Because of their power, drugs were entrusted to priests or doctors or controlled by law. In the last 20 years, there has been a rapid increase in the amount of drug use and the variety of drugs available. Today, every part of society is touched, rich and poor, young, old, families, schools, and at work. Drug abuse is a Public Health issue which we cant ignore. The National Institute on drug abuse is part of the alcohol drug abuse and Mental Health administration. It is the lead United States agency for drug abuse research. We have been asked to bring the best tools in Scientific Investigation to address critical questions about drug abuse and addiction. We need to know what causes drug abuse, how do we treat it, and most important, how do we prevent it . We need cooperation from scientists around the world to attack the problems associated with drug abuse. We need Common Research tools and definitions that will enable us to together on this worldwide problem. The first step for all of us is to acknowledge that we have a problem. You start drinking and that puts you in a different crowd of people then if you are drinking and then you start smoking, and in that puts you in an even more secluded crowd, and then you may be trying marijuana at a party, and that puts you in another crowd. It is like a cycle, a vicious cycle. You get sucked into it. Narrator to break the cycle of drug abuse takes an effort that touches many areas. The first task is to gather accurate data. When the National Institute on drug abuse was formed in 1974, there was Little Information on the extent of the drug problem in the United States. Since then, we have applied the latest techniques to develop an accurate base of information and common language about drug use in our society. Developing a database takes time and patience, but after it is in place, we have an ongoing source of Accurate Information about the health of our citizens. The foundation is built on three large Data Collection efforts the National Household survey on drug abuse, the dawn network and monitoring the future, a High School Senior survey. The National Household survey is our principal source of information about drug use in the general population. It is a survey of over 8000 individuals, administered every two or three years. The second data source is dawn, the drug abuse warning network. It determines the frequency of drugrelated emergencies and deaths. The third source of data provides information on a very important section of our population, High School Seniors. We call it monitoring the future. It is directed by dr. Lloyd johnston. Beginning in 1975, we started interviewing High School Students around the country each year during we go into about 135 high schools a year, survey students in classrooms like this one. They fill out questionnaires on their own. We collect them. There are about 70,000 respondents each year. This is the age group in this society and most societies which is most at risk for involvement with illicit drugs. We are looking right where the problem tends to like. The friends you hang around with the pressure is great here. It comes down to curiosity, what your friends are doing, what is popular. You might feel like you dont fit in if you are not doing drugs. Drug use is a phenomenon, which is hard to study, because it is illicit and illegal in most countries. Surveys are one of the most effective means of gathering data on this behavior. Generally, are indications are that the data is quite valid. It tells us something about the size of the problem, types of people involved, and what drugs. Over time, it tells us about how that is changing. New problems are emerging, what progress are we making. Up 1980, we saw a continuous increase in most forms of illicit drug use among young people. Since then, we have seen a gradual decline in illicit drug use among young people. The major exception has occurred with cocaine. We find that although there has not been an increase in the number of people using, those that do use are using more dangerous forms. Smoking the drug more often, using crack. Number of young people using it every day, and we have seen a doubling in the number of young people who say they have tried to quit and been unable. It is like the group cant make the bad fit better. I dont want to have to look back 30 years from now and say i wish i hadnt done that. Narrator along with this broad, social perspective, scientists are looking at the microscopic mechanisms of how the body is affected by drugs. We initiate and support research on the cutting edge of what has to be one of the most thrilling scientific journeys of our time, the discovery of the actual workings of the brain. The initial investigation into the mechanisms of heroin addiction led to the discovery of opioid receptors. This opened up a new class of neurotransmitters to study and lead to new ways of thinking about the brain. We are in the midst of a worldwide revolution in neuroscience. We are pursuing molecular and cellular, and organ level, Central NervousSystem Research to determine the mechanisms, changes, and how to block the changes. You were looking at areas that are transmitters, developing treatment drugs. Other promising directions include the application of new technologies, such as the pet scan. A doctor is evaluating this technique. We are studying being the studying the neuroanatomy of Substance Abuse. This is very exciting time to be someone looking at brain chemistry. We have tools that our disposal at our disposal that we never had before. Human studies cannot be performed, such that we can, at the same time, ask our subject what the effect of the drug is on his mood, how it is making him feel, and simultaneously, we can do metabolic mapping studies in his brain. Pet scans we obtained give us pictures of slices of brain activity. We can look at how the radio tracer is incorporated into different parts of the brain at the same time that the subject is feeling high. We have a major interest in how cocaine influences brain activity, and we are also interested in the effects of opioids. We are just beginning our studies with cocaine. Today, we will begin our second metabolic mapping study of cocaines affect associated with cocaine euphoria. We have no idea what we will find. We need to find out all we can about the Oil Chemistry of drugs, but equally important, we need to know who is vulnerable. Longterm prevention requires that we look at the causes and conditions of Substance Abuse in the life of an individual. Can we predict who will be at risk for drug abuse, and if we can, how do we intervene to prevent it . For over 20 years, a doctor has been looking at early predictors of later Substance Abuse. We were able to determine several developmental paths. One of particular interest, the early aggressive behavior and the shy and aggressive behavior of children. We found it to be strongly predictive of heavy Substance Abuse by age 16 or 17. If you take marijuana use, for example, 45 of the shy, aggressive firstgraders were heavy users by age 16 or 17. Maybe 30 of the aggressive children, the shy children alone, as low as 10 . Those children who were neither shy and aggressive or similar between 50 and 20 . One intervention between 15 and 20 . One intervention is strongly predictive of drugs later, that is the Good Behavior game. This consists of assigning children to teams. Three teams per first and second grade classroom. These teams that points for Good Behavior, points taken away for bad behavior. These two teams did very well. They only i only had to talk to those two teams wants. That is good. This is my very good team. The first intervention makes use of positive pressure. The children get interested in each other, and they are were ordered together as a group. They are rewarded together as a group. The other intervention is directed at reading, mastery and other subject matters, but primarily reading. Read the sentence, please. Good. Now how can we say this in a different way . Craig . Good. The important thing to understand about Prevention Research on drugs is that the developmental paths are vital to map out. If you change the earlier course of a developmental path, generally speaking, you have a marked increase in the impact of that early change later on. If you teach a child reading, the first 30 words are vitally important to the next thousands of words to muscle that a little bit of change early words, so that a little bit of change early on the longrange research of the dr. And his colleagues will continue to yield results for years. People need to know about prevention now. To reach the public, television is essential. You want some refer . Some reefer . Just say no. No, man. Why dont you get out of here, man . Just say no just say no just say no no, no just say no no [echoing] anyone that says cocaine is not addicted, they lie. When you do do contain, when you do cocaine, you lie to yourself about being in control. Anyone who tells you it is ok, is a liar. Cocaine, the big lie. These prevention efforts must reach all parts of society. The Household Survey shows that among 18 to 25yearolds, a generation entering the workplace, 66 have used illicit drugs, 44 in the last year. The cost of drug abuse to all of us multiply when drugs enter the workplace, and some occupations, the results can be disastrous. Drug impaired judgment by a Traffic Controller or missile control officer or a city bus driver can cause significant risk to public safety. There are other longterm effects that are equally serious absenteeism, criminal behavior, and a loss of productivity affects the individual employer the individual, employer, and the nations Overall Economic health. At the National Institute on drug abuse, we are working to establish a National Policy concerning drugs in the workplace in order to help employers deal with this district of Health Problem. One of the most basic issues is how various drugs and after effects changed our performance. A doctor is developing data on the effects of cocaine on performance. We are going to take this to him and, who is a nondrug user, and have him do some tasks as a control for people we are going to bring in pool b coming off of cocaine. We are going to look at what we think our performance deficits when people crash. We are interested in the effects of cocaine itself on the task on this aspect. It has fascinated me to see people in withdrawal from the drug do more poorly on cognitive measures. Since the people coming in will we totally withdrawing from cocaine but we need some controlled data with nondrug users. Just push the button when any square changes direction. [button pressing] just identifying the problem is not enough. Our philosophy is to get the substantive using employee into treatment, provide them with the help they need, and get them back on the job. To encourage this, we provide Technical Assistance to develop Employee Assistance programs. Treatment of the individual who has a drug problem is a difficult but essential part of our attack on drug abuse. From a treatment perspective, drug addiction is a chronic relapsing disease, often compensated by psychological problems and negative environmental conditions. We cant look to a vaccine to provide at your. To provide a cure. Treatments and use such as methadone maintenance, drugfree outpatient clinics, and therapeutic communities achieve significant and lasting results for many patients. With new forms of drug abuse and a wider spectrum of the population involved, research into new treatments and new treatment combinations is a high priority. At yield university, a doctor is working on a wide range of treatment possibilities. We have a variety of treatment approaches we use in treating the cocaine abuser, heroin addict, poly drug user, and our first premise is that we dont have the answer. We need to keep coming up with new techniques and to evaluate the existing approaches. Part of evaluation is not just seeing what treatment works, but what treatment works for what patient. Patient treatment matching is one of the most important and exciting parts of doing treatment evaluation. When i see an addict, i try and keep in mind that this is an individual who may have problems in the whole bio psycho social sphere. A Treatment Program may need a plan on appropriate interventions and all of those three spheres, biologic, psychological and social. It is not likely that anyone discipline is going to be able to come up with all of the answers. I just cant stop taking cocaine. In the 1970s, cocaine was primarily believed to be a psychological problem. There is Little Research into the physiological aspects of the cocaine addiction. We have a project because the cocaine challenge project, in which we are looking at the interaction of cocaine with both drugs that may be used to treat cocaine and with drugs that people who use cocaine may take that may cause them even more trouble if they take the two in combination. The treatment paradigms we have been able to set up enable us to quickly move to test new drugs, so that if we have some bright ideas about a new agent that may be helpful, we can test it with patience and tested in the challenge laboratory. If someone else comes up with what sounds like an exciting idea, we can test that. Our surveys and our experience shows that drug abuse is costly changing. We face the new challenge of different kinds of drugs, new patterns of use, and new problems associated with drug use. Most recently, the tragic onset of the aids virus is a Great InternationalHealth Problem is testing our ability to respond to this challenge. The emergence of intravenous drug use as a major risk factor in aids infection and transmission has placed us in a unique position to attack the spread of this perplexing and deadly killer. A doctor is a leader in this effort. We have around 2030 people in treatment for intravenous drug use, and this new treatment alone, we are stopping them from using the needle which is effective for transmission for the virus. We are doing aids education programs. I want you to understand the intricacies of it. Maybe you just want to know, what happens . A lot of people dont want to go through this. They say, that is a bunch of bull ship. What i want to know, if you take this test and it comes back positive, do i have aids . You may or may not have it, but most likely you dont. What the test means is that you have been infected and that you can infect somebody else. So that is why we got to change our whole behavior. We cant share needles. When people are educated about this virus and the effects of this virus and how it is transmitted, they seem to change their behavior, and it is that goal that we are trying to reach. We have found that 64 of our patient population, positive for the antibody hiv virus, a whopping 64 . That is an incredible figure. This information there is not much out there. They dont really discuss it or try to get into it. They just dont know what they doing. Or people need to realize this is going to kill us. It will be more it will be much better. Im going to die anyway, so why not does die like i am . You are Walking Around and you know you are going to die. [indiscernible] you need to knows you dont give it to your woman. Right . So your argument is out the window. If you care about life. Nobody ever came back and told me what death was. Nobody ever came back and said it is good. Should have to take that close to you to want to know about something that is killing society. We are uniquely in the position to handle the problem of aids, because they have always had scientists and clinical scientists. That is, people who are aware of what is going on on a daytoday basis of their on the street. They have combined both basic Science Research and Clinical Research to the point where they were very much aware that this problem could be transmitted through the use of needles and certainly among intravenous drug users. In that instance, we are using Research Methods to see whether the teachings have resulted in a lesser transmission of the virus. I really just shook it off, but this is very serious. Drug abuse is not going to go away easily. Much more needs to be known about its cause, treatment, and prevention. Our understanding is growing through basic science and Clinical Research. Our continued search for knowledge is essential for the effective control of this worldwide Public Health problem. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] [captions Copyright National cable satellite corp. 2018] the from madman across the water asking about an issue that still resounds today and this question is about how many people were fathered by u. S. G. I. s in vietnam, how were they each read it 45 beers after the u. S. Departure . You could be featured in our next life program. Join the conversation on facebook and on twitter. Q a,night on cspans noah feldman and his book the three lives of james madison. The constitution is madisons monument. The constitution is all around you. The threepart structure of government. The way government interacts. The exercise of free speech. All of that is madison from monument. That was the case in st. Pauls where Christopher Renfro monument said christopher wrens monument said, look around you. Sunday night on cspan. The state departments u. S. Diplomacy Center Pavilion opened in january 2015. It includes exhibits and artifacts and they plan to eventually open a museum. Up next, we visit the centers collection storage area and its artifacts. There was a surprise attack and we now know that this was an al qaeda attack on the embassy in tanzania. On the morning of the attack, she was in a meeting with the kenyan minister of commerce. His office was quite close to the embassy, just across the parking lot really. The department of commerce colleagues were upstairs upstairs at the meeting. I was coming back for just a few minutes. The ceiling caved in, and i thought i was going to die. I thought i am going to die. I didnt. , down 21 flights of stairs with my colleagues. I kept thinking, i just need to get out of this building. Back to my embassy, into be medical unit, and i will be all right. Into the medical unit, and i will be all right. It was when we exited the building and i saw the charred of what was once human beings, looked up and saw that my embassy was destroyed that i realized there was no medical unit to go to and i was going to have to take charge. Head. Was injured on her she very crucial that she very graciously donated the suit she was wearing that day. You can still see the bloodstains that remain on that suit from that horrible morning. Next on American History tv, historians and University Leaders discuss free speech and College Freedom on campuses and the responsibilities of administrators, faculties, and students in sharing ideas. They also talk about how social media has changed the nature of discourse in university settings. This is about an hour and a half recorded at the annual meeting held this year in washington, d. C. I am sanford unger, director of the free speech project at georgetown university. Among other things, former president of Goucher College in baltimore. We have an excellent panel. We have actually, appropriately enough two leaders of liberal , arts colleges and two leaders