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PRINCIPLES REGARDING THE USE OF ILLEGAL DRUGS, ALCOHOL

AND TOBACCO

The American Medical Student Association:

1.             In regard to education:

a.             Regarding drug and alcohol use:

1.             SUPPORTS efforts to educate the public—especially school-aged persons—regarding drug use and addiction and alternatives to drug use; (2006)

2.             SUPPORTS drug education efforts, especially for school-aged persons, which encourage decision-making based on accurate information, self-knowledge and scientific data. These efforts should include, but not be limited to, abstinence from all substances. (2006)

3.             ENCOURAGES continued efforts in health education, which would inform children, adolescents and adults of the dangers involved in alcohol use, including its effects on decision-making and judgment. (1995)

4.             SUPPORTS educational programs for medical students, physicians and other health professionals concerning drug use and addiction. ENCOURAGES educational programs to provide adequate information about licit and illicit substances and their effects; discuss the consequences of overdose, withdrawal and addiction surrounding different substances; include harm reduction principles such as safer-use strategies for patients who are unwilling to stop using entirely; and examine the social contexts in which substance use occurs. (2006)

5.             Furthermore, since alcoholism constitutes a major health problem, AMSA ENCOURAGES all medical schools to include programs in the multifactorial disease/disorder of alcoholism in their curriculum with emphasis on early recognition and treatment of medical and behavioral manifestations, as well as the pathogenesis and epidemiology.  All such programs should provide both factual knowledge and compassionate attitude with which to help persons in need of such treatment and include the components described in (4) above (2006);

6.             STRONGLY SUPPORTS efforts to educate the public regarding Fetal Alcohol Syndrome, its causes and effects, and that such efforts should include but not be limited to educational advertisements paid for by manufacturers of alcoholic beverages and appropriate warning labels on all alcoholic beverages. (1988)

b.             Regarding tobacco use:

1.             STRONGLY ENCOURAGES all medical schools to include tobacco cessation in training for medical students, residents and practicing physicians. (1998)

2.             SUPPORTS physicians and physicians-in-training in becoming knowledgeable about current tobacco cessation techniques, in identifying tobacco users in their clinical encounters and in assisting these users to quit. (1998)

2.             Regarding research:

a.             URGES that additional funding be provided for research regarding the medical and psychological nature of addicting drugs and the epidemiology and appropriate treatment of addicted persons, including the psychological needs of female and male substance abusers and the fetal alcohol syndrome;

b.             ENCOURAGES research regarding the feasibility of the prevention of the Wernicke-Korsakoff Syndrome by the addition of Thiamine to alcohol; (1985)

c.             SUPPORTS appropriate clinical research In regard to the efficacy of therapeutic cannabis use in smoked, pill or other forms; (1999)

d.             SUPPORTS appropriate research into the potential to treat disease with psychedelic/entheogenic substances including, but not limited to, mescaline, LSA/LSD, psilocybin and harmaline. (2005)

3.             Regarding health and treatment:

a.             BELIEVES that drug abuse and addiction are not primarily criminal problems, but are health problems with socioeconomic and legal implications, and as such, should be dealt with by health professionals and, therefore, OPPOSES any legislation and/or actions by the Justice Department that fail to deal with drug abuse and addiction as health problems;

b.             URGES that comprehensive, community-based drug treatment centers be widely available, including culturally competent treatment programs to meet the special needs of women, people of color, lesbian, gay, bisexual and transgender people, people with disabilities and other marginalized populations; (2006)

c.             RECOGNIZES that there are many alternatives to problematic substance use, and that complete abstinence from all substance use is one, but not the only, solution; and therefore SUPPORTS the creation of community-based treatment modes that advocate self-determination, rational decision-making, and total health as defined by the patient, and which therefore may or may not include complete abstinence as part of a patient’s treatment program. (2006)

d.             SUPPORTS harm-reduction-based modalities, including but not limited to needle exchange programs, as proven and effective methods of promoting health and reducing harm among substance users who may not be ready to stop using entirely; (2006)

e.             RECOGNIZES that the health needs of alcoholics and other substance users merit the same degree of attention and concern as the needs of any other segment of society and ENCOURAGES health professionals to provide compassionate and competent care to all patients, regardless of whether or not they use substances; (2006)

f.              ENDORSES the addition of thiamine to alcoholic beverages as a preventive measure against Wernicke-Korsakoff Syndrome, but RECOGNIZES that this is neither a treatment nor a cure for alcoholism. (1986)

4.             Regarding Advertisement and Manufacture:

a.             URGES pharmaceutical companies, physicians and other health providers to exert greater discretion with regard to the manufacture, advertising, supply and distribution of often-abused prescription drugs such as amphetamines and barbiturates;

b.             SUPPORTS legislation to ban all advertising for alcoholic beverages on radio and television, or require these advertisers to provide equal and comparable time for health messages about alcohol; (1985)

c.             URGES alcohol companies to change their advertising campaigns to use only models who appear older than the drinking age, to eliminate advertisements promoting underage, irresponsible, or excessive drinking, and to include high contrast warning messages in all print ads and verbal warnings on television and radio ads. (1922)

d.             URGES alcohol companies to include the drinking age on all packaging and advertisements in bold contrast print. (1992)

e.             URGES stricter laws and law enforcement in an effort to reduce death and injury from automobile accidents, including the following provisions; labeling of alcohol products as not to be consumed immediately before or during  driving;

5.             Regarding government policy:

a.             RECOGNIZES that drug use occurs within all segments of the population, regardless of race, economic status, culture, ethnicity, gender, sexual orientation and gender identity, or nationality, and therefore STRONGLY OPPOSES drug-related legislation and/or law enforcement tactics that selectively target poor people and people of color. (2006)

b.             SUPPORTS a shift of emphasis of federal drug policy away from expensive and ineffective international interdiction policies and overly harsh, punitive policies that tend to disproportionately affect people of color and poor people, and toward innovative, community-based approaches, including, but not limited to alternatives to traditional incarceration, such as rehabilitation and community service; and community-based approaches to drug control, which may include community policing, restorative justice, and other sustained coalitions between communities, healthcare workers, policy makers, law enforcement and other constituencies concerned with the public welfare. (2006)

c.             SUPPORTS appropriate measures to control alcoholism and other forms of addiction; including but not limited to: culturally competent, community-controlled prevention and treatment models; accessible and accurate drug and alcohol education programs; and adequate, nationally-standardized, labeling and packaging of legally-sold drug and alcohol products.  RECOGNIZES that incarceration has not been shown to reduce rates of addiction, and therefore DISCOURAGES a criminal justice response to drug use instead of health-based approaches. (2006)

d.             SUPPORTS efforts directed toward the prevention of intoxicated driving, especially innovative, community-based approaches (such as designated driver programs) that do not solely rely upon criminal justice-based solutions. (2006)

6.             In regard to preventive issues:

a.             STRONGLY SUPPORTS increased public education programs regarding the health hazards of cigarettes and other tobacco products;

b.             SUPPORTS those efforts aimed at preventing cigarette smoking in children, adolescents and other high-risk groups, as well as future research into discovering behavioral motivation behind smoking; (1995)

c.             SUPPORTS a cigarette safety act that would authorize the Consumer Product Safety Commission to establish performance standards to ensure that cigarettes and little cigars have a minimum capacity for igniting smoldering upholstered furniture and mattress fires;

d.             SUPPORTS the goal of the Surgeon General and of Healthy People 2010 to reduce the rate of smoking in America by 2010 to only 12% of adults and 16% of teenagers. (2003)

7.             In regard to marketing and advertising:

a.             STRONGLY URGES the use of federal, state and local funds for television and radio anti-smoking messages as a major component of the anti-smoking effort, and URGES that an increased federal tax on all tobacco products be specifically used to supplement such funds.

b.             SUPPORTS mandatory disclosure of the levels of tar, nicotine, and carbon monoxide produced by each brand of cigarette when smoked, such information to be included both on packages and in all cigarette advertising;

c.             SUPPORTS a comprehensive policy both here and abroad discouraging the promotion, sales and use of tobacco products; (1986)

d.             SUPPORTS Truth in Advertising where advertisers must explain to the public that nicotine intake depends on how they smoke and that nicotine can become an addictive drug; (1986)

e.             OPPOSES any form of media advertising of tobacco products and SUPPORTS federal legislation prohibiting such advertising. (1987)

f.              STRONGLY SUPPORTS legislation banning the advertisement of all tobacco products in government regulated media or requiring these media to give equal and comparable time for health messages related to tobacco use, and STRONGLY URGES the reduction of such advertising in nonregulated media. (1985)

g.             SUPPORTS regulations requiring full disclosure of the constituents and additives of each brand of tobacco product. (1990)

h.             SUPPORTS legislation outlawing the distribution of tobacco products as free samples or with coupons. (1990)

i.              OPPOSES the sale of out-of-package cigarettes and BELIEVES this practice should be made illegal. (1992)

j.              OPPOSES the sale of tobacco products in vending machines and BELIEVES this marketing method should be eliminated. (1992)

k.             SUPPORTS a federal regulation requiring licensure for the sale of tobacco, increasing the legal age for tobacco purchase in all states to 18 years old and local enforcement of this age limit by requiring proof of identification.  AMSA further SUPPORTS fines for vendors who do not comply and revocation of tobacco licenses upon multiple violations. (1992)

l.              SUPPORTS that the revenue from these fines fund anti-smoking education programs. (1992)

8.             In regard to women and pregnancy:

a.             SUPPORTS the increased funding and support of research of harmful effects of maternal smoking on the fetus; (1986)

b.             URGES women who intend to become pregnant to stop smoking and urges physicians who care for such women to assist them in smoking cessation; (1986)

9.             In regard to worldwide tobacco use:

a.             SUPPORTS legislation prohibiting the U.S. Trade Representative, the Departments of State and Commerce, or any other U.S. agency from actively encouraging, persuading, or compelling any foreign government to import, market, promote, advertise, or distribute tobacco products. (1990)

b.             SUPPORTS legislation requiring any manufacturer who sells tobacco products in the United States to place the same health warnings that are required in the United States in advertisements and on packages sold abroad, in the native language. (1990)

c.             SUPPORTS restricting the use of U.S. funds by international trade and monetary agencies such as the World Bank and the International Monetary Fund from being used to provide financial or technical support for tobacco agriculture and manufacture. (1990)

d.             ENCOURAGES increased U.S. funding and participation in international smoking control efforts. (1990)

e.             ENCOURAGES the United States to organize an international collaborative project to gather health data on the health, economic and environmental consequences of worldwide tobacco use. (1990)

f.              SUPPORTS a Framework Convention on Tobacco Control, which will strongly promulgate concrete methods to control tobacco corporate commerce and marketing in order to protect the health of all peoples from the carcinogenic effects of primary and secondary tobacco smoke. (2002)

10.           SUPPORTS increasing insurance premiums for known, active smokers to shift the economic responsibility and cost back to those demanding more health services secondary to their tobacco-related illnesses;

11.           STRONGLY SUPPORTS the use of federal tax on cigarettes to fund increased research on the prevention/treatment of cancer and cardiovascular disease and increased disease prevention programs; and URGES the discontinuation for tobacco production and the Tobacco Support Program, with said funds being used to finance a transition to the production of more healthful crops;

12.           STRONGLY OPPOSES the continuation of federal price supports of tobacco crops;

13.           SUPPORTS efforts to ban or restrict smoking in all  public places, and that:

a.             “public places” shall include public transportation vehicles and terminals, elevators, enclosed public places of recreation and entertainment, public waiting rooms of health facilities, public rest rooms, public schools and institutes of higher education, department stores, restaurants, bars, clubs, (2003) public meetings, public places of business and government-owned buildings; (1995)

b.             smoking shall be banned in public places and until that time, provisions should be made for smoking and no-smoking areas with separate ventilation; (1995)

c.             “no smoking” areas be large enough to comfortably accommodate all who wish to utilize them;

d.             legislation in this area satisfy the following four elements identified by the American Lung Association as important in assuring the effectiveness of anti-smoking legislation:

1.             definition of terms, particularly those words which have more than one connotation (e.g., “public places”);

2.             requirement that plainly visible signs be posted in all areas where smoking is restricted or prohibited to alert everyone to the regulations in effect;

3.             clear delegation of authority:  identification of the officials and/or agencies responsible for the publicity, posting and enforcement;

4.             designation of penalties for violations to provide incentives for adhering to the regulation;

14.           URGES the Federal Trade Commission and the Food and Drug Administration (FDA) to recognize that low-yield cigarettes cannot be supported as being “better” for one’s health; (1986)

15.           SUPPORTS research and public education on the deleterious effects of smokeless tobacco; (1986)

16.           SUPPORTS the development of multi-component public programming and support groups to help tobacco users stop the destructive use of these products; (1986)

17.           BELIEVES that out of mutual professional courtesy and respect, physicians and medical students should not smoke at professional meetings;

18.           STRONGLY SUPPORTS regulation of all tobacco containing products under the statutes of the Food, Drug, and Cosmetics Act and the Consumer Product Safety Act, as are all other substances taken into the human body. (1989)

19.           SUPPORTS the establishment of a Center for Tobacco Products at the Centers for Disease Control and Prevention to coordinate educational and research activities, launch a national counter advertising campaign, and provide grants to reduce tobacco usage among pregnant women, children and blue-collar workers, but SUGGESTS establishing the FDA as a regulatory authority on tobacco containing products. (1990)

20.           OPPOSES exposing children to any form of tobacco whether inside or outside the home and SUPPORTS banning smoking in areas outside the home where children are, including, but not limited to schools, day care-centers and play areas; (1995)

21.           STRONGLY OPPOSES any government subsidies for the growth, production, distribution or sales of tobacco and RECOGNIZES the potential economic impact of this resolution, and URGES federal action to facilitate developmental conversion of tobacco-dominated regional economies to alternative production. (1995)

22.           ENCOURAGES state and local legislatures, state medical societies, medical professional societies, student groups, and other anti-tobacco organizations to support the introduction of local and state legislation to ban tobacco use in public places and businesses as a public health worker’s rights issue. (2003)

23.           URGES businesses that serve alcohol to offer incentives to patrons who elect to be designated drivers. (2005)