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War on drugs – Wikipedia

War on Drugs is an American term[6][7] usually applied to the U.S. federal government’s campaign of prohibition of drugs, military aid, and military intervention, with the stated aim being to reduce the illegal drug trade.[8][9] The initiative includes a set of drug policies that are intended to discourage the production, distribution, and consumption of psychoactive drugs that the participating governments and the UN have made illegal. The term was popularized by the media shortly after a press conference given on June 18, 1971, by President Richard Nixonthe day after publication of a special message from President Nixon to the Congress on Drug Abuse Prevention and Controlduring which he declared drug abuse “public enemy number one”. That message to the Congress included text about devoting more federal resources to the “prevention of new addicts, and the rehabilitation of those who are addicted”, but that part did not receive the same public attention as the term “war on drugs”.[10][11][12] However, two years prior to this, Nixon had formally declared a “war on drugs” that would be directed toward eradication, interdiction, and incarceration.[13] Today, the Drug Policy Alliance, which advocates for an end to the War on Drugs, estimates that the United States spends $51 billion annually on these initiatives.[14]

On May 13, 2009, Gil Kerlikowskethe Director of the Office of National Drug Control Policy (ONDCP)signaled that the Obama administration did not plan to significantly alter drug enforcement policy, but also that the administration would not use the term “War on Drugs”, because Kerlikowske considers the term to be “counter-productive”.[15] ONDCP’s view is that “drug addiction is a disease that can be successfully prevented and treated… making drugs more available will make it harder to keep our communities healthy and safe”.[16] One of the alternatives that Kerlikowske has showcased is the drug policy of Sweden, which seeks to balance public health concerns with opposition to drug legalization. The prevalence rates for cocaine use in Sweden are barely one-fifth of those in Spain, the biggest consumer of the drug.[17]

In June 2011, the Global Commission on Drug Policy released a critical report on the War on Drugs, declaring: “The global war on drugs has failed, with devastating consequences for individuals and societies around the world. Fifty years after the initiation of the UN Single Convention on Narcotic Drugs, and years after President Nixon launched the US government’s war on drugs, fundamental reforms in national and global drug control policies are urgently needed.”[18] The report was criticized by organizations that oppose a general legalization of drugs.[16]

The first U.S. law that restricted the distribution and use of certain drugs was the Harrison Narcotics Tax Act of 1914. The first local laws came as early as 1860.[19] In 1919, the United States passed the 18th Amendment, prohibiting the sale, manufacture, and transportation of alcohol, with exceptions for religious and medical use. In 1920, the United States passed the National Prohibition Act (Volstead Act), enacted to carry out the provisions in law of the 18th Amendment.

The Federal Bureau of Narcotics was established in the United States Department of the Treasury by an act of June 14, 1930 (46 Stat. 585).[20] In 1933, the federal prohibition for alcohol was repealed by passage of the 21st Amendment. In 1935, President Franklin D. Roosevelt publicly supported the adoption of the Uniform State Narcotic Drug Act. The New York Times used the headline “Roosevelt Asks Narcotic War Aid”.[21][22]

In 1937, the Marihuana Tax Act of 1937 was passed. Several scholars have claimed that the goal was to destroy the hemp industry,[23][24][25] largely as an effort of businessmen Andrew Mellon, Randolph Hearst, and the Du Pont family.[23][25] These scholars argue that with the invention of the decorticator, hemp became a very cheap substitute for the paper pulp that was used in the newspaper industry.[23][26] These scholars believe that Hearst felt[dubious discuss] that this was a threat to his extensive timber holdings. Mellon, United States Secretary of the Treasury and the wealthiest man in America, had invested heavily in the DuPont’s new synthetic fiber, nylon, and considered[dubious discuss] its success to depend on its replacement of the traditional resource, hemp.[23][27][28][29][30][31][32][33] However, there were circumstances that contradict these claims. One reason for doubts about those claims is that the new decorticators did not perform fully satisfactorily in commercial production.[34] To produce fiber from hemp was a labor-intensive process if you include harvest, transport and processing. Technological developments decreased the labor with hemp but not sufficient to eliminate this disadvantage.[35][36]

On October 27, 1970, Congress passes the Comprehensive Drug Abuse Prevention and Control Act of 1970, which, among other things, categorizes controlled substances based on their medicinal use and potential for addiction.[37] In 1971, two congressmen released an explosive report on the growing heroin epidemic among U.S. servicemen in Vietnam; ten to fifteen percent of the servicemen were addicted to heroin, and President Nixon declared drug abuse to be “public enemy number one”.[37][38]

Although Nixon declared “drug abuse” to be public enemy number one in 1971,[39] the policies that his administration implemented as part of the Comprehensive Drug Abuse Prevention and Control Act of 1970 were a continuation of drug prohibition policies in the U.S., which started in 1914.[37][40]

“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.” John Ehrlichman, to Dan Baum[41][42][43] for Harper’s Magazine[44] in 1994, about President Richard Nixon’s war on drugs, declared in 1971.[45][46]

In 1973, the Drug Enforcement Administration was created to replace the Bureau of Narcotics and Dangerous Drugs.[37]

The Nixon Administration also repealed the federal 210-year mandatory minimum sentences for possession of marijuana and started federal demand reduction programs and drug-treatment programs. Robert DuPont, the “Drug czar” in the Nixon Administration, stated it would be more accurate to say that Nixon ended, rather than launched, the “war on drugs”. DuPont also argued that it was the proponents of drug legalization that popularized the term “war on drugs”.[16][unreliable source?]

In 1982, Vice President George H. W. Bush and his aides began pushing for the involvement of the CIA and U.S. military in drug interdiction efforts.[47]

The Office of National Drug Control Policy (ONDCP) was originally established by the National Narcotics Leadership Act of 1988,[48][49] which mandated a national anti-drug media campaign for youth, which would later become the National Youth Anti-Drug Media Campaign.[50] The director of ONDCP is commonly known as the Drug czar,[37] and it was first implemented in 1989 under President George H. W. Bush,[51] and raised to cabinet-level status by Bill Clinton in 1993.[52] These activities were subsequently funded by the Treasury and General Government Appropriations Act of 1998.[53][54] The Drug-Free Media Campaign Act of 1998 codified the campaign at 21 U.S.C.1708.[55]

The Global Commission on Drug Policy released a report on June 2, 2011, alleging that “The War On Drugs Has Failed.” The commissioned was made up of 22 self-appointed members including a number of prominent international politicians and writers. U.S. Surgeon General Regina Benjamin also released the first ever National Prevention Strategy.[56]

On May 21, 2012, the U.S. Government published an updated version of its Drug Policy.[57] The director of ONDCP stated simultaneously that this policy is something different from the “War on Drugs”:

At the same meeting was a declaration signed by the representatives of Italy, the Russian Federation, Sweden, the United Kingdom and the United States in line with this: “Our approach must be a balanced one, combining effective enforcement to restrict the supply of drugs, with efforts to reduce demand and build recovery; supporting people to live a life free of addiction.”[59]

In March 2016 the International Narcotics Control Board stated that the International Drug Control treaties do not mandate a “war on drugs.”[60]

According to Human Rights Watch, the War on Drugs caused soaring arrest rates that disproportionately targeted African Americans due to various factors.[62] John Ehrlichman, an aide to Nixon, said that Nixon used the war on drugs to criminalize and disrupt black and hippie communities and their leaders.[63]

The present state of incarceration in the U.S. as a result of the war on drugs arrived in several stages. By 1971, different stops on drugs had been implemented for more than 50 years (for e.g. since 1914, 1937 etc.) with only a very small increase of inmates per 100,000 citizens. During the first 9 years after Nixon coined the expression “War on Drugs”, statistics showed only a minor increase in the total number of imprisoned.

After 1980, the situation began to change. In the 1980s, while the number of arrests for all crimes had risen by 28%, the number of arrests for drug offenses rose 126%.[64] The result of increased demand was the development of privatization and the for-profit prison industry.[65] The US Department of Justice, reporting on the effects of state initiatives, has stated that, from 1990 through 2000, “the increasing number of drug offenses accounted for 27% of the total growth among black inmates, 7% of the total growth among Hispanic inmates, and 15% of the growth among white inmates.” In addition to prison or jail, the United States provides for the deportation of many non-citizens convicted of drug offenses.[66]

In 1994, the New England Journal of Medicine reported that the “War on Drugs” resulted in the incarceration of one million Americans each year.[67] In 2008, the Washington Post reported that of 1.5 million Americans arrested each year for drug offenses, half a million would be incarcerated.[68] In addition, one in five black Americans would spend time behind bars due to drug laws.[68]

Federal and state policies also impose collateral consequences on those convicted of drug offenses, such as denial of public benefits or licenses, that are not applicable to those convicted of other types of crime.[69] In particular, the passage of the 1990 SolomonLautenberg amendment led many states to impose mandatory driver’s license suspensions (of at least 6 months) for persons committing a drug offense, regardless of whether any motor vehicle was involved.[70][71] Approximately 191,000 licenses were suspended in this manner in 2016, according to a Prison Policy Initiative report.[72]

In 1986, the U.S. Congress passed laws that created a 100 to 1 sentencing disparity for the trafficking or possession of crack when compared to penalties for trafficking of powder cocaine,[73][74][75][76] which had been widely criticized as discriminatory against minorities, mostly blacks, who were more likely to use crack than powder cocaine.[77] This 100:1 ratio had been required under federal law since 1986.[78] Persons convicted in federal court of possession of 5grams of crack cocaine received a minimum mandatory sentence of 5 years in federal prison. On the other hand, possession of 500grams of powder cocaine carries the same sentence.[74][75] In 2010, the Fair Sentencing Act cut the sentencing disparity to 18:1.[77]

According to Human Rights Watch, crime statistics show thatin the United States in 1999compared to non-minorities, African Americans were far more likely to be arrested for drug crimes, and received much stiffer penalties and sentences.[79]

Statistics from 1998 show that there were wide racial disparities in arrests, prosecutions, sentencing and deaths. African-American drug users made up for 35% of drug arrests, 55% of convictions, and 74% of people sent to prison for drug possession crimes.[74] Nationwide African-Americans were sent to state prisons for drug offenses 13 times more often than other races,[80] even though they only supposedly comprised 13% of regular drug users.[74]

Anti-drug legislation over time has also displayed an apparent racial bias. University of Minnesota Professor and social justice author Michael Tonry writes, “The War on Drugs foreseeably and unnecessarily blighted the lives of hundreds and thousands of young disadvantaged black Americans and undermined decades of effort to improve the life chances of members of the urban black underclass.”[81]

In 1968, President Lyndon B. Johnson decided that the government needed to make an effort to curtail the social unrest that blanketed the country at the time. He decided to focus his efforts on illegal drug use, an approach which was in line with expert opinion on the subject at the time. In the 1960s, it was believed that at least half of the crime in the U.S. was drug related, and this number grew as high as 90 percent in the next decade.[82] He created the Reorganization Plan of 1968 which merged the Bureau of Narcotics and the Bureau of Drug Abuse to form the Bureau of Narcotics and Dangerous Drugs within the Department of Justice.[83] The belief during this time about drug use was summarized by journalist Max Lerner in his celebrated[citation needed] work America as a Civilization (1957):

As a case in point we may take the known fact of the prevalence of reefer and dope addiction in Negro areas. This is essentially explained in terms of poverty, slum living, and broken families, yet it would be easy to show the lack of drug addiction among other ethnic groups where the same conditions apply.[84]

Richard Nixon became president in 1969, and did not back away from the anti-drug precedent set by Johnson. Nixon began orchestrating drug raids nationwide to improve his “watchdog” reputation. Lois B. Defleur, a social historian who studied drug arrests during this period in Chicago, stated that, “police administrators indicated they were making the kind of arrests the public wanted”. Additionally, some of Nixon’s newly created drug enforcement agencies would resort to illegal practices to make arrests as they tried to meet public demand for arrest numbers. From 1972 to 1973, the Office of Drug Abuse and Law Enforcement performed 6,000 drug arrests in 18 months, the majority of the arrested black.[85]

The next two Presidents, Gerald Ford and Jimmy Carter, responded with programs that were essentially a continuation of their predecessors. Shortly after Ronald Reagan became President in 1981 he delivered a speech on the topic. Reagan announced, “We’re taking down the surrender flag that has flown over so many drug efforts; we’re running up a battle flag.”[86] For his first five years in office, Reagan slowly strengthened drug enforcement by creating mandatory minimum sentencing and forfeiture of cash and real estate for drug offenses, policies far more detrimental to poor blacks than any other sector affected by the new laws.[citation needed]

Then, driven by the 1986 cocaine overdose of black basketball star Len Bias,[dubious discuss] Reagan was able to pass the Anti-Drug Abuse Act through Congress. This legislation appropriated an additional $1.7 billion to fund the War on Drugs. More importantly, it established 29 new, mandatory minimum sentences for drug offenses. In the entire history of the country up until that point, the legal system had only seen 55 minimum sentences in total.[87] A major stipulation of the new sentencing rules included different mandatory minimums for powder and crack cocaine. At the time of the bill, there was public debate as to the difference in potency and effect of powder cocaine, generally used by whites, and crack cocaine, generally used by blacks, with many believing that “crack” was substantially more powerful and addictive. Crack and powder cocaine are closely related chemicals, crack being a smokeable, freebase form of powdered cocaine hydrochloride which produces a shorter, more intense high while using less of the drug. This method is more cost effective, and therefore more prevalent on the inner-city streets, while powder cocaine remains more popular in white suburbia. The Reagan administration began shoring public opinion against “crack”, encouraging DEA official Robert Putnam to play up the harmful effects of the drug. Stories of “crack whores” and “crack babies” became commonplace; by 1986, Time had declared “crack” the issue of the year.[88] Riding the wave of public fervor, Reagan established much harsher sentencing for crack cocaine, handing down stiffer felony penalties for much smaller amounts of the drug.[89]

Reagan protg and former Vice-President George H. W. Bush was next to occupy the oval office, and the drug policy under his watch held true to his political background. Bush maintained the hard line drawn by his predecessor and former boss, increasing narcotics regulation when the First National Drug Control Strategy was issued by the Office of National Drug Control in 1989.[90]

The next three presidents Clinton, Bush and Obama continued this trend, maintaining the War on Drugs as they inherited it upon taking office.[91] During this time of passivity by the federal government, it was the states that initiated controversial legislation in the War on Drugs. Racial bias manifested itself in the states through such controversial policies as the “stop and frisk” police practices in New York city and the “three strikes” felony laws began in California in 1994.[92]

In August 2010, President Obama signed the Fair Sentencing Act into law that dramatically reduced the 100-to-1 sentencing disparity between powder and crack cocaine, which disproportionately affected minorities.[93]

Commonly used illegal drugs include heroin, cocaine, methamphetamine, and, marijuana.

Heroin is an opiate that is highly addictive. If caught selling or possessing heroin, a perpetrator can be charged with a felony and face twofour years in prison and could be fined to a maximum of $20,000.[94]

Crystal meth is composed of methamphetamine hydrochloride. It is marketed as either a white powder or in a solid (rock) form. The possession of crystal meth can result in a punishment varying from a fine to a jail sentence. As with other drug crimes, sentencing length may increase depending on the amount of the drug found in the possession of the defendant.[95]

Cocaine possession is illegal across the U.S., with the cheaper crack cocaine incurring even greater penalties. Having possession is when the accused knowingly has it on their person, or in a backpack or purse. The possession of cocaine with no prior conviction, for the first offense, the person will be sentenced to a maximum of one year in prison or fined $1,000, or both. If the person has a prior conviction, whether it is a narcotic or cocaine, they will be sentenced to two years in prison, a $2,500 fine, or both. With two or more convictions of possession prior to this present offense, they can be sentenced to 90 days in prison along with a $5,000 fine.[96]

Marijuana is the most popular illegal drug worldwide. The punishment for possession of it is less than for the possession of cocaine or heroin. In some U.S. states, the drug is legal. Over 80 million Americans have tried marijuana. The Criminal Defense Lawyer article claims that, depending on the age of person and how much the person has been caught for possession, they will be fined and could plea bargain into going to a treatment program versus going to prison. In each state the convictions differ along with how much marijuana they have on their person.[97]

Some scholars have claimed that the phrase “War on Drugs” is propaganda cloaking an extension of earlier military or paramilitary operations.[9] Others have argued that large amounts of “drug war” foreign aid money, training, and equipment actually goes to fighting leftist insurgencies and is often provided to groups who themselves are involved in large-scale narco-trafficking, such as corrupt members of the Colombian military.[8]

From 1963 to the end of the Vietnam War in 1975, marijuana usage became common among U.S. soldiers in non-combat situations. Some servicemen also used heroin. Many of the servicemen ended the heroin use after returning to the United States but came home addicted. In 1971, the U.S. military conducted a study of drug use among American servicemen and women. It found that daily usage rates for drugs on a worldwide basis were as low as two percent.[98] However, in the spring of 1971, two congressmen released an alarming report alleging that 15% of the servicemen in Vietnam were addicted to heroin. Marijuana use was also common in Vietnam. Soldiers who used drugs had more disciplinary problems. The frequent drug use had become an issue for the commanders in Vietnam; in 1971 it was estimated that 30,000 servicemen were addicted to drugs, most of them to heroin.[11]

From 1971 on, therefore, returning servicemen were required to take a mandatory heroin test. Servicemen who tested positive upon returning from Vietnam were not allowed to return home until they had passed the test with a negative result. The program also offered a treatment for heroin addicts.[99]

Elliot Borin’s article “The U.S. Military Needs its Speed”published in Wired on February 10, 2003reports:

But the Defense Department, which distributed millions of amphetamine tablets to troops during World War II, Vietnam and the Gulf War, soldiers on, insisting that they are not only harmless but beneficial.

In a news conference held in connection with Schmidt and Umbach’s Article 32 hearing, Dr. Pete Demitry, an Air Force physician and a pilot, claimed that the “Air Force has used (Dexedrine) safely for 60 years” with “no known speed-related mishaps.”

The need for speed, Demitry added “is a life-and-death issue for our military.”[100]

One of the first anti-drug efforts in the realm of foreign policy was President Nixon’s Operation Intercept, announced in September 1969, targeted at reducing the amount of cannabis entering the United States from Mexico. The effort began with an intense inspection crackdown that resulted in an almost shutdown of cross-border traffic.[101] Because the burden on border crossings was controversial in border states, the effort only lasted twenty days.[102]

On December 20, 1989, the United States invaded Panama as part of Operation Just Cause, which involved 25,000 American troops. Gen. Manuel Noriega, head of the government of Panama, had been giving military assistance to Contra groups in Nicaragua at the request of the U.S. which, in exchange, tolerated his drug trafficking activities, which they had known about since the 1960s.[103][104] When the Drug Enforcement Administration (DEA) tried to indict Noriega in 1971, the CIA prevented them from doing so.[103] The CIA, which was then directed by future president George H. W. Bush, provided Noriega with hundreds of thousands of dollars per year as payment for his work in Latin America.[103] When CIA pilot Eugene Hasenfus was shot down over Nicaragua by the Sandinistas, documents aboard the plane revealed many of the CIA’s activities in Latin America, and the CIA’s connections with Noriega became a public relations “liability” for the U.S. government, which finally allowed the DEA to indict him for drug trafficking, after decades of tolerating his drug operations.[103] Operation Just Cause, whose purpose was to capture Noriega and overthrow his government; Noriega found temporary asylum in the Papal Nuncio, and surrendered to U.S. soldiers on January 3, 1990.[105] He was sentenced by a court in Miami to 45 years in prison.[103]

As part of its Plan Colombia program, the United States government currently provides hundreds of millions of dollars per year of military aid, training, and equipment to Colombia,[106] to fight left-wing guerrillas such as the Revolutionary Armed Forces of Colombia (FARC-EP), which has been accused of being involved in drug trafficking.[107]

Private U.S. corporations have signed contracts to carry out anti-drug activities as part of Plan Colombia. DynCorp, the largest private company involved, was among those contracted by the State Department, while others signed contracts with the Defense Department.[108]

Colombian military personnel have received extensive counterinsurgency training from U.S. military and law enforcement agencies, including the School of Americas (SOA). Author Grace Livingstone has stated that more Colombian SOA graduates have been implicated in human rights abuses than currently known SOA graduates from any other country. All of the commanders of the brigades highlighted in a 2001 Human Rights Watch report on Colombia were graduates of the SOA, including the III brigade in Valle del Cauca, where the 2001 Alto Naya Massacre occurred. US-trained officers have been accused of being directly or indirectly involved in many atrocities during the 1990s, including the Massacre of Trujillo and the 1997 Mapiripn Massacre.

In 2000, the Clinton administration initially waived all but one of the human rights conditions attached to Plan Colombia, considering such aid as crucial to national security at the time.[109]

The efforts of U.S. and Colombian governments have been criticized for focusing on fighting leftist guerrillas in southern regions without applying enough pressure on right-wing paramilitaries and continuing drug smuggling operations in the north of the country.[110][111] Human Rights Watch, congressional committees and other entities have documented the existence of connections between members of the Colombian military and the AUC, which the U.S. government has listed as a terrorist group, and that Colombian military personnel have committed human rights abuses which would make them ineligible for U.S. aid under current laws.[citation needed]

In 2010, the Washington Office on Latin America concluded that both Plan Colombia and the Colombian government’s security strategy “came at a high cost in lives and resources, only did part of the job, are yielding diminishing returns and have left important institutions weaker.”[112]

A 2014 report by the RAND Corporation, which was issued to analyze viable strategies for the Mexican drug war considering successes experienced in Columbia, noted:

Between 1999 and 2002, the United States gave Colombia $2.04 billion in aid, 81 percent of which was for military purposes, placing Colombia just below Israel and Egypt among the largest recipients of U.S. military assistance. Colombia increased its defense spending from 3.2 percent of gross domestic product (GDP) in 2000 to 4.19 percent in 2005. Overall, the results were extremely positive. Greater spending on infrastructure and social programs helped the Colombian government increase its political legitimacy, while improved security forces were better able to consolidate control over large swaths of the country previously overrun by insurgents and drug cartels.

It also notes that, “Plan Colombia has been widely hailed as a success, and some analysts believe that, by 2010, Colombian security forces had finally gained the upper hand once and for all.”[113]

The Mrida Initiative is a security cooperation between the United States and the government of Mexico and the countries of Central America. It was approved on June 30, 2008, and its stated aim is combating the threats of drug trafficking and transnational crime. The Mrida Initiative appropriated $1.4 billion in a three-year commitment (20082010) to the Mexican government for military and law enforcement training and equipment, as well as technical advice and training to strengthen the national justice systems. The Mrida Initiative targeted many very important government officials, but it failed to address the thousands of Central Americans who had to flee their countries due to the danger they faced everyday because of the war on drugs. There is still not any type of plan that addresses these people. No weapons are included in the plan.[114][115]

The United States regularly sponsors the spraying of large amounts of herbicides such as glyphosate over the jungles of Central and South America as part of its drug eradication programs. Environmental consequences resulting from aerial fumigation have been criticized as detrimental to some of the world’s most fragile ecosystems;[116] the same aerial fumigation practices are further credited with causing health problems in local populations.[117]

In 2012, the U.S. sent DEA agents to Honduras to assist security forces in counternarcotics operations. Honduras has been a major stop for drug traffickers, who use small planes and landing strips hidden throughout the country to transport drugs. The U.S. government made agreements with several Latin American countries to share intelligence and resources to counter the drug trade. DEA agents, working with other U.S. agencies such as the State Department, the CBP, and Joint Task Force-Bravo, assisted Honduras troops in conducting raids on traffickers’ sites of operation.[118]

The War on Drugs has been a highly contentious issue since its inception. A poll on October 2, 2008, found that three in four Americans believed that the War On Drugs was failing.[119]

At a meeting in Guatemala in 2012, three former presidents from Guatemala, Mexico and Colombia said that the war on drugs had failed and that they would propose a discussion on alternatives, including decriminalization, at the Summit of the Americas in April of that year.[120] Guatemalan President Otto Prez Molina said that the war on drugs was exacting too high a price on the lives of Central Americans and that it was time to “end the taboo on discussing decriminalization”.[121] At the summit, the government of Colombia pushed for the most far-reaching change to drugs policy since the war on narcotics was declared by Nixon four decades prior, citing the catastrophic effects it had had in Colombia.[122]

Several critics have compared the wholesale incarceration of the dissenting minority of drug users to the wholesale incarceration of other minorities in history. Psychiatrist Thomas Szasz, for example, writes in 1997 “Over the past thirty years, we have replaced the medical-political persecution of illegal sex users (‘perverts’ and ‘psychopaths’) with the even more ferocious medical-political persecution of illegal drug users.”[123]

Penalties for drug crimes among American youth almost always involve permanent or semi-permanent removal from opportunities for education, strip them of voting rights, and later involve creation of criminal records which make employment more difficult.[124] Thus, some authors maintain that the War on Drugs has resulted in the creation of a permanent underclass of people who have few educational or job opportunities, often as a result of being punished for drug offenses which in turn have resulted from attempts to earn a living in spite of having no education or job opportunities.[124]

According to a 2008 study published by Harvard economist Jeffrey A. Miron, the annual savings on enforcement and incarceration costs from the legalization of drugs would amount to roughly $41.3 billion, with $25.7 billion being saved among the states and over $15.6 billion accrued for the federal government. Miron further estimated at least $46.7 billion in tax revenue based on rates comparable to those on tobacco and alcohol ($8.7 billion from marijuana, $32.6 billion from cocaine and heroin, remainder from other drugs).[125]

Low taxation in Central American countries has been credited with weakening the region’s response in dealing with drug traffickers. Many cartels, especially Los Zetas have taken advantage of the limited resources of these nations. 2010 tax revenue in El Salvador, Guatemala, and Honduras, composed just 13.53% of GDP. As a comparison, in Chile and the U.S., taxes were 18.6% and 26.9% of GDP respectively. However, direct taxes on income are very hard to enforce and in some cases tax evasion is seen as a national pastime.[126]

The status of coca and coca growers has become an intense political issue in several countries, including Colombia and particularly Bolivia, where the president, Evo Morales, a former coca growers’ union leader, has promised to legalise the traditional cultivation and use of coca.[127] Indeed, legalization efforts have yielded some successes under the Morales administration when combined with aggressive and targeted eradication efforts. The country saw a 1213% decline in coca cultivation[127] in 2011 under Morales, who has used coca growers’ federations to ensure compliance with the law rather than providing a primary role for security forces.[127]

The coca eradication policy has been criticised for its negative impact on the livelihood of coca growers in South America. In many areas of South America the coca leaf has traditionally been chewed and used in tea and for religious, medicinal and nutritional purposes by locals.[128] For this reason many insist that the illegality of traditional coca cultivation is unjust. In many areas the U.S. government and military has forced the eradication of coca without providing for any meaningful alternative crop for farmers, and has additionally destroyed many of their food or market crops, leaving them starving and destitute.[128]

The CIA, DEA, State Department, and several other U.S. government agencies have been alleged to have relations with various groups which are involved in drug trafficking.

Senator John Kerry’s 1988 U.S. Senate Committee on Foreign Relations report on Contra drug links concludes that members of the U.S. State Department “who provided support for the Contras are involved in drug trafficking… and elements of the Contras themselves knowingly receive financial and material assistance from drug traffickers.”[129] The report further states that “the Contra drug links include… payments to drug traffickers by the U.S. State Department of funds authorized by the Congress for humanitarian assistance to the Contras, in some cases after the traffickers had been indicted by federal law enforcement agencies on drug charges, in others while traffickers were under active investigation by these same agencies.”

In 1996, journalist Gary Webb published reports in the San Jose Mercury News, and later in his book Dark Alliance, detailing how Contras, had been involved in distributing crack cocaine into Los Angeles whilst receiving money from the CIA.[citation needed] Contras used money from drug trafficking to buy weapons.[citation needed]

Webb’s premise regarding the U.S. Government connection was initially attacked at the time by the media. It is now widely accepted that Webb’s main assertion of government “knowledge of drug operations, and collaboration with and protection of known drug traffickers” was correct.[130][not in citation given] In 1998, CIA Inspector General Frederick Hitz published a two-volume report[131] that while seemingly refuting Webb’s claims of knowledge and collaboration in its conclusions did not deny them in its body.[citation needed] Hitz went on to admit CIA improprieties in the affair in testimony to a House congressional committee. There has been a reversal amongst mainstream media of its position on Webb’s work, with acknowledgement made of his contribution to exposing a scandal it had ignored.

According to Rodney Campbell, an editorial assistant to Nelson Rockefeller, during World War II, the United States Navy, concerned that strikes and labor disputes in U.S. eastern shipping ports would disrupt wartime logistics, released the mobster Lucky Luciano from prison, and collaborated with him to help the mafia take control of those ports. Labor union members were terrorized and murdered by mafia members as a means of preventing labor unrest and ensuring smooth shipping of supplies to Europe.[132]

According to Alexander Cockburn and Jeffrey St. Clair, in order to prevent Communist party members from being elected in Italy following World War II, the CIA worked closely with the Sicilian Mafia, protecting them and assisting in their worldwide heroin smuggling operations. The mafia was in conflict with leftist groups and was involved in assassinating, torturing, and beating leftist political organizers.[133]

In 1986, the US Defense Department funded a two-year study by the RAND Corporation, which found that the use of the armed forces to interdict drugs coming into the United States would have little or no effect on cocaine traffic and might, in fact, raise the profits of cocaine cartels and manufacturers. The 175-page study, “Sealing the Borders: The Effects of Increased Military Participation in Drug Interdiction”, was prepared by seven researchers, mathematicians and economists at the National Defense Research Institute, a branch of the RAND, and was released in 1988. The study noted that seven prior studies in the past nine years, including one by the Center for Naval Research and the Office of Technology Assessment, had come to similar conclusions. Interdiction efforts, using current armed forces resources, would have almost no effect on cocaine importation into the United States, the report concluded.[135]

During the early-to-mid-1990s, the Clinton administration ordered and funded a major cocaine policy study, again by RAND. The Rand Drug Policy Research Center study concluded that $3 billion should be switched from federal and local law enforcement to treatment. The report said that treatment is the cheapest way to cut drug use, stating that drug treatment is twenty-three times more effective than the supply-side “war on drugs”.[136]

The National Research Council Committee on Data and Research for Policy on Illegal Drugs published its findings in 2001 on the efficacy of the drug war. The NRC Committee found that existing studies on efforts to address drug usage and smuggling, from U.S. military operations to eradicate coca fields in Colombia, to domestic drug treatment centers, have all been inconclusive, if the programs have been evaluated at all: “The existing drug-use monitoring systems are strikingly inadequate to support the full range of policy decisions that the nation must make…. It is unconscionable for this country to continue to carry out a public policy of this magnitude and cost without any way of knowing whether and to what extent it is having the desired effect.”[137] The study, though not ignored by the press, was ignored by top-level policymakers, leading Committee Chair Charles Manski to conclude, as one observer notes, that “the drug war has no interest in its own results”.[138]

In mid-1995, the US government tried to reduce the supply of methamphetamine precursors to disrupt the market of this drug. According to a 2009 study, this effort was successful, but its effects were largely temporary.[139]

During alcohol prohibition, the period from 1920 to 1933, alcohol use initially fell but began to increase as early as 1922. It has been extrapolated that even if prohibition had not been repealed in 1933, alcohol consumption would have quickly surpassed pre-prohibition levels.[140] One argument against the War on Drugs is that it uses similar measures as Prohibition and is no more effective.

In the six years from 2000 to 2006, the U.S. spent $4.7 billion on Plan Colombia, an effort to eradicate coca production in Colombia. The main result of this effort was to shift coca production into more remote areas and force other forms of adaptation. The overall acreage cultivated for coca in Colombia at the end of the six years was found to be the same, after the U.S. Drug Czar’s office announced a change in measuring methodology in 2005 and included new areas in its surveys.[141] Cultivation in the neighboring countries of Peru and Bolivia increased, some would describe this effect like squeezing a balloon.[142]

Richard Davenport-Hines, in his book The Pursuit of Oblivion,[143] criticized the efficacy of the War on Drugs by pointing out that

1015% of illicit heroin and 30% of illicit cocaine is intercepted. Drug traffickers have gross profit margins of up to 300%. At least 75% of illicit drug shipments would have to be intercepted before the traffickers’ profits were hurt.

Alberto Fujimori, president of Peru from 1990 to 2000, described U.S. foreign drug policy as “failed” on grounds that “for 10 years, there has been a considerable sum invested by the Peruvian government and another sum on the part of the American government, and this has not led to a reduction in the supply of coca leaf offered for sale. Rather, in the 10 years from 1980 to 1990, it grew 10-fold.”[144]

At least 500 economists, including Nobel Laureates Milton Friedman,[145] George Akerlof and Vernon L. Smith, have noted that reducing the supply of marijuana without reducing the demand causes the price, and hence the profits of marijuana sellers, to go up, according to the laws of supply and demand.[146] The increased profits encourage the producers to produce more drugs despite the risks, providing a theoretical explanation for why attacks on drug supply have failed to have any lasting effect. The aforementioned economists published an open letter to President George W. Bush stating “We urge…the country to commence an open and honest debate about marijuana prohibition… At a minimum, this debate will force advocates of current policy to show that prohibition has benefits sufficient to justify the cost to taxpayers, foregone tax revenues and numerous ancillary consequences that result from marijuana prohibition.”

The declaration from the World Forum Against Drugs, 2008 state that a balanced policy of drug abuse prevention, education, treatment, law enforcement, research, and supply reduction provides the most effective platform to reduce drug abuse and its associated harms and call on governments to consider demand reduction as one of their first priorities in the fight against drug abuse.[147]

Despite over $7 billion spent annually towards arresting[148] and prosecuting nearly 800,000 people across the country for marijuana offenses in 2005[citation needed] (FBI Uniform Crime Reports), the federally funded Monitoring the Future Survey reports about 85% of high school seniors find marijuana “easy to obtain”. That figure has remained virtually unchanged since 1975, never dropping below 82.7% in three decades of national surveys.[149] The Drug Enforcement Administration states that the number of users of marijuana in the U.S. declined between 2000 and 2005 even with many states passing new medical marijuana laws making access easier,[150] though usage rates remain higher than they were in the 1990s according to the National Survey on Drug Use and Health.[151]

ONDCP stated in April 2011 that there has been a 46 percent drop in cocaine use among young adults over the past five years, and a 65 percent drop in the rate of people testing positive for cocaine in the workplace since 2006.[152] At the same time, a 2007 study found that up to 35% of college undergraduates used stimulants not prescribed to them.[153]

A 2013 study found that prices of heroin, cocaine and cannabis had decreased from 1990 to 2007, but the purity of these drugs had increased during the same time.[154]

The War on Drugs is often called a policy failure.[155][156][157][158][159]

The legality of the War on Drugs has been challenged on four main grounds in the U.S.

Several authors believe that the United States’ federal and state governments have chosen wrong methods for combatting the distribution of illicit substances. Aggressive, heavy-handed enforcement funnels individuals through courts and prisons; instead of treating the cause of the addiction, the focus of government efforts has been on punishment. By making drugs illegal rather than regulating them, the War on Drugs creates a highly profitable black market. Jefferson Fish has edited scholarly collections of articles offering a wide variety of public health based and rights based alternative drug policies.[160][161][162]

In the year 2000, the United States drug-control budget reached 18.4 billion dollars,[163] nearly half of which was spent financing law enforcement while only one sixth was spent on treatment. In the year 2003, 53 percent of the requested drug control budget was for enforcement, 29 percent for treatment, and 18 percent for prevention.[164] The state of New York, in particular, designated 17 percent of its budget towards substance-abuse-related spending. Of that, a mere one percent was put towards prevention, treatment, and research.

In a survey taken by Substance Abuse and Mental Health Services Administration (SAMHSA), it was found that substance abusers that remain in treatment longer are less likely to resume their former drug habits. Of the people that were studied, 66 percent were cocaine users. After experiencing long-term in-patient treatment, only 22 percent returned to the use of cocaine. Treatment had reduced the number of cocaine abusers by two-thirds.[163] By spending the majority of its money on law enforcement, the federal government had underestimated the true value of drug-treatment facilities and their benefit towards reducing the number of addicts in the U.S.

In 2004 the federal government issued the National Drug Control Strategy. It supported programs designed to expand treatment options, enhance treatment delivery, and improve treatment outcomes. For example, the Strategy provided SAMHSA with a $100.6 million grant to put towards their Access to Recovery (ATR) initiative. ATR is a program that provides vouchers to addicts to provide them with the means to acquire clinical treatment or recovery support. The project’s goals are to expand capacity, support client choice, and increase the array of faith-based and community based providers for clinical treatment and recovery support services.[165] The ATR program will also provide a more flexible array of services based on the individual’s treatment needs.

The 2004 Strategy additionally declared a significant 32 million dollar raise in the Drug Courts Program, which provides drug offenders with alternatives to incarceration. As a substitute for imprisonment, drug courts identify substance-abusing offenders and place them under strict court monitoring and community supervision, as well as provide them with long-term treatment services.[166] According to a report issued by the National Drug Court Institute, drug courts have a wide array of benefits, with only 16.4 percent of the nation’s drug court graduates rearrested and charged with a felony within one year of completing the program (versus the 44.1% of released prisoners who end up back in prison within 1-year). Additionally, enrolling an addict in a drug court program costs much less than incarcerating one in prison.[167] According to the Bureau of Prisons, the fee to cover the average cost of incarceration for Federal inmates in 2006 was $24,440.[168] The annual cost of receiving treatment in a drug court program ranges from $900 to $3,500. Drug courts in New York State alone saved $2.54 million in incarceration costs.[167]

Describing the failure of the War on Drugs, New York Times columnist Eduardo Porter noted:

Jeffrey Miron, an economist at Harvard who studies drug policy closely, has suggested that legalizing all illicit drugs would produce net benefits to the United States of some $65 billion a year, mostly by cutting public spending on enforcement as well as through reduced crime and corruption. A study by analysts at the RAND Corporation, a California research organization, suggested that if marijuana were legalized in California and the drug spilled from there to other states, Mexican drug cartels would lose about a fifth of their annual income of some $6.5 billion from illegal exports to the United States.[169]

Many believe that the War on Drugs has been costly and ineffective largely because inadequate emphasis is placed on treatment of addiction. The United States leads the world in both recreational drug usage and incarceration rates. 70% of men arrested in metropolitan areas test positive for an illicit substance,[170] and 54% of all men incarcerated will be repeat offenders.[171]

There are also programs in the United States to combat public health risks of injecting drug users such as the Needle exchange programme. The “needle exchange programme” is intended to provide injecting drug users with new needles in exchange for used needles to prevent needle sharing.

Covert activities and foreign policy

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Philippines War on Drugs | Human Rights Watch

Tilted election playing field in Turkey; European Court of Justice confirms rights of same-sex couples; Philippine policepromoting abusers; Vietnam’s cyber security law; Nigerian military trying to smear Amnesty International; Paris names imprisoned Bahrainrights activist Nabeel Rajaban honorary citizen; Intimidation ofjournalists in the US; Brutal US treatment of refugees; and Russia’s World Cup amid Syria slaughter.

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War on Drugs | United States history | Britannica.com

War on Drugs, the effort in the United States since the 1970s to combat illegal drug use by greatly increasing penalties, enforcement, and incarceration for drug offenders.

The War on Drugs began in June 1971 when U.S. Pres. Richard Nixon declared drug abuse to be public enemy number one and increased federal funding for drug-control agencies and drug-treatment efforts. In 1973 the Drug Enforcement Agency was created out of the merger of the Office for Drug Abuse Law Enforcement, the Bureau of Narcotics and Dangerous Drugs, and the Office of Narcotics Intelligence to consolidate federal efforts to control drug abuse.

The War on Drugs was a relatively small component of federal law-enforcement efforts until the presidency of Ronald Reagan, which began in 1981. Reagan greatly expanded the reach of the drug war and his focus on criminal punishment over treatment led to a massive increase in incarcerations for nonviolent drug offenses, from 50,000 in 1980 to 400,000 in 1997. In 1984 his wife, Nancy, spearheaded another facet of the War on Drugs with her Just Say No campaign, which was a privately funded effort to educate schoolchildren on the dangers of drug use. The expansion of the War on Drugs was in many ways driven by increased media coverage ofand resulting public nervousness overthe crack epidemic that arose in the early 1980s. This heightened concern over illicit drug use helped drive political support for Reagans hard-line stance on drugs. The U.S. Congress passed the Anti-Drug Abuse Act of 1986, which allocated $1.7 billion to the War on Drugs and established a series of mandatory minimum prison sentences for various drug offenses. A notable feature of mandatory minimums was the massive gap between the amounts of crack and of powder cocaine that resulted in the same minimum sentence: possession of five grams of crack led to an automatic five-year sentence while it took the possession of 500 grams of powder cocaine to trigger that sentence. Since approximately 80% of crack users were African American, mandatory minimums led to an unequal increase of incarceration rates for nonviolent black drug offenders, as well as claims that the War on Drugs was a racist institution.

Concerns over the effectiveness of the War on Drugs and increased awareness of the racial disparity of the punishments meted out by it led to decreased public support of the most draconian aspects of the drug war during the early 21st century. Consequently, reforms were enacted during that time, such as the legalization of recreational marijuana in a number of states and the passage of the Fair Sentencing Act of 2010 that reduced the discrepancy of crack-to-powder possession thresholds for minimum sentences from 100-to-1 to 18-to-1. While the War on Drugs is still technically being waged, it is done at much less intense level than it was during its peak in the 1980s.

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War on Drugs | United States history | Britannica.com

The War on Drugs (band) – Wikipedia

The War on Drugs is an American indie rock band from Philadelphia, Pennsylvania, formed in 2005. The band consists of Adam Granduciel (lyrics, vocals, guitar), David Hartley (bass), Robbie Bennett (keyboards), Charlie Hall (drums), Jon Natchez (saxophone, keyboards) and Anthony LaMarca (guitar).

Founded by close collaborators Granduciel and Kurt Vile, The War on Drugs released their debut studio album, Wagonwheel Blues, in 2008. Vile departed shortly after its release to focus on his solo career. The band’s second studio album Slave Ambient was released in 2011 to favorable reviews and extensive touring.

The band’s third album, Lost in the Dream, was released in 2014 following extensive touring and a period of loneliness and depression for primary songwriter Granduciel. The album was released to widespread critical acclaim and increased exposure. Previous collaborator Hall joined the band as its full-time drummer during the recording process, with saxophonist Natchez and additional guitarist LaMarca accompanying the band for its world tour. Signing to Atlantic Records, the six-piece band released their fourth album, A Deeper Understanding, in 2017, which won the Grammy Award for Best Rock Album at the 60th Annual Grammy Awards.

In 2003, frontman Adam Granduciel moved from Oakland, California to Philadelphia, where he met Kurt Vile, who had also recently moved back to Philadelphia after living in Boston for two years.[2] The duo subsequently began writing, recording and performing music together.[3] Vile stated, “Adam was the first dude I met when I moved back to Philadelphia in 2003. We saw eye-to-eye on a lot of things. I was obsessed with Bob Dylan at the time, and we totally geeked-out on that. We started playing together in the early days and he would be in my band, The Violators. Then, eventually I played in The War On Drugs.”[4]

Granduciel and Vile began playing together as The War on Drugs in 2005. Regarding the band’s name, Granduciel noted, “My friend Julian and I came up with it a few years ago over a couple bottles of red wine and a few typewriters when we were living in Oakland. We were writing a lot back then, working on a dictionary, and it just came out and we were like “hey, good band name” so eventually when I moved to Philadelphia and got a band together I used it. It was either that or The Rigatoni Danzas. I think we made the right choice. I always felt though that it was the kind of name I could record all sorts of different music under without any sort of predictability inherent in the name”[5]

While Vile and Granduciel formed the backbone of the band, they had a number of accompanists early in the group’s career, before finally settling on a lineup that added Charlie Hall as drummer/organist, Kyle Lloyd as drummer and Dave Hartley on bass.[6] Granduciel had previously toured and recorded with The Capitol Years, and Vile has several solo albums.[7] The group gave away its Barrel of Batteries EP for free early in 2008.[8] Their debut LP for Secretly Canadian, Wagonwheel Blues, was released in 2008.[9]

Following the album’s release, and subsequent European tour, Vile departed from the band to focus on his solo career, stating, “I only went on the first European tour when their album came out, and then I basically left the band. I knew if I stuck with that, it would be all my time and my goal was to have my own musical career.”[4] Fellow Kurt Vile & the Violators bandmate Mike Zanghi joined the band at this time, with Vile noting, “Mike was my drummer first and then when The War On Drugs’ first record came out I thought I was lending Mike to Adam for the European tour but then he just played with them all the time so I kind of had to like, while they were touring a lot, figure out my own thing.”[10]

The lineup underwent several changes, and by the end of 2008, Kurt Vile, Charlie Hall, and Kyle Lloyd had all exited the group. At that time Granduciel and Hartley were joined by drummer Mike Zanghi, whom Granduciel also played with in Kurt Vile’s backing band, the Violators.

After recording much of the band’s forthcoming studio album, Slave Ambient, Zanghi departed from the band in 2010. Drummer Steven Urgo subsequently joined the band, with keyboardist Robbie Bennett also joining at around this time. Regarding Zanghi’s exit, Granduciel noted: “I loved Mike, and I loved the sound of The Violators, but then he wasn’t really the sound of my band. But you have things like friendship, and he’s down to tour and he’s a great guy, but it wasn’t the sound of what this band was.”[11]

Slave Ambient was released to favorable reviews in 2011.[citation needed]

In 2012, Patrick Berkery replaced Urgo as the band’s drummer.[12]

On December 4, 2013 the band announced the upcoming release of its third studio album, Lost in the Dream (March 18, 2014). The band streamed the album in its entirety on NPR’s First Listen site for a week before its release.[13]

Lost in the Dream was featured as the Vinyl Me, Please record of the month in August 2014. The pressing was a limited edition pressing on mint green colored vinyl.

In June 2015, The War on Drugs signed with Atlantic Records for a two-album deal.[14]

On Record Store Day, April 22, 2017, The War on Drugs released their new single “Thinking of a Place.”[15] The single was produced by frontman Granduciel and Shawn Everett.[16] April 28, 2017, The War on Drugs announced a fall 2017 tour in North America and Europe and that a new album was imminent.[17] On June 1, 2017, a new song, “Holding On”, was released, and it was announced that the album would be titled A Deeper Understanding and was released on August 25, 2017.[18]

The 2017 tour begins in September, opening in the band’s hometown, Philadelphia, and it concludes in November in Sweden.[19]

A Deeper Understanding was nominated for the International Album of the Year award at the 2018 UK Americana Awards[20].

At the 60th Annual Grammy Awards, on January 28th, 2018, A Deeper Understanding won the Grammy for Best Rock Album [21]

Granduciel and Zanghi are both former members of founding guitarist Vile’s backing band The Violators, with Granduciel noting, “There was never, despite what lazy journalists have assumed, any sort of falling out, or resentment”[22] following Vile’s departure from The War on Drugs. In 2011, Vile stated, “When my record came out, I assumed Adam would want to focus on The War On Drugs but he came with us in The Violators when we toured the States. The Violators became a unit, and although the cast does rotate, we’ve developed an even tighter unity and sound. Adam is an incredible guitar player these days and there is a certain feeling [between us] that nobody else can tap into. We don’t really have to tell each other what to play, it just happens.”

Both Hartley and Granduciel contributed to singer-songwriter Sharon Van Etten’s fourth studio album, Are We There (2014). Hartley performs bass guitar on the entire album, with Granduciel contributing guitar on two tracks.

Granduciel is currently[when?] producing the new Sore Eros album. They have been recording it in Philadelphia and Los Angeles on and off for the past several years.[4]

In 2016, The War on Drugs contributed a cover of “Touch of Grey” for a Grateful Dead tribute album called Day of the Dead. The album was curated by The National’s Aaron and Bryce Dessner.[19]

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A Brief History of the Drug War | Drug Policy Alliance

This video from hip hop legend Jay Z and acclaimed artist Molly Crabapple depicts the drug wars devastating impact on the Black community from decades of biased law enforcement.

The video traces the drug war from President Nixon to the draconian Rockefeller Drug Laws to the emerging aboveground marijuana market that is poised to make legal millions for wealthy investors doing the same thing that generations of people of color have been arrested and locked up for. After you watch the video, read on to learn more about the discriminatory history of the war on drugs.

Many currently illegal drugs, such as marijuana, opium, coca, and psychedelics have been used for thousands of years for both medical and spiritual purposes. So why are some drugs legal and other drugs illegal today? It’s not based on any scientific assessment of the relative risks of these drugs but it has everything to do with who is associated with these drugs.

The first anti-opium laws in the 1870s were directed at Chinese immigrants. The first anti-cocaine laws in the early 1900s were directed at black men in the South. The first anti-marijuana laws, in the Midwest and the Southwest in the 1910s and 20s, were directed at Mexican migrants and Mexican Americans. Today, Latino and especially black communities are still subject to wildly disproportionate drug enforcement and sentencing practices.

In the 1960s, as drugs became symbols of youthful rebellion, social upheaval, and political dissent, the government halted scientific research to evaluate their medical safety and efficacy.

In June 1971, President Nixon declared a war on drugs. He dramatically increased the size and presence of federal drug control agencies, and pushed through measures such as mandatory sentencing and no-knock warrants.

A top Nixon aide, John Ehrlichman, later admitted: You want to know what this was really all about. The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what Im saying. We knew we couldnt make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.Nixon temporarily placed marijuana in Schedule One, the most restrictive category of drugs, pending review by a commission he appointed led by Republican Pennsylvania Governor Raymond Shafer.

In 1972, the commission unanimously recommended decriminalizing the possession and distribution of marijuana for personal use. Nixon ignored the report and rejected its recommendations.

Between 1973 and 1977, however, eleven states decriminalized marijuana possession. In January 1977, President Jimmy Carter was inaugurated on a campaign platform that included marijuana decriminalization. In October 1977, the Senate Judiciary Committee voted to decriminalize possession of up to an ounce of marijuana for personal use.

Within just a few years, though, the tide had shifted. Proposals to decriminalize marijuana were abandoned as parents became increasingly concerned about high rates of teen marijuana use. Marijuana was ultimately caught up in a broader cultural backlash against the perceived permissiveness of the 1970s.

The presidency of Ronald Reagan marked the start of a long period of skyrocketing rates of incarceration, largely thanks to his unprecedented expansion of the drug war. The number of people behind bars for nonviolent drug law offenses increased from 50,000 in 1980 to over 400,000 by 1997.

Public concern about illicit drug use built throughout the 1980s, largely due to media portrayals of people addicted to the smokeable form of cocaine dubbed crack. Soon after Ronald Reagan took office in 1981, his wife, Nancy Reagan, began a highly-publicized anti-drug campaign, coining the slogan “Just Say No.”

This set the stage for the zero tolerance policies implemented in the mid-to-late 1980s. Los Angeles Police Chief Daryl Gates, who believed that casual drug users should be taken out and shot, founded the DARE drug education program, which was quickly adopted nationwide despite the lack of evidence of its effectiveness. The increasingly harsh drug policies also blocked the expansion of syringe access programs and other harm reduction policies to reduce the rapid spread of HIV/AIDS.

In the late 1980s, a political hysteria about drugs led to the passage of draconian penalties in Congress and state legislatures that rapidly increased the prison population. In 1985, the proportion of Americans polled who saw drug abuse as the nation’s “number one problem” was just 2-6 percent. The figure grew through the remainder of the 1980s until, in September 1989, it reached a remarkable 64 percent one of the most intense fixations by the American public on any issue in polling history. Within less than a year, however, the figure plummeted to less than 10 percent, as the media lost interest. The draconian policies enacted during the hysteria remained, however, and continued to result in escalating levels of arrests and incarceration.

Although Bill Clinton advocated for treatment instead of incarceration during his 1992 presidential campaign, after his first few months in the White House he reverted to the drug war strategies of his Republican predecessors by continuing to escalate the drug war. Notoriously, Clinton rejected a U.S. Sentencing Commission recommendation to eliminate the disparity between crack and powder cocaine sentences.

He also rejected, with the encouragement of drug czar General Barry McCaffrey, Health Secretary Donna Shalalas advice to end the federal ban on funding for syringe access programs. Yet, a month before leaving office, Clinton asserted in a Rolling Stone interview that “we really need a re-examination of our entire policy on imprisonment” of people who use drugs, and said that marijuana use “should be decriminalized.”

At the height of the drug war hysteria in the late 1980s and early 1990s, a movement emerged seeking a new approach to drug policy. In 1987, Arnold Trebach and Kevin Zeese founded the Drug Policy Foundation describing it as the loyal opposition to the war on drugs. Prominent conservatives such as William Buckley and Milton Friedman had long advocated for ending drug prohibition, as had civil libertarians such as longtime ACLU Executive Director Ira Glasser. In the late 1980s they were joined by Baltimore Mayor Kurt Schmoke, Federal Judge Robert Sweet, Princeton professor Ethan Nadelmann, and other activists, scholars and policymakers.

In 1994, Nadelmann founded The Lindesmith Center as the first U.S. project of George Soros Open Society Institute. In 2000, the growing Center merged with the Drug Policy Foundation to create the Drug Policy Alliance.

George W. Bush arrived in the White House as the drug war was running out of steam yet he allocated more money than ever to it. His drug czar, John Walters, zealously focused on marijuana and launched a major campaign to promote student drug testing. While rates of illicit drug use remained constant, overdose fatalities rose rapidly.

The era of George W. Bush also witnessed the rapid escalation of the militarization of domestic drug law enforcement. By the end of Bush’s term, there were about 40,000 paramilitary-style SWAT raids on Americans every year mostly for nonviolent drug law offenses, often misdemeanors. While federal reform mostly stalled under Bush, state-level reforms finally began to slow the growth of the drug war.

Politicians now routinely admit to having used marijuana, and even cocaine, when they were younger. When Michael Bloomberg was questioned during his 2001 mayoral campaign about whether he had ever used marijuana, he said, “You bet I did and I enjoyed it.” Barack Obama also candidly discussed his prior cocaine and marijuana use: “When I was a kid, I inhaled frequently that was the point.”

Public opinion has shifted dramatically in favor of sensible reforms that expand health-based approaches while reducing the role of criminalization in drug policy.

Marijuana reform has gained unprecedented momentum throughout the Americas. Alaska, California, Colorado, Nevada, Oregon, Maine, Massachusetts, Washington State, and Washington D.C. have legalized marijuana for adults. In December 2013, Uruguay became the first country in the world to legally regulate marijuana. In Canada, Prime Minister Justin Trudeau plans legalize marijuana for adults by 2018.

In response to a worsening overdose epidemic, dozens of U.S. states passed laws to increase access to the overdose antidote, naloxone, as well as 911 Good Samaritan laws to encourage people to seek medical help in the event of an overdose.

Yet the assault on American citizens and others continues, with 700,000 people still arrested for marijuana offenses each year and almost 500,000 people still behind bars for nothing more than a drug law violation.

President Obama, despite supporting several successful policy changes such as reducing the crack/powder sentencing disparity, ending the ban on federal funding for syringe access programs, and ending federal interference with state medical marijuana laws did not shift the majority of drug policy funding to a health-based approach.

Now, the new administration is threatening to take us backward toward a 1980s style drug war. President Trump is calling for a wall to keep drugs out of the country, and Attorney General Jeff Sessions has made it clear that he does not support the sovereignty of states to legalize marijuana, and believes good people dont smoke marijuana.

Progress is inevitably slow, and even with an administration hostile to reform there is still unprecedented momentum behind drug policy reform in states and localities across the country. The Drug Policy Alliance and its allies will continue to advocate for health-based reforms such as marijuana legalization, drug decriminalization, safe consumption sites, naloxone access, bail reform, and more.

We look forward to a future where drug policies are shaped by science and compassion rather than political hysteria.

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Information about Genetic Testing | School of Medicine …

Even with the success of the Human Genome Project, there still isn’t a genetic test for every disease. A disease may run in a family and clearly be inherited, but the gene responsible may not be identified yet. Our team will see if there is a genetic test available for the condition running in your family.

If a test exists, we will find the best laboratory to use. Some laboratories offer clinical testing and must follow federal quality control standards. Clinical laboratories typically quote a fixed price and a standard return time for results.

Other laboratories offer research testing and are usually linked to academic centers and universities. They do testing at no cost in most cases. Often research laboratories do not provide results. If they do, it may take months or years to deliver results. Research test results should be confirmed in a clinical laboratory if medical management is based on the result.

Testing costs and turnaround times vary. Genetic test results are usually ready in three to four weeks. Though genetic testing costs are often paid for by insurance carriers, patients may be required to pay some or all of the cost when the test is ordered. When indicated we can write a letter of medical necessity explaining the benefits genetic testing might have for you. This can often increase the likelihood that your insurance company will pay for the testing.

Not everyone who has a genetic disease will have a mutation or a biochemical abnormality that shows up in testing. Because of this limitation, in a family it makes sense to first test someone who has had the disease in question.

If a genetic risk factor is found, ways of managing or preventing the disease due to that genetic risk can be discussed. Additionally, at-risk relatives can check their own status by testing for that specific risk factor. If that specific genetic risk factor is not found in an at-risk relative (i.e., they have a normal test result), he or she can be reassured. If the at-risk relative has a positive genetic test result, he or she has a greater chance of getting the condition. Relatives whose risk has been confirmed can start screening and prevention practices targeted for their genetic risk.

Sometimes testing a family member who has the disease isn’t possible. (The person may be dead, unavailable or unwilling to be tested.) Then, an unaffected person can take the test. Finding a genetic risk factor will certainly give useful information. But a normal test result doesn’t always mean there’s no risk. Many genes responsible for an inherited susceptibility are not yet known. In other words, a normal test result can exclude the genetic risk factors that have been tested but not the possibility of an inherited susceptibility. It may be valuable to test other family members.

If you were to have genetic testing it would be important to interpret your test results in light of your personal and family medical history. We will also identify family members who might benefit from genetic consultation and genetic testing. If necessary, we can provide referrals for relatives outside the Denver area.

If you test positive for a genetic condition, you can better understand how this condition arose in you and your relatives. If you do not yet have symptoms, you can start to plan for the future, such as planning for a family, career, and retirement. You might want to start seeing specialists to help manage the condition. Preventive actions may be useful as well. Drugs, diet and lifestyle changes may help prevent the disease improve treatment.

Close relatives might value having this information. They can go through testing themselves to determine their disease risks and the best treatment approach.

If you test negative for a genetic risk factor that is known to run in your family you may be relieved that a major risk factor has been excluded.

Diagnosing a genetic condition does not tell us how or when the disease will develop. Although DNA-based genetic testing is very accurate, there is a chance that an inherited mutation will be missed. If a mutation is not found, the test results cannot exclude the possibility of an inherited risk since there may be a mutation in another gene for which testing was not done. If you still have symptoms of a genetic condition, a normal test result might not get you ‘off the hook’. An inherited disease risk can only be excluded if a known mutation in the family has been excluded.

Family relationships may be affected by this information. If you have a genetic condition, other family members might benefit by also knowing. In the process of sharing your genetic risk information, family members may learn things about you that you do not want known. In addition, you may learn things about relatives that you did not want to know. For example, it may be revealed that a family member is adopted.

Some people find it hard to learn that they carry a gene that makes their risk of developing a disease greater. They may feel many emotions, including anger, fear about the future, anxiety about their health or guilt about passing a mutation on to their children. They may be shocked by the news. They may go through denial or a change in their self-esteem.

Knowing that you have a higher risk of getting a particular disease (when you don’t currently show symptoms) may affect your ability to be insured (health, life and disability). Several state and federal laws prohibit use of genetic information by health insurance companies. In general, health insurers cannot use this information as a pre-existing condition that could disqualify you when applying for new insurance. Genetic information cannot be used to raise premium payments or to deny coverage. However, these laws are not fully comprehensive and may not entirely prevent discrimination. You may want to contact your insurance company to see what effect, if any, genetic testing may have on your coverage.

Sometimes genetic test results are uninformative or ambiguous, making it difficult or impossible to say if a person has a higher risk. These ambiguous results can be the most difficult as they don’t provide a clear-cut answer.

For people with normal test results, where the genetic risk in the family has been excluded, a variety of emotions might occur. Most people feel tremendous relief. Others may feel survivor guilt, wondering why they were spared the risk. This can sometimes lead to changes in relationships between family members.

In some cases, an inherited risk for disease seems likely but the gene responsible has not yet been identified. The Adult Medical Genetics Program can help link families with researchers studying that disease. We can contact researchers for you and help you become part of the gene discovery studies. Although being part of research studies doesn’t always give you answers, it does allow you to contribute to science.

More:

Information about Genetic Testing | School of Medicine …

Genetic predisposition – Wikipedia

A genetic predisposition is a genetic characteristic which influences the possible phenotypic development of an individual organism within a species or population under the influence of environmental conditions. In medicine, genetic susceptibility to a disease refers to a genetic predisposition to a health problem,[1] which may eventually be triggered by particular environmental or lifestyle factors, such as tobacco smoking or diet. Genetic testing is able to identify individuals who are genetically predisposed to certain diseases.

Predisposition is the capacity we are born with to learn things such as language and concept of self. Negative environmental influences may block the predisposition (ability) we have to do some things. Behaviors displayed by animals can be influenced by genetic predispositions. Genetic predisposition towards certain human behaviors is scientifically investigated by attempts to identify patterns of human behavior that seem to be invariant over long periods of time and in very different cultures.

For example, philosopher Daniel Dennett has proposed that humans are genetically predisposed to have a theory of mind because there has been evolutionary selection for the human ability to adopt the intentional stance.[1] The intentional stance is a useful behavioral strategy by which humans assume that others have minds like their own. This assumption allows you to predict the behavior of others based on personal knowledge of what you would do.

In 1951, Hans Eysenck and Donald Prell published an experiment in which identical (monozygotic) and fraternal (dizygotic) twins, ages 11 and 12, were tested for neuroticism. It is described in detail in an article published in the Journal of Mental Science. in which Eysenck and Prell concluded that, “The factor of neuroticism is not a statistical artifact, but constitutes a biological unit which is inherited as a whole….neurotic Genetic predisposition is to a large extent hereditarily determined.”[2]

E. O. Wilson’s book on sociobiology and his book Consilience discuss the idea of genetic predisposition to behaviors

The field of evolutionary psychology explores the idea that certain behaviors have been selected for during the course of evolution.

The Genetic Information Nondiscrimination Act, which was signed into law by President Bush on May 21, 2008,[3] prohibits discrimination in employment and health insurance based on genetic information.

Read the original post:

Genetic predisposition – Wikipedia

Information about Genetic Testing | School of Medicine …

Even with the success of the Human Genome Project, there still isn’t a genetic test for every disease. A disease may run in a family and clearly be inherited, but the gene responsible may not be identified yet. Our team will see if there is a genetic test available for the condition running in your family.

If a test exists, we will find the best laboratory to use. Some laboratories offer clinical testing and must follow federal quality control standards. Clinical laboratories typically quote a fixed price and a standard return time for results.

Other laboratories offer research testing and are usually linked to academic centers and universities. They do testing at no cost in most cases. Often research laboratories do not provide results. If they do, it may take months or years to deliver results. Research test results should be confirmed in a clinical laboratory if medical management is based on the result.

Testing costs and turnaround times vary. Genetic test results are usually ready in three to four weeks. Though genetic testing costs are often paid for by insurance carriers, patients may be required to pay some or all of the cost when the test is ordered. When indicated we can write a letter of medical necessity explaining the benefits genetic testing might have for you. This can often increase the likelihood that your insurance company will pay for the testing.

Not everyone who has a genetic disease will have a mutation or a biochemical abnormality that shows up in testing. Because of this limitation, in a family it makes sense to first test someone who has had the disease in question.

If a genetic risk factor is found, ways of managing or preventing the disease due to that genetic risk can be discussed. Additionally, at-risk relatives can check their own status by testing for that specific risk factor. If that specific genetic risk factor is not found in an at-risk relative (i.e., they have a normal test result), he or she can be reassured. If the at-risk relative has a positive genetic test result, he or she has a greater chance of getting the condition. Relatives whose risk has been confirmed can start screening and prevention practices targeted for their genetic risk.

Sometimes testing a family member who has the disease isn’t possible. (The person may be dead, unavailable or unwilling to be tested.) Then, an unaffected person can take the test. Finding a genetic risk factor will certainly give useful information. But a normal test result doesn’t always mean there’s no risk. Many genes responsible for an inherited susceptibility are not yet known. In other words, a normal test result can exclude the genetic risk factors that have been tested but not the possibility of an inherited susceptibility. It may be valuable to test other family members.

If you were to have genetic testing it would be important to interpret your test results in light of your personal and family medical history. We will also identify family members who might benefit from genetic consultation and genetic testing. If necessary, we can provide referrals for relatives outside the Denver area.

If you test positive for a genetic condition, you can better understand how this condition arose in you and your relatives. If you do not yet have symptoms, you can start to plan for the future, such as planning for a family, career, and retirement. You might want to start seeing specialists to help manage the condition. Preventive actions may be useful as well. Drugs, diet and lifestyle changes may help prevent the disease improve treatment.

Close relatives might value having this information. They can go through testing themselves to determine their disease risks and the best treatment approach.

If you test negative for a genetic risk factor that is known to run in your family you may be relieved that a major risk factor has been excluded.

Diagnosing a genetic condition does not tell us how or when the disease will develop. Although DNA-based genetic testing is very accurate, there is a chance that an inherited mutation will be missed. If a mutation is not found, the test results cannot exclude the possibility of an inherited risk since there may be a mutation in another gene for which testing was not done. If you still have symptoms of a genetic condition, a normal test result might not get you ‘off the hook’. An inherited disease risk can only be excluded if a known mutation in the family has been excluded.

Family relationships may be affected by this information. If you have a genetic condition, other family members might benefit by also knowing. In the process of sharing your genetic risk information, family members may learn things about you that you do not want known. In addition, you may learn things about relatives that you did not want to know. For example, it may be revealed that a family member is adopted.

Some people find it hard to learn that they carry a gene that makes their risk of developing a disease greater. They may feel many emotions, including anger, fear about the future, anxiety about their health or guilt about passing a mutation on to their children. They may be shocked by the news. They may go through denial or a change in their self-esteem.

Knowing that you have a higher risk of getting a particular disease (when you don’t currently show symptoms) may affect your ability to be insured (health, life and disability). Several state and federal laws prohibit use of genetic information by health insurance companies. In general, health insurers cannot use this information as a pre-existing condition that could disqualify you when applying for new insurance. Genetic information cannot be used to raise premium payments or to deny coverage. However, these laws are not fully comprehensive and may not entirely prevent discrimination. You may want to contact your insurance company to see what effect, if any, genetic testing may have on your coverage.

Sometimes genetic test results are uninformative or ambiguous, making it difficult or impossible to say if a person has a higher risk. These ambiguous results can be the most difficult as they don’t provide a clear-cut answer.

For people with normal test results, where the genetic risk in the family has been excluded, a variety of emotions might occur. Most people feel tremendous relief. Others may feel survivor guilt, wondering why they were spared the risk. This can sometimes lead to changes in relationships between family members.

In some cases, an inherited risk for disease seems likely but the gene responsible has not yet been identified. The Adult Medical Genetics Program can help link families with researchers studying that disease. We can contact researchers for you and help you become part of the gene discovery studies. Although being part of research studies doesn’t always give you answers, it does allow you to contribute to science.

Originally posted here:

Information about Genetic Testing | School of Medicine …

About the Fred A. Litwin Family Centre in Genetic Medicine

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About the Fred A. Litwin Family Centre in Genetic Medicine

Medical genetics – Wikipedia

Medical genetics is the branch of medicine that involves the diagnosis and management of hereditary disorders. Medical genetics differs from human genetics in that human genetics is a field of scientific research that may or may not apply to medicine, while medical genetics refers to the application of genetics to medical care. For example, research on the causes and inheritance of genetic disorders would be considered within both human genetics and medical genetics, while the diagnosis, management, and counselling people with genetic disorders would be considered part of medical genetics.

In contrast, the study of typically non-medical phenotypes such as the genetics of eye color would be considered part of human genetics, but not necessarily relevant to medical genetics (except in situations such as albinism). Genetic medicine is a newer term for medical genetics and incorporates areas such as gene therapy, personalized medicine, and the rapidly emerging new medical specialty, predictive medicine.

Medical genetics encompasses many different areas, including clinical practice of physicians, genetic counselors, and nutritionists, clinical diagnostic laboratory activities, and research into the causes and inheritance of genetic disorders. Examples of conditions that fall within the scope of medical genetics include birth defects and dysmorphology, mental retardation, autism, mitochondrial disorders, skeletal dysplasia, connective tissue disorders, cancer genetics, teratogens, and prenatal diagnosis. Medical genetics is increasingly becoming relevant to many common diseases. Overlaps with other medical specialties are beginning to emerge, as recent advances in genetics are revealing etiologies for neurologic, endocrine, cardiovascular, pulmonary, ophthalmologic, renal, psychiatric, and dermatologic conditions.

In some ways, many of the individual fields within medical genetics are hybrids between clinical care and research. This is due in part to recent advances in science and technology (for example, see the Human genome project) that have enabled an unprecedented understanding of genetic disorders.

Clinical genetics is the practice of clinical medicine with particular attention to hereditary disorders. Referrals are made to genetics clinics for a variety of reasons, including birth defects, developmental delay, autism, epilepsy, short stature, and many others. Examples of genetic syndromes that are commonly seen in the genetics clinic include chromosomal rearrangements, Down syndrome, DiGeorge syndrome (22q11.2 Deletion Syndrome), Fragile X syndrome, Marfan syndrome, Neurofibromatosis, Turner syndrome, and Williams syndrome.

In the United States, physicians who practice clinical genetics are accredited by the American Board of Medical Genetics and Genomics (ABMGG).[1] In order to become a board-certified practitioner of Clinical Genetics, a physician must complete a minimum of 24 months of training in a program accredited by the ABMGG. Individuals seeking acceptance into clinical genetics training programs must hold an M.D. or D.O. degree (or their equivalent) and have completed a minimum of 24 months of training in an ACGME-accredited residency program in internal medicine, pediatrics, obstetrics and gynecology, or other medical specialty.[2]

Metabolic (or biochemical) genetics involves the diagnosis and management of inborn errors of metabolism in which patients have enzymatic deficiencies that perturb biochemical pathways involved in metabolism of carbohydrates, amino acids, and lipids. Examples of metabolic disorders include galactosemia, glycogen storage disease, lysosomal storage disorders, metabolic acidosis, peroxisomal disorders, phenylketonuria, and urea cycle disorders.

Cytogenetics is the study of chromosomes and chromosome abnormalities. While cytogenetics historically relied on microscopy to analyze chromosomes, new molecular technologies such as array comparative genomic hybridization are now becoming widely used. Examples of chromosome abnormalities include aneuploidy, chromosomal rearrangements, and genomic deletion/duplication disorders.

Molecular genetics involves the discovery of and laboratory testing for DNA mutations that underlie many single gene disorders. Examples of single gene disorders include achondroplasia, cystic fibrosis, Duchenne muscular dystrophy, hereditary breast cancer (BRCA1/2), Huntington disease, Marfan syndrome, Noonan syndrome, and Rett syndrome. Molecular tests are also used in the diagnosis of syndromes involving epigenetic abnormalities, such as Angelman syndrome, Beckwith-Wiedemann syndrome, Prader-willi syndrome, and uniparental disomy.

Mitochondrial genetics concerns the diagnosis and management of mitochondrial disorders, which have a molecular basis but often result in biochemical abnormalities due to deficient energy production.

There exists some overlap between medical genetic diagnostic laboratories and molecular pathology.

Genetic counseling is the process of providing information about genetic conditions, diagnostic testing, and risks in other family members, within the framework of nondirective counseling. Genetic counselors are non-physician members of the medical genetics team who specialize in family risk assessment and counseling of patients regarding genetic disorders. The precise role of the genetic counselor varies somewhat depending on the disorder.

Although genetics has its roots back in the 19th century with the work of the Bohemian monk Gregor Mendel and other pioneering scientists, human genetics emerged later. It started to develop, albeit slowly, during the first half of the 20th century. Mendelian (single-gene) inheritance was studied in a number of important disorders such as albinism, brachydactyly (short fingers and toes), and hemophilia. Mathematical approaches were also devised and applied to human genetics. Population genetics was created.

Medical genetics was a late developer, emerging largely after the close of World War II (1945) when the eugenics movement had fallen into disrepute. The Nazi misuse of eugenics sounded its death knell. Shorn of eugenics, a scientific approach could be used and was applied to human and medical genetics. Medical genetics saw an increasingly rapid rise in the second half of the 20th century and continues in the 21st century.

The clinical setting in which patients are evaluated determines the scope of practice, diagnostic, and therapeutic interventions. For the purposes of general discussion, the typical encounters between patients and genetic practitioners may involve:

Each patient will undergo a diagnostic evaluation tailored to their own particular presenting signs and symptoms. The geneticist will establish a differential diagnosis and recommend appropriate testing. These tests might evaluate for chromosomal disorders, inborn errors of metabolism, or single gene disorders.

Chromosome studies are used in the general genetics clinic to determine a cause for developmental delay/mental retardation, birth defects, dysmorphic features, and/or autism. Chromosome analysis is also performed in the prenatal setting to determine whether a fetus is affected with aneuploidy or other chromosome rearrangements. Finally, chromosome abnormalities are often detected in cancer samples. A large number of different methods have been developed for chromosome analysis:

Biochemical studies are performed to screen for imbalances of metabolites in the bodily fluid, usually the blood (plasma/serum) or urine, but also in cerebrospinal fluid (CSF). Specific tests of enzyme function (either in leukocytes, skin fibroblasts, liver, or muscle) are also employed under certain circumstances. In the US, the newborn screen incorporates biochemical tests to screen for treatable conditions such as galactosemia and phenylketonuria (PKU). Patients suspected to have a metabolic condition might undergo the following tests:

Each cell of the body contains the hereditary information (DNA) wrapped up in structures called chromosomes. Since genetic syndromes are typically the result of alterations of the chromosomes or genes, there is no treatment currently available that can correct the genetic alterations in every cell of the body. Therefore, there is currently no “cure” for genetic disorders. However, for many genetic syndromes there is treatment available to manage the symptoms. In some cases, particularly inborn errors of metabolism, the mechanism of disease is well understood and offers the potential for dietary and medical management to prevent or reduce the long-term complications. In other cases, infusion therapy is used to replace the missing enzyme. Current research is actively seeking to use gene therapy or other new medications to treat specific genetic disorders.

In general, metabolic disorders arise from enzyme deficiencies that disrupt normal metabolic pathways. For instance, in the hypothetical example:

Compound “A” is metabolized to “B” by enzyme “X”, compound “B” is metabolized to “C” by enzyme “Y”, and compound “C” is metabolized to “D” by enzyme “Z”. If enzyme “Z” is missing, compound “D” will be missing, while compounds “A”, “B”, and “C” will build up. The pathogenesis of this particular condition could result from lack of compound “D”, if it is critical for some cellular function, or from toxicity due to excess “A”, “B”, and/or “C”. Treatment of the metabolic disorder could be achieved through dietary supplementation of compound “D” and dietary restriction of compounds “A”, “B”, and/or “C” or by treatment with a medication that promoted disposal of excess “A”, “B”, or “C”. Another approach that can be taken is enzyme replacement therapy, in which a patient is given an infusion of the missing enzyme.

Dietary restriction and supplementation are key measures taken in several well-known metabolic disorders, including galactosemia, phenylketonuria (PKU), maple syrup urine disease, organic acidurias and urea cycle disorders. Such restrictive diets can be difficult for the patient and family to maintain, and require close consultation with a nutritionist who has special experience in metabolic disorders. The composition of the diet will change depending on the caloric needs of the growing child and special attention is needed during a pregnancy if a woman is affected with one of these disorders.

Medical approaches include enhancement of residual enzyme activity (in cases where the enzyme is made but is not functioning properly), inhibition of other enzymes in the biochemical pathway to prevent buildup of a toxic compound, or diversion of a toxic compound to another form that can be excreted. Examples include the use of high doses of pyridoxine (vitamin B6) in some patients with homocystinuria to boost the activity of the residual cystathione synthase enzyme, administration of biotin to restore activity of several enzymes affected by deficiency of biotinidase, treatment with NTBC in Tyrosinemia to inhibit the production of succinylacetone which causes liver toxicity, and the use of sodium benzoate to decrease ammonia build-up in urea cycle disorders.

Certain lysosomal storage diseases are treated with infusions of a recombinant enzyme (produced in a laboratory), which can reduce the accumulation of the compounds in various tissues. Examples include Gaucher disease, Fabry disease, Mucopolysaccharidoses and Glycogen storage disease type II. Such treatments are limited by the ability of the enzyme to reach the affected areas (the blood brain barrier prevents enzyme from reaching the brain, for example), and can sometimes be associated with allergic reactions. The long-term clinical effectiveness of enzyme replacement therapies vary widely among different disorders.

There are a variety of career paths within the field of medical genetics, and naturally the training required for each area differs considerably. The information included in this section applies to the typical pathways in the United States and there may be differences in other countries. US practitioners in clinical, counseling, or diagnostic subspecialties generally obtain board certification through the American Board of Medical Genetics.

Genetic information provides a unique type of knowledge about an individual and his/her family, fundamentally different from a typically laboratory test that provides a “snapshot” of an individual’s health status. The unique status of genetic information and inherited disease has a number of ramifications with regard to ethical, legal, and societal concerns.

On 19 March 2015, scientists urged a worldwide ban on clinical use of methods, particularly the use of CRISPR and zinc finger, to edit the human genome in a way that can be inherited.[3][4][5][6] In April 2015 and April 2016, Chinese researchers reported results of basic research to edit the DNA of non-viable human embryos using CRISPR.[7][8][9] In February 2016, British scientists were given permission by regulators to genetically modify human embryos by using CRISPR and related techniques on condition that the embryos were destroyed within seven days.[10] In June 2016 the Dutch government was reported to be planning to follow suit with similar regulations which would specify a 14-day limit.[11]

The more empirical approach to human and medical genetics was formalized by the founding in 1948 of the American Society of Human Genetics. The Society first began annual meetings that year (1948) and its international counterpart, the International Congress of Human Genetics, has met every 5 years since its inception in 1956. The Society publishes the American Journal of Human Genetics on a monthly basis.

Medical genetics is now recognized as a distinct medical specialty in the U.S. with its own approved board (the American Board of Medical Genetics) and clinical specialty college (the American College of Medical Genetics). The College holds an annual scientific meeting, publishes a monthly journal, Genetics in Medicine, and issues position papers and clinical practice guidelines on a variety of topics relevant to human genetics.

The broad range of research in medical genetics reflects the overall scope of this field, including basic research on genetic inheritance and the human genome, mechanisms of genetic and metabolic disorders, translational research on new treatment modalities, and the impact of genetic testing

Basic research geneticists usually undertake research in universities, biotechnology firms and research institutes.

Sometimes the link between a disease and an unusual gene variant is more subtle. The genetic architecture of common diseases is an important factor in determining the extent to which patterns of genetic variation influence group differences in health outcomes.[12][13][14] According to the common disease/common variant hypothesis, common variants present in the ancestral population before the dispersal of modern humans from Africa play an important role in human diseases.[15] Genetic variants associated with Alzheimer disease, deep venous thrombosis, Crohn disease, and type 2 diabetes appear to adhere to this model.[16] However, the generality of the model has not yet been established and, in some cases, is in doubt.[13][17][18] Some diseases, such as many common cancers, appear not to be well described by the common disease/common variant model.[19]

Another possibility is that common diseases arise in part through the action of combinations of variants that are individually rare.[20][21] Most of the disease-associated alleles discovered to date have been rare, and rare variants are more likely than common variants to be differentially distributed among groups distinguished by ancestry.[19][22] However, groups could harbor different, though perhaps overlapping, sets of rare variants, which would reduce contrasts between groups in the incidence of the disease.

The number of variants contributing to a disease and the interactions among those variants also could influence the distribution of diseases among groups. The difficulty that has been encountered in finding contributory alleles for complex diseases and in replicating positive associations suggests that many complex diseases involve numerous variants rather than a moderate number of alleles, and the influence of any given variant may depend in critical ways on the genetic and environmental background.[17][23][24][25] If many alleles are required to increase susceptibility to a disease, the odds are low that the necessary combination of alleles would become concentrated in a particular group purely through drift.[26]

One area in which population categories can be important considerations in genetics research is in controlling for confounding between population substructure, environmental exposures, and health outcomes. Association studies can produce spurious results if cases and controls have differing allele frequencies for genes that are not related to the disease being studied,[27] although the magnitude of this problem in genetic association studies is subject to debate.[28][29] Various methods have been developed to detect and account for population substructure,[30][31] but these methods can be difficult to apply in practice.[32]

Population substructure also can be used to advantage in genetic association studies. For example, populations that represent recent mixtures of geographically separated ancestral groups can exhibit longer-range linkage disequilibrium between susceptibility alleles and genetic markers than is the case for other populations.[33][34][35][36] Genetic studies can use this admixture linkage disequilibrium to search for disease alleles with fewer markers than would be needed otherwise. Association studies also can take advantage of the contrasting experiences of racial or ethnic groups, including migrant groups, to search for interactions between particular alleles and environmental factors that might influence health.[37][38]

More here:

Medical genetics – Wikipedia

Information about Genetic Testing | School of Medicine …

Even with the success of the Human Genome Project, there still isn’t a genetic test for every disease. A disease may run in a family and clearly be inherited, but the gene responsible may not be identified yet. Our team will see if there is a genetic test available for the condition running in your family.

If a test exists, we will find the best laboratory to use. Some laboratories offer clinical testing and must follow federal quality control standards. Clinical laboratories typically quote a fixed price and a standard return time for results.

Other laboratories offer research testing and are usually linked to academic centers and universities. They do testing at no cost in most cases. Often research laboratories do not provide results. If they do, it may take months or years to deliver results. Research test results should be confirmed in a clinical laboratory if medical management is based on the result.

Testing costs and turnaround times vary. Genetic test results are usually ready in three to four weeks. Though genetic testing costs are often paid for by insurance carriers, patients may be required to pay some or all of the cost when the test is ordered. When indicated we can write a letter of medical necessity explaining the benefits genetic testing might have for you. This can often increase the likelihood that your insurance company will pay for the testing.

Not everyone who has a genetic disease will have a mutation or a biochemical abnormality that shows up in testing. Because of this limitation, in a family it makes sense to first test someone who has had the disease in question.

If a genetic risk factor is found, ways of managing or preventing the disease due to that genetic risk can be discussed. Additionally, at-risk relatives can check their own status by testing for that specific risk factor. If that specific genetic risk factor is not found in an at-risk relative (i.e., they have a normal test result), he or she can be reassured. If the at-risk relative has a positive genetic test result, he or she has a greater chance of getting the condition. Relatives whose risk has been confirmed can start screening and prevention practices targeted for their genetic risk.

Sometimes testing a family member who has the disease isn’t possible. (The person may be dead, unavailable or unwilling to be tested.) Then, an unaffected person can take the test. Finding a genetic risk factor will certainly give useful information. But a normal test result doesn’t always mean there’s no risk. Many genes responsible for an inherited susceptibility are not yet known. In other words, a normal test result can exclude the genetic risk factors that have been tested but not the possibility of an inherited susceptibility. It may be valuable to test other family members.

If you were to have genetic testing it would be important to interpret your test results in light of your personal and family medical history. We will also identify family members who might benefit from genetic consultation and genetic testing. If necessary, we can provide referrals for relatives outside the Denver area.

If you test positive for a genetic condition, you can better understand how this condition arose in you and your relatives. If you do not yet have symptoms, you can start to plan for the future, such as planning for a family, career, and retirement. You might want to start seeing specialists to help manage the condition. Preventive actions may be useful as well. Drugs, diet and lifestyle changes may help prevent the disease improve treatment.

Close relatives might value having this information. They can go through testing themselves to determine their disease risks and the best treatment approach.

If you test negative for a genetic risk factor that is known to run in your family you may be relieved that a major risk factor has been excluded.

Diagnosing a genetic condition does not tell us how or when the disease will develop. Although DNA-based genetic testing is very accurate, there is a chance that an inherited mutation will be missed. If a mutation is not found, the test results cannot exclude the possibility of an inherited risk since there may be a mutation in another gene for which testing was not done. If you still have symptoms of a genetic condition, a normal test result might not get you ‘off the hook’. An inherited disease risk can only be excluded if a known mutation in the family has been excluded.

Family relationships may be affected by this information. If you have a genetic condition, other family members might benefit by also knowing. In the process of sharing your genetic risk information, family members may learn things about you that you do not want known. In addition, you may learn things about relatives that you did not want to know. For example, it may be revealed that a family member is adopted.

Some people find it hard to learn that they carry a gene that makes their risk of developing a disease greater. They may feel many emotions, including anger, fear about the future, anxiety about their health or guilt about passing a mutation on to their children. They may be shocked by the news. They may go through denial or a change in their self-esteem.

Knowing that you have a higher risk of getting a particular disease (when you don’t currently show symptoms) may affect your ability to be insured (health, life and disability). Several state and federal laws prohibit use of genetic information by health insurance companies. In general, health insurers cannot use this information as a pre-existing condition that could disqualify you when applying for new insurance. Genetic information cannot be used to raise premium payments or to deny coverage. However, these laws are not fully comprehensive and may not entirely prevent discrimination. You may want to contact your insurance company to see what effect, if any, genetic testing may have on your coverage.

Sometimes genetic test results are uninformative or ambiguous, making it difficult or impossible to say if a person has a higher risk. These ambiguous results can be the most difficult as they don’t provide a clear-cut answer.

For people with normal test results, where the genetic risk in the family has been excluded, a variety of emotions might occur. Most people feel tremendous relief. Others may feel survivor guilt, wondering why they were spared the risk. This can sometimes lead to changes in relationships between family members.

In some cases, an inherited risk for disease seems likely but the gene responsible has not yet been identified. The Adult Medical Genetics Program can help link families with researchers studying that disease. We can contact researchers for you and help you become part of the gene discovery studies. Although being part of research studies doesn’t always give you answers, it does allow you to contribute to science.

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Information about Genetic Testing | School of Medicine …

Genetic predisposition – Wikipedia

A genetic predisposition is a genetic characteristic which influences the possible phenotypic development of an individual organism within a species or population under the influence of environmental conditions. In medicine, genetic susceptibility to a disease refers to a genetic predisposition to a health problem,[1] which may eventually be triggered by particular environmental or lifestyle factors, such as tobacco smoking or diet. Genetic testing is able to identify individuals who are genetically predisposed to certain diseases.

Predisposition is the capacity we are born with to learn things such as language and concept of self. Negative environmental influences may block the predisposition (ability) we have to do some things. Behaviors displayed by animals can be influenced by genetic predispositions. Genetic predisposition towards certain human behaviors is scientifically investigated by attempts to identify patterns of human behavior that seem to be invariant over long periods of time and in very different cultures.

For example, philosopher Daniel Dennett has proposed that humans are genetically predisposed to have a theory of mind because there has been evolutionary selection for the human ability to adopt the intentional stance.[1] The intentional stance is a useful behavioral strategy by which humans assume that others have minds like their own. This assumption allows you to predict the behavior of others based on personal knowledge of what you would do.

In 1951, Hans Eysenck and Donald Prell published an experiment in which identical (monozygotic) and fraternal (dizygotic) twins, ages 11 and 12, were tested for neuroticism. It is described in detail in an article published in the Journal of Mental Science. in which Eysenck and Prell concluded that, “The factor of neuroticism is not a statistical artifact, but constitutes a biological unit which is inherited as a whole….neurotic Genetic predisposition is to a large extent hereditarily determined.”[2]

E. O. Wilson’s book on sociobiology and his book Consilience discuss the idea of genetic predisposition to behaviors

The field of evolutionary psychology explores the idea that certain behaviors have been selected for during the course of evolution.

The Genetic Information Nondiscrimination Act, which was signed into law by President Bush on May 21, 2008,[3] prohibits discrimination in employment and health insurance based on genetic information.

Original post:

Genetic predisposition – Wikipedia

About the Fred A. Litwin Family Centre in Genetic Medicine

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About the Fred A. Litwin Family Centre in Genetic Medicine

Information about Genetic Testing | School of Medicine …

Even with the success of the Human Genome Project, there still isn’t a genetic test for every disease. A disease may run in a family and clearly be inherited, but the gene responsible may not be identified yet. Our team will see if there is a genetic test available for the condition running in your family.

If a test exists, we will find the best laboratory to use. Some laboratories offer clinical testing and must follow federal quality control standards. Clinical laboratories typically quote a fixed price and a standard return time for results.

Other laboratories offer research testing and are usually linked to academic centers and universities. They do testing at no cost in most cases. Often research laboratories do not provide results. If they do, it may take months or years to deliver results. Research test results should be confirmed in a clinical laboratory if medical management is based on the result.

Testing costs and turnaround times vary. Genetic test results are usually ready in three to four weeks. Though genetic testing costs are often paid for by insurance carriers, patients may be required to pay some or all of the cost when the test is ordered. When indicated we can write a letter of medical necessity explaining the benefits genetic testing might have for you. This can often increase the likelihood that your insurance company will pay for the testing.

Not everyone who has a genetic disease will have a mutation or a biochemical abnormality that shows up in testing. Because of this limitation, in a family it makes sense to first test someone who has had the disease in question.

If a genetic risk factor is found, ways of managing or preventing the disease due to that genetic risk can be discussed. Additionally, at-risk relatives can check their own status by testing for that specific risk factor. If that specific genetic risk factor is not found in an at-risk relative (i.e., they have a normal test result), he or she can be reassured. If the at-risk relative has a positive genetic test result, he or she has a greater chance of getting the condition. Relatives whose risk has been confirmed can start screening and prevention practices targeted for their genetic risk.

Sometimes testing a family member who has the disease isn’t possible. (The person may be dead, unavailable or unwilling to be tested.) Then, an unaffected person can take the test. Finding a genetic risk factor will certainly give useful information. But a normal test result doesn’t always mean there’s no risk. Many genes responsible for an inherited susceptibility are not yet known. In other words, a normal test result can exclude the genetic risk factors that have been tested but not the possibility of an inherited susceptibility. It may be valuable to test other family members.

If you were to have genetic testing it would be important to interpret your test results in light of your personal and family medical history. We will also identify family members who might benefit from genetic consultation and genetic testing. If necessary, we can provide referrals for relatives outside the Denver area.

If you test positive for a genetic condition, you can better understand how this condition arose in you and your relatives. If you do not yet have symptoms, you can start to plan for the future, such as planning for a family, career, and retirement. You might want to start seeing specialists to help manage the condition. Preventive actions may be useful as well. Drugs, diet and lifestyle changes may help prevent the disease improve treatment.

Close relatives might value having this information. They can go through testing themselves to determine their disease risks and the best treatment approach.

If you test negative for a genetic risk factor that is known to run in your family you may be relieved that a major risk factor has been excluded.

Diagnosing a genetic condition does not tell us how or when the disease will develop. Although DNA-based genetic testing is very accurate, there is a chance that an inherited mutation will be missed. If a mutation is not found, the test results cannot exclude the possibility of an inherited risk since there may be a mutation in another gene for which testing was not done. If you still have symptoms of a genetic condition, a normal test result might not get you ‘off the hook’. An inherited disease risk can only be excluded if a known mutation in the family has been excluded.

Family relationships may be affected by this information. If you have a genetic condition, other family members might benefit by also knowing. In the process of sharing your genetic risk information, family members may learn things about you that you do not want known. In addition, you may learn things about relatives that you did not want to know. For example, it may be revealed that a family member is adopted.

Some people find it hard to learn that they carry a gene that makes their risk of developing a disease greater. They may feel many emotions, including anger, fear about the future, anxiety about their health or guilt about passing a mutation on to their children. They may be shocked by the news. They may go through denial or a change in their self-esteem.

Knowing that you have a higher risk of getting a particular disease (when you don’t currently show symptoms) may affect your ability to be insured (health, life and disability). Several state and federal laws prohibit use of genetic information by health insurance companies. In general, health insurers cannot use this information as a pre-existing condition that could disqualify you when applying for new insurance. Genetic information cannot be used to raise premium payments or to deny coverage. However, these laws are not fully comprehensive and may not entirely prevent discrimination. You may want to contact your insurance company to see what effect, if any, genetic testing may have on your coverage.

Sometimes genetic test results are uninformative or ambiguous, making it difficult or impossible to say if a person has a higher risk. These ambiguous results can be the most difficult as they don’t provide a clear-cut answer.

For people with normal test results, where the genetic risk in the family has been excluded, a variety of emotions might occur. Most people feel tremendous relief. Others may feel survivor guilt, wondering why they were spared the risk. This can sometimes lead to changes in relationships between family members.

In some cases, an inherited risk for disease seems likely but the gene responsible has not yet been identified. The Adult Medical Genetics Program can help link families with researchers studying that disease. We can contact researchers for you and help you become part of the gene discovery studies. Although being part of research studies doesn’t always give you answers, it does allow you to contribute to science.

See more here:

Information about Genetic Testing | School of Medicine …

Medical genetics – Wikipedia

Medical genetics is the branch of medicine that involves the diagnosis and management of hereditary disorders. Medical genetics differs from human genetics in that human genetics is a field of scientific research that may or may not apply to medicine, while medical genetics refers to the application of genetics to medical care. For example, research on the causes and inheritance of genetic disorders would be considered within both human genetics and medical genetics, while the diagnosis, management, and counselling people with genetic disorders would be considered part of medical genetics.

In contrast, the study of typically non-medical phenotypes such as the genetics of eye color would be considered part of human genetics, but not necessarily relevant to medical genetics (except in situations such as albinism). Genetic medicine is a newer term for medical genetics and incorporates areas such as gene therapy, personalized medicine, and the rapidly emerging new medical specialty, predictive medicine.

Medical genetics encompasses many different areas, including clinical practice of physicians, genetic counselors, and nutritionists, clinical diagnostic laboratory activities, and research into the causes and inheritance of genetic disorders. Examples of conditions that fall within the scope of medical genetics include birth defects and dysmorphology, mental retardation, autism, mitochondrial disorders, skeletal dysplasia, connective tissue disorders, cancer genetics, teratogens, and prenatal diagnosis. Medical genetics is increasingly becoming relevant to many common diseases. Overlaps with other medical specialties are beginning to emerge, as recent advances in genetics are revealing etiologies for neurologic, endocrine, cardiovascular, pulmonary, ophthalmologic, renal, psychiatric, and dermatologic conditions.

In some ways, many of the individual fields within medical genetics are hybrids between clinical care and research. This is due in part to recent advances in science and technology (for example, see the Human genome project) that have enabled an unprecedented understanding of genetic disorders.

Clinical genetics is the practice of clinical medicine with particular attention to hereditary disorders. Referrals are made to genetics clinics for a variety of reasons, including birth defects, developmental delay, autism, epilepsy, short stature, and many others. Examples of genetic syndromes that are commonly seen in the genetics clinic include chromosomal rearrangements, Down syndrome, DiGeorge syndrome (22q11.2 Deletion Syndrome), Fragile X syndrome, Marfan syndrome, Neurofibromatosis, Turner syndrome, and Williams syndrome.

In the United States, physicians who practice clinical genetics are accredited by the American Board of Medical Genetics and Genomics (ABMGG).[1] In order to become a board-certified practitioner of Clinical Genetics, a physician must complete a minimum of 24 months of training in a program accredited by the ABMGG. Individuals seeking acceptance into clinical genetics training programs must hold an M.D. or D.O. degree (or their equivalent) and have completed a minimum of 24 months of training in an ACGME-accredited residency program in internal medicine, pediatrics, obstetrics and gynecology, or other medical specialty.[2]

Metabolic (or biochemical) genetics involves the diagnosis and management of inborn errors of metabolism in which patients have enzymatic deficiencies that perturb biochemical pathways involved in metabolism of carbohydrates, amino acids, and lipids. Examples of metabolic disorders include galactosemia, glycogen storage disease, lysosomal storage disorders, metabolic acidosis, peroxisomal disorders, phenylketonuria, and urea cycle disorders.

Cytogenetics is the study of chromosomes and chromosome abnormalities. While cytogenetics historically relied on microscopy to analyze chromosomes, new molecular technologies such as array comparative genomic hybridization are now becoming widely used. Examples of chromosome abnormalities include aneuploidy, chromosomal rearrangements, and genomic deletion/duplication disorders.

Molecular genetics involves the discovery of and laboratory testing for DNA mutations that underlie many single gene disorders. Examples of single gene disorders include achondroplasia, cystic fibrosis, Duchenne muscular dystrophy, hereditary breast cancer (BRCA1/2), Huntington disease, Marfan syndrome, Noonan syndrome, and Rett syndrome. Molecular tests are also used in the diagnosis of syndromes involving epigenetic abnormalities, such as Angelman syndrome, Beckwith-Wiedemann syndrome, Prader-willi syndrome, and uniparental disomy.

Mitochondrial genetics concerns the diagnosis and management of mitochondrial disorders, which have a molecular basis but often result in biochemical abnormalities due to deficient energy production.

There exists some overlap between medical genetic diagnostic laboratories and molecular pathology.

Genetic counseling is the process of providing information about genetic conditions, diagnostic testing, and risks in other family members, within the framework of nondirective counseling. Genetic counselors are non-physician members of the medical genetics team who specialize in family risk assessment and counseling of patients regarding genetic disorders. The precise role of the genetic counselor varies somewhat depending on the disorder.

Although genetics has its roots back in the 19th century with the work of the Bohemian monk Gregor Mendel and other pioneering scientists, human genetics emerged later. It started to develop, albeit slowly, during the first half of the 20th century. Mendelian (single-gene) inheritance was studied in a number of important disorders such as albinism, brachydactyly (short fingers and toes), and hemophilia. Mathematical approaches were also devised and applied to human genetics. Population genetics was created.

Medical genetics was a late developer, emerging largely after the close of World War II (1945) when the eugenics movement had fallen into disrepute. The Nazi misuse of eugenics sounded its death knell. Shorn of eugenics, a scientific approach could be used and was applied to human and medical genetics. Medical genetics saw an increasingly rapid rise in the second half of the 20th century and continues in the 21st century.

The clinical setting in which patients are evaluated determines the scope of practice, diagnostic, and therapeutic interventions. For the purposes of general discussion, the typical encounters between patients and genetic practitioners may involve:

Each patient will undergo a diagnostic evaluation tailored to their own particular presenting signs and symptoms. The geneticist will establish a differential diagnosis and recommend appropriate testing. These tests might evaluate for chromosomal disorders, inborn errors of metabolism, or single gene disorders.

Chromosome studies are used in the general genetics clinic to determine a cause for developmental delay/mental retardation, birth defects, dysmorphic features, and/or autism. Chromosome analysis is also performed in the prenatal setting to determine whether a fetus is affected with aneuploidy or other chromosome rearrangements. Finally, chromosome abnormalities are often detected in cancer samples. A large number of different methods have been developed for chromosome analysis:

Biochemical studies are performed to screen for imbalances of metabolites in the bodily fluid, usually the blood (plasma/serum) or urine, but also in cerebrospinal fluid (CSF). Specific tests of enzyme function (either in leukocytes, skin fibroblasts, liver, or muscle) are also employed under certain circumstances. In the US, the newborn screen incorporates biochemical tests to screen for treatable conditions such as galactosemia and phenylketonuria (PKU). Patients suspected to have a metabolic condition might undergo the following tests:

Each cell of the body contains the hereditary information (DNA) wrapped up in structures called chromosomes. Since genetic syndromes are typically the result of alterations of the chromosomes or genes, there is no treatment currently available that can correct the genetic alterations in every cell of the body. Therefore, there is currently no “cure” for genetic disorders. However, for many genetic syndromes there is treatment available to manage the symptoms. In some cases, particularly inborn errors of metabolism, the mechanism of disease is well understood and offers the potential for dietary and medical management to prevent or reduce the long-term complications. In other cases, infusion therapy is used to replace the missing enzyme. Current research is actively seeking to use gene therapy or other new medications to treat specific genetic disorders.

In general, metabolic disorders arise from enzyme deficiencies that disrupt normal metabolic pathways. For instance, in the hypothetical example:

Compound “A” is metabolized to “B” by enzyme “X”, compound “B” is metabolized to “C” by enzyme “Y”, and compound “C” is metabolized to “D” by enzyme “Z”. If enzyme “Z” is missing, compound “D” will be missing, while compounds “A”, “B”, and “C” will build up. The pathogenesis of this particular condition could result from lack of compound “D”, if it is critical for some cellular function, or from toxicity due to excess “A”, “B”, and/or “C”. Treatment of the metabolic disorder could be achieved through dietary supplementation of compound “D” and dietary restriction of compounds “A”, “B”, and/or “C” or by treatment with a medication that promoted disposal of excess “A”, “B”, or “C”. Another approach that can be taken is enzyme replacement therapy, in which a patient is given an infusion of the missing enzyme.

Dietary restriction and supplementation are key measures taken in several well-known metabolic disorders, including galactosemia, phenylketonuria (PKU), maple syrup urine disease, organic acidurias and urea cycle disorders. Such restrictive diets can be difficult for the patient and family to maintain, and require close consultation with a nutritionist who has special experience in metabolic disorders. The composition of the diet will change depending on the caloric needs of the growing child and special attention is needed during a pregnancy if a woman is affected with one of these disorders.

Medical approaches include enhancement of residual enzyme activity (in cases where the enzyme is made but is not functioning properly), inhibition of other enzymes in the biochemical pathway to prevent buildup of a toxic compound, or diversion of a toxic compound to another form that can be excreted. Examples include the use of high doses of pyridoxine (vitamin B6) in some patients with homocystinuria to boost the activity of the residual cystathione synthase enzyme, administration of biotin to restore activity of several enzymes affected by deficiency of biotinidase, treatment with NTBC in Tyrosinemia to inhibit the production of succinylacetone which causes liver toxicity, and the use of sodium benzoate to decrease ammonia build-up in urea cycle disorders.

Certain lysosomal storage diseases are treated with infusions of a recombinant enzyme (produced in a laboratory), which can reduce the accumulation of the compounds in various tissues. Examples include Gaucher disease, Fabry disease, Mucopolysaccharidoses and Glycogen storage disease type II. Such treatments are limited by the ability of the enzyme to reach the affected areas (the blood brain barrier prevents enzyme from reaching the brain, for example), and can sometimes be associated with allergic reactions. The long-term clinical effectiveness of enzyme replacement therapies vary widely among different disorders.

There are a variety of career paths within the field of medical genetics, and naturally the training required for each area differs considerably. The information included in this section applies to the typical pathways in the United States and there may be differences in other countries. US practitioners in clinical, counseling, or diagnostic subspecialties generally obtain board certification through the American Board of Medical Genetics.

Genetic information provides a unique type of knowledge about an individual and his/her family, fundamentally different from a typically laboratory test that provides a “snapshot” of an individual’s health status. The unique status of genetic information and inherited disease has a number of ramifications with regard to ethical, legal, and societal concerns.

On 19 March 2015, scientists urged a worldwide ban on clinical use of methods, particularly the use of CRISPR and zinc finger, to edit the human genome in a way that can be inherited.[3][4][5][6] In April 2015 and April 2016, Chinese researchers reported results of basic research to edit the DNA of non-viable human embryos using CRISPR.[7][8][9] In February 2016, British scientists were given permission by regulators to genetically modify human embryos by using CRISPR and related techniques on condition that the embryos were destroyed within seven days.[10] In June 2016 the Dutch government was reported to be planning to follow suit with similar regulations which would specify a 14-day limit.[11]

The more empirical approach to human and medical genetics was formalized by the founding in 1948 of the American Society of Human Genetics. The Society first began annual meetings that year (1948) and its international counterpart, the International Congress of Human Genetics, has met every 5 years since its inception in 1956. The Society publishes the American Journal of Human Genetics on a monthly basis.

Medical genetics is now recognized as a distinct medical specialty in the U.S. with its own approved board (the American Board of Medical Genetics) and clinical specialty college (the American College of Medical Genetics). The College holds an annual scientific meeting, publishes a monthly journal, Genetics in Medicine, and issues position papers and clinical practice guidelines on a variety of topics relevant to human genetics.

The broad range of research in medical genetics reflects the overall scope of this field, including basic research on genetic inheritance and the human genome, mechanisms of genetic and metabolic disorders, translational research on new treatment modalities, and the impact of genetic testing

Basic research geneticists usually undertake research in universities, biotechnology firms and research institutes.

Sometimes the link between a disease and an unusual gene variant is more subtle. The genetic architecture of common diseases is an important factor in determining the extent to which patterns of genetic variation influence group differences in health outcomes.[12][13][14] According to the common disease/common variant hypothesis, common variants present in the ancestral population before the dispersal of modern humans from Africa play an important role in human diseases.[15] Genetic variants associated with Alzheimer disease, deep venous thrombosis, Crohn disease, and type 2 diabetes appear to adhere to this model.[16] However, the generality of the model has not yet been established and, in some cases, is in doubt.[13][17][18] Some diseases, such as many common cancers, appear not to be well described by the common disease/common variant model.[19]

Another possibility is that common diseases arise in part through the action of combinations of variants that are individually rare.[20][21] Most of the disease-associated alleles discovered to date have been rare, and rare variants are more likely than common variants to be differentially distributed among groups distinguished by ancestry.[19][22] However, groups could harbor different, though perhaps overlapping, sets of rare variants, which would reduce contrasts between groups in the incidence of the disease.

The number of variants contributing to a disease and the interactions among those variants also could influence the distribution of diseases among groups. The difficulty that has been encountered in finding contributory alleles for complex diseases and in replicating positive associations suggests that many complex diseases involve numerous variants rather than a moderate number of alleles, and the influence of any given variant may depend in critical ways on the genetic and environmental background.[17][23][24][25] If many alleles are required to increase susceptibility to a disease, the odds are low that the necessary combination of alleles would become concentrated in a particular group purely through drift.[26]

One area in which population categories can be important considerations in genetics research is in controlling for confounding between population substructure, environmental exposures, and health outcomes. Association studies can produce spurious results if cases and controls have differing allele frequencies for genes that are not related to the disease being studied,[27] although the magnitude of this problem in genetic association studies is subject to debate.[28][29] Various methods have been developed to detect and account for population substructure,[30][31] but these methods can be difficult to apply in practice.[32]

Population substructure also can be used to advantage in genetic association studies. For example, populations that represent recent mixtures of geographically separated ancestral groups can exhibit longer-range linkage disequilibrium between susceptibility alleles and genetic markers than is the case for other populations.[33][34][35][36] Genetic studies can use this admixture linkage disequilibrium to search for disease alleles with fewer markers than would be needed otherwise. Association studies also can take advantage of the contrasting experiences of racial or ethnic groups, including migrant groups, to search for interactions between particular alleles and environmental factors that might influence health.[37][38]

Continue reading here:

Medical genetics – Wikipedia

Genetic predisposition – Wikipedia

A genetic predisposition is a genetic characteristic which influences the possible phenotypic development of an individual organism within a species or population under the influence of environmental conditions. In medicine, genetic susceptibility to a disease refers to a genetic predisposition to a health problem,[1] which may eventually be triggered by particular environmental or lifestyle factors, such as tobacco smoking or diet. Genetic testing is able to identify individuals who are genetically predisposed to certain diseases.

Predisposition is the capacity we are born with to learn things such as language and concept of self. Negative environmental influences may block the predisposition (ability) we have to do some things. Behaviors displayed by animals can be influenced by genetic predispositions. Genetic predisposition towards certain human behaviors is scientifically investigated by attempts to identify patterns of human behavior that seem to be invariant over long periods of time and in very different cultures.

For example, philosopher Daniel Dennett has proposed that humans are genetically predisposed to have a theory of mind because there has been evolutionary selection for the human ability to adopt the intentional stance.[1] The intentional stance is a useful behavioral strategy by which humans assume that others have minds like their own. This assumption allows you to predict the behavior of others based on personal knowledge of what you would do.

In 1951, Hans Eysenck and Donald Prell published an experiment in which identical (monozygotic) and fraternal (dizygotic) twins, ages 11 and 12, were tested for neuroticism. It is described in detail in an article published in the Journal of Mental Science. in which Eysenck and Prell concluded that, “The factor of neuroticism is not a statistical artifact, but constitutes a biological unit which is inherited as a whole….neurotic Genetic predisposition is to a large extent hereditarily determined.”[2]

E. O. Wilson’s book on sociobiology and his book Consilience discuss the idea of genetic predisposition to behaviors

The field of evolutionary psychology explores the idea that certain behaviors have been selected for during the course of evolution.

The Genetic Information Nondiscrimination Act, which was signed into law by President Bush on May 21, 2008,[3] prohibits discrimination in employment and health insurance based on genetic information.

Read more:

Genetic predisposition – Wikipedia


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