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.

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.

HOW PEOPLE TAKE OPIATES

HOW PEOPLE TAKE OPIATES

Most opiate drugs enter the bloodstream easily from many different

routes because they dissolve in fatty substances and so can cross intocells. Heroin and fentanyl represent one extreme—they are so fat-soluble that they can be absorbed across the mucosal lining of the nose. Most other opiates are not quite that fat-soluble and cannot be absorbed well after snorting. However, some opiates including the natural ingredients of the opium poppy form a vapor if heated and can be absorbed into the body if they are smoked—that is the basis of the use of the "opium pipe" as the traditional device of ancient as well as more recent history. Almost all opiates can be absorbed from the stomach, although injection is a much more efficient route for some, like morphine, that are more poorly absorbed from the stomach than others.

Intravenous injection is the route that delivers opiates into the blood­stream the fastest. Because intravenous injection is more difficult and more dangerous than other routes, many users do not start this way. Instead, they start by skin-popping—injecting drugs subcutaneously (just beneath the skin). Heroin powder is dissolved and injected. Morphine, fentanyl, and meperidine almost always appear as legally prepared injec­tion forms that have been diverted from medical use. Snorting heroin has become a common route for new drug users. In part, users are avoiding the stigma—and risk of infectious diseases including hepatitis and AIDS—that come with injecting a drug. In part, they may believe mistak­enly that they cannot become addicted if they don't inject drugs. Pre­scription opiates like codeine, hydromorphone (Dilaudid), oxycodone (Percodan, OxyContin), meperidine (Demerol), and, of course, metha­done (Dolophine) are available as pills. Sometimes drug users resort to grinding up pills of codeine, hydrocodone, or methadone and injecting the suspension when they cannot get opiates any other way. This is an extremely risky business because the other pill components do not dis­solve in saline. Injecting particles into a blood vessel can irritate the blood vessel, thus setting off a chain of reactions that lead to vascular inflamma­tion and permanent damage. In addition, a pill particle can lodge in a small vessel and block off the blood supply to an area of the body.

NITROUS OXIDE AND OTHER GAS ANESTHETICS

NITROUS OXIDE AND OTHER GAS ANESTHETICS

WHAT THEY ARE AND HOW THEY WORK

One of the most important drug experiences anyone can have is that of proper anesthesia in the operating room. Most surgery could not be car­ried out without proper anesthesia, because it serves three important functions: pain relief, muscular relaxation, and loss of consciousness. All of the gas anesthetics produce the loss of consciousness, and some of them produce the muscle relaxation and pain relief The reason for pain relief is obvious: No one would want to be cut and probed without pain suppression. Because most general anesthetics produce only loss of con­sciousness and not pain relief, a pain suppressor is added by an anesthesi­ologist. Muscular relaxation is required so that involuntary muscle contractions will not get in the way of the surgeon's work. Finally, the loss of consciousness provides the patient relief from the anxiety and bore­dom of the operating room and perhaps some very welcome amnesia for the whole experience. It is probably this characteristic of gas anesthetics that leads to their abuse.

Surgery wasn't always so easy. Until 1847 it was carried out without the help of anesthetic agents. Before then, there might have been a little help from alcohol or opium, but mostly the patient was held down by an array of strong men while the surgeon worked in spite of the patient's screams. But in 1847 things changed at the Massachusetts General Hospital when ether was first used, Ether had been synthesized recently, and dentists had begun to notice that it had anesthetic properties. A dentist named Mor­ton claimed that he could produce surgical anesthesia with this miracle compound and that he would demonstrate it at Mass General. With the observation gallery full and the men arrayed to hold down the patient as usual, the dentist appeared with the anesthesia machine he had invented to administer the ether. For the first time a patient underwent major sur­gery while asleep but with his heart and respiration safely intact. Within a month the word had spread and ether became a powerful part of medi­cine and surgery.

Ether was a great general anesthetic because it fulfilled the requirements for anesthesia, but it was flammable and could cause operating room fires. Modern nonflammable anesthetic agents, like halothane, are both effec­tive and potent, and anesthesia is achieved by breathing air containing just a small percentage of these gases. This makes them great for the operating room and bad for drug abusers, because it is so easy to overdose with them. As higher levels of anesthesia are achieved, three significant systems are impaired: respiration, blood pressure, and heart contractions.

Breathing is produced by the firing of a group of nerve cells deep in the brain. They are a little resistant to anesthetics, but at high levels their activity is suppressed, and respiration is depressed. Also, the smooth muscle cells that keep blood vessels at a set diameter relax, and this causes a drop in blood pressure. Finally, anesthetics can have a direct effect on the ability of the heart to contract, so it becomes weaker and prone to dis­ruptions of its rhythm. Halothane is particularly tricky because the dif­ference between the concentration that is effective and the one that causes problems is small.

Lots of chemicals and gases can be anesthetic agents, ranging from inert gases like xenon to the most modern compounds. Scientists still do not know exactly how anesthetics work. We know that they suppress the firing of nerve cells, and some can relax various muscles. At this point the best evidence is that, in part, they suppress consciousness by increasing the action of the neurotransmitter GAF3A (see the "Brain Basics" chapter for an explanation of GABA), which inhibits excitable activity in neural

networks.

When an anesthetic gas is inhaled, the sequence of responses is fairly uniform for many of the agents. There can be a brief period of excitation or stimulation, like after the first drink of alcohol. This is followed by pain relief, dizziness, weakness, and general depression of functions. At higher levels, reflexes such as eye blinking, swallowing, and vomiting can be lost. Finally, heart function and respiration are lost and the person dies. Some agents (such as enflurane) have more excitatory effects at overdose, and at high levels these effects can cause epileptic seizures. Other agents produce little in the way of stimulation and only depress the nervous system.

The window of concentration between anesthesia and death is very nar­row for these drugs. In medical settings the gases are carefully mixed with oxygen and survival body functions are monitored continuously. The anesthesiologist is fully capable of maintaining breathing for the patient or administering cardiac stimulants if necessary. Even with this level of care, problems can occur. Without careful surveillance, a person is at enormous risk of either dying or sustaining permanent brain damage.

NITRITES

NITRITES

WHAT THEY ARE AND HOW THEY WORK

These chemicals are yellow, volatile, and flammable liquids that have a fruity odor. The nitrites are part of a large class of drugs (including amyl nitrite, butyl nitrite, isobutyl nitrite, and the nitrates like nitroglycerin) that relax the smooth muscles that control the diameter of blood vessels and the iris of the eye, keep the anus closed, and keep us from dribbling urine. When these muscles relax, the blood vessels enlarge and blood pressure falls, more light is let into the eye, and the bowels are let loose.

The medical uses of these compounds have a long and successful his­tory, beginning with the synthesis of nitroglycerin in 1846. That's right—nitroglycerin, the explosive that we all know about, is also a very important drug. Chemists first noticed that just a bit of it on the tongue produced a severe headache (they did not know that this was because it dilated blood vessels); within a year it was medically used by placing it under the tongue to relieve heart pain caused by blocked blood vessels. Like all of these compounds, nitroglycerin relaxes blood vessels, and today it is very commonly used to relieve the pain that patients with heart disease feel when one of the vessels supplying blood to their heart has a spasm (angina pectoris). Remember the scene in movies when an old per­son grabs his heart, falls to the floor, and struggles to get his medicine out of his pocket? Then the bad guy takes the medicine away and the victim dies? Almost certainly, it was nitroglycerin that he needed.

The nitrites, like the amyl nitrite "poppers" that some people use for rec­reation, have the same basic effects as nitroglycerin. They were first syn­thesized and used medically in 1857, but soon physicians found them to be short lasting and unreliable, so nitroglycerin under the tongue has remained the medicine of choice. Amyl nitrite is now used clinically only when the very rapid absorption through inhalation is necessary for some cardiac medical procedures.

The side effects of nitrates and nitrites are common and consistent, and they are related to the dilation of blood vessels. When physicians pre­scribe these drugs, they tell their patients to expect headache, flushing of the skin, dizziness, weakness, and perhaps loss of consciousness if body position is changed rapidly.

As with almost all drugs, there is a lot we don't know about how they work. In this case, we really don't know exactly why the nitrites have the mental effects that make them attractive for some people to use. Users report a physical sensation of warmth, a giddy feeling, and a pounding heart. The psychological sensations are the removal of inhibitions, skin sensitivity, and a sense of exhilaration and acceleration before sexual orgasm. There is a rather common visual disturbance consisting of a bright yellow spot with purple radiations.' These effects may arise from the dilation of some blood vessels in the brain. Finally, some people use these drugs not for the mental effects but for their muscle-relaxing prop­erties to permit anal intercourse.