LEGAL MEDICINE Prepared by: Olaf Augustus A.

Benosa
BLOCK C – sy 2023-2024 17-17500

Addiction:

A chronic disease is influenced by a combination of genetic, psychosocial, and environmental factors.

It is characterized by a progressive and potentially fatal trajectory, marked by an impaired control over
substance use, an obsessive preoccupation with it, and continued usage despite the occurrence of
adverse consequences.

• Primary Aspect: Addiction is distinguished from underlying mental health issues such as
depression or anxiety, often becoming the primary concern in an individual’s life.

• Chronic & Genetic Aspects: Addiction is a lifelong condition, akin to chronic diseases such as
diabetes. While a genetic predisposition plays a significant role, environmental factors also
contribute substantially to its development.

• Progression & Fatality: Addiction tends to worsen over time and can lead to fatal outcomes
such as strokes and heart attacks. It is associated with a range of societal consequences,
including mental illness, homelessness, crime, decreased productivity, and increased
healthcare costs.

• Phases of Addiction: Addiction progresses through prodromal, crucial, and chronic phases,
each characterized by escalating levels of use, impaired control, physical dependency, and
emotional distress.

• Recovery and Treatment: Addiction is treatable, and recovery involves a transition from denial
to honesty, from shame to self-respect, and from despair to hope.

• Drug Testing and Rehabilitation: The Republic Act No. 9165 provides guidelines for drug
testing methods and their validity. Rehabilitation processes for drug users involve
assessments, involvement of accredited physicians, categorization based on usage patterns,
detoxification, treatment in rehabilitation centers, and aftercare.

• Nicotine Addiction and Smoking: The presentation details the addictive nature of nicotine, the
cycle of smoking, its harmful effects, and the benefits of smoking cessation. It underscores
the difficulty in quitting due to nicotine’s addictive properties and enumerates the health risks
associated with smoking.

• Correlation between Drug Addiction as a Disease and Philippine Laws:

• Recognition of Addiction as a Disease: While Philippine drug laws primarily focus on control,
penalties, and rehabilitation for drug offenses, there’s an implicit recognition of addiction as a
disease. The information provided in the PowerPoint aligns with the understanding of
addiction as a chronic and progressive condition influenced by genetic, psychosocial, and
environmental factors.

• Consideration in Treatment Approaches: Acknowledging addiction as a disease underscores

the need for comprehensive treatment approaches that focus on rehabilitation, support, and
addressing the root causes beyond mere punitive measures.
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

A. Drug Laws:

The PowerPoint presentation outlines addiction as a chronic, progressive, and fatal

disease influenced by genetic, psychosocial, and environmental factors. It provides details
about the phases of addiction, drug testing procedures, smoking cessation, and rehabilitation
processes. These insights align with the complexities of addiction as addressed in the
Philippine laws on drug control, rehabilitation, and treatment, emphasizing the importance of
holistic approaches for addressing addiction.,

g testing procedures,
The Republic Act No. 9165, also known as the Comprehensive Dangerous Drugs Act
of 2002, is the primary law in the Philippines that deals with drugs and addiction. This law
focuses on drug control, penalties, and rehabilitation for drug-related offenses. It implicitly
recognizes addiction as a chronic and progressive condition, although it does not explicitly
label it as a disease.

Here are some points from the law to consider that align with the understanding of addiction
as a disease:

1. Holistic Approach to Rehabilitation: The law declares the policy of the State to provide
effective mechanisms or measures to re-integrate into society individuals who have
fallen victims to drug abuse or dangerous drug dependence through sustainable
programs of treatment and rehabilitation1. This aligns with the understanding of
addiction as a disease that requires comprehensive treatment and rehabilitation.
2. Recognition of Drug Dependence: The law refers to “drug dependents” and provides
for their treatment and rehabilitation in centers1. This suggests an understanding that
individuals can become dependent on drugs, which is a key aspect of addiction as a
disease.
3. Balancing Drug Control and Medical Needs: The law aims to achieve a balance in the
national drug control program so that people with legitimate medical needs are not
prevented from being treated with adequate amounts of appropriate medications,
which include the use of dangerous drugs1. This recognizes that some individuals may
require certain drugs for medical purposes, and their use of these drugs should be
managed appropriately to prevent addiction.
4. Prevention and Education: The law mandates an intensive and unrelenting campaign
against the trafficking and use of dangerous drugs through an integrated system of
planning, implementation, and enforcement of anti-drug abuse policies, programs, and
projects1. This reflects an understanding that preventing addiction requires a multi-
faceted approach, including education and enforcement of anti-drug policies.

B. Is Drug Addiction considered as a disease by the present laws on drugs and addiction in the
Philippines?

While Philippine laws primarily focus on drug control, penalties, and rehabilitation for drug-
related offenses, the descriptions provided in the PowerPoint align with the understanding of
addiction as a disease influenced by genetic, psychosocial, and environmental factors.
Though not explicitly stated, there's an implicit recognition within the laws regarding addiction
as a chronic and progressive condition. Pow

erPoint
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

C. Actions Taken Considering Addiction as a Disease

Recognizing addiction as a disease necessitates a paradigm shift in the approach towards its
management. This recognition calls for comprehensive treatment strategies that include:

1. Rehabilitation: Implement comprehensive rehabilitation programs that include

detoxification, counseling, therapy, and skills training. For example, the Department of
Health (DOH) could establish more rehabilitation centers across the country, ensuring they
are accessible to individuals from all socio-economic backgrounds.
2. Support: Establish support systems such as hotlines for immediate assistance, peer
support groups for shared experiences, and family therapy sessions to educate and
involve the family in the recovery process. For instance, local government units (LGUs)
could initiate community-based support groups.
3. Addressing Underlying Factors: Conduct regular community assessments to identify and
address factors contributing to addiction, such as unemployment, lack of education, or
mental health issues. Government agencies could collaborate with non-government
organizations (NGOs) and academic institutions for research and program development.
4. Education and Prevention: Implement school-based programs that educate children and
adolescents about the risks of drug use. Regular community seminars could also be
conducted to raise awareness among adults. Media campaigns on television, radio, and
social media can also be effective in reaching a wider audience.
5. Policy and Legislation: Regularly review and update laws and regulations related to drug
use and addiction. This could involve stricter penalties for drug trafficking, incentives for
businesses that support the recovery of their employees, and protection for individuals in
recovery against discrimination. Policymakers could also advocate for the allocation of
more funds for addiction prevention and treatment programs.
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

POWERPOINT PRESENTATION OUTLINE

Definition of Addiction:

• Addiction is a primary, chronic disease with genetic, psychosocial, and environmental factors
influencing its development and manifestations.
• It is often progressive and fatal.
• It is characterized by continuous or periodic impaired control over use, preoccupation with
use, use despite adverse consequences, and distortions in thinking, notably denial.

Primary Aspect:

• Addiction is not a symptom of an underlying problem, such as depression, anxiety, or low self-
esteem, but a separate disease with its own course and complications.
• It’s the number one problem in an individual’s life.

Chronic Aspect:

• Chronic means “lasting forever.” Diabetes, heart disease, and emphysema are chronic
diseases – so is addiction.

Genetic Aspect:

• Addiction is partly genetic, though psychosocial and environmental factors such as

depression, anxiety, traumatic events, and family dynamics play a part in how it develops and
manifests itself.
• If you have a parent or close relative who is addicted, you probably were born with a reduced
supply of and ability to use natural brain chemicals that help you feel good.
• Children of alcoholics have a 3 to 4 times increased risk of addiction.
• Twin studies show a 60% risk for monozygotic twins and a 39% risk for dizygotic twins.
• Adoption studies show a 4 times increased risk if biological parents are alcoholic, even if
adoptive parents are not alcoholic.

Progressive Aspect:

• The same drugs that make us feel euphoric, excited, and free of physical and emotional pain
eventually steal our brain’s normal ability to sense pleasure.
• Addiction gets worse, not better.

Fatal Aspect:

• Addiction-related causes of death include strokes, heart attacks, and respiratory arrest. Most
deaths related to addiction involve a traumatic event.
• Other consequences include neurotoxicity, AIDS, cancer, mental illness, heart disease,
homelessness, crime, violence, increased health care costs, decreased productivity, and
accidents.
•
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

Phases of Addiction:

1. Prodromal Phase: Characterized by using alcohol or other drugs as “rewards,” tolerance,

concealing use, and preoccupation.
2. Crucial Phase: Characterized by impaired control, continued use despite harmful
consequences, unsuccessful attempts to limit or stop use, and alcohol and drug-centered
behavior.
3. Chronic Phase: Characterized by binges, value conflict, physical dependency, and significant
emotional and spiritual pain.

TAKE NOTE:

• Addiction is not just a primary, chronic, genetic, progressive, and fatal disease. It
is also a treatable disease. No one begins using a mood-altering substance with
the intention of becoming addicted to it.

Progression of Addiction:

• The progression of the disease can leave individuals and their lives in shambles, leading to
feelings of hopelessness and helplessness.
• Facing addiction can be painful, but it is the first step towards recovery.
• Recovery involves moving from denial to honesty, shame to self-respect, fear to courage, and
despair to hope.

Addiction as a Brain Disease:

• Scientific evidence shows that drugs change the brain’s chemistry and structure, creating
what is called “a disease state.”
• Today, addiction is described as “fundamentally a brain disease.”
• Brain adaptation to the drug-induced effects leads to addiction.
• This includes sensitization (an increased nerve cell response to repeated drug exposure) and
learning (enduring changes in the emotional brain as a result of aspects of the drug exposure
that resemble types of conditioned behavior).

Causes of Addiction:

• Within the person: Genetic predisposition (when exposed to psychoactive drugs), need to
diminish potent emotional and psychiatric symptoms, rebellion against the older generation,
escape from reality, need for fun and recreation, curiosity and desire to experiment, spiritual
vacuum, boredom, and physical pain or illness.
• In the environment: Various environmental factors increase the likelihood of exposure to
specific drugs. For instance, certain drugs are more frequently used within certain cultures
and found in certain geographic areas. Drug use often occurs in the context of social networks.
Other environmental causes include excessive parental control, permissive society, affluence,
poverty, social pressure from the peer group, dysfunctional family, and broken home situation.
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

Drug Testing in Relation to RA 9165:

• Reasons for drug testing include mandatory drug testing, random drug testing, reasonable
suspicion/cause, post accidents, follow-up, return to duty, and pre-employment.
• Methods of testing include a screening test (sensitive) and a confirmatory test (specific).
• All positive drug test results are subjected to confirmatory testing using Gas Chromatography
Mass Spectrometer or other modern, acceptable methods.

Abusing Alcohol and Other Drugs:

• Abusing alcohol and other drugs compels individuals to act against their own will and values,
risk important relationships, and shirk significant responsibilities.
• These are signs that individuals have a disease and need help, not that they have a moral
failing.

ADDICTION is a complex disease influenced by various factors, and it requires comprehensive

approaches for prevention and treatment. It also highlights the importance of understanding the
nature of addiction to reduce stigma and support recovery.

Test Result:

• As per Section 36, the test result is valid for one year from the date of issue and may be used
for other purposes.
• As per Section 38, a positive screening lab test must be confirmed for it to be valid in court.

Confirmatory Testing:

• Confirmatory testing is done using Gas Chromatography Mass Spectrometry (GC-MS), which
has 99% sensitivity and accuracy. It is considered the gold standard for confirmatory testing.
• The process involves molecular fingerprinting of the substance it wants to isolate.

Specimen Retention:

• Negative result specimens are retained for 5 days.

• Positive result specimens are retained for a minimum of 15 days.
• Adulterated, substituted, invalid result specimens are retained for 15 days.
• For judicial proceedings or upon request, specimens can be retained for up to a year.

Detection Periods:

• Methamphetamine: 3-5 days in urine, up to 90 days in hair, 1-3 days in blood.

• THC (single use): 2-3 days in urine, up to 90 days in hair, 2-3 days in blood.
• THC (chronic use): Up to 12 days in urine, up to 90 days in hair, 2 weeks in blood.
• Cocaine: 4-5 days in urine, up to 90 days in hair.
• Opiates: 8 hours in urine, up to 90 days in hair.
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

Rehabilitation Process for Suspected Drug Users:

• If a drug test is positive, the Drug Abuse Program Coordinator conducts an assessment.
• Accredited Department of Health (DOH) physicians are involved in the process.
• Depending on the assessment, the individual is categorized as an experimenter or occasional
user, or a drug-dependent individual.
• The Drug Abuse Program (DAP) Coordinator or an outpatient center is involved in the case of
experimenters or occasional users.
• Schools are involved in the process.
• In cases of dual diagnosis, psychiatric hospitals are involved.
• Detoxification is carried out for drug-dependent individuals.
• Drug-dependent individuals are sent to treatment and rehabilitation centers, which can be
government-operated (GO) or non-governmental organizations (NGOs).
• Aftercare is provided following treatment and rehabilitation.
• These steps are part of the rehabilitation process for voluntary submission cases.

Cigarette Smoking and Nicotine Addiction

Nicotine Addiction and Smoking Cycle:

• Nicotine is highly addictive, making quitting hard.

• The smoking cycle includes a physical lift (3 mins), withdrawal symptoms (15-20 mins), and
feelings of relaxation when nicotine levels are low (5-15 mins).

Philippine Global Youth Tobacco Survey (GYTS) 2000:

• 4 out of 10 students have tried smoking.

• 1 out of 5 students are current smokers.
• Only 4 in 10 think smoking is harmful to their health.
• Smoking prevalence was highest among the poor.

Chemicals and Toxins in Tobacco:

• There are 4,000 compounds (~50 carcinogens) in a cigarette, many of which are poisonous.

Harmful Effects of Cigarette Smoking:

• Immediate effects include repeated cough & colds, asthma attacks, bad breath, infections of
teeth and gums, staining of teeth and gums, easy fatigability, and nicotine addiction.
• Long-term effects include heart disease & hypertension, cancer of the lungs, throat or mouth,
peptic ulcer disease, early wrinkles, and risks during pregnancy (premature, small or even dead
babies).

Smoking, Pregnancy, and Babies:

• Smoking mothers have more premature births, stillbirths, and infant deaths.
• There is an increased risk of miscarriage and having low birth weight babies.
• Babies born of smoking mothers have poorer immunity and suffer a higher incidence of
infectious diseases.
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

Passive Smoking:

• Second-hand smoke has high concentrations of carbon monoxide and many toxic and
carcinogenic substances.
• It puts a person at equal risk as active smokers for developing diseases such as lung cancer
and ischemic heart disease.
• It is especially bad for children, leading to absenteeism and frequent acute respiratory
infections.

Benefits of Smoking Cessation:

• 20 minutes after quitting: Heart rate and blood pressure drops.

• 12 hours after quitting: Carbon monoxide level in the blood drops to normal.
• 2 weeks to 3 months after quitting: Circulation improves and lung function increases.
• 1 to 9 months after quitting: Coughing and shortness of breath decreases; cilia regain normal
function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the
risk of infection.
• 1 year after quitting: The excess risk of coronary heart disease is half that of a smoker’s.
• 5 years after quitting: Stroke risk is reduced to that of a non-smoker 5 to 15 years after quitting.
• 10 years after quitting: The lung cancer death rate is about half that of a person who continues
smoking. The risk of cancer of the mouth, throat, esophagus, bladder, cervix, and pancreas
decrease.
• 15 years after quitting: The risk of coronary heart disease is the same as of a non-smoker’s.

Why Quitting Smoking is Difficult

• Nicotine in tobacco is addictive, similar to methamphetamine.

• A regular cigarette contains about 1 to 2 milligrams of nicotine.
• The amount of nicotine intake depends on the number of puffs taken, depth of inhalation, and
duration of smoking.

Effects of Nicotine

• It produces psychological dependence (cravings), causing feelings of alertness or relaxation,

and disturbs the neurotransmitters of the brain.
• It also leads to physical dependence, tolerance, and withdrawal symptoms.

Withdrawal Symptoms of Smoking

• These symptoms do not happen to everyone but are more pronounced among chronic regular
smokers who suddenly cut back and greatly reduce the amount of nicotine in the body.
• Symptoms may last for a few days up to several weeks and usually start within a few hours of
the last cigarette smoked and peak at about 2 to 3 days after when most of the nicotine and
its by-products have been eliminated.
• Symptoms include dizziness, depression, frustration, impatience, anger, anxiety, irritability,
sleep disturbance, trouble concentrating, restlessness, boredom, headaches, tiredness,
increased appetite, weight gain, constipation, gas, cough, dry mouth, sore throat, nasal drip,
and chest tightness.
LEGAL MEDICINE Prepared by: Olaf Augustus A. Benosa
BLOCK C – sy 2023-2024 17-17500

Support for Quitting

• Support from family members and health care providers is important in providing assistance.
• It’s important to remind the ex-smoker that they will feel better every day the more days they
stay smoke-free.

Tobacco Control Measures in the Philippines

• Lobbying of passage of HB 3364 “Graphic Health Warnings”.

• 28.3% (17.3 million) of those aged 15 & above smoke tobacco.
• Among those who smoked in the last 12 months, 47.8% attempted to quit and 4.5% made it
successfully.
• Among current smokers, 60.6% stated they are interested to quit.
• There is a need for Smoking Cessation Clinics for almost 10 million Filipinos.
• The role of teachers, leaders, and parents is crucial in helping smokers to quit.