Global Commission on Drug Policy: Legalization, decriminalization, and the war on drugs

A commission made up of some big names, though not really any names of addiction or drug researchers I noticed, just released a report that’s making a lot of noise throughout every news channel including NPR (see here, and here for stories) and others (see CNN). They want the debate about the current state of drug regulation expanded, and since I’ve written on the issue before, I figured it’s time for another stab at this. Continue reading “Global Commission on Drug Policy: Legalization, decriminalization, and the war on drugs”

Addiction Treatment Admissions in the United States: Everyone, meet TEDS

Dirk Hanson

What a difference a decade makes.

Do you know what drug use trends are ongoing?Between 1998 and 2008, addiction treatment admissions in the U.S. increased markedly for methamphetamine (crystal meth), prescription opiates, and marijuana. Treatment admissions for alcohol and cocaine declined over the same period, while heroin admissions remained roughly the same.

The Treatment Episode Data Set (TEDS), which the Substance Abuse and Mental Health Services Administration (SAMHSA) uses to compile its report, includes only those addiction treatment facilities that receive state alcohol or drug agency funds, and which are represented in state administrative data systems. Despite this caveat, the TEDS study matters, because states use reports of this kind to shift limited resources from one treatment focus to another, based on demand. Continue reading “Addiction Treatment Admissions in the United States: Everyone, meet TEDS”

About Addiction: Addiction Recovery, Alcohol, and Drug Legalization

Yes, you’ve got it, it’s your 30 seconds of news about addiction from around the world (wide web). Enjoy the reading – you can claim you learned your “new thing of the day.”

Addiction recovery- Inpatient and Outpatient treatment plans

Addiction Recovery-Recovering from addiction is hard, no matter what type of addiction it is. In order to complete a successful recovery from addiction, a positive attitude helps. Holding a positive attitude increases the chances that the recovery attempt will be a successful one. We’ve written often about addiction treatment and tips to increase sucess.

Recovery Now– What are the stages to inpatient addiction treatment? According to Recovery Now, the stages of inpatient treatment include:  intake, detox, stabilization, and long term recovery. Though I don’t necessarily agree with every aspect of this article, it contains some good information about addiction treatment that every reader should know. This additional piece from Recovery Now discusses the appropriateness of inpatient versus outpatient addiction treatment for specific patients.

Alcohol use

Science Daily– We’ve talked about the link that has been found between family history of alcoholism and an individual’s obesity risk.  In this study a family history of alcoholism produced an increased risk for obesity, though the environment also played a large role in this link. Environmental factors include the types of foods that are eaten- foods that are typically high in calories from sugars, salt and fat.

Desert News– Everyone knows at least one person whose life has been affected by alcohol abuse in some form or another. Here is a story of how alcohol negatively affected a woman’s life and how it overtook her life ultimately leading to her death.

The Sydney Morning Herald– Drunk Driving is not just a problem in the United States, driving under the influence of alcohol appears to be a problem in other countries as well.  In Australia almost 1,400 people were arrested for alcohol-related offenses.

AOL Health-There is a multitude of information found on billboards and in TV commercials which explains the risks of drunk and drugged driving. Despite this information 30 million Americans are driving drunk each year and 10 million are driving while they are under the influence of drugs. This problem is very serious and is most problematic among drivers who are aged 16-25. Although there has been a drop in the overall number of individuals who are driving while they are under the influence, one in three car accidents still occur from drunk driving.

Drugs- The dangers of legal drugs, Marijuana, Adderall, and Methadone

Belfast TelegraphAlcohol and legal drugs are okay in small doses and can even be helpful in medical settings and for overall health. However it is important to note that there have been many more alcohol related deaths than deaths from illegal substances such as heroin and crystal meth. By far alcohol is the greatest perpetrator followed by prescription drugs including amphetamines, benzodiazepines and antidepressants. In Ireland in 2009 alone there were 283 alcohol-related deaths were registered in the north and 276 the previous year.

NIH News- There has been a recent increase in marijuana use among 8th graders according to NIDA’s monitoring the future survey. It was reported that the rate of eighth-graders who are using illicit drugs is 16 percent, a 2.5 increase from the previous year’s use of 14.5 percent. Among high school seniors cigarette use has declined but marijuana, ecstasy and prescription drug use has increased. Marijuana use among adolescents is so problematic because it affects the brains development as well as a person’s learning, judgment, and motor skills. Additionally 1 in 6 people who start using it as adolescents become addicted. The spike in the drug use may be attributed to the debate on legalization which may give a false impression that the drug has no negative effects or consequences.

‘WisconsinWatch.org– Use of Adderall, a medication for ADHD, is on the rise and in demand on many college campuses. Adderall is increasing in popularity and is easily accessible on college campuses because it helps individuals study.  The drug is particularly popular in the University of Wisconsin and many students are taking it despite the negative side effects it may bring. School officials are not educating the university population of the ill effects of Adderall so it continues to be used as a study aid. At least part of the worry has to do with the potential for such students to move on to even stronger versions of amphetamines such as crystal meth, so maybe the efforts should focus on teaching students about addiction to amphetamines and the associated risks.

Scotsman NewsMethadone a drug which is used to prevent withdrawal symptoms in individuals who were addicted to opiate drugs (and as a replacement medication in heroin addiction treatment) is going to be in high demand after nearly £2 million worth of the heroin was discovered on a raid in Scotland.  Police hope that by working with healthcare professionals they can help these drug users seek addiction treatment. Anyone who was effected by the drug raid are offered the support and care they need

Victimization and Drug Legalization

Physorg.com– A potential link has been found between victimization (and hence trauma) and the prevalence of substance use disorders. This was most evident for homosexual and bisexual men and women than it was for heterosexual men and women. Both gay men and women reported high prevalence rates of victimization some point in their lifetime with lesbian women twice as likely to report victimization experiences. Men and women who reported two or more victimization experiences were found to have higher odds of alcohol and other drug dependence.

London Evening Standard– Should drugs be legalized? That is the question that is popping up in many states across the United States.  Is marijuana safer if it is regulated by the state?  The argument for legalizing drugs goes a little something like this: Despite drugs being illegal there will always be a demand for them so if drugs are legalized then governments will be able to control drug quality before they are sold on the streets. Tax income from drug sales can then to educate individuals about drugs and to aid individuals who need addiction treatment

North West Evening Mail– Paul Brown, the director of Cumbria Alcohol and Drug Advisory Service spoke out after former drugs policy minister Bob Ainsworth and he called for the decriminalization of all banned substances. Brown informed attendees that only Portugal has decriminalized drugs and since that occurred crime rates have fallen and more individuals are willing to seek treatment for drug problems. Many substances that are legal such as alcohol and tobacco are bigger killers than drugs that are criminalized. Alcohol and tobacco kill an average 40,000 people a year this is 10 times more than any illegal drug.

Should all drugs be decriminalized? A UK debate

Christopher Russell

In a recent UK parliamentary debate, Bob Ainsworth MP, a former Home Office minister in charge of drugs policy, called for the decriminalization of all drugs. Ainsworth, the most senior UK politician to publicly endorse a system of decriminalization, joins respected figures from the medical and research communities in recent months in suggesting that the decriminalization of drugs would significantly improve public health and reduce crime further than is being achieved under the current system of criminalization. Ainsworth argues that that the past 50 years of the War on Drugs has been counter-productive to its intended goals of reducing the availability of drugs and improving public health. Furthermore, he claims that billions of pounds had been spent without preventing the wide availability of drugs, reducing the wide use of drugs, or weakening the illicit drug market. Consequently, Ainsworth proposes that the drug market be taken out of the hands of organized criminals and be placed into the hands of medical professionals and licensed vendors. Such a change in policy would mark a return to UK drug policy prior to the mid-1960’s in which drug use was treated as a health issue, not a criminal issue.

“It is time to replace our failed war on drugs with a strict system of legal regulation, to make the world a safer, healthier place, especially for our children. This (policy of criminalization) has been going on for 50 years now and it isn’t getting better. The drugs trade is as big, as powerful as it ever was across the world. Prohibition isn’t the answer to this problem” he said.

It is important to understand that Ainsworth is not arguing that drugs like heroin and cocaine should be freely available to buy in the same way that adults can buy alcoholic drinks and tobacco products. Rather, he argues that drugs be decriminalized, which is different from legalized. Decriminalizing would likely mean the government would control all aspects of the manufacture, quality, purity, distribution, and trade of drugs, including who will be licensed to provide drugs. Legalization would mean drugs could be traded in the free market, a position which Ainsworth is explicitly against. “I’m not proposing the liberalization and the legalization of heroin so we can all get zonked out on the street corner” Ainsworth said in an interview with BBC’s Radio 4.

Why decriminalize drugs?

The argument for decriminalization is based on the hypothesis that the legal regulated supply of drugs will draw trade away from the illicit market and so reduce crime related to the illicit sale and purchase of drugs; improve the health of users by providing quality-controlled drugs under the guidance and supervision of licensed individuals; increase the uptake of addiction treatment; allow treatment providers to reconnect with a group of drug users who do not typically seek or know about treatment options or have distanced themselves from treatment providers for fear of criminal prosecution; and improve drug education for current and would-be drug users.

If decriminalizing does shift the drug market toward legal vendors, a major benefit could be the medical and addiction research communities’ sudden widespread access to a population of drug users who are notoriously difficult to reach. This access would allow medical professionals and researchers obtain rich first-hand information as to why these people started using drugs and why they use drugs today, to provide drug education, to provide assistance with any problems relating to employment, housing, relationships or physical and mental health. Decriminalizing drugs may therefore better place treatment providers to support those who want help and to minimise harm in those who continue to use. Paradoxically then, while many people believe decriminalization will send a message to the youth that drug use is acceptable as well as maintaining use in current users, proponents of decriminalization argue that, by reconnecting drug users to the health community, legal regulation of drugs will actually increase in the number of people quitting drugs and provide earlier opportunities to deliver educational interventions to ‘would-be’ drug users.

What might decriminalization look like?

While Ainsworth did not describe in detail how drugs should be regulated, Steve Rolles, Head of Research for the Transform Drug Policy Foundation, which campaigns for the decriminalization of drugs, released a ‘blueprint for regulation’ in December, 2009 which described how models of regulation for different types of drug would improve health and decrease crime. The report proposes that cannabis and opium could be sold and consumed on membership-based “coffee shop-style” licensed premises and would likely be subjected to similar trade laws as those currently applied to tobacco products; cocaine, ecstasy and amphetamines could be sold by licensed pharmacists or named purchasers; and psychedelic drugs, including hallucinogens such as LSD or Salvia could be used only under supervision in licensed “drug clubs” or similar venues. Rolles said: “Drugs are here to stay, so we have a choice – either criminals control them, or governments do. By the cautious implementation of a legally regulated regime, we can control products, prices, vendors, outlets, availability and using environments through a range of regulatory models, depending on the nature of the drug, and evidence of what works”.

Rolles also echoed Ainsworth’s sentiments about the futility and counter-productiveness of prohibition in a recent BBC radio interview: “It hasn’t reduced drug use, it hasn’t prevented the availability of drugs, but it has created a whole raft of secondary problems associated with the illegal market, including making drugs more dangerous than they already are and undermining public health and fuelling crime”.

Rolles called on the UK government to consider evidence about the effectiveness of the prohibition policy both in the UK and other countries and health and crime projections under a decriminalized system. Craig McClure, foreword author on the Transform Drug Policy Foundation report and former executive director of the International Aids Society states that several Latin American governments have already realised how their war on drugs have undermined public health goals and fueled crime and have already moved, or are moving, towards decriminalization and a public health model targeting the prevention and treatment of drug misuse.

What next for the decriminalization deabte?

Knowing that drug decriminalization is a sensitive, emotion-laden, divisive idea, and therefore public support from fellow MPs will initially be largely absent, Ainsworth has called for an impact assessment to be conducted on the Misuse of Drugs Act, 1971 – the legislation which introduced drug classification in the UK – rather than calling for drugs to be decriminalized outright.

“I call on those on all sides of the debate to support an independent, evidence-based review, exploring all policy options, including: further resourcing the war on drugs, decriminalizing the possession of drugs, and legally regulating their production and supply” he said. As influential political, medical and scientific forces join to pressure a review of the efficacy of current drug policy, there is a sense in the UK that drug decriminalization is slowly moving from an ideological conviction to an evidence-based alternative to a failing system of prohibition.

Please write your comments about the prospect of drug decriminalization in the box below.

References:

Bob Ainsworth BBC 1 television interview, 16th December, 2010. Accessible at http://www.bbc.co.uk/news/uk-12005824

Bob Ainsworth BBC Radio 4 interview, 16th December, 2010. Accessible at http://www.bbc.co.uk/news/uk-12005824

Transform Drug Policy Foundation (2009). After the war on drugs: Blueprint for regulation. Accessible at http://www.tdpf.org.uk/Transform_Drugs_Blueprint.pdf

Medical and political support for the Transform Drug Policy Foundation’s ‘blueprint for regulation’ (2009) report. Accessible at http://www.tdpf.org.uk/blueprint%20download.htm

Proposition 19 defeated – The false hope of change with young support for Prop 19

MarijuanaWell, no matter the hope for some before November 2nd, voters in California chose not to pass Prop 19 – the legislation that would have made that State the first in the Union to explicitly legalize the sale of marijuana within its borders. I’ve already said that I support the drug’s decriminalization, and I would actually support the decriminalization of all drug use, but as an ex drug dealer myself, I think going for legalization would have been somewhat premature.

Why Proposition 19 failed – Young weed smokers?

One of the interesting notions brought up during this recent debate had to do with the fact that young voters were overwhelmingly supporting the passage of proposition 19. Some writers on the topic were making the assertion that this means the likely legalization of marijuana use in the very near future regardless of the fate of prop 19. I disagree. In fact, many of those who opposed the passage of a legalization law are baby boomers – individuals who themselves smoked quite a bit of weed and were supporting its integration into society along with a host of other libertarian ideas in their youth. But the passage of time changes more than the number of wrinkles on people’s faces, and political opinions and wills are certainly among those things who shift with age. That’s why I personally think we’re a long way from passing any law that, like Prop 19, tries to legalize all aspects of the marijuana trade. I’m all for medical marijuana where it helps, and reducing the drug’s scheduling will go a long way towards that, but I don’t think we’re going to see marijuana getting full legal status anytime soon.

People on different sides of this debate will call these older voters hypocrites, but I say that since around 80% of youths engage generally in deviant behavior (if you define illegal as deviant), I think we should leave the bigger decisions to people with a little more complete brain development and a lot more experience. Besides, could we translate the fact that young voters, who supposedly supported the passage of proposition 19, stayed at home as evidence that marijuana use does reduce motivation even when it comes to passing laws affecting its own consumption? The notion doesn’t bode well for ever passing a law having anything to do with weed. I jest of course… sort of.

Proposition 19 – Marijuana legalization or nothing? The business of weed

On November 2nd, California voters will be asked to determine whether they’d like to change the legal status of marijuana, and for the first time ever, advocates of legalization may actually accomplish their goals. There are a number of reasons why a well-intentioned voter would choose legalization, from the potential billions of dollars in tax revenue to the reduced burden of non-violent drug cases on a mired legal system. Unfortunately, without the opportunity to vote for decriminalization rather than full legalization, these voters are being presented with a false choice between a senseless century-old prohibition policy and a new option designed not to maximize the safety of California’s citizens, but rather to greatly enrich a chosen few.

Proposition 19 – Marijuana legalization and taxation

Proponents of Proposition 19 have many valid arguments working in their favor. Foremost among them is the simple but wide-reaching argument that marijuana users, like users of most other drugs, should not be jailed for their personal use. Study after study shows that the vast majority of those who experiment with drugs do not develop dependence or addiction problems, and that those who do develop such problems benefit far more from addiction treatment than from incarceration. In fact, supporters of legalization often cite Portugal as an example of a country that has reaped great social benefit from treating drug abuse and possession as a public health, rather than criminal, issue. Portugal, however, has never legalized any drug; their possession, rather, has been decriminalized, while the drug trade itself remains illegal. The crucial benefit of this approach speaks to the strength of market forces: by keeping drugs illegal, we keep them expensive enough to provide a disincentive to serious and widespread abuse. If fully legalized, the extreme reduction in cost, along with the clever and predatory marketing of marijuana in less stigmatized formats- cookies, lollipops, teas – could drive use up far closer to the levels currently seen for alcohol abuse, and with 15 million American dependent on alcohol, we all know how that fight is going. Given the high public cost of treatment and the correlated increase in depression, schizophrenia, and other related disorders, the perceived financial windfall of legalization may be nothing more than a cloud of smoke. The increase in use however is almost certain.

Driving while high – Polydrug use and marijuana

There is also the question of road safety. While proponents of marijuana are quick to point to a handful of studies that proclaim low to no risk when operating a motor vehicle, they are often too eager to ignore numerous other studies including simulation studies and research from countries such as Australia and Canada, which keep national databases on accident statistics. In Australia, one such study found a 300% to 600% increase in fatal car accidents when drivers were positive for THC (depending on concentration), and Canadian studies have shown that the combination of marijuana and alcohol can be more dangerous for drivers than the combination of alcohol and benzodiazapines. Given that nearly half of individuals admitted to drug addiction treatment include marijuana among their polydrug use pattern, the notion that newly legal marijuana users would not combine their pot use with alcohol or other drugs seems highly dubious. It certainly won’t help that drivers might suddenly be able to buy their weed brownies in the same place as their Bud Light.

Legalization versus decriminalization – Who really benefits from prop 19?

There is no doubt, however, about the one California group that stands to unequivocally gain from the legalization, not decriminalization, of marijuana- the entrepreneurs that have staked their claim to what they see as potentially a very big business. Decriminalization, by diverting marijuana users from the legal system and focusing our efforts on getting compulsive users into treatment, will both save taxpayer money and do far more for public health than legalization or the status-quo. What it will not do is make men like Richard Lee, Oakland’s major marijuana-sales benefactor and one of Prop 19’s biggest financial supporters, any richer. As California voters cast their ballot in a few short weeks, they should by all means carefully consider making a statement about our nation’s failed drug policies and misplaced law enforcement priorities. They should also carefully consider the solution that isn’t being presented as an option- and why.

Drug legalization – For, against, and in between options

gavelA recent assembly bill in California is the latest legal proposal that the state begin to regulate, and collect taxes, on marijuana. This is one of the first bills for drug legalization we’ve had in a while. Most of my readers probably assume that I believe drugs have no place in our society, but this sort of assessment would be far from true. As I’ve pointed out in numerous posts on here, only a relatively small percentage of people that try drugs get addicted to them. In fact, I believe that education and regulation, rather than outright criminalization, may end up being our best solution.

Still, unlike many, I’m not ready to jump the gun yet. I think the issue should be studied scientifically, carefully, and that the results should guide our decisions. It is very possible that legalization would greatly increase the drug use problem in the US. The two most commonly used, and abused, drugs in the U.S. are currently tobacco and alcohol, the two widely-available legal drugs;  the third in-line is marijuana, which enjoys a near-decriminalized status in a number of states. I don’t think this is a coincidence, and neither do a whole bunch of other smart people (look here for a nice overview of both-sides of this argument, and here for a RAND report).

Still, it’s also possible that drug legalization wouldn’t produce those results, and there’s little doubt in my mind that decriminalization would alleviate many of the common problems that currently go hand-in-hand with drug use: Crime, violence, accidental poisoning, etc. I also believe that if the drugs were legal, the reduction in stigma, health-care coverage, and the availability of far better research could possibly help us in better treating addicts.

The bottom line is that we don’t know and that unless we examine every solution, we’re most likely to miss some opportunities. I also don’t think that outright legalization or the current, harsh, penalties are the true answer. I think that being dogmatic about either position is going to leave us with half-measures, and we don’t want that. It also leaves us with unrealistic solutions – For instance, complete drug legalization is simply not going to happen, which leaves questions as to age limits, use restrictions, and dispensation that unless answered make the debate a purely theoretical one.

In addition to the above link about the bill, there’s a group of law enforcement officials that believes in the repeal of drug prohibition, and not because they use drugs themselves. Just to be fair, the US department of justice has put out a publication speaking out against drug legalization.

Again, if I’ve learned anything in my studies is that a more refined compromise is probably our best actual solution. Still, coming to this agreement will require a lot of work on both sides.