Appendix D: Information and Resources Concerning Substance Use

HEALTH EFFECTS OF ALCOHOL AND OTHER DRUGS

Psychoactive drugs are a class of drugs most frequently used socially or recreationally (and often illegally). These drugs act on the central nervous system (CNS), or more specifically the brain, creating altered states of consciousness. They may increase CNS activity (stimulants, such as cocaine, Ritalin, amphetamines), decrease CNS activity (depressants, such as alcohol, barbiturates, tranquilizers, opiates), cause the creation of illusions (hallucinogens, such as LSD,

peyote, mushrooms, PCP), or have a combined effect (marijuana). Every drug has multiple effects on the brain and the body. Addiction to any of these substances is a disease that affects the sufferer mentally, emotionally, physically, and spiritually. It can also have a profound effect on those closest to the addicted person.

SHORT TERM OR ACUTE EFFECTS

Impaired judgment, which can lead to physical injuries, accidents, violent behavior or unpredictable mood swings;
Acute psychotic episodes;
Risky sexual situations, which may result in impaired sexual response, sexually transmitted diseases, unplanned pregnancy, sexual assault, rape;
Hangovers;
Increased nervousness;
Tremors;
Shortness of breath;
Anxiety/panic reactions;
Reduced energy and stamina;
Digestive problems (nausea, vomiting, diarrhea, ulcer irritation), dehydration, halitosis;
Cardiovascular changes;
Seizures;
Loss of consciousness; or
Death.

LONG TERM OR CHRONIC EFFECTS

Systemic Disorders. Increased heart rate, increased or sudden decrease in blood pressure, hyperactivity, decreased oxygen in blood supply to the brain, decreased immune system function, AIDS or hepatitis from needle sharing, reverse tolerance, hemorrhage, delirium tremens (D.T.s) from acute withdrawal, death.
Brain/Central Nervous System Disorders. Short-term memory loss, concentration difficulties, damaged nerve connections, disruption of “chemical messengers.”
Mental Health Disorders. Sleep disorders, eating disorders, fatigue, acute or chronic depression, hallucinations, suicidal thoughts/actions, personality changes, delusional states, anxiety disorders, psychosis.
Digestive Disorders. Ulcers in the mouth, diseases of the gums, inflammation of the esophagus, stomach, and pancreas, ulcers, cirrhosis, fatty liver disease, alcoholic hepatitis.
Respiratory System Disorders. Painful nosebleeds, nasal erosion, tuberculosis, chronic lung diseases including emphysema and chronic bronchitis, exacerbation of sinus and asthma conditions, increased risk of lung cancer, decreased vital lung capacity.
Sexual/Reproductive Disorders. Impotence, atrophy of testicles, impaired sperm production, absence of menstrual period, decrease in desire/arousal/performance, birth defects.
Endocrine/Nutrition/Metabolic Disorders. Malnutrition, vitamin/mineral deficiencies, acute gout, obesity, diabetes, decreased testosterone levels in men, appetite disorders, weight gain or loss, impaired immune system.
Skin and Subcutaneous Tissue Disorders. Skin infections, unsightly changes in the skin, dry skin, boils, skin abscesses, itching, increase in skin moles and benign skin tumors, spider angiomas, edema.
Pregnancy and Fetal Development. Fetal Alcohol Syndrome, low birth weight babies, increased risk of miscarriage, stillbirth, increased risk of Sudden Infant Death Syndrome, brain damage, congenital deformities, addiction in the newborn.
Other Disorders. Prone to cross-addiction to other drugs including prescription medications, laxatives, analgesics, and caffeine. Additionally, chronic abusers have an increased incidence of fractures, sprains, burns, lacerations, bruises, concussions, and other traumas.

FEDERAL PENALTIES AND SANCTIONS FOR ILLEGAL POSSESSION OF A CONTROLLED SUBSTANCE

21 U.S.C. 844(a)

1st conviction: Up to 1 year imprisonment and fined at least $1,000 but not more than $100,000, or both.

After one (1) prior drug conviction: At least 15 days in prison, not to exceed two (2) years and fined at least $2,500 but not more than $250,000, or both.

After 2 or more prior drug convictions: At least 90 days in prison, not to exceed 3 years and fined at least $5,000 but not more than $250,000, or both.

Special sentencing provision for possession of crack cocaine: Mandatory at least 5 years in prison, not to exceed 20 years and fined up to $250,000, or both, if:

1st conviction and the amount of crack possessed exceeds five (5) grams.
2nd crack conviction and the amount of crack possessed exceeds three (3) grams.
3rd or subsequent crack conviction and the amount of crack possessed exceeds 1 gram.

21 U.S.C. 853(a)(2) and 881(a)(7)

Forfeiture of personal and real property used to possess or to facilitate possession of a controlled substance if that offense is punishable by more than one year of imprisonment. (See special sentencing provisions re: crack.)

21 U.S.C. 881(a)(4)

Forfeiture of vehicles, boats, aircraft or any other conveyance used to transport or conceal a controlled substance.

21 U.S.C. 844a

Civil fine of up to $10,000.

21 U.S.C. 853a

Denial of Federal benefits, such as student loans, grants, contracts, and professional and commercial licenses, up to 1 year for first offense, up to 5 years for second and subsequent offenses.

18 U.S.C. 922(g)

Ineligible to receive or possess a firearm or ammunition.

Miscellaneous

Revocation of certain Federal licenses and benefits, e.g., pilot licenses, public housing tenancy, etc., are vested within the authorities of individual Federal agencies. Note: These are only Federal penalties and sanctions. Additional State of North Carolina penalties and sanctions may apply.

Effect on Financial Aid

Under the 2000 reauthorization of the Higher Education Act, eligibility for federal student aid is jeopardized for students convicted of a drug possession charge. For a first conviction, eligibility for aid may be suspended for one year; two years for a second; permanently for a third. Eligibility is restored once a student completes a drug rehabilitation program or has the conviction overturned.

NORTH CAROLINA STATE LAWS REGARDING ALCOHOL AND DRUGS

For complete information regarding North Carolina state laws governing drugs, consult the North Carolina Controlled Substances Act or the North Carolina Toxic Vapors Act in the North Carolina General Statutes, Article 5, Chapter 90.

RESOURCES FOR ALCOHOL, DRUG, AND TOBACCO CONCERNS

Emergency Phone Numbers

Duke Emergency Medical Service and/or Police 911/919-684-2444 Alcohol-related emergencies can be difficult to assess. When in doubt, contact professionals.

Duke Hospital Emergency Department 911/919-684-2413

If an intoxicated student cannot be aroused, is breathing erratically or slowly, or appears to be in a life- threatening state, get the student to the Emergency Department. Duke Emergency Medical Service or Duke Police can assist in transporting students.

24-hour confidential advice on alcohol or drug-related emergencies can be obtained through Holly Hill Hospital at 1-800-422-1840 or 1-800-447-1800.

Local Inpatient/Outpatient Treatment Facilities
Holly Hill Hospital 3019 Falstaff Road Raleigh, NC 27610 hollyhillhospital.com	919-250-7000
Fellowship Hall 5140 Dunstan Road Greensboro, NC 27405 fellowshiphall.com	800-659-3381
Local Outpatient Treatment Facilities
Duke Child Development and Behavioral Health 402 Trent Drive DUMC Box 2906 Durham, NC 27710 ipmh.duke.edu/content/cdbh	919-668-5559
Information, Screening, and Education
DuWell studentaffairs.duke.edu/duwell	919-681-8421

DuWell provides substance use screenings for students which identify risk factors and assist the student to develop a harm reduction plan with the goal to minimize problems regarding substance use. DuWell offers assistance and support for students interested in changing their substance use patterns. The office provides assistance with educational programming for student living groups and organizations.

Student Health studentaffairs.duke.edu/studenthealth 919-681-WELL (9355) Student Health offers screening, evaluation, education and referral for alcohol and substance use/ abuse.

Individual Assessment and Counseling

Counseling and Psychological Services (CAPS) studentaffairs.duke.edu/caps 919-660-1000

CAPS offers evaluation, consultation, counseling, and referral for individuals with alcohol and other substance abuse issues. A substance abuse specialist is available for personal consultation and counseling for students who are concerned about themselves or others because of alcohol or drug use.

UNC Health Care’s Alcohol and Substance Abuse Program 919-966-6039

www.unchealthcare.org/site/healthpatientcare/alcoholsubstanceabuse

UNC offers a center for intensive outpatient treatment of chemical dependency and substance abuse.

Cocaine Anonymous ca.org 1-800-347-8998

An around-the-clock information and referral service, staffed by recovering cocaine addict counselors.

First Step Services www.firststepnc.com 919-833-8899

First Step specializes in intensive outpatient programs for individuals suffering from drug and alcohol abuse, stressing abstinence from mind and mood altering substances during the course of treatment.

C.S.A.P. 1-800-662-HELP; 1-800-662-9832 for information in Spanish

A 24-hour hotline maintained by the Center of Substance Abuse Prevention offers confidential information and referral.

N.C.A.D.I. www.samhsa.gov 1-800-729-6686

The National Clearinghouse for Alcohol and Drug Information offers free print information on alcohol and other drugs. Other media may be available for rent or purchase.

Cancer Information Service 1-800-422-6237

Free telephone smoking cessation counseling, materials, support, referrals. Information in Spanish when needed.

American Lung Association 1-800-586-4872

Self-help materials available.

Academic courses related to alcohol use, treatment, and research

See course listings through the Office of University Registrar (registrar.duke.edu) or the Bulletin of each school.

Support Groups

Alcoholics Anonymous (AA) aanc32.org / aanc33.org 919-286-9499 / 1-800-662-4357

AA offers emergency support for individuals with alcohol problems in addition to group meetings. Many have found the 12-step program to be crucial in their recovery. Meeting locations in the Durham area can be found on the AA website.

Narcotics Anonymous (NA) na.org 919-956-5900

Similar to Alcoholics Anonymous, except focused on drug abuse/addiction issues. A variety of drugs are addressed, including marijuana and prescription medications.

ACOA/Al-Anon al-anon.alateen.org 919-403-0687 / 1-888-4AL-ANON

ACOA and Al-Anon meetings are support groups for family members dealing with the impact of living with, or being close to an alcoholic. Meeting locations in the Durham area can be found on the Al-Anon website.

FEDERAL DRUG TRAFFICKING PENALTIES FOR MARIJUANA (SCHEDULE I)
Drug	Quantity	First Offense	Second Offense
Marijuana	1,000 kg or more mixture; or 1,000 or more plants	Not less than 10 years or more than life If death or serious bodily injury, not less than 20 years or more than life Fine not more than $10 million if an individual, $50 million if other than an individual	Not less than 20 years or more than life If death or serious bodily injury, life imprisonment Fine not more than $20 million if an individual, $75 million if other than an individual
Marijuana	100 kg to 999 kg mixture; or 100 to 999 plants	Not less than 5 years or more than 40 years If death or serious bodily injury, not less than 20 years or more than life Fine not more than $5 million if an individual, $25 million if other than an individual	Not less than 10 years or more than life If death or serious bodily injury, life imprisonment Fine not more than $8 million if an individual, $50 million if other than an individual
Marijuana	50 kg to 99 kg mixture; or 50 to 99 plants	Not more than 20 years If death or serious bodily injury, not less than 20 years or more than life Fine $1 million if an individual, $5 million if other than an individual	Not more than 30 years If death or serious bodily injury, life imprisonment Fine $2 million if an individual, $10 million if other than individual
Hashish	More than 10 kg
Hashish Oil	More than 1 kg
Marijuana	Less than 50 kg (but does not include 50 or more plants regardless of weight) 1-49 marijuana plants	Not more than 5 years Fine not more than $250,000, $1 million other than individual	Not more than 10 years Fine $500,000 if an individual, $2 million if other than individual
Hashish	10 kg or less
Hashish Oil	1 kg or less

Source: bit.ly/federaldrugtraffickingpenalties

FEDERAL DRUG TRAFFICKING PENALTIES
Drug/Schedule	Quantity	Penalties	Quantity	Penalties
Cocaine (Schedule II)	500-4999 gms mixture	First Offense: Not less than 5 years, and not more than 40 yrs. If death or serious bodily injury, not less than 20 years or more than life. Fine of not more than $5 million if an individual, $25 million if not an individual Second Offense: Not less than 10 years, and not more than life. If death or serious bodily injury, life imprisonment. Fine of not more than $8 million if an individual, $50 million if not an individual	5 kg or more	First Offense: Not less than 10 years, and not more than life. If death or serious bodily injury, not less than 20 years or more than life. Fine of not more than $10 million if an individual, $50 million if not an individual Second Offense: Not less than 20 years, and not more than life. If death or serious bodily injury, life imprisonment. Fine of not more than $20 million if an individual, $75 million if not an individual 2 or more prior offenses: Life imprisonment. Fine of not more than $20 million if an individual, $75 million if not an individual
Cocaine Base (Schedule II)	28-279 gms mixture	280 gms or more mixture
Fentanyl (Schedule IV)	40-399 gms mixture	400 gms or more mixture
Fentanyl Analogue (Schedule I)	10-99 gms mixture	100 gms or more mixture
Heroin (Schedule I)	100-999 gms mixture	1 kg or more mixture
LSD (Schedule I)	1-9 gms mixture	10 gms or more mixture
Methamphetamine (Schedule II)	5-49 gms pure or 50-499 gms mixture	50 gms or more pure or 500 gms or more mixture
PCP (Schedule II)	10-99 gms pure or 100-999 gms mixture	100 gms or more pure or 1 kg or more mixture
Penalties
Other Schedule I & II substances	Any amount	First Offense: Not more that 20 years. If death or serious bodily injury, not less than 20 years, or more than life. Fine $1 million if an individual, $5 million if not an individual Second Offense: Not more than 30 years. If death or serious bodily injury, life imprisonment. Fine $2 million if an individual, $10 million if not an individual
Any drug product containing Gamma Hydroxybutyric Acid	Any amount
Flunitrazepam (Schedule IV)	1 gm or more
Other Schedule III drugs	Any amount	First Offense: Not more than 10 years. If death or serious bodily injury, not more than 15 years. Fine not more than $500,000 if an individual, $2.5 million if not an individual Second Offense: Not more than 20 years. Fine not more than $1 million if an individual, $5 million if not an individual
All other Schedule IV drugs (other than one gram or more of Flunitrazepam)	Any amount	First Offense: Not more than 5 years. Fine not more than $250,000 if an individual, $1 million if not an individual Second Offense: Not more than 10 years. Fine not more than $500,000 if an individual, $2 million if not an individual
All Schedule V drugs	Any amount	First Offense: Not more than 1 year. Fine not more than $100,000 if an individual, $250,000 if not an individual Second Offense: Not more than 4 years. Fine not more than $200,000 if an individual, $500,000 if not an individual

For complete information regarding North Carolina state laws governing alcohol, consult the North Carolina General Statutes, Chapter 18B. Criminal penalties for a violation of these laws include a misdemeanor conviction, community service, possible loss of driver’s license, and/or fines. Repeat violations incur greater penalties. The complete statutes are available online at ncga.state.nc.us/gascripts/Statutes/Statutes.asp.

Highlights of State Statutes

It is illegal for anyone less than 21 years of age to:

Possess or consume malt beverages, unfortified or fortified wine, spirituous liquor, or mixed beverages;
Purchase or attempt to purchase malt beverages, unfortified or fortified wine, spirituous liquor, or mixed beverages.

It is illegal for anyone (regardless of age) to:

Aid or abet another in the unlawful sale, purchase, or possession of malt beverages, unfortified or fortified wine, spirituous liquor, or mixed beverages;

Fraudulently use identification in obtaining or attempting to obtain alcoholic beverages.