advisor took the position that all relatives ought to be included. The mother protested that she didn't need her girls included in light of the fact that she - needed to keep them far from Jim." Again, this sort of data gave profitable analytic signals concerning the mother-little girls coalition inside the Galvani family. The specialist demanded that the little girls be included and mother yielded. On the topic of the grandma's cooperation in the treatment, the father protested enthusiastically in light of the fact that her wellbeing was poor. 

THIRD, FOURTH, AND FIFTH (FAMILY) SESSIONS 

All relatives with the exception of the grandma were available amid the following three sessions, spreading over a time of a month and a half. The general subject of these three sessions was the manner by which the guardians would make Jim more dependable as long as he kept on living with the family. The advisor emphatically accentuated that Jim's stay with the family was just brief, that will be, that he would be moving out alone. The guardians were guided by the advisor to together settle on some solid choices concerning Jim's conduct. For instance, the guardians concurred that he ought to negligibly have three prospective employee meet-ups a day. The guardians chose what number of companions Jim could welcome to the house at any one time and what hours he may have companions in the home. Points of confinement were determined to how much liquor he could expend at home and what the outcomes would be on the off chance that he broke this understanding. In particular, the guardians consented to put him out of the house if his pee tests showed utilization of unlawful medications. 

Emphasize that what is most vital is that these principles be mutually consulted by the guardians. Ordinarily, guardians of addicts think that its hard to endless supply of anything; along these lines, the most effortless issues to center upon are identified with making solid standards about what they, as guardians, will acknowledge while their child keeps on living with them. Once more, the understood message to the guardians is that the someone who is addicted's quality is transitory, yet that he will be obliged to take after their mutually created controls as long as he stays with them. 

Mr. Galvani was reliably the all the more considerate of the guardians. He and Jim had a past filled with intermittently remaining out late during the evening drinking. Mrs. Galvani was disappointed with the drinking propensities for both spouse and child. On some icy nights amid the winter, Mr. Galvani would hold up until the point that the nearby bars shut (2 A.m.) and after that go and escort his child home. These illustrations were utilized as a reason for testing Mr. Galvani's paternalistic overindulgence.* Mother seemed irritated at her better half's tolerance, yet could never transparently scrutinize him inside these sessions. Amid this time of roughly a month and a half Jim was extremely helpful, excessively so. He relentlessly lessened his methadone dose, hunt down work dili-delicately, complied with the new house rules concerning errands, companions, liquor, and security of his sister's rooms. His pee tests were reliably spotless. 

6th (INDIVIDUAL) SESSION 

The 6th session was not an arranged session. Jim called the specialist and said it was dire that he talk with only him. On the telephone he griped that he was encountering withdrawal impacts from the methadone and that he was getting bothered by the advisor - blending up this poop in my family.- An individual meeting was masterminded inside hours and the fiend demanded that he was registering with Redtown Hospital quickly. The advisor offered to help Jim in acquiring extra methadone if that was what he required, yet Jim can't. He was obstinate, notwithstanding getting to be noticeably combative, when the advisor gave some negligible sign that he contradicted the possibility of Jim going into the doctor's facility right now. An arrangement amongst fiend and advisor had been made a month and a half already that Jim would enter the healing facility just exactly when the outpatient detoxification was almost entire. A more conventional medication instructor may conceptu-alize Jim's "frenzy response as a reaction to interior tension and the security that the healing center offers the someone who is addicted as a method for restricting nervousness. From a family frameworks perspective, in any case, this sudden move in conduct and demeanor on Jim's part motioned to the specialist that something agitating was likely occurrence in the family and that Jim was accepting his standard part of centering consideration upon himself. The choice in the matter of what to do a-t this point was a pivotal one in wording both of case administration and of arranging procedure. The advisor couldn't prevent Jim from marking himself into the healing center since he was a veteran and had the privilege to enter a VA doctor's facility freely. In the meantime, his entering himself into the healing facility was a piece of the repeating emergency process engaged with the compulsion cycle. In the event that the specialist did not make an intercession now, he would lose an operation portunity to roll out truly huge improvements in the family. It was suspected that the most ideal arrangement was not to restrict Jim's want to enter the healing center, however to demand that it ought not occur until the point that the family could meet to talk about the circumstance. This choice was made basically on the premise that it is smarter to attempt and have some impact upon the course that a group of runaway stallions moves, as opposed to be trampled endeavoring to stop them. A family session was booked for the following day. 

SEVENTH (FAMILY) SESSION 


The objective of this family session was to emphatically underscore how Jim's approaching hospitaliza tion and de tox ification ought to be unique in relation to past hospitalizations. The advisor reliably underscored the way that this detox was exceptional and that it would be the last one, ever. Mrs. Galvani and Jim's sisters exhibited a straightforwardness in testing Jim that had not been showed in past sessions. Previously, hospitalization (with detoxification) happened without family input;