Growing Call by Leaders Worldwide to End the War on Drugs

Letter to UN signed by over 1,000 worldwide leaders

The drug control regime that emerged during the last century has proven disastrous for global health, security and human rights. Focused overwhelmingly on criminalization and punishment, it created a vast illicit market that has enriched criminal organizations, corrupted governments, triggered explosive violence, distorted economic markets and undermined basic moral values.

Humankind cannot afford a 21 st century drug policy as ineffective and counter-productive as the last century’s. A new global response to drugs is needed, grounded in science, compassion, health and human rights.

The role of criminalization and criminal justice must be limited to the extent truly required to protect health and safety. Leadership must come from those who recognize that psychoactive drug use is first and foremost a matter of health. Drug control efforts must never do more harm than good, or cause more harm than drug misuse itself.

We need to have society focus on helping people recover from drug addiction. The war on the poor and abused in society by our legal system just makes things worse. We need to improve.

Over 1,000 Leaders Worldwide Call for End to “Disastrous” Drug War, Ahead of UN Special Session

The unprecedented list of signatories includes a range of people from Senators Elizabeth Warren, Cory Booker and Bernie Sanders to businessmen Warren Buffett, George Soros, Richard Branson, Barry Diller, actors Michael Douglas and Woody Harrelson, Super Bowl champion Tom Brady, singers John Legend and Mary J. Blige, activists Reverend Jesse Jackson, Gloria Steinem and Michelle Alexander, as well as distinguished legislators, cabinet ministers, and former UN officials.

There is a great deal of human suffering caused by drug addiction and abuse (including alcohol and the abuse of prescription drugs). We need to create solutions to help people avoid ruining their lives and the lives of those they love. Our police attacking those people and wagging war on them is not something society should tolerate.

Related: Funding Drug Addiction Treatment Would Cost 1/7 the Cost of the Current Criminal System Focused PolicyDrug Treatment Funding Can More Than Pay For Itself With Reduced Crime CostsThe Causes of Drug Addiction are ComplexThe War on Drugs has been a Huge Failure with Massive Unintended Consequences

President Obama Proposes $1.1 Billion in New Funding to Address the Prescription Opioid Abuse and Heroin Use Epidemic

President Obama’s Budget includes new mandatory funding to help ensure that all Americans who want treatment can get the help they need. I have posted the whole press release because if I link to it, the link will break with the next president (https://www.whitehouse.gov/the-press-office/2016/02/02/president-obama-proposes-11-billion-new-funding-address-prescription).

Prescription drug abuse and heroin use have taken a heartbreaking toll on too many Americans and their families, while straining resources of law enforcement and treatment programs. More Americans now die every year from drug overdoses than they do in motor vehicle crashes. New data from the Centers for Disease Control and Prevention (CDC) show that opioids—a class of drugs that include prescription pain medications and heroin—were involved in 28,648 deaths in 2014. In particular, CDC found a continued sharp increase in heroin-involved deaths and an emerging increase in deaths involving synthetic opioids, such as fentanyl.

The President has made clear that addressing the opioid overdose epidemic is a priority for his Administration and has highlighted tools that are effective in reducing drug use and overdose, like evidence-based prevention programs, prescription drug monitoring, prescription drug take-back events, medication-assisted treatment and the overdose reversal drug naloxone. Under the Affordable Care Act, substance use disorder services are essential health benefits that are required to be covered by health plans in the Health Insurance Marketplace. The law also required that covered substance use disorder benefits are comparable to medical and surgical benefits.

The President’s FY 2017 Budget takes a two-pronged approach to address this epidemic. First, it includes $1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use. This funding will boost efforts to help individuals with an opioid use disorder seek treatment, successfully complete treatment, and sustain recovery. This funding includes:

  • $920 million to support cooperative agreements with States to expand access to medication-assisted treatment for opioid use disorders. States will receive funds based on the severity of the epidemic and on the strength of their strategy to respond to it. States can use these funds to expand treatment capacity and make services more affordable.
  • $50 million in National Health Service Corps funding to expand access to substance use treatment providers. This funding will help support approximately 700 providers able to provide substance use disorder treatment services, including medication-assisted treatment, in areas across the country most in need of behavioral health providers.
  • $30 million to evaluate the effectiveness of treatment programs employing medication-assisted treatment under real-world conditions and help identify opportunities to improve treatment for patients with opioid use disorders.

This investment, combined with other efforts underway to reduce barriers to treatment for substance use disorders, will help ensure that every American who wants treatment can access it and get the help they need.

Second, the President’s Budget includes approximately $500 million — an increase of more than $90 million — to continue and build on current efforts across the Departments of Justice (DOJ) and Health and Human Services (HHS) to expand state-level prescription drug overdose prevention strategies, increase the availability of medication-assisted treatment programs, improve access to the overdose-reversal drug naloxone, and support targeted enforcement activities. A portion of this funding is directed specifically to rural areas, where rates of overdose and opioid use are particularly high. To help further expand access to treatment, the Budget includes an HHS pilot project for nurse practitioners and physician assistants to prescribe buprenorphine for opioid use disorder treatment, where allowed by state law.

Building on Actions to Address the Opioid Epidemic

In October 2015, the President announced a number of new public and private sector actions to address this issue, including a Presidential Memorandum on prescriber training and opioid use disorder treatment. He also announced a commitment by more than 40 provider groups that more than 540,000 health care providers will complete training on appropriate opioid prescribing in the next two years. After just over three months, these groups reported that more than 66,000 providers have completed prescriber training to date, putting them on target to meet their goal.

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Cocaine addiction: Scientists discover ‘back door’ into the brain

Individuals addicted to cocaine may have difficulty in controlling their addiction because of a previously-unknown ‘back door’ into the brain, circumventing their self-control, suggests a new study led by the University of Cambridge.

A second study from the team suggests that a drug used to treat paracetamol overdose may be able to help individuals who want to break their addiction and stop their damaging cocaine seeking habits.

Although both studies were carried out in rats, the researchers believe the findings will be relevant to humans.

Cocaine is a stimulant drug that can lead to addiction when taken repeatedly. Quitting can be extremely difficult for some people: around four in ten individuals who relapse report having experienced a craving for the drug – however, this means that six out of ten people have relapsed for reasons other than ‘needing’ the drug.

“Most people who use cocaine do so initially in search of a hedonic ‘high’,” explains Dr David Belin from the Department of Pharmacology at the University of Cambridge. “In some individuals, though, frequent use leads to addiction, where use of the drug is no longer voluntary, but ultimately becomes a compulsion. We wanted to understand why this should be the case.”

Drug-taking causes a release in the brain of the chemical dopamine, which helps provide the ‘high’ experienced by the user. Initially the drug taking is volitional – in other words, it is the individual’s choice to take the drug – but over time, this becomes habitual, beyond their control.

Previous research by Professor Barry Everitt from the Department of Psychology at Cambridge showed that when rats were allowed to self-administer cocaine, dopamine-related activity occurred initially in an area of the brain known as the nucleus accumbens, which plays a significant role driving ‘goal-directed’ behaviour, as the rats sought out the drug. However, if the rats were given cocaine over an extended period, this activity transferred to the dorsolateral striatum, which plays an important role in habitual behaviour, suggesting that the rats were no longer in control, but rather were responding automatically, having developed a drug-taking habit.

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Almost everything we think we know about addiction is wrong

Almost everything we think we know about addiction is wrong.

Addiction is just one symptom of the crisis of disconnection that is happening all around us.

The opposite of addiction is not sobriety. The opposite of addiction is connection.

In the video they talk about one of the things we posted about earlier (in The Causes of Drug Addiction are Complex): the conditions of addiction expedients that form the basis of our understanding are questionable.

The claim made in the video is that psychology is much more the cause of addiction than chemistry. There certainly is plenty of evidence suggesting psychology is very important.

The video makes the claim it is largely about a “crisis of disconnection.” That if we don’t make strong interpersonal connections we will seek solace in the form of something that distracts us (drugs or something else).

These ideas are explored further in Johann Hari’s book about drugs and addiction: Chasing the Scream.

Related: Drug Addictions Often Disappear Over Time, even without treatmentMethods to Treat AddictionFunding Drug Addiction Treatment Would Cost 1/7 the Cost of the Current Criminal System Focused PolicyCombination Strategy to Treat Alcohol Dependence

CC Sabathia Entered a Treatment Facility for Alcoholism

CC Sabathia a pitcher for the New York Yankees has announced he has entered a treatment facility for alcoholism as the Yankees are starting the playoffs.

photo of CC Sabathia

Photo of CC Sabathia, from his official web site.

His statement:

Today I am checking myself into an alcohol rehabilitation center to receive the professional care and assistance needed to treat my disease.

I love baseball and I love my teammates like brothers, and I am also fully aware that I am leaving at a time when we should all be coming together for one last push toward the World Series. It hurts me deeply to do this now, but I owe it to myself and to my family to get myself right. I want to take control of my disease, and I want to be a better man, father and player.

I want to thank the New York Yankees organization for their encouragement and understanding. Their support gives me great strength and has allowed me to move forward with this decision with a clear mind.

As difficult as this decision is to share publicly, I don’t want to run and hide. But for now please respect my family’s need for privacy as we work through this challenge together.

Being an adult means being accountable. Being a baseball player means that others look up to you. I want my kids — and others who may have become fans of mine over the years — to know that I am not too big of a man to ask for help. I want to hold my head up high, have a full heart and be the type of person again that I can be proud of. And that’s exactly what I am going to do.

I am looking forward to being out on the field with my team next season playing the game that brings me so much happiness.

It is good he realizes he has a problem and is seeking treatment.

Upon signing with the Yankees prior to the 2009 season, Sabathia became the highest-paid pitcher in MLB history. He is now 35 years old.

This is another reminder that alcoholism is a devastating problem to a large number of people. Treatment is helpful but we also really need better options for addiction treatment (and more study of what is effective) to help those in need.

Related: Jon Hamm Exits Rehab for Alcohol AddictionThe Success Rate of AA is Only 5-10%Colin Farrell Wanted To Be A Better Dad

Jon Hamm Exits Rehab for Alcohol Addiction

Jon Hamm is best known for his role as Don Draper on Mad Men. He has recently completed a stay at a rehabilitation center where he sought treatment for alcohol addiction.

Jon Hamm

Jon Hamm at PaleyFest 2014

He reportedly received rehab treatment at the Silver Hill Hospital in New Canaan, Connecticut which is affiliated with Yale University.

The hospital describes their addiction treatment program as follows:

The Addiction Program provides a highly structured, intensive program of education, behavioral skill development and increasing psychological awareness. The focus of this abstinence-based program is to help patients identify triggers and learn relapse prevention strategies that will help them remain substance-free.

Treatment for addiction disorders often begins in our inpatient level of care. Patients are admitted for detoxification from alcohol, prescription medication and other substances. Simultaneous treatment of psychiatric symptoms is also provided for mood and other psychiatric disorders as needed. The goals of this phase of treatment are crisis stabilization, symptom reduction and medication management. This phase of care is generally covered by insurance.

After stabilization, the next phase of treatment is our Transitional Living Program. Patients reside on campus as they focus on developing a psychological understanding of their illness and developing new behavioral skills to manage their recovery process. The length of stay for this phase of treatment is 4 weeks, and some patients extend their treatment beyond this minimum. This program is self-pay – a small portion of the program may be covered by insurance. Our staff will help you determine if you have this benefit.

Related: Representative Patrick J. Kennedy Spends a Month in RehabRobert Downey Jr. Rehab SuccessRussell Brand’s Testimony on Dealing with Drug Addiction

Funding Drug Addiction Treatment Would Cost 1/7 the Cost of the Current Criminal System Focused Policy

Treatment: Effective (But Unpopular) Weapon Against Drugs

Paying for treatment of hard-core drug users is a bone in the throat of middle class taxpayers–and small wonder. Drug abusers are not an appealing group, and the programs themselves largely fail to wean their clients off drugs for good. Nonetheless, say RAND researchers, treatment programs are a sound investment of public funds because they effectively cut consumption–and consumption is what drives the drug trade.

RAND corporation aims to provide policy guidance, driven by data and research, to policy makers. They differ from many others in that they pay more attention to what works than to the interest groups often telling politicians what to do. RAND is willing to take stands that others are not and often propose policies that conflict with the accepted positions held to for decades by interest groups.

When data supports a policy RAND will encourage the use of that policy even if it seems odd – like paying for drug treatment for those breaking the law. Without treatment RAND data shows the government will spend 7 times as much money. But politicians have been resisting spending 1/7 as much money because they fear voters can’t understand that doing so is wise. This is from a 1995 report by RAND:

Treatment is seven times more cost-effective in reducing cocaine consumption than the best supply-control program and could cut consumption by a third if it were extended to all heavy users, according to the study. Such a strategy could also substantially reduce the number of users and the costs they inflict on society through crime and lost productivity.

And RAND doesn’t even factor in the costs of wasted lives, pain and suffering that are aided by good addition treatment help. Some propose we aid drug users with treatment programs because human suffering is something we should reduce when we can. RAND proposes we do so based solely on the hard cash benefits government will gain. It is hard to argue with a program that reduces costs by 86% (6/7).

While we may have made a little progress has been made in getting more funding since 1995, if we have it is a tiny portion of what would be a wise investment. The failure to use addiction treatment progress continues to add to the budget deficits our governments face and the suffering of drug abusers in our society.

Related: Drug Treatment Funding Can More Than Pay For Itself With Reduced Crime CostsImproving Addiction Treatment with The University of Wisconsin MadisonWhat Should Society Do About Drug Addicts That Are Not Seeking Treatment?

Vermont to Treat Heroin Abuse as Health Issue Instead of Fighting “War” with Addicts

Vermont Quits War on Drugs to Treat Heroin Abuse as Health Issue

[Governor] Shumlin urged the legislature to approve a new set of drug policies that go beyond the never-ending cat-and-mouse between cops and dealers. Along with a crackdown on traffickers, he proposed rigorous addiction prevention programs in schools and doctors’ offices, as well as more rehabilitation options for addicts. “We must address it as a public health crisis,” Shumlin said, “providing treatment and support rather than simply doling out punishment, claiming victory, and moving on to our next conviction.”

Representative Thomas Burditt… “As everybody knows, the war on drugs is lost, pretty much. It’s time to go down a new road.”

This is one small effort, among many, to find solutions instead of continuing the failed policies used for decades. Sadly those failed policies still dominate the efforts given by governments throughout the USA. The costs to the economy and personal lives of the people is enormous. We need to experiment to find better methods to reduce he harm done to society due to drug addiction.

Related: The Death of Philip Seymour Hoffman Highlights the Increased Use of HeroinPrescription Painkillers Kill More People Every Year in USA than Heroin and Cocaine CombinedDrug Treatment Funding Can More Than Pay For Itself With Reduced Crime Costs

The Success Rate of AA is Only 5-10%

The treatment of drug addiction continues to be difficult. Even finding data on success rates is hard. And analyzing that data is difficult (the data is not straight forward and leaves open many possible questions or criticisms). This study calls into question the effectiveness of a 12-step recovery method to treat addiction.

With Sobering Science, Doctor Debunks 12-Step Recovery

There is a large body of evidence now looking at AA success rate, and the success rate of AA is between 5 and 10 percent. Most people don’t seem to know that because it’s not widely publicized. … There are some studies that have claimed to show scientifically that AA is useful. These studies are riddled with scientific errors and they say no more than what we knew to begin with, which is that AA has probably the worst success rate in all of medicine.

It’s not only that AA has a 5 to 10 percent success rate; if it was successful and was neutral the rest of the time, we’d say OK. But it’s harmful to the 90 percent who don’t do well. And it’s harmful for several important reasons. One of them is that everyone believes that AA is the right treatment. AA is never wrong, according to AA. If you fail in AA, it’s you that’s failed.

The reason that the 5 to 10 percent do well in AA actually doesn’t have to do with the 12 steps themselves, it has to do with the camaraderie. It’s a supportive organization with people who are on the whole kind to you and it gives you a structure. Some people can make a lot of use of that. And to its credit, AA describes itself as a brotherhood, rather than a treatment.

image of the Sober Truth book cover

Dr. Lance Dodes has written a book looking at the data behind the results of AA. The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry.

Related: Looking at the Evidence of Treating AlcoholismHow Effective is Drug Addiction Treatment?, NIH studyImproving Addiction Treatment with The University of Wisconsin, MadisonMethods Used to Treat Addiction

The Death of Philip Seymour Hoffman Highlights the Increased Use of Heroin

We lost a great actor with the death of Philip Seymour Hoffman. Once again the danger of drug use has resulted in the loss of life. He sought treatment for his addiction but failed to avoid an untimely death.

photo of Philip Seymour Hoffman by Jean Jacques Georges

Philip Seymour Hoffman at the Paris premiere of The Ides of March in 2011 by photo by Jean Jacques Georges

Hoffman death puts focus on heroin’s comeback

Hoffman, 46, was found on the bathroom floor of his New York City apartment with a syringe in his left arm and glassine bags usually associated with heroin. Police say they are investigating substances found in the apartment to determine which drugs were present, but Hoffman has been open about his drug use, which included prescription pills and heroin, and his decades-long struggle to stay sober.

As authorities crack down on clinics that prescribe pain pills by the thousands and pharmaceutical companies change their formulas so the pills are more difficult to abuse, opiate addicts are turning to cheaper and more-plentiful heroin.

In recent years, the number of people abusing prescription pain pills has dropped steadily as heroin use increased. The number of people 12 and older who regularly abuse OxyContin dropped from 566,000 in 2010 to 358,000 in 2012, the National Survey on Drug Use and Health reported in December. The number of regular heroin users soared from 239,000 in 2010 to 335,000 in 2012, the survey found.

The tragedy caused by the abuse of drugs damages millions every day. We have to do a better job of reducing the damage done to society due to the abuse of drugs. Celebrities shine a light on the problem but it is a widespread problem that has an immense impact throughout society.

Related: Russell brand’s testimony on dealing with drug addictionPrescription painkillers kill more every year in usa than heroin and cocaine combined Eminem’s ‘relapse’ explores his drug addition and rehabilitation