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Justice Policy Institute Press Release: Data Shows Substance Abuse Treatment Reduces Crime

FOR IMMEDIATE RELEASE: Monday, January 22, 2008 Contact: LaWanda Johnson (202) 558-7974 x308 WASHINGTON - Community-based substance abuse treatment reduces crime rates and helps states reduce corrections costs, according to a new policy brief released today by the Justice Policy Institute (JPI). The Substance Abuse Treatment and Public Safety brief found that the sooner substance abuse is treated, the bigger the long-term cost savings and increases in public safety. At a time when some have raised concerns about the release of people convicted of drug offenses from federal prison due to U.S. Sentencing Commission reforms, the research shows that substance abuse treatment helps individuals transition successfully from the criminal justice system to the community. "This new report confirms that investing in drug and alcohol treatment is both socially responsible and fiscally prudent and should be a top public policy priority," said Maryland Delegate Bill Bronrott, chair of the House Committee on Drug and Alcohol Abuse. "The report documents the tangible results of treatment, such as cutting crime, reclaiming lives, and making healthier families and safer communities. More investments in these lifesaving and cost-effective services are needed now to expand the benefits of treatment that this report so clearly demonstrates." The policy brief--the last in a series that examines the impact of positive social investments on public safety--found that: Increases in admissions to substance abuse treatment are associated with reductions in crime rates. Admissions to drug treatment increased 37.4 percent and federal spending on drug treatment increased 14.6 percent from 1995 to 2005. During the same period, violent crime fell 31.5 percent. In California, where Proposition 36 diverted thousands of people from prison and jail to treatment, violent crime fell at a rate that exceeded the national average. In Maryland, where policymakers have been working to implement various approaches to diverting prison-bound people to treatment, the counties that relied on drug treatment were more likely to achieve significant crime rate reductions than those that relied on drug imprisonment. Increased admissions to drug treatment are associated with reduced incarceration rates. States with a higher drug treatment admission rate than the national average send, on average, 100 fewer people to prison per 100,000 in the population than states that have lower than average drug treatment admissions. California, in particular, experienced decreases in incarceration rates when jurisdictions increased the number of people sent to drug treatment. Substance abuse treatment prior to contact with the justice system yields public safety benefits early on. Research has shown that drug treatment programs improve life outcomes for individuals and decreases the likelihood that a drug-involved person will be involved in the criminal justice system. Substance abuse treatment helps individuals transition successfully from the criminal justice system to the community. Community-based drug treatment programs reduce the chance that a person will become involved in the criminal justice system after release from prison. Substance abuse treatment is more cost-effective than prison or other punitive measures. The Washington State Institute for Public Policy (WSIPP) found that community-based drug treatment is extremely beneficial in terms of cost, especially compared to prison. Every dollar spent on drug treatment in the community is estimated to return $18.52 in benefits to society in terms of reduced incarceration rates and associated crime costs to taxpayers. "If lawmakers invest in community-based substance abuse treatment--instead of prison beds--for people living with addiction, our communities will reap tremendous benefits," says JPI Executive Director Sheila Bedi. "Crime rates will decrease, families will remain intact and since treatment is less expensive than incarceration, state budget dollars can be redeployed to meet education, housing, infrastructure and other pressing needs. " For more information on this or other research, contact LaWanda Johnson at 202-558-7974 ext. 308.
Localização: 
Washington, DC
United States

Asia: China Set to Adopt Anti-Drug Law

China's National People's Congress is set to pass that country's first anti-drug law to curb drug use and trafficking. Currently, drug offenses are handled under China's general criminal law.

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Chinese anti-drug poster
The Congress this week is studying a third draft of the law after its Law Committee announced Sunday the law was "ready for adoption." If passed in its current form, the drug law would mark a step forward for China's estimated 1.16 million registered drug users. Current regulations require drug users to be confined in rehabilitation centers, but under the new law, many would be able to undergo treatment in their communities.

The law would also exclude minors under 16 and pregnant or breastfeeding women from compulsory isolated drug rehabilitation, although this provision was controversial. Some lawmakers argued that youthful drug offenders could receive treatment designed especially for them in an isolated environment.

"If some parents are unable to help their addicted children rehabilitate, and community corrections have proved ineffective as well, then young addicts should receive isolated compulsive drug-rehab," they argued.

Among the drugs banned in the new drug law are opium, heroin, morphine, marijuana, methamphetamine, and cocaine. The law also sets strict rules on the clinical use of pharmaceuticals and other chemicals and medicines that could be used to make illegal narcotics, such as methadone and ephedrine.

China's opium trade was virtually wiped out after the Communist Party took power in 1949 -- an historically unique event -- after the party combated it using the same draconian repression with which it attacked Chinese society as a whole. Like prostitution and other perceived Western vices, however, opium has staged a comeback in China in the wake of economic reforms over the past three decades. The Chinese government reports that the number of registered drug users had increased by a whopping 35% between 2000 and 2005.

It is unclear what criminal sanctions the new law contains. Under current Chinese law, drug trafficking can merit sentences as severe as death. Some 50,000 people were arrested on drug trafficking charges last year.

Drug Treatment: Federal Budget Provides Same Funding or Small Increases for Treatment, Prevention Programs, But Reduces Safe and Drug-Free Grants Program

As part of the half-trillion dollar omnibus appropriations bill approved by Congress this week and expected to be signed shortly by President Bush, drug treatment and prevention funding was approved with small changes from last year. Most treatment and prevention programs saw level funding or small increases, with the exception of the Safe and Drug-Free Schools and Communities grants program, which took a significant hit.

Under the spending measure, drug and alcohol education, prevention, treatment and research programming will receive the following amounts:

  • The Substance Abuse Prevention and Treatment (SAPT) Block Grant will receive $1.7587 billion, funding roughly level to FY 2007 and the President's budget request.
  • The Center for Substance Abuse Treatment (CSAT) will receive $399.8 million, $895,000 over FY 2007 and $52 million over the President's budget request.
  • The Center for Substance Abuse Prevention (CSAP) will receive $194.12 million, a $1.2 million increase over 2007 and $37.6 million over the President's request.
  • The Safe and Drug-Free Schools and Communities (SDFSC) State Grants program will receive $294.76 million, a cut of $51.7 million from last year's funding but $194.7 million over the President's FY 2008 budget request.
  • The National Institute on Drug Abuse (NIDA) will receive $1.001 billion, $2 million over FY 2007 and $1 million more than the President's budget request.
  • The National Institute on Alcohol Abuse and Alcoholism (NIAAA) will receive $436.26 million, a $674,000 million increase over last year's funding and approximately $700,000 less than the President's budget request.

While the Safe and Drug-Free Schools and Communities grant program was slashed to just under $300 million, that is still almost $200 million more than the Bush administration requested. Other areas of the federal drug budget changed too -- see feature story this issue for further information.

Feature: The 2007 International Drug Policy Reform Conference -- Mr. Costa Meets the Opposition

The 2007 International Drug Policy Reform Conference in New Orleans kicked off with a bang Thursday as Antonio Maria Costa, head of the UN Office on Drugs and Crime, told a boisterous and sometimes combative audience of drug reformers that while a drug-free world is probably not attainable, it is almost certainly desirable, and that he would continue to work toward that goal.

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Antonio Maria Costa (courtesy DrugWarRant.com
Costa, who as head of the UNODC is the leading cheerleader for the global drug prohibition regime and chief chider of governments UNODC believes are not making sufficient efforts in the war on drugs, is the highest placed drug war figure to ever address a drug reform conference. But while his attendance could mark the beginning of a broader dialog on global drug policy, at various points Thursday it seemed more like a dialog of the deaf.

His remarks came on the opening morning of the three-day conference hosted by the Drug Policy Alliance, and co-hosted by Students for Sensible Drug Policy, the Marijuana Policy Project, Law Enforcement Against Prohibition, the American Civil Liberties Union, the Harm Reduction Coalition, and the Criminal Justice Policy Foundation. With more than a thousand attendees, the joint 2007 conference is the largest drug reform conference ever.

"A drug-free world is not a slogan I use," Costa told the opening morning crowd. "It is an aspiration, not an operational target, much as one aspires to eliminate poverty or hunger or disease."

While Costa flatly rejected drug legalization, he also suggested that drug law enforcement was not the ultimate "solution" to drug use and the drug trade. Even if all the drugs produced around the world this year could be eradicated, he said, they would be planted again next year -- and if farmers in Colombia or Afghanistan didn't want to plant them, farmers somewhere else would. "While law enforcement is necessary, it is not sufficient," he told the crowd.

The answer, Costa argued, is not on the supply side but the demand side. "Lowering demand is the necessary condition to make drug policy realistic and sustainable," he said, adding that that could be achieved by "prevention, harm reduction, and treatment, combined with comprehensive health programs."

Then the top global anti-drug bureaucrat took on the topic of legalization. "Some people say drug use is a personal choice and nobody else's business," he said, as the room erupted with sustained applause. The room quickly quieted, however, as Costa continued: "I have some problems with this. First, this is a health issue. Drug abuse is a disease affecting the brain, triggered by individual vulnerability," he suggested, as scattered hissing and booing broke out.

"Drugs are not dangerous because they are illegal, they are illegal because they are dangerous," Costa bravely soldiered on, only to be met with a crescendo of boos.

Costa also addressed the argument that drug prohibition creates violence, if only obliquely. "You say prohibition creates violence and crime by creating a lucrative black market, so legalize drugs to defeat organized crime. I agree with you, but this is not only an economic argument," he maintained. "Legalization will increase the damage done to individuals and society."

For Costa, there are no drug users, only "addicts" who need help. "Why do we have these ideological debates about drug addiction?" he complained. "People aren't divided about treating tuberculosis or AIDS."

Careful to repeatedly mention that he supported harm reduction as well as prevention and treatment, Costa called on the audience to join him as an "extremist of the center" in an effort to destroy demand for drugs. "We all want to help the farmers and the drug addicts and reduce the crime and violence," he said. "Let us build on this common ground to build a safer and healthier world."

Costa's positions did not go unchallenged. Immediately following him at the podium was Kasia Malinowska-Sempruch, Director of the International Harm Reduction Development program at the Open Society Institute, who went through a litany of repression of drug users: ranging from Russia, where police often block them from gaining access to health care; to China, where police wait outside needle exchanges and arrest people on the way out; to Thailand, where authorities killed thousands of suspected drug users in 2003; to India, where throwing users in cages passes as drug treatment; and Kazakhstan, where female users are subjected to body searches and forced to engage in sex acts to get their seized drugs back.

"When you look at the UNODC report on drug treatment in India," she noted, "those people in the cages are going to be counted. There are no standards for what is drug treatment; the numbers are self-reported."

Costa took even more flak at a lunchtime question and answer session immediately following the presentation. As attendees eager to see the exchange packed the room past capacity, a cavalcade of drug policy reformers and scholars took aim at the UNODC head and his arguments.

"This is a healthy opening," said UC Santa Cruz sociologist Craig Reinarman, who praised Costa for his fortitude in coming to the conference and his charm in making his case. "If you're wrong on most of the arguments, it helps if you're charming." Reinarman challenged Costa on his prescription to deal with drug users by subjecting them to drug treatment. "We agree on making treatment available to all who want it, but the vast majority of people who use illicit drugs do not become addicts who need treatment. The idea that you will treat people who don't have a disease flies in the face of everything I know about medicine," Reinarman said.

He also attacked Costa's claim that reducing supply would reduce demand and the problems attendant with drug use. "The availability of drugs is not correlated with drug problems," he said, citing the case of the Netherlands. "It is surrounded by countries with far more restrictive prohibitionist policies that also have higher figures for use, addiction, overdose deaths, and the like. The notion that there is a correlation between repressive drug policies and use levels is just not borne out by the facts."
Costa did not respond directly to Reinarman, instead diverting the observation by claiming that the Netherlands had "poisoned Europe" with amphetamines produced there, probably an even less apt reference to Dutch production of ecstasy, which in UN-speak is an "amphetamine-type stimulant."

Wealthy San Francisco libertarian John Gilmore reproved Costa for talking treatment while continuing to endorse repression of drug use. "We don't prosecute diabetics," he noted. Costa did not respond.

"Most of what you said flew in the face of reality," chided Pat O'Hare, executive director of the International Harm Reduction Association, who took special umbrage at Costa's repeated call for tackling the problem through reducing demand. "We don't know how to reduce demand," he said bluntly. "I want regulation; right now, we have almost no control. I'm prepared to accept slightly more drug use, but a load less harm."

Again, Costa failed to respond directly, although he grew increasingly testy. In response to a query about medical marijuana, he almost sneered: "I don't believe in buying joints," he said. "You don't need to lick mold to get penicillin," he said, eliciting groans and jeers from the crowd.

To charges that the global prohibition regime he cheerleads is financing terrorism and political violence around the globe, Costa agreed that indeed groups like the FARC in Colombia and the Taliban in Afghanistan were profiting from the black market drug trade. "The best response is to quit buying that stuff," was the solution he proffered, a response that brought laughter and jeers.

And with that, the UN's head drug-fighter was gone, off to catch a plane for New York as the conference attendees collectively took a deep breath and scratched their heads. Whether Costa was persuaded to see the errors of his ways remains to be seen, and, given his performance Thursday, that seems most unlikely. But the fact that the top global drug-fighter felt it necessary to enter the lion's den and take on the pride suggests that the movement is making progress. As that old agitator Mahatma Gandhi once said, "First they ignore you, then they ridicule you, then they fight you, then you win."

[Editor's Note: The New Orleans conference continues through Saturday. Look for more reports in the Chronicle next week and some blog posts in the meantime.]

Visit http://www.drugwarrant.com for extensive blogging from the conference, and check back at http://stopthedrugwar.org too.

Africa: NGOs Criticize Emphasis on Cutting Drug Supply, Urge Attention to Demand Reduction

Non-governmental organizations (NGOs) from across West and Central Africa meeting last weekend in Dakar, Senegal, criticized the United Nations (UN) and West and Central African governments for focusing on reducing the supply of drugs to the extent that they are ignoring demand reduction strategies, according to the UN news service IRIN.

The region has received increasing attention in recent months as a transshipment point for South American cocaine headed for insatiable European markets. It also produces marijuana for local consumption and export to Europe.

While money is beginning to flow into the region in an effort to suppress the drug trade, that money is not being matched with funds for treatment and prevention, said delegates to the meeting, part of a global NGO forum called "Beyond 2008" and coordinated by the Vienna NGO Committee on Narcotic Drugs.

"There is total disequilibrium with regards to the means given to different actors in the fight against drugs," Cheikh Diop, president of the Federation of Senegalese NGOs Fighting against Drugs, told IRIN. "So much money is invested in the fight against drug trafficking or the reduction of supply; but when it comes to reducing the demand -- or the users themselves -- organizations working on this approach have almost no financial means."

"We don't have the means to do what we want to do," said Abdoulaye Diouf, local organizer of the meeting and manager of the Senegalese Jacques Chirac drug information and awareness center.

"The fight against drugs will never succeed solely through repression," the anti-drug federation's Diop said. "How long have we been putting people in jail? And how long has the drug problem continued?"

He said there are few if any treatment facilities available for drug users in West Africa. Poverty-stricken street kids who fall into drugs need to be given alternatives and the general population must be educated about the risks of drug use, he said.

NGOs have become deeply involved in the fight to reduce drug use since the UN General Assembly special session on the global drug problem in 1998, but they complain that they lack resources, as well as training in research, analysis, and marketing. And governments too often ignore them, they said.

"There is almost no collaboration between NGOs and government," Diouf said. "When it comes to planning and implementing activities, NGOs are ignored in many countries."

Drug War Chronicle Book Review: "Addiction-Proof Your Child: A Realistic Approach to Preventing Drug, Alcohol, and Other Dependencies," by Stanton Peele (2007, Seven Rivers Press, 258 pp., $14.95 PB)

Phillip S. Smith, Writer/Editor

Teens on drugs! Almost nothing in America these days frightens parents as or throws society into a conniption fit as much as the prospect of young people using drugs. That's why we have DARE, zero tolerance, drug dogs in schools, drug testing in schools, and all those other programs and policies designed to eliminate teen drug use.

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There is, of course, legitimate reason for concern: No one wants charming little junior to grow up to be a junkie, no one wants his son to end up as a drug overdose statistic or his daughter to wander the streets selling herself for the next rock of crack. Less dramatically, no parents want their kids to fail to achieve their potential because they're spending their days sitting on the couch smoking pot or their nights driving around swilling booze.

But the programs and policies devised so far to eliminate or at least reduce teen drug use have demonstrably failed. For decades, about half of all teens report having used some drug, and even higher numbers report drinking. Naturally, parents, school administrators, and police call for redoubled efforts in the face of such numbers, as if more of the same failed approaches would result in a different outcome.

When it comes to teen drug use, it's time for an intervention, and who better than Dr. Stanton Peele, the New Jersey-based psychologist who has been studying and writing about addiction and related issues for decades? Peele is controversial -- he rejects the currently popular "disease model" of addiction, he scoffs at "abstinence only" approaches to recovery -- but his latest contribution, "Addiction-Proof Your Child," is calm, collected, and a common sense approach to grappling with teen drug use.

A primary message for parents from Dr. Peele is "don't freak out." As noted, teen drug use is so prevalent as to be normal, just part of adolescent life. Yes, there are indeed dangers related to drug use and drinking, but, as Peele shows, most teens use drugs without overdosing, becoming junkies or prostitutes, or otherwise destroying their lives. If your kid is smoking pot, it doesn't mean he is necessarily on the path to perdition, and the casual teen pot smoker certainly doesn't need to be stuffed into some kind of 12-step, just-say-no, abstinence-based treatment program. In fact, Peele argues, such programs may only make things worse. Reshaping a young person's perceptions so that he identifies himself as an "addict" is self-defeating and disempowering, Peele believes.

It's not that Peele thinks addiction is a myth -- quite the contrary. Peele has an expansive definition of addiction that includes not only dependence on mind-altering substances, but also phenomena like video gaming and internet porn addictions, and even food addiction, which he sees as a leading contributor to the current epidemic of teen obesity.

But unlike the molecular fetishists of the disease model of addiction, led by Dr. Nora Volkow and her well-funded legions of researchers at NIDA, Peele sees addiction not so much as a biopharmacological phenomenon, but as a behavioral one. As Peele titles one chapter, "The problem is addiction, not drugs."

Healthy, well-adjusted kids who are taught good values and personal responsibility are less likely to run into problems with drug use, or video gaming, or overeating, Peele posits. It makes sense. We all know people who used drugs as teenagers, and we all need to acknowledge that the fact that a kid smoked pot doesn't mean he is inevitably headed for skid row.

In "Addiction-Proof Your Child," Peele puts his decades of clinical experience in dealing with problematic (and not so problematic) drug use to work for parents, educators, and anyone else dealing with what can be a frightening issue. He is clear, compelling, and level-headed, and the book is full of easily digestible wisdom about what it takes to make an "addiction-proof" child.

"Addiction-Proof Your Child" is a desperately needed intervention in an area too often filled with hysterical fears. We don't want our kids to become junkies, but as Peele shows, there are much better and sensible approaches than relying on DARE cops and their horror stories or 12-step programs and their insistence on life-long identities as "addicts." DRCNet regularly offers books as premiums for our donors. This one needs to be added to our list right now. It is most useful, full of insights, and a healthy corrective to the misinformation and disinformation that all too often passes for drug education.

Feature: Is Addiction a Brain Disease? Biden Bill to Define It as Such is Moving on Capitol Hill

A bill introduced by Sen. Joe Biden (D-DE) that would define addiction as a brain disease is moving in the Senate. Treatment professionals, mainstream scientists, and recovery advocates see it as a good thing. There are some skeptics, though.

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NIDA book cover, with brain scan image
The bill, the Recognizing Addiction as a Disease Act of 2007 (S. 1011), would also change the name of the National Institute on Drug Abuse (NIDA) to the National Institute on Diseases of Addiction, and change the name of the National Institute on Alcohol Abuse and Alcoholism to the National Institute on Alcohol Disorders and Health.

"Addiction is a neurobiological disease -- not a lifestyle choice -- and it's about time we start treating it as such," said Sen. Biden in a statement when he introduced this bill this spring. "We must lead by example and change the names of our federal research institutes to accurately reflect this reality. By changing the way we talk about addiction, we change the way people think about addiction, both of which are critical steps in getting past the social stigma too often associated with the disease. This bill is a small but important step towards stripping away the social stigma surrounding the treatment of diseases of addiction," said Sen. Biden.

The measure is garnering bipartisan support. It passed out of the Senate Health, Education, Labor and Pensions (HELP) committee in June with the backing of Sen. Mike Enzi (R-WY), the ranking minority committee member. "Science shows us the addiction to alcohol or any other drug is a disease," Enzi said in a statement marking the vote. "While the initial decision to use drugs is a choice, there comes a time when continued use turns on the addiction switch in the brain. That time can vary depending on factors ranging from genetics to environment to type of drug and frequency of use. Because of that and the continued stereotypes and challenges that are often barriers to people with addiction issues seeking treatment I am proud to support this legislation. Although the names of the Institutes will change, their mission -- preventing and treating drug and alcohol addiction -- will remain the same."

The politicians are taking their cue from neurological researchers led by NIDA scientists who have been working for years to find the magic link between the brain and compulsive drug use. Dr. Nora Volkow, current head of NIDA, has been leading the charge, and Biden and Enzi could have been reading from her briefing book.

"Drug addiction is a brain disease," said Volkow in a typical NIDA news release. "Although initial drug use might be voluntary, once addiction develops this control is markedly disrupted. Imaging studies have shown specific abnormalities in the brains of some, but not all, addicted individuals. While scientific advancements in the understanding of addiction have occurred at unprecedented speed in recent years, unanswered questions remain that highlight the need for further research to better define the neurobiological processes involved in addiction."

Not surprisingly, the treatment and recovery communities, anxious to see the social climate shift to one of more support and less punishment for the addicted, support the legislation. "Recognizing addiction is the next step forward," said Daniel Guarnera, government relations liaison for the NAADAC -- The Association for Addiction Professionals. "NIDA and its scientists have demonstrated overwhelmingly that addiction is not a behavioral trait, but rather is caused by physiological changes to the body that make people want to use addictive substances. This bill allows the terminology to catch up with the science."

Although the bill does little more than make a congressional pronouncement and rename a couple of institutes, it is still an important step, said Guarnera. "Yes, it's symbolic, but that symbolism is hugely important, because language should reflect medical knowledge, and medical knowledge has demonstrated that drug abuse is a physical phenomenon."

"We utterly endorse this bill," said Pat Taylor, executive director of Faces and Voices of Recovery, a treatment and recovery advocacy umbrella organization. "I think it's a great idea to rename the agencies. People with drug and alcohol problems can and do recover from addiction. Calling them 'abusers' just stigmatizes them."

Taylor and her organization are actively supporting the bill, she said. "We've sent letters of endorsement for the bill," she said. "People blame people for their drug and alcohol problems, so this is an important issue for the recovery community. We need to rethink how we talk about this."

Is addiction in fact a brain disease? Some researchers think that's too simple. Scott Lilienfeld, a professor of psychology at Emory University told ABC News last week: "What I find troubling with the brain disease rhetoric is that it's grossly oversimplified, it boils down an incredibly complex problem to not necessarily the most important explanation. You can view a psychological problem on many levels. Low level explanation refers to molecules in the brain. There are other levels including people's personality traits and moods, people's parents, environment. Higher level than this is community."

"Every level tells you something useful," Lilienfeld continued. "Brain disease is only one level among many and not even the most helpful. Implying it's the only level of explanation, that's counterproductive."

Some mavericks go even further. "No, addiction is not a brain disease," said Dr. Jeffrey Schaler, a psychologist and professor in the Department of Justice, Law and Society at American University in Washington, DC, and author of "The Myth of Addiction." "Diseases are physical wounds, cellular abnormalities. Addiction is a behavior, something that a person does. Diseases are things a person has," he argued.

"You can't will away a real disease," Schaler continued. "But people will away behaviors they don't like all the time."

Others feel that the concept of addiction itself is too imprecise. "There is no clear conception of what people mean by the word 'addiction,' and there are numerous papers on this unsatisfactory concept," said Professor John Davies, head of the Center for Applied Social Psychology at the University of Strathclyde in Scotland, another prominent critic of the "addiction is a brain disease" model. Using drugs and 'addiction' are not synonymous," Davies continued, noting that many "fun drug users" become "addicts" as soon as they end up in court.

"Of course, people can and do get into an awful mess when they fail to manage their habit effectively," Davies concedes. "But look at the data. Harmful damaging drug use is heavily social-class related whereas drug use per se is less so. People give up the so-called 'disease' when their lives change, they get a new partner, a new job, a move of house."

"Sen. Biden's crusade is part of a decades-long, political struggle to isolate drug habits in users and to obscure the social and historical factors that ultimately underline so-called drug problems," said Richard De Grandpre, author of "The Cult of Pharmacology: How America Became The World's Most Troubled Drug Culture" (see review here next week), citing the case of the Vietnam war veterans who picked up opiate habits, but who, for the most part, rapidly shed them upon returning home.

"These vets used chronically and were said to be addicted. What happened to their addictions?" De Grandpre asked. "The feared epidemic did not materialize because the social factors that sustained heroin use in Vietnam had all but disappeared upon returning."

Davies sees the addiction label as having pernicious consequences for problem users as well. "It makes things far worse," he said. It makes people believe that the roots of their behavior are beyond their capacity to control, which is the last thing you need when you're trying to get someone to change their behavior."

How should drug policy reformers (e.g., those concerned first and foremost with loosening prohibitionist drug policies) respond to the Biden bill? Rhetorically, both the "disease" and "choice" models have been used repeatedly to justify draconian policies -- the former at drug sellers, who mostly are not kingpins or monsters seeking to addict children to their goods, but get charged as such in the court of public opinion -- the latter at problem users, or even users in general, because they should just stop, because it's a choice.

"I tend to think that language changes that reduce the fuel in the drug discussion will help rather than hurt our cause," said David Borden, executive director of Stop the Drug War (DRCNet, publisher of this newsletter). "Terms like 'Diseases of Addiction' pack less verbal or rhetorical punch than shorter ones like 'Drug Abuse,' and are less useful for purposes of political propaganda. If the names of the agencies shift, the language coming out of the agencies will also have to shift, at least somewhat, and that will help -- it will be harder for politicians to focus their rhetoric on nonsense statements like 'all use is abuse,' if 'abuse' is no longer the government-endorsed term of choice in the discussion."

"Those are political concerns, however," Borden pointed out. "If 'disease' is a scientifically imprecise term for describing the set of conditions that are commonly known as 'addiction' -- and it seems to me that it probably is -- then Congress and NIDA probably shouldn't be using the term for that purpose. I'd be more comfortable with the bill if it used slightly different language." Still, he thinks it's probably a net positive. "I think the obvious message of the terminology shift would be to say that people with drug problems are not really criminals, and that's a good thing."

"Plus if addiction isn't a disease, there's still obviously some condition that some people have, physical for at least some of them, that makes it harder for them to make favorable choices," Borden added. "Otherwise I don't think there would be thousands of people risking arrest or overdose to inject themselves daily with heroin, or millions knowingly doing what they're doing to themselves with cigarette smoking. So I'm not sure that the imprecision in the term chosen for the discussion is such a big problem."

Schaler disagrees. "Drug policy reformers play into the hands of the therapeutic state when they support the idea that drug addiction is a treatable disease," he said. "It means doctors have more power over people instead of just drug agents."

In principle, neither Congressional fiat, nor therapists' concerns over what the right message is to send to patients, nor advocates' concerns over what will ultimately lead to better policies, should take a second seat in this debate -- the question is fundamentally a scientific one, and a philosophical one. With Congress holding the purse strings for the bulk of addictions research in this country, however, Congress' choices now may indeed affect the language being used in the future for some time to come. And language can indeed have an impact in ways going beyond its initial purposes.

Memo to Lindsay Lohan, Paris Hilton and Al Gore III: Drug Treatment Isn't a Silver Bullet

Localização: 
United States
Publication/Source: 
AlterNet (CA)
URL: 
http://www.alternet.org/story/58672/

Southeast Asia: Singapore Gives Treatment Option to Marijuana, Cocaine Users

Beginning August 1, marijuana and cocaine users caught in Singapore will face mandatory treatment at Drug Rehabilitation Centers, the Central Narcotics Bureau announced Wednesday. That means cocaine snorters and pot smokers will be given the same shot at "rehabilitation" as other drug users in the Southeast Asian city-state. Previously, marijuana and cocaine users were not eligible for treatment and faced stiff prison sentences.

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Singapore Central Narcotics Bureau logo
But they better get it right the first time. People who undergo treatment and relapse and get arrested again will face a mandatory minimum five-year prison sentence and three strokes of the cane. Third offenders are looking at seven years and six strokes of the cane.

People who undergo "rehabilitation" and suffer relapses face a mandatory minimum seven-year prison sentence, as well as between six and 12 strokes of the cane.

Singapore has some of the world's toughest drug trafficking laws, and its Misuse of Drugs Act includes the death penalty for some drug offenses, including the trafficking of more than 660 grams (slightly more than one pound) of marijuana. Now, it will also have some of the world's harshest marijuana law enforcement directed at users.

DPA Press Release: NY Poised to Become First State to Require Addiction Programs to be Smoke-Free, Aimed at Helping Clients Quit Smoking; Treatment Advocates See Rule as a Mixed Bag

For Immediate Release: July 24, 2007 Contact: Tony Newman at (646) 335-5384 NY Poised to Become First State to Require Addiction Treatment Programs to be Smoke-free, Aimed at Helping Clients Quit Smoking Treatment Advocates See New Rule as a Mixed Bag: Applaud Effort to Help Smokers Quit; Warn of Possible New Barriers to Treatment Created by Smoke-free Centers New York Alcohol and Substance Abuse Service officials announced today a new rule that will require treatment centers to help their patients to quit smoking. The plan, which is slated to take effect next year, will require treatment centers to help patients quit smoking by offering nicotine replacement therapy, including nicotine gum and patches, to all smokers. For those lacking health insurance, the nicotine replacement therapy will be free of charge. The treatment centers also will be required to be smoke-free. Smokers will be prohibited from smoking at the centers. Officials estimate the new law will impact 110,000 patients on any given day. Approximately 92 percent of those in alcohol and other drug treatment programs are cigarette smokers, according to official estimates. Treatment advocates have mixed feelings about the new rule. They are applauding the effort to help people quit smoking, but warn that the smoking ban may deter some smokers who are hoping to quit other addictions. “Smoking leads to more premature deaths than all illicit drugs combined and it is a positive development to offer nicotine replacement therapy to all who want it,” said Ethan Nadelmann, executive director of the Drug Policy Alliance. “But prohibiting smoking at the treatment centers may discourage people who want and need treatment to other drugs, but are not willing or able to stop smoking.” Many people struggling with addiction may have problems with multiple drugs, both legal and illegal. Advocates caution against barriers that will discourage people from seeking out help. “Not everyone can or wants to abstain from all drugs all at once,” said Tony Newman, media director at the Drug Policy Alliance. “Do we really want to set up barriers for someone who wants to quit heroin, but may not be ready to quit cigarettes? We need open doors that encourage people to get help for their problems, whether it be for illegal or legal drugs, and not rules that drive people away from life-saving programs.”
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