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.

POSITIVE HEALTH EFFECTS

POSITIVE HEALTH EFFECTS

Although we always urge caution when interpreting correlational studies, a recent large study based at the National Cancer Institute collected health data from more than 400,000 individuals in their fifties and sixties start¬ing in 1995 and following them for thirteen years. Across that time, men who drank two or three cups of coffee per day were 10 percent less likely to have died, and women were 13 percent less likely to have died. The study was not designed to answer the question of why coffee drinking was associated with better survival, but the findings are worth knowing about.

Two studies published in 2012 suggest that caffeine may also have bene¬fits for memory function when memory is challenged or in decline. In one study, individuals with "mild cognitive impairment"—a strong predictor of Alzheimer's disease—had their memory function evaluated and caf¬feine levels measured at the beginning of the study and again several years later. Those who had caffeine levels consistent with drinking about three cups of coffee were significantly less likely to have developed Alzheimer's disease than were those with no caffeine in their systems. This doesn't mean that caffeine prevents Alzheimer's disease. It could be that there was something else about the lifestyles of the people who had caffeine in their systems that helped forestall the onset of full Alzheimer's symptoms. For example, because caffeine in a stimulant it could simply have made the subjects more alert, making them more likely to engage in social or intellectual activities, both of which have been shown to promote cogni¬tive health in older people. The second recent study was a lab experiment with animals that had their memory function impaired when their brains were deprived of oxy­gen for a brief time. This condition, called "ischemia," often happens when people suffer a stroke and is known to result in memory and other cognitive deficits. Half of the mice received a dose of caffeine before the oxygen deprivation and the other half did not. Later, the mice that had received the caffeine regained their ability to form new memories 33 per­cent faster than the ones that had received no caffeine. It was as if the presence of caffeine at the time of the ischemia protected the animals' brains from suffering the full effect of the loss of oxygen. This could have been due to the caffeine disrupting the actions of adenosine in the brain. We wrote about how this action is part of why caffeine creates alertness. But when brain cells are injured or under stress, adenosine can reach dan­gerously high levels and actually damage the cells. Having the caffeine on board when the animals brains were stressed may have reduced the potential toxic effect of adenosine. Of course, this does not mean that everybody should walk around buzzed on caffeine all the time just in case they suffer a stroke or brain injury. But if it happens to be there, it might be protective.

CUCUMBERS AND PICKLES: CHANGES IN THE BRAIN

CUCUMBERS AND PICKLES: CHANGES IN THE BRAIN

So what changes between the fifth time that you get your muffin and the time that you waited at the bakery door until opening time each day, neglecting your job or forgetting to take your children to school? You do this even if the muffin tastes lousy. It is this sort of compulsive, repetitive involvement in drug taking despite negative consequences that most experts view as addiction.

Use of addictive drugs can be viewed in a similar way. Many people drink alcohol occasionally, or even sometimes use cocaine at parties. However, for some people, the first social experiences with drugs gradu­ally evolve into more continual use. Alcohol use provides an example. While 50 percent of the adult population of the United States drink alco­hol occasionally, of these about 10 percent drink heavily and about 5 per­cent engage in addictive patterns of drinking.

Clearly, something happens in addicts that makes the need to consume drugs so great that they will go to extreme lengths to obtain the drug. What changes in the brain explain this? We have heard recovered addicts compare the change in their behavior and lives to the change from a cucumber to a pickle. Once a cucumber is turned into a pickle, it cannot

be turned back. Is this a real analogy? If so, then the Alcoholics Anony‑ mous approach of lifetime abstinence from drugs becomes a convincing solution to alcoholism.

Most scientists think that changes gradually occur in the reward circuit of the brain as it adapts to the continuous presence of the drug. However, we don't completely understand exactly which changes are the most important for addiction. The simplest change is easy to understand: with daily stimulation by addictive drugs, the reward system comes to "expect" this artificial stimulus. When people stop using drugs abruptly, the reward system is shut down—it has adapted to the daily "expectation" of drugs to maintain its function. We know of one biochemical change in the brains of all addicts that may explain this result. The brains of alcoholics, meth-amphetamine addicts, heroin addicts, and even compulsive eaters show a common biochemistry—they have low levels of one of the receptors that normally receive dopamine. This makes sense—in response to a constant barrage of dopamine, the cell that receives it is just trying to shut down. Recovering heroin addicts often report that every time they inject heroin, they are trying to recapture the feeling of their early experience with the drug, which gave a pleasure that they never quite reached again. People who are in a stimulant "binge," taking hits every few hours, can have the same experience. They respond by "chasing the high," taking the drug every hour or so to recapture the first rush. Only when they stop taking the drug for a while does their initial sensitivity return.

Some recovering cocaine addicts say that they do not feel pleasure in any­thing for a while after they stop using cocaine. Imagine how difficult it must be to stop using a drug that gives incredible pleasure, when even things that are usually enjoyable give no pleasure during withdrawal. This inability to feel pleasure may be one of the powerful reasons why people have great diffi­culty giving up cocaine. If there is a substance at an addict's fingertips that can make him feel better immediately, clearly the impulse to take it can

become overwhelming.

Some of the changes in the brain of a person who uses addictive drugs repeatedly are just a result of normal learning in the brain. Let's go back to our bakery one more time. As our imaginary muffin addict approaches the store each day, he remembers the route and looks forward to the smell of newly baked muffins wafting down the street. Pretty soon, the smell of the bakery alone can cause an intense longing for the pastries before he gets there. What happens when our muffin addict decides that the daily search for muffins is taking too long, or when the bakery raises prices so much that he won't pay? If he goes "cold turkey" and quits muffins alto­gether, he had better find another way to go to work, because he will find that the route to the bakery, the smell of the muffins, and many of the experiences associated with going to the bakery will cause an intense longing for a muffin. This type of longing has ruined many a diet, and this type of learning plays an important role in addiction as well. Simply showing a former cocaine user a photograph of a crack pipe will trigger a strong craving for the drug, and recent studies of brain activity show that areas of the brain involved in memory are activated while he looks at these pictures.

There is another kind of "learning" that happens in the brains of addicts that makes it hard for them to stop using drugs. This is the part of the brain that plans for the future. Under normal circumstances, if an animal or person finds a reinforcer, her brain remembers where and how it happened and plans to check back the next time she needs food or sex. This ability to plan for the future is perhaps the most sophisticated thing our brain does. However, in a crack user, what this part of the brain focuses on is finding crack—the repeated stimulation with this one rein­forcer can also "hijack" these planning centers in the same way. So it isn't simply the pleasure the drugs cause that motivates drug use but our abil­ity to remember and plan for future pleasure. This may be one of the most long-lasting changes that happen in the brain.

New research shows that there is a final step in addiction: when taking the drug becomes as automatic as tying your shoes. Scientists have shown that another part of the dopamine system that is important for the transi­tion of this learning to something automatic gradually changes, too, but more slowly. Eventually, hitting the bar to get an injection of drug becomes a habit. This behavior has become an automatic and controlling part of your behavior.