Addiction in Society

Addiction—the thematic malady for our society—entails every type of psychological and societal problem

A New Drug Control Policy: Managing Drug Use

As more people die of drug overdoses, we tell them not to take drugs

You heard a lot about taking drugs if you grew up, like I did, in the 1960s.  Come to think of it, you heard a lot about drugs if you grew up in the 1970s, 1980s, and, like my kids, the 1990s and 2000s.  Thank God you don't hear much about drug use now, in the second decade of the 21st Century.

Ooops!

Let's see. There was marijuana -- well, there still is, isn't there? Perhaps you heard that it has been legalized in several states (Washington and Colorado). And legalization is unlikely to stop there.

Then, in the 1980s, there was cocaine and, following on it, its close relation in terms of drug effects, meth (one was distilled as crack, the other is called crank).  Actually, you still hear a lot about that, don't you?

Then there was ecstasy, or MDMA, which was made illegal in most countries.  Oh, did you know, at the same time, its use has been approved in a number of countries for its therapeutic possibilities?

After ecstasy came a host of designer drugs.  Now, new designer drugs are produced so rapidly, they overwhelm the resources of agencies charged with regulating them.   This article, called "A New Global Drug Problem," focuses on these proliferating synthetic substances (along with newly legalized marijuana):

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During a press conference in London, Raymond Yans, president of the United Nations’ drug-monitoring body, the International Narcotics Control Board, said that recently passed laws in Colorado and Washington were nothing short of pathways “for recreational use.”

The world has a growing drug problem, and much of the drugs are legal.

The proliferation of both traditional garden-variety illicit drugs and high-end, pharmaceutically complex drugs – as well as the opening of previously closed markets, has officials from Brussels to New York in a tizzy.

But that's not the latest drug worry here in the United States.  That worry is pharmaceutical painkillers, which have been announced to be the largest -- and a growing (particularly among women) -- cause of overdose deaths.

Prescription pain pill addiction was originally seen as a man’s problem, a national epidemic that began among workers doing backbreaking labor in the coal mines and factories of Appalachia. But a new analysis of federal data has found that deaths in recent years have been rising far faster among women, quintupling since 1999.

More women now die of overdoses from pain pills like OxyContin than from cervical cancer or homicide. And though more men are dying, women are catching up, according to the analysis by the Centers for Disease Control and Prevention. And the problem is hitting white women harder than black women, and older women harder than younger ones.

Do you get the feeling that we haven't gotten a handle on this problem with our current approaches?  NBC's national news program last night focused on the latest drug scourge by identifying a young woman who became addicted to pain pills, went on to heroin, entered recovery, and is now helping an older woman undergoing treatment for her addiction to painkillers.

Incidentally, last year NBC News featured a segment called "Crackdown on painkiller abuse fuels new wave of heroin addiction," which seems to describe the younger woman's trajectory in drug use and addiction.

So, let's summarize drug use in America:

  • Since the 1960s, the U.S. and the world have been overwhelmed by drug use.  The problem never disappears.  In fact, judging from recent announcements, over the last half century drug use has proliferated and worsened.
  • The nature of the drugs of concern varies from decade to decade.  Currently, we are overwhelmed by legal drugs -- designer drugs developed too rapidly to regulate, along with prescribed pain medications.
  • Our response is to call for the elimination of this or that drug (except in the case of marijuana, which may be in the process of legalization; and ecstasy, whose therapeutic dimension is being explored; and painkillers which, of course, can never be eliminated), and to treat people for drug abuse in costly treatment centers organized around the 75-year-old 12-step program of AA.

Our approach to individual drug use for the past half century has these elements:

  • Tell people not to use drugs.
  • If they use drugs tell them to stop.
  • If they become addicted, tell them to quit.

The results: Many people don't use street drugs. Many who do stop using them.  But virtually every American has used powerful psychoactive substances if we include prescription painkillers and mood modifiers along with illicit drugs.  A majority -- perhaps a substantial majority -- continues to do so (even without counting alcohol).  Their number is growing, as are drug problems, and most particularly the worst such problem -- drug-related deaths.

Let's imagine what a new way of thinking about this situation and a new approach to these conditions looks like:

  • Accept that drug use is a ubiquitous feature of modern life.
  • Develop policies to minimize the harms that occur as a result of ubiquitous drug use.
  • Develop people's competence at managing drug use, since this is now a necessary life skill.

I know -- a very highly visionary approach.  But what realistic alternative can you imagine?

(Disclosure: I am developing a proposal for sensible cannabis use with Debby Goldsberry.)

Follow Stanton on Twitter and at his Life Process Program.

Stanton Peele, PhD, JD, is the author of Recover! and developer of the online Life Process Program. He has been a pioneer in the addiction field since publication of Love and Addiction in 1975.

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