Tag Archives: drug addiction

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 Miracle That Saved Robert Downey Jr.

It is nice to read about successes in addressing drug addiction and the damage it causes to people. Robert Downey Jr. continues to provide such an example with his long successful career after years of struggles with drug addiction.

Susan Downey: Iron Woman

For a long time, however, it seemed as if that never-grow-up quality was going to land Robert in an early grave. After sauntering into our hearts as the doomed rich kid Julian in 1987′s Less Than Zero and proving himself a comic genius with his Oscar-nominated performance in 1992′s Chaplin, Robert spent roughly five years (from 1996 to 2001) in a long, heavily publicized death dance with crack cocaine, heroin, gunplay, and prison — at one point, even wandering into a neighbor’s home and passing out in a child’s bedroom. By the time he was released from court-ordered rehab in 2002, he was largely considered unemployable in Hollywood and was able to convince producer Silver to hire him for Gothika only by agreeing to have a good chunk of his salary withheld until the film wrapped.

But Robert was not quite finished with what he refers to as his Darth Vader side. “I did meet Darth Vader, for like a minute,” Susan acknowledges, “right after the movie wrapped, and I said immediately, ‘This isn’t gonna work.’ I made it clear that to stay with me, nothing could happen.”

Something about Susan’s ultimatum clicked. Around July 4, 2003, Robert stopped at a Burger King on the Pacific Coast Highway, threw his drugs in the ocean, and decided that he was done for good. “I think he saw what we had,” Susan says. “There was something magical there, something we couldn’t put our finger on. He always says that we became this third thing when we got together — something that neither of us could have become by ourselves — and I think that’s true.”

Success for one individual don’t easily translate to others. It is normally many individual things that all line up to make it work. Robert had been to rehab before and relapsed. Plenty of addicts get ultimatums and relapse. Plenty of people find love and proceed to mess it up. But in this case Robert was able to make a change and has been able to enjoy great success and happiness.

Related: Robert Downey Jr. Rehab SuccessRobin Williams Reflects on Rehab‘Marcia Brady’ Recovers After Drug Addiction

The Causes of Drug Addiction are Complex

image of comic panels from rat addiction experiment

Comic panels, by Stuart McMillen, of the rat park drug addiction experiment, see the full comic.

The causes of drug addiction are not simple. Like many medical issues they are a complex interaction of factors.

Drug addiction: The complex truth by Tom Stafford

Many studies have shown rats and monkeys will neglect food and drink in favour of pressing levers to obtain morphine (the lab form of heroin). With the right experimental set up, some rats will self-administer drugs until they die. At first glance it looks like a simple case of the laboratory animals losing control of their actions to the drugs they need. It’s easy to see in this a frightening scientific fable about the power of these drugs to rob us of our free will.

But there is more to the real scientific story, even if it isn’t widely talked about. The results of a set of little-known experiments carried out more than 30 years ago paint a very different picture, and illustrate how easy it is for neuroscience to be twisted to pander to popular anxieties. The vital missing evidence is a series of studies carried out in the late 1970s in what has become known as “Rat Park”. Canadian psychologist Bruce Alexander, at the Simon Fraser University in British Columbia, Canada, suspected that the preference of rats to morphine over water in previous experiments might be affected by their housing conditions.

Rats are smart, social creatures. Living in a small cage on their own is a form of sensory deprivation. Rat Park was what neuroscientists would call an enriched environment, or – if you prefer to look at it this way – a non-deprived one. In Alexander’s tests, rats reared in cages drank as much as 20 times more morphine than those brought up in Rat Park.

As the article notes more research is needed, but there should be more research into the importance of social environment on drug abuse and drug abuse treatment.

Related: Methods to treat addictionHow effective is drug addiction treatment in the USA?Prescription drug abuse in the USALooking at the evidence of treating alcoholism

Prescription Painkillers Kill More Every Year in USA than Heroin and Cocaine Combined

Overdose deaths from prescription painkillers have skyrocketed in the past decade. Every year, nearly 15,000 people die from overdoses involving these drugs—more than those who die from heroin and cocaine combined.

The abuse of prescription painkillers has risen dramatically in the last 15 years; in 1999 4,000 people were killed by these drugs (less than a third of the current numbers of deaths).

Find more information on prescription drug abuse and treatment options from the United States Center for Disease Control.

Related: Prescription Drug Abuse in the USAPrescription Drug Abuse: Pain Killers Can Lead to AdditionDecline in the Misuse of Prescription Drugs in the USA (reported in 2008, was the data accurate?)Brett Favre Overcomes Painkiller Addiction

What Should Society Do About Drug Addicts That Are Not Seeking Treatment?

What to do about drug addicts that are not interested in treatment (yet?) is open to debate. Strict law enforcement would say that the government shouldn’t provide any support to those that are taking illegal action (taking drugs they can’t legally take). And that argument makes some sense. The biggest problem with it is the results of such policies have not been very effective. Society suffers. Should society suffer because taking action to reduce burdens on society can be seen as taking it easy on criminals?

Denmark offers rooms monitored by nurses for drug addicts to use, and crime seems to have been reduced:

Year on year, burglaries in the wider area are down by about 3%, theft from vehicles and violence down about 5%, and possession of weapons also down. “From the police perspective, I can see the benefits,” said Orye. “It feels calmer.”

Critics say that such rooms make it easier for drug users to abuse themselves and send the wrong message. Only five people using Copenhagen’s room have been put on treatment since October.

Petersen, like many others using the room or floating around the courtyard outside, said that she does not want and would never seek treatment. But every day that she comes here to inject she meets health professionals, social workers and people offering treatment in case she suddenly want to rise from rock bottom, say the room’s staff. Petersen might change her mind one day, said Nanna Gotfredsen, a lawyer who campaigned for the room.

Michael Olsen, a local resident who was a key figure in persuading authorities to accept the idea of a consumption room, said that he felt moved to champion the cause when he found addicts taking drugs in his bins, and women urinating in a phone box because all the toilets in the area had been sealed to stop addicts injecting there.

The best strategies for society are not obvious. The last 50 years have not been a very successful period for society dealing with the problems caused by drug addiction. Hopefully we can experiment and find solutions that are better.

I do think we have moved toward more support for treatment for those seeking help to overcome drug addiction and to stay clean. Moving more in that direction seems wise to me.

Related: UK Drug Policy Commission Recommends Decriminalizing Drug UseRussell Brand’s Testimony on Dealing with Drug AddictionHow Effective is Drug Addiction Treatment?2012 National Drug Control Strategy for the USA

2012 National Drug Control Strategy for the USA

The USA has published their 2012 National Drug Control Strategy. The intro from President Obama includes:

Illicit drug use in America contributed to an estimated $193 billion in crime, health, and lost productivity costs in 2007, the year for which the most recent estimate is available. In today’s challenging economic environment, we cannot afford such a drain on our economy and public resources. While difficult budget decisions must be made at all levels of government, we must ensure continued support for policies and programs that reduce drug use and its enormous costs to American society.

Research has documented that substance use disorder treatment is a sound public investment. For example, a 2006 study found that every dollar spent on treatment yielded an average of seven dollars in costs savings. The majority of these savings came from reduced criminal justice system involvement and increased employment earnings. **Benefit-cost in the California treatment outcome project: Does substance abuse treatment‘pay or itself’? Health Services Research, 41(1), 192-213, 2006**

Other studies document substantial cost-offsets in the healthcare domain alone . Another 2006 study reported a net savings of $2,500 per person per year in Medicaid costs associated with treatment, and a State of Washington report found that treatment yielded a con- servatively estimated $252 per person per month in cost reductions associated with medical care and state and community psychiatric hospitalizations. **The effect of substance abuse treatment on medicaid expenditures among general assistance welfare clients in Washington State, The Milbank Quarterly, 84(3), 555-576, 2006 and Washington State supplemental security income (SSI) cost-offset pilot project: 2002 progress report.

In 2010, an estimated 23.1 million Americans (9.1%) aged 12 or older needed specialized treatment for a substance use disorder, but only 2.6 million (roughly 11.2% of them) received it. We need to stop wasting money and lives and costing our society much more over the long term.

In 2010, over seven million people in the United States were under the supervision of the criminal justice system: over two million incarcerated and the remaining five million on probation or parole.

Compounding the significant expenditures on corrections is the fact that far too many offenders return to drug use and reenter the criminal justice system. Among state prisoners with substance use disorders, 53% had at least three prior sentences to probation or incarceration, compared to 32% of other inmates.

Many offenders deal with a chronic substance use disorder—a disease for which too many are inadequately treated. These offenders need effective substance use disorder and mental health treatment while incarcerated and should continue with recovery support services that assist with employment, housing, medical care, and other support upon their reentry into the community.

Related: UK Drug Policy Commission Recommends Decriminalizing Drug UseDrug Treatment Funding Can More Than Pay For Itself With Reduced Crime CostsImproving Addiction Treatment with The University of Wisconsin – Madison

Prescription Drug Abuse in the USA

Some key findings from the Council of State Governments study on Prescription Drug Abuse in America (from 2004). The report is obviously a bit outdated but the problem continues to grow.

  • More than 6.2 million people were current illicit users of prescription drugs in 2002.
  • In 2001, prescription drug abuse and misuse were estimated to impose approximately $100 billion annually in health care costs.
  • In Florida, there were 328 deaths attributed to heroin overdoses in 2001 compared to 957 deaths due to overdoses of the prescription pain medications. The trend continued in 2002, when more Floridians died from prescription drug overdoses than use of illegal drugs.

Prescription Drugs: Abuse and Addiction from the NIH (revised in 2011).

Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and older) have used prescription drugs for nonmedical reasons at least once in their lifetimes.

The number of prescriptions for some of these medications has increased dramatically since the early 1990s. Moreover, a consumer culture amenable to “taking a pill for what ails you” and the perception of prescription drugs as less harmful than illicit drugs are other likely contributors to the problem. It is an urgent one: unintentional overdose deaths involving opioid pain relievers have quadrupled since 1999, and by 2007, outnumbered those involving heroin and cocaine.

Years of research have shown that addiction to any drug (illicit or prescribed) is a brain disease that can be treated effectively. Treatment must take into account the type of drug used and the needs of the individual. Successful treatment may need to incorporate several components, including detoxification, counseling, and sometimes the use of addiction medications. Multiple courses of treatment may be needed for the patient to make a full recovery.

Related: How effective is drug addiction treatment?Center for substance abuse treatment (US HHS)Brett Favre overcomes painkiller addiction

Drug Treatment Funding Can More Than Pay For Itself With Reduced Crime Costs

Some interesting details and data from Texas government web site.

Drug users constitute a large and growing proportion of the criminal justice population. Drug users not only commit a substantial amount of crime, but as the frequency of drug use increases, the frequency of crime increases and the severity of crimes committed also increases.

Drug use in the general population appears to have declined over the past decade, yet the number of drug-involved offenders is increasing. The number of convictions for drug violations in Texas has increased from 8,103 in 1980 to 23,126 in 1988, a 185 percent increase in less than ten years.

Estimates of lifetime drug users among the nation’s incarcerated population range from 80 to 87 percent.

The American Correctional Association notes that more than 95 percent of drug and alcohol offenders will be discharged from prison, most without receiving any treatment. Because of the high association between drug abuse and recidivism, it is in the public interest to place offenders in the kinds of treatment programs that have been found effective. A noticeable reduction in drug use and criminality can occur with an alliance between the criminal justice system and drug abuse treatment.

Public expenditures for drug abuse treatment are wise and prudent investments. Treatment works to reduce crime, drug abuse, and recidivism. Sustained reductions in recidivism can be achieved up to six years after treatment. With appropriate drug abuse treatment more than 75 percent of offenders with chronic substance abuse histories can reenter the community and lead socially acceptable life styles.

For every dollar spent for drug treatment, $11.54 is saved in social costs, including law enforcement costs, losses to victims, and government funds for health care.

Research has shown that funds invested in drug treatment reduces future criminal justice costs for treated offenders. Every dollar spent on residential drug treatment in probation saves $2.10 in future criminal justice costs. Every dollar spent on outpatient drug treatment in probation saves $4.28 in future criminal justice costs.

This is an old report, from 1997 but the basic model doesn’t change. A large amount of criminal activity is driven by drug addiction. To reduce crime in society drug addiction needs to be reduced. While success rates of drug addiction treatment centers are far from perfect the results more than pay for the cost – just in reduced crime costs (without even considering the better lives these people lead and the benefits to their children and loved ones).

Related: The Rise and Fall of America’s First Prison for Drug AddictsResults of 4 Year Study of Women in Drug TreatmentAlcohol is a Major Cause of Drug Rehab AdmissionsHow Effective is Drug Addiction Treatment?

Russell Brand’s Testimony on Dealing with Drug Addiction

Celebrity Russell Brand makes very intelligent comments to a UK government inquiry on how to deal with drug addiction problems. He was an addict and has been drug free now for years.

His main point seems to be that we need to take a pragmatic approach to what is a primarily a health problem not a criminal problem. Abstinence (all all drugs – including legal ones such as alcohol) based recovery is what he has succeeded with and he believes in. “I think what we need is love and compassion… because it deals with the problem and reducing crime”

Russell’s book, My Booky Wook, discusses this life including his drug use and recovery.

Related: Eminem’s ‘Relapse’ Explores His Drug Addition and RehabilitationPrinciples of Effective Drug Treatment and RehabilitationHow Effective is Drug Addiction Treatment?

Reducing Harm Due to Drug Use Should be the Aim – Not War

Toronto formally endorses harm reduction on drug use

Dr. Wood said Toronto’s commitment is an important symbolic step that solidifies Toronto’s commitment to fighting drug addiction in more nuanced ways than a “war-on-drugs” stance. It’s one he hopes will create more dialogue about changing Canada’s strategy on a national level.

An alternative to the war on drugs

the punitive enforcement of drug policy becoming largely immune from meaningful scrutiny.14 A curiously self justifying logic now prevails in which the harms of prohibition—such as drug related organised crime and deaths from contaminated heroin—are conflated with the harms of drug use. These policy related harms then bolster the apparent menace of drugs and justify the continuation, or intensification, of prohibition. This has helped create a high level policy environment that routinely ignores or actively suppresses critical scientific engagement and is uniquely divorced from most public health and social policy norms, such as evaluation of interventions using established indicators of health and wellbeing.

‘War on drugs’ behind endless misery

From a scientific perspective, we must accept that law enforcement will never meaningfully reduce the flow of drugs. Economists know that the drug seizures we see over and over again as part of police photo ops have the perverse effect of making it that much more profitable for someone else to sell drugs. The laws of supply and demand have simply overwhelmed police efforts. With young people reporting that obtaining illicit drugs is easier than getting alcohol or tobacco, the situation could not get much worse.
Strong scientific evidence points to the effectiveness of alternative regulatory models established in Portugal, the Netherlands and Switzerland to counter the disastrous consequences of illicit drug use and drug policies.

The Cato Institute, a respected U.S. think tank, has released a report on alternative drug policies. Several years ago, Portugal parted ways with the U.S. and decriminalized all drugs so that resources could focus on prevention and treatment of drug use. The report shows Portugal’s policies have dramatically reduced HIV rates as drug addiction has been viewed as a health, rather than criminal justice, problem. In addition, Portugal now has the lowest rates of marijuana use in the European Union, with experts suggesting that the health focus has taken some of the glamour out of illegal drugs.