DRUG DEPENDENCE

Laws related to Drug Dependence RA 6425 - Dangerous Drugs Act of 1972 Amended by PD 44, 1675, 1683, 1708, BP 179 RA 9165 Comprehensive Dangerous Drugs Act of 2002

Biosocial factors Philippines Transhipment point to and from the Golden Triangle Warm humid weather conducive to the growth of marijuana Young population The Philippines is a mirror image of the US Men are by nature pleasure-loving or hedonistic Profit motive of pushers and drug lords Gradual disappearance of the nuclear Filipino family and the emergence of a permissive society Discovery of new drugs by scientists to alleviate human diseases. These drugs have both beneficial as well as deleterious effect

Other Reasons FOR DRUG USE Enhance social situations- peer pressure, used out of curiosity, used for fun or to get high Self-medication to relieve anxiety, depression, insomnia, pain or to increase alertness Terms Drug Any substance (plant, animal, mineral) used as medicine Any substance used in the composition or preparation of medicine Habit-forming Drug Drug may be taken repeatedly without producing addiction and is not generally detrimental to the individual or society Drug Dependence a state of psychic or physical dependence or both, of a dangerous drug, arising in a person following the administration or use of that drug on a periodic or continuous basis (Sec. 2g, RA 6425) DRUG DEPENDENCE Drug Addiction- a state of periodic or chronic intoxication produced by the repeated consumption of a drug whether synthetic or natural, found to be detrimental to the individual and to society (WHO) Drug Habituation the desire to have continuous use of the drug but with the capacity to refrain from physically using it

Addiction The person has the desire (compulsion) to continue taking the drug or to obtain it by any means Tendency to increase the dose Psychological or physical dependence Detrimental effect to society & individual

Habituation The desire to use the drug is not compulsive but merely psychological There is little or no tendency to increase the dose The dependence is not physical but psychological Detrimental effect to the individual only

COSAP
Commission on Substance Abuse Prevention Cebu City Office on Substance Abuse Prevention A public office in the City Government under the office of the mayor that does liaison work and coordinates with government offices and agencies involved in the enforcement of laws related to the prevention, suppression or regulation of illegal drugs and substances of abuses. VISION A drug free Cebu City that is safe and prosperous, through a dynamic and responsive partnership between the government and society contributing to eradicate drug abuse MISSION To eradicate the illicit supply and demand for dangerous drugs and to promote a barangay cooperation in drug abuse prevention with an effective program in educating the danger of drug use and vigilance on presence of drug peddlers so as to attain an environment that is safe, prosperous, and drug free community. Profile of a Drug abuser COSAP - (January December, 2000) Mean age: Sex ratio: Civil status: Occupation: Education: Residence: Drug abused: Type of user: 25 years old 9 male:1 female single (54.63 %) unemployed (48.95%) HS level (31.34%) Cebu City (80.89%) Shabu (94.33%) Mono-user (71.6

Physical signs and symptoms Withdrawal Symptoms Feeling of fear and anxiety Muscle twitching Yawning Sweating Lacrimation (profuse tears) Abdominal cramps Gooseflesh Death in most drug users is due to Respiratory depression Cardiac arrest Fatal accidents due to hallucinatory experiences Common Drugs amphetamine group Stimulants and appetite suppressors Produce paranoid hallucinations, dry mouth, ulcerations of the mouth, insomnia, high fever Examples: Ecstasy produces adrenalin Shabu produces dopamine Other drugs Inhalants volatile substances (ethylene) Morphine Group heroin Cocaine cocaine bugs Cannabis Group liquid or heated resin; similar to alcohol intoxication Barbiturate Group Seconal,Penthotal Hallucinogenic Group marijuana, LSD

Gunshot Wounds
FIREARM Technical Definition: An instrument used for the propulsion of a projectile by the expansive force of gases coming from the burning of gunpowder Legal Definition (Sec. 877, Revised Administrative Code) Firearm or arm, as herein used, includes rifles, muskets, shotguns, revolvers, pistols, and all other deadly weapons from which a bullet, ball, shot, shell, or other missile may be discharged by means of gunpowder or other explosives. The term also includes air rifles except such as being of small caliber and limited range are used as toys. The barrel of any firearm shall be considered as a complete firearm for all purposes thereof.

Components of a Weapon Cartridge or ammunition A complete unfired unit consisting of bullet, primer, cartridge case and powder charge Firearm The instrument for the propulsion of a projectile by the expansive forces of gases from a burning gunpowder Objects/Substances coming out from the gun muzzle after fire Bullet Flame Gas (heated, compressed and expanded) Residues coming from Bullet - fragment (jacket, lead) Powder particles - powder grains, soot, graphite Primer - lead, barium, antimony, etc Barrel - lubricant, rust, dust Cartridge case copper, zinc

TERMS Smoke (Soot, Smudging, Fouling, Smoke Blackening) Byproduct of combustion of the gunpowder Almost black and deposited on the target (can be wiped off) Seen within a distance of up to 12 inches Powder Grains Unburned, burning or partially burned powder together with graphite that comes out of the muzzle Responsible for tattooing (stippling, peppering) around the gunshot wound of entrance Powder Burns

Blackening of the margin of the gunshot wound of entrance due to smoke smudging, gunpowder tattooing and the burning of the wound margin Abrasion Collar Depression of the skin upon contact with the rough surface of the bullet Metal fouling Small abrasions or superficial lacerations on the skin around the wound Tandem Bullet Two or more bullets leave the barrel one after the other and entered the target in a common hole Singeing of hair Burning of hair Souvenir bullet Bullet that has been lodged and remained in the body Bullet migration Bullet that travelled to another part of the body Bullet embolism A special form of bullet migration wherein the bullet enters the heart or a big blood vessel and is carried by the blood to some part of the body Wound of exit Always bigger than the missile Edges are everted No definite shape (-) contusion collar Always absent Underlying tissues protruding Paraffin test always (-) May be absent

Wound of entrance Appears smaller than the missile Edges are inverted Oval or round shape (+) contusion collar or contact ring Tattooing or smudging may be present (near fire) Underlying tissues not protruding Paraffin test may be (+) Always present

Odd and Even Rule in Gunshot Wound If the number of gunshot wounds of entrance and exit found in the body of the victim is EVEN, the presumption is that no bullet is lodged in the body, but if the number of gunshot wounds of entrance and exit is ODD, the presumption is that one or more bullets might have been lodged in the body

X-ray Examination in Gunshot Wounds Facilitate the location of the bullet Reveal fragmentation Show bone involvement, like fracture Reveal the trajectory of the bullet Show the effects of the bullet wound like haemorrhage, escape of air, laceration and other injuries

Paraffin test Also known as Dermal Nitrate Test, Diphenylamine test, Lungs test, Gonzales test Test on the skin of the dorsum of the hand or at the site of the wound of entrance (+) in the presence of nitrate or nitrite Not conclusive NOT self-incriminatory because the act is purely mechanical and does not require the use of mental faculty

Questions a Physician is expected to answer in Court Could the wound or wounds be inflicted by the weapon presented? At what range was it fired? What was the direction of the fire? May it be possible that those gunshot wounds were self-inflicted? Were there signs of struggle in the victim? Did the victim die instantaneously? Where was the relative position of the assailant and he victim when the shot was fired?

Gunshot Suicide Accessibility of the involved part to the hand of the victim Usually only one gunshot wound Distance is short or close range Presence of a suicide note History of depression Wounding weapon tightly held by the victim (+) paraffin test Exclusion of other evidences

Gunshot-Homicide Wound found in any part of the body Victim at a certain distance from the assailant Signs of struggle (defense wound) may be present Disturbance of the surrounding Wounding weapon usually not found at the scene of the crime Testimony of witnesses

Gunshot- Accident Usually one gunshot wound Wound in any part of the body Absence of personal grudge between the victim and the one who fired the gun Testimony from witnesses

Gunshot- Murder Usually at the back (treachery) Multiple gunshot wounds Wounds show far distance fire Wounds in the vital parts of the body like the head, heart, chest No defense wounds or any sign of struggle Firearm usually of high muzzle velocity Seldom is there any witness to the crime Presence of aggravating circumstances, superior strength, aid of armed men, etc

Entrance wounds

Entrance wound, abrasion collar

Trajectory of bullet (probe)

Bullet on X-ray

Medico-legal Aspects of Sexual Crime

Criminologic characteristics Rape is an ancient and universal crime It existed since the dawn of history Reaction to its repression depends on the moral value of society and its gravity as a social problem Close physical contact between the offender and the victim Generally, it is a crime committed by one sex against the opposite sex Sex is an inborn instinct Must be acceptable morally Punishable: anti-social means of sexual gratification Crime committed in strict privacy Many sex crimes are committed, but not reported; if reported, they are not investigated; if investigated, they are not prosecuted Crime occurs in every social class Unlike other crimes, forgiveness or marriage between the offender and the victim extinguishes the criminal liability of the offender The severity of punishment does not deter its commission Its consequence pregnancy- becomes a legal problem If the offender is in middle age, the victims are usually children The psychic trauma of rape on the victim depends on her moral standard REPUBLIC ACT NO. 8353 AN ACT EXPANDING THE DEFINITION OF THE CRIME OF RAPE, RECLASSIFYING THE SAME AS A CRIME AGAINST PERSONS, AMENDING FOR THE PURPOSE ACT NO. 3815, AS AMENDED,OTHERWISE KNOWN AS THE REVISED PENAL CODE, AND FOR OTHER PURPOSES. Sec. 2. Rape as a Crime Against Persons. The crime of rape shall hereafter be classified as a Crime Against Persons under Title Eight of Act No. 3815, As amended, otherwise known as the Revised Penal Code. Accordingly, there shall be incorporated into Title Eight of the same Code a new chapter to be known as Chapter Three on Rape, to read as follows: Chapter Three -"Rape "Article 266-A. Rape: When And How Committed. Rape is committed: 1) By a man who shall have carnal knowledge of a woman under any of the following circumstances: a) Through force, threat, or intimidation; b) When the offended party is deprived of reason or otherwise unconscious; c) By means of fraudulent machination or grave abuse of authority

d) d) when the offended party is under twelve (12) years of age or is demented, even though none of the circumstances mentioned above be present 2. By any person who, under any of the circumstances mentioned in paragraph 1 hereof, shall commit an act of sexual assault by inserting his penis into another persons mouth or anal orifice, or any instrument or object, into the genital or anal orifice of another person. Carnal knowledge The act of a man having sexual bodily connection with a woman (old definition) SEXUAL INTERCOURSE (from State of Connecticut, Judicial Branch) Definition 1: "Sexual intercourse" means vaginal intercourse, anal intercourse, fellatio or cunnilingus between persons regardless of sex. Definition 2: "Sexual intercourse" means intercourse, real or simulated, whether genital-genital, oral-genital, anal-genital or oral-anal, whether between persons of the same or opposite sex or between a human and an animal, or with an artificial genital Maslows hierarchy of needs

Sexual response cycle male Excitement phase Penile erection, flushing, increase in HR and BP, generalized muscle tension Plateau phase Further penile enlargement, further testicular enlargement , elevation and rotation Further increase in vital signs and muscle tension Orgasmic phase General loss of voluntary control occurs, flushing and vital signs reaches its peak, rhythmic contractions expel semen Resolution Phase More than 50% of erection is lost rapidly in the first stage of resolution,

generalized muscle relaxation flushing disappears vital signs return to normal

Sexual response cycle Male: one basic sexual response pattern Excitement steady progression to plateau orgasm - resolution Female Three sexual response patterns Rapid progression to plateau orgasm rapid resolution Steady progression to plateau orgasm (s) slow resolution Slow progression to plateau minor surges towards orgasm causing prolonged pleasurable feelings without a definitive orgasm Male reproductive system Side view

Front view

Sperm Cell

Egg cell from the ovary during ovulation

Internal Female reproductive system Side view

Front view

External View

Supreme Court decisions Carnal knowledge / Rape Slight penetration of the sexual organ of the female by the sexual organ of the male Not necessary that hymen be ruptured Enough that labia be penetrated Absence of sperm does not negate the commission of rape Not necessary that the woman is unchaste or a prostitute RAPE (+)evidence of force Presence of physical in juries on the victim is a strong evidence of force Contusion on the face, arms and thighs Abrasions on the elbow and back of the head Presence of genital infection (especially STDs) is evidence of physical injury Conditions constituting rape Depriving the woman of her reason Insane or mentally deficient woman Under the influence of alcohol or depressant drugs Woman is unconscious Natural sleep Woman with sleeping sickness Unconscious due to physical injury Intake of narcotics or depressants Under 12 years of age (statutory rape) regardless of Force or intimidation Deprivation of reason or consciousness Consent or being a prostitute Medical evidences of rape Victim History of the circumstances leading to the abuse Age of the victim at the time of the abuse Menstrual history Date, time and place of the commission of the crime Date , time and place of physical examination Condition of clothing Gait, facial expression, body movements and mental attitude Physical and mental development Bodily signs of violence must be accurately described Examination of genitalia and breasts Swelling Tenderness or pain Contusions

 Abrasions Lacerations hymen Blood Semen and sperms Other discharges like pus Examination of pubic hairs semen, sperms, blood stains, body louse Evidences from the offender Physical development and strength Physical injuries Condition of sex organ Pubic hairs (+) or (-) genital infection Potency or impotency