Treatment Of Drug Use As A Disease example essay topic

The use and abuse of non-prescription drugs has been a problem in America since colonial times. Historically, the reaction to this problem has been the enforcement of prohibition laws and providing total abstinence education. This has resulted in big business in America; according to the United States Office of National Drug Control Policy, the federal government spent $19.2 billion dollars in 2003 on the war on drugs (1). Unfortunately, the abstinence based education and prohibition laws that are incorporated in the war on drugs have been wholly ineffective in slowing the demand for illicit drugs, and have had the opposite effects of driving up demand, street value, and drug-related crimes. The U.S. war on drugs bases its success on a decrease, and eventual eradication of the prevalence of drug use, a goal that has yet to be met.

Detroit chief of police Jerry Oliver, in a 2002 interview with ABC news, said "Clearly, we " re losing the war on drugs in this country [and] it's insanity to keep doing the same thing over and over again" (qt d. in Stossel). As the war on drugs continues to fail and cost this country billions of dollars, it has become clear that a new approach to the problem is needed. By changing the focus from trying to decrease the overall use of drugs to focusing on decreasing the negative side effects (both personal and societal) of drug use, our country will finally be able to make significant steps forward in our drug problem. This approach is known as harm reduction. Harm reduction is a multi-faceted philosophy that includes various strategies to help lessen the negative impact of drug abuse on our society. These negative impacts include death, disease, suffering and crime.

One of the basic assumptions which harm reduction is based on is "there has never been, is not now, and never will be a drug-free society" (Drug Policy Alliance). Some of the approaches endorsed by harm reduction are science-based, rather than scare tactic education, treatment for drug addicts instead of imprisonment, and the reduction of health risks for addicts still actively using drugs. The programs which have grown out of these ideals will not only reduce the cost of the drug war through reduction of imprisonment and law enforcement costs, but will reduce the spread of diseases associated with drug use such as HIV / AIDS. While abstinence based education has become the accepted form of teaching young people about the dangers of drugs, these programs have also drawn wide criticism because of their failure to make any real difference in youth drug use.

According to Mathe a Falco, "Many schools rely on programs which have not been evaluated, or worse yet, have been found to have no impact. In 1988, a review of 350 different school programs found that only 33 had any valid evaluation data, while just three programs reported reductions in tobacco, alcohol or drug use" (qt d. in Rosenbaum). One of the most prolific abstinence based education programs is DARE (Drug Abuse Resistance Education). The program, founded in 1983, places police officers in classrooms to provide training to help youth recognize the dangers of drug use, resist peer pressure to try drugs, and focuses on the importance of avoiding drug use of any kind.

In 2002, a study funded by the Partnership for a Drug-Free America found that 48% of the teen population has tried illegal drugs (United States). Abstinence based education programs ultimately imply and teach false information: that a single use of any number of drugs can kill a child or leave them addicted. Once these children enter their teen years, the numbers presented by the Partnership imply that it is likely they are going to be exposed to drugs. Once they try drugs or see others try them, if they do not see the outcomes taught to them as immediately evident, they become mistrustful of all the other information that was taught to them. This renders the entire program useless. In 2001, the U.S. Surgeon General called DARE "ineffective", and the head of the National Institute on Drug Abuse called the program just one of many anti-drug programs which do not work (Zernike).

However, the flawed curriculum's are still being taught in schools around the country. Harm reduction calls for factual, scientific education to replace the education methods that are being used today that have been proven unsuccessful. William Miller, a program director of the youth substance abuse facility Berkshire Farm Center, believes that when teenagers are presented with science-based information and choose to remain drug free because of it, they are more likely to remain drug free (Myers). Information on individual drugs is presented in an unbiased manner; both the good effects and bad effects are brought up and discussed. Because no frightening material is presented, no glamour is attached to the drugs, and false information is not provided, course material is never discredited by the children's personal experiences. While education is the most important resource in addressing drug use in children, adults dealing with addiction need proactive treatment options that will help minimize the harm they are causing themselves until they can choose to become drug free.

One of the biggest health concerns for drug addicts, specifically IV drug users, is the spread of HIV / AIDS. Many IV drug users are unable or unwilling to discontinue use. Needle exchange programs have been working for years to reduce the spread of infectious diseases among these drug users by allowing them to exchange used needles for new clean ones. These programs are also beneficial because they provide critical contact between otherwise hard to reach drug users and outreach services. If clean needles are available free of charge to drug users, they will be less likely to share dirty needles and spread disease. In research conducted by the Canadian Harm Reduction Network, 60 to 100 percent of worldwide heterosexual HIV infection is related to IV drug use, and 40 percent of those infected users are in a relationship with a non-IV drug user (Diane Riley & Pat O'Hare).

Needle exchange programs therefore not only slow the infection of HIV / AIDS among IV drug users, but will also reduce the rate of transmission to non-users. Needle exchange programs have helped reduce the rate of HIV infection among drug injectors in New York City from 60 percent in 1990 to approximately 15 percent in 2004, according to Allan Clear, the executive director of the Harm Reduction Coalition (Clear). Unfortunately, needle exchange programs are currently excluded from federal funding by Congress, despite the clear benefits. Until these programs gain federal funding, they will continue to run under private funding, making access to these sites limited to only areas where funding has been obtainable. Many addicts without access to those locations will not receive this much-needed help. Another program already under use in the United States and endorsed by harm reduction experts is providing methadone to heroin addicts.

Methadone is a synthetic substitute for heroin, and by administering specific regulated doses to heroin addicts they are able to gain control of their lives. Methadone does not provide the same high as heroin, but it does eliminates withdrawal, and users participating in methadone programs are able to separate themselves from high-risk activities associated with drug use such as crime and drug injection. It is interesting to note that United States Substance Abuse and Mental Health Services Administration (SAMHSA) reports that it does not support harm reduction approaches, but it does support methadone maintenance for addicts (Myers). Methadone programs are generally accepted as a harm reduction approach because they do not eliminate drug abuse and addiction, they simply replace one addiction with another.

If one form of harm reduction is generally accepted and has proven successful, the other ideas are certainly worth trying in place of programs that are not currently working. One of the drawbacks to methadone programs is that many heroin addicts do not choose to participate because they are not ready to give up the high heroin provides. In several European countries, the problem is addressed by allowing physicians to prescribe heroin. The prescribed heroin is given in a controlled manner, and although the addicts are still using drugs, the negative effects of crime and health risks are reduced. Switzerland recently ran a three-year national experiment of prescribing heroin to addicts, and found that "the health and well-being of the users in the programs clearly improved" (Riley & O'Hare). After education and treatment, one of the most important aspects of the harm reduction module is providing treatment to addicts instead of incarcerating them.

This goal can only be accomplished by loosening current prohibition laws and the abolishment of mandatory minimums. Under these current laws, addicts stand a much higher chance of being arrested for their activities than they do of receiving treatment for their addictions. In a 2001 survey, the PEW Research Center found that a majority of Americans favored the treatment of drug use as a disease rather than a crime. When given the options of either stopping drug importation, arresting drug dealers, providing drug treatment, providing drug education or arresting drug users, the same study showed that arresting drug users was the least important concern among Americans (Pew Research). In 1997 alone, close to 80 percent of drug arrests were for simple possession, not for dealing or trafficking (Beatty, Holman and Schiraldi). The high arrest rate of drug users has caused both the state and federal prison systems to become extremely overcrowded.

While America only represents 5 percent of the world's population, 25 percent of prisoners worldwide are in American prisons (Beatty, Holman and Schiraldi). Expenses to build new prisons are being paid for by taxpayers, the majority whom do not support the arrest of a large portion of these non-violent offenders. This overcrowding also increases the chances of violent offenders being released to make room for drug related arrests. In light of the changing attitudes towards the treatment of drug users as addicts rather than criminals, many states have started passing laws which allow judges to sentence rehabilitation instead of prison time. However, since our federal government still believes in prohibition above treatment, these laws only apply on a state level, and federal prosecutors still rely on mandatory minimums to convict first time non-violent offenders to lengthy prison sentences. States such as Arizona, California and Washington DC have all passed legislation within the past decade which are aimed at sending non-violent drug offenders to rehab.

In Arizona, the Drug Medical ization Prevention and Control Act of 1996 sends first and second time offenders to treatment. In 1999, the act saved Arizona taxpayers $6.7 million dollars (Drug Policy Alliance). A similar act passed in 2000 in California is expected to save taxpayers $1.5 billion dollars over five years, and prevent the need for a new $500 million dollar prison construction project (Drug Policy Alliance). Voters in Washington DC passed an act in 2002 which would not only provide treatment for drugs users and those charged with simple possession, but also allows charges in those cases to be dismissed if defendants finish their court mandated treatment.

Acts such as these are huge steps in the right direction, and proponents of harm reduction are pleased to see the nationwide climate becoming more accepting of harm reduction strategies. However, there is still no federally mandated act or law, a step which needs to happen in order for thousands of people each year to get the help they need. Opponents of harm reduction often base their arguments on the false idea that advocates of harm reduction wish to enable drug users. Harm reduction proponents simply recognize that history has proven that eliminating the use of illicit drugs is not possible, and they wish to minimize the risks of these behaviors until the time that total eradication is possible. The opposition often doesn't realize that there are harm reduction strategies in effect in this country that they are already possibly supporting.

Other than methadone programs, designated driver programs are another example of harm reduction programs already in action. While it may not be possible to stop people from drinking excessively, it is possible to reduce their harm on themselves and others by preventing them from getting behind the wheel. Even Barry McCaffrey, the director of the Office of National Drug Control Policy, which has been known for its opposition to harm reduction, has admitted that there are serious flaws in the current treatment of the drug problem in America: "It is clear that we cannot arrest our way out of the problem of chronic drug abuse and drug-driven crime. We cannot continue to apply policies and programs that do not deal with the root causes of substance abuse and attendant crime. Nor should we expect to continue to have the widespread societal support for our counter-drug programs if the American people begin to believe these programs are unfair" (qt d. in Beatty, Holman, & Schiraldi).

74 percent of Americans polled by the Pew Research Center believe that America is losing the drug war (Pew Research). Our country is in a crisis, and the methods that we have been using in an attempt to solve this crisis have proven time and time again to be unsuccessful. One of the hallmarks of a civilized society is its ability to learn from its mistakes, and devise humane and innovative solutions to its problems. Without new ideas, our society will stagnate and fall crippled by its problems. Unlike our government's current treatment of drug abuse, harm reduction does not just wish to stick a band-aid on the drug problem by imprisoning the addicted, releasing them to continue their addiction and providing no end to their suffering. Harm reduction's success may not be an immediate fix, but it is a long-term solution to what has become a very long-term problem.

Bibliography

Beatty, Phillip, Holman, Barry and Schiraldi, Vincent. "Poor Prescription: The Costs of Imprisoning Drug Offenders in the United States". Center on Juvenile and Criminal Justice 2002.
25 July 2004.
Clear, Allan. Letter to National Institute of Health. 7 May 2004.
Drug Policy Alliance. "What is Harm Reduction?" Drugpolicy. org March 2001.
21 July 2004.
Drug Policy Alliance. "Treatment vs. Incarceration" Drugpolicy. org 2004.
Myers, Jim. "Just Say Less". Youth Today May 2003.
Pew Research Center. "Interdiction and Incarceration Still Top Remedies" People-Press. com 21 March 2001.
Riley, Diane & O'Hare, Pat. "Harm Reduction: Policy and Practice". Prevention Researcher 2000.
Rosenbaum, Martha. "Kids, Drugs, and Drug Education, A Harm Reduction Approach" Drug text. org 1996.
22 July 2004.
Stossel, John. "Just Say No: Government's War on Drugs Fails". ABC News. com 30 July, 2002.
United States. Office of National Drug Control Policy. National Drug Control Strategy: FY 2003 Budget Summary.
Feb 2002.
United States. Partnership for a Drug-Free America. A Snapshot of the Teen Drug Problem in America Today 2002.
web Kate. "Anti-Drug Program Says it will Adopt a New Strategy". The New York Times on the Web 15 Feb. 2001.