6 The Encyclopedia of Addictive Drugs
HOW ARE ABUSE RISKS MEASURED?
Historical experience shows addiction to be more likely with some drugs
than with others, just as some road intersections are more hazardous than
others even though anyone might drive through them safely at a given time.
Whether the subject be drugs or intersections, persons concerned about dan-
gers attempt to discover if similarities exist. Do certain characteristics of in-
tersections (speed limits, stop signs, obscured vision) indicate whether danger
is more likely? Characteristics of drugs, particularly their chemical formulas,
are examined to determine similarities that might indicate whether particular
drugs have more addictive or abuse potential than others. For example, the
shape of a drug’s molecule may determine how a user’s body reacts, so drugs
with molecules of a similar shape might be expected to have similar effects.
Also, new substances derived from an old drug may be assumed to have
similarities to the old drug.Schedules
In the United States the result has been a blend of science and law called
“scheduling,” set up in 1970 by the federal Comprehensive Drug Abuse Pre-
vention and Control Act, which replaced all previous federal narcotics laws.
(The legal definition of “narcotics” includes stimulants such as cocaine and
hallucinogens such asLSD.) Scheduling is an ongoing process affected by the
same influences that shape other laws. Sometimes Congress or a state legis-
lature puts a drug in a particular schedule. Sometimes a federal or state official
does so. Like all law, scheduling has an element of arbitrariness, enhanced as
federal statutes interact with state laws and local ordinances. Nonetheless,
even though results can be puzzling, basic principles in scheduling are clear.
In the United States drugs are either scheduled or unscheduled. Unsched-
uled drugs may be benign or highly dangerous, available over the counter or
by prescription only, perhaps even available to children through a plant grow-
ing wild in the woods. A hospital emergency room may deal with someone
who uses an unscheduled drug, but the U.S. Drug Enforcement Administra-
tion probably will not. Almost all drugs are unscheduled, whether they be
pharmaceutical creations from a laboratory or natural products harvested
from the soil.
Scheduled drugs are theoretically ranked by their potential for abuse. Not
all abuse is addictive, but the rankings imply that some drugs are more of an
addiction hazard than others. At the time this book was written, five schedules
existed. Generally drugs in a lower-numbered schedule are considered more
prone to abuse than those in higher-numbered schedules. Heroin is a Schedule
I drug. A cough medicine available without prescription might be in Schedule
V. Schedule I is also used for abused drugs having no medical use approved
by regulatory agencies in the United States. Thus Schedule I includes mari-
juana even though decades of research have shown it to be more benign than
most drugs listed in other schedules. Schedule I also includes some drugs
(dextromoramide,dipipanone,phenoperidine, and others) used routinely by
doctors in other countries but that lack approval from U.S. authorities. So