Thursday, February 23, 2012

Drugs-- A Guest Post From Dr. Lee Rogers (D-CA)


Yesterday, we wondered who would wind up with a longer criminal rap sheet by November, Howard "Buck" McKeon in California or Michael "Mikey Suits" Grimm in New York. Staten Island Democrats haven't coalesced around an opponent for Grimm yet, but Santa Clarita, Simi Valley and Antelope Valley Democrats are very much behind Dr. Lee Rogers, who won the official endorsement of the California Democratic Party last week-- as well as an endorsement from Blue America. After the whole nation's attention focused on the death of Whitney Houston last week, we asked Lee to discuss drug abuse and addiction from a doctor’s perspective. Here's a guest post he did between campaign stops (and surgeries) yesterday:

Replace the “War On Drugs” with the “War On Addiction”

The tragic death of singer Whitney Houston has publicized again the difficulties that some face with drug addiction. Addiction is a complex brain disease that results in a compulsive behavior of seeking and using drugs. In many cases, the addict knows that the substance has deleterious effects on their health, but the nature of addiction leads them continue the behavior. Addiction is not as simple as a choice to use or not to use.

Addiction comes in many forms other than illegal substances, like nicotine, alcohol, foods, shopping, gambling, video games, and sex. Even though a similar physiologic process occurs with all addictions, only with drugs does society think that incarcerating the addict is acceptable.

Here are some statistics from the National Institute on Drug Abuse:
Alcohol: 30 million people drove under the influence of alcohol at least once in the past year

Tobacco: Rates have declined in 12- to 17-year-olds to 9%, but in young adults 18 to 25 years old, the rates are 36% in 2009.

Marijuana: Most measures of marijuana use increased in high school aged children and young adults. Twenty-one percent of high school seniors reportedly used marijuana in the past 30 days.

Cocaine: Current cocaine or crack use has declined in all age groups from 2.3 million users in 2003 to 1.6 million users in 2009.

Methamphetamines: Use of methamphetamines declined from 6.5% in 1999 to 2.2% in 2010.

Prescription Drugs: Nonmedical use of narcotics remained relatively stable, as did the use of Adderall.

With all these people suffering from this disease, one would expect a national outcry for action. One would expect government funding of treatment programs aimed at managing addictions and preventing relapse. Not even close. We have reactionary laws and overloaded court systems. America has the highest incarceration rate in the world. Of the 2.3 million inmates in U.S. prisons, 25% are due to drug offenses at a cost of $70 billion per year. Some states have mandatory sentencing and three-strikes-and-you’re-out laws for drug crimes which can result in life imprisonment. Additionally, penalties vary based on the type of drug. In some states, possession of crack cocaine is treated much harsher than powder cocaine. This leads to a racial disparity in penalty enforcement since minorities more frequently use cheaper crack cocaine.

Prescription drug abuse is treated differently by society, but may be a larger problem. In 2005, an estimated 4.4 million teenagers misused prescription pain relievers, 2.3 million took a prescription stimulant, and 2.2 million abused over-the-counter drugs such as cough syrup. Prescription drug overdose was responsible for 22,400 deaths in 2005, causing more deaths than illicit drugs. Recent deaths from prescription drug abuse and misuse have plagues the entertainment industry, with Whitney Houston, Michael Jackson, Heath Ledger, and Brittany Murphy all falling victims. While prescription drug abuse and diversion is a crime, abusers are rarely prosecuted, but they also rarely get resources to help them quit. Society doesn’t view it as serious as illicit drug abuse and friends or family may not intervene. Rehabilitative centers are expensive and drug abuse is frequently omitted from health insurance coverage.

My Congressional district in California is typical for American suburbia. We have seen an increase in heroin use, school expulsions, and related deaths. In order to reverse this troubling trend, we need to attack it head on. Prevention is the best policy for drug addiction. Identifying those at risk, providing education, and targeting and prosecuting sources. When addiction does occur, recognizing that it is a brain disease and engaging a team of medical and social experts to treat it and prevent recidivism.

The War On Drugs has been a failed policy and resulted in enormous expense, an increase in violence, and violations of civil rights. How could one consider it successful? Today, drug use is rampant and more extreme violence occurs than before the “war.” Because of criminalization of drug use, convicts fall into a circular trap, which prevents them from effective rehabilitation and entering society. Drug offenses create a permanent underclass of people who have limited educational or job opportunities.

I have heard the argument that our War On Drugs is responsible for the instability in our Southern neighbors, especially Mexico. The illegal drug industry in Mexico is fueled by American demand and creates wealthy cartels who corrupt the government and wreak havoc on cities. But American policy does little to reduce “customers” for the Mexican traffickers. In fact, it makes the cartels richer by artificially inflating the price of the drug since it is prohibited. Remember the crime surrounding the alcohol industry in the U.S. during prohibition.

It’s time to reevaluate our drug policies in the U.S. A better group of policies would be a War On Addiction with appropriately-aimed resources. We could save some of the $70 billion a year from incarcerating non-violent drug offenders and some of the $15 billion a year the US spends on the War On Drugs and dedicate it to programs to treat addicts and prevent relapses. We could spend that money on programs to educate students and young people. So instead of paternalistically telling them to say “no” to drugs, we provide them with evidence on the dangers of illicit drug use which helps them to arrive at their own decision. We can take steps to remove the stigma of drug addiction so those who need help are not dissuaded from seeking it. Furthermore, we can work to make drug abuse and addiction a cobered benefit in insurance plans.

Don’t misinterpret my message. Production and distribution of illicit drugs should remain a crime and traffickers should be punished, but addicts should be treated. Let’s get tough on addiction.

Labels: , ,


At 1:06 AM, Anonymous Anonymous said...

"Production and distribution of illicit drugs should remain a crime and traffickers should be punished, ..."

Arresting drug dealers is pointless. Every dealer that has ever been arrested has been immediately replaced. Forty years of arresting dealers and every market has all the dealers it wants. We will run out of dealers when we run out of young men looking to make a buck.

Interdiction is also pointless. You've read about "big" busts. You've never seen the headline :
Heroin Users Growing Anxious, Six Days and Still No Supply
Interdiction results in minor and temporary changes in price. Every urban area has all drugs available at reasonable prices.

The first thing to notice about the war against people who use drugs is that nothing has ever been accomplished. There is no discussion of milestones achieved or corners turned because there have been none. There is no discussion of an exit strategy because there is no theoretical basis for one. The entire war should end because it has entirely failed. Advocating that the war should continue as planned against the "bad" guys is a mistake. The war creates the "bad" guys. Ending the war would eliminate them.

At 7:44 PM, Blogger lindacheekmd said...

The war on addiction should aim at the cause, not just treatment for the addict. Let's try preventing addiction instead of just covering it up like we do with everything else in conventional medicine.
And stop attacking good pain management physicians like myself, putting hundreds of legitimate pain patients on the street creating more addiction. Book--Target: Pain Doc.

At 1:14 AM, Blogger Unknown said...

Because of the increase of drugs cases, there's also a continues increase of addiction treatment in California.


Post a Comment

<< Home