American society has changed from being one that tolerated a wide variety of individual drug use to being one that attempts strict control over some types of drugs. This change occurred in response to social concerns in three areas: first, drug toxicity; second, the potential for drug dependence; and third, drug-related crime and violence.
Drug toxicity can refer either to physiological poisoning or to dangerous disruption of behavior. Toxicity can be acute, resulting from the presence of too much of a drug, or chronic, resulting from long-term exposure to a drug.
The Drug Abuse Warning System, known by its acronym DAWN, collects data on drug-related emergency room visits and drug-related deaths. The data from DAWN should be viewed in conjunction with information on the relative usage rates of a drug. For example, heroin and cocaine have high risks of toxicity per user, but their overall public health impact is low compared to that of tobacco and alcohol, which are much more widely used. Prescription drugs are also important contributors to overall statistics on drug toxicity. People who inject drugs face the specific toxicity risk of HIV infection and other blood-borne diseases.
A second major area of concern is the risk that drug use will lead to dependence. Drug dependence is linked to three basic processes. The first is tolerance, in which repeated use of a drug leads to diminished effects as the user's body develops ways to compensate for the chemical imbalance caused by the drug. The second is physical dependence, defined by the occurrence of withdrawal symptoms if drug use is