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”
How many of you think that giving a crystal meth user condoms will increase their drug use? Probably not many. What if instead the question had to do with giving that same user clean needles rather than having them share a dirty one? Or having him reduce his drug use instead of stopping completely? I bet there would be a little more disagreement there.
Some of you may have heard of the harm-reduction approach to drug abuse counseling and treatment, but many of you likely haven’t because the term itself is essentially taboo in the United States. The idea is to approach the patient (or client) without the shaming or expectations of abstinence that normally come with drug treatment. Instead, the counselors hope to reduce as much of the negative things associated with the drug use.
For example, almost all drug injecting users end up with hepatitis C due to dirty-needle sharing. As in the above example, harm reduction practitioners would seek to provide users with clean needles, thereby reducing needle sharing and the transmission of disease. Risky sexual behavior is often associated with methamphetamine, and crack use; instead of targeting the use itself, often, interventions attempt to reduce unprotected sex, reducing HIV transmission in the process.
Harm reduction has many supporters, but unfortunately, there are at least as many people who are against it. The claim is that harm reduction doesn’t stop drug use, and that we shouldn’t be in the business of making drug use easier. In fact, though they have no data to support it, some people argue that giving users clean needles is likely to exacerbate their drug use. My argument is that life as a drug user is pretty difficult as is, and if we can provide a way to show drug addicts that people actually care about their well-being, we might help some of them see the light.
Even more to the point, my thinking is that HIV, Hepatitis C, and other conditions often helped by harm-reduction, have to be considered as additional societal costs of drug abuse. If harm reduction helps us tackle those collateral costs, I’m all for it as an additional tool.
The bottom line is this: If we can use multiple tools to solve a problem, why limit ourselves unnecessarily to only one? If harm reduction helps, why not use it in conjunction with abstinence treatment?
As I’ve mentioned in previous posts, it’s time for us to stop resorting to ridiculous moral judgments and start focusing on solving the problem. If we can help an addict use less, use fewer drugs, or use more responsibly, I say we should go for it!!!
Back in the 70s, heroin was mostly filler, and the good stuff was 5% pure or so. Nowadays a new, more potent, version of the stuff is killing people all around the country with widely varying purities as high as 90%.
What makes black tar dangerous
When heroin was weak, shooting it was the best way to get high, which kept many people away from it. But this relatively new stuff (it’s been around California for a while), brought in from Mexico and known by the name Black Tar, is strong enough to make smoking, or snorting, it a viable option for a nice long high. It’s a much easier sell for the dealers too – no more ugly needles, they tell their customers you can “just smoke it like weed,” which is true until you get hooked.
Like any other form of heroin, black tar will cause some serious changes in a user’s body and brain, messing with the body’s pain, digestion, and mood systems. The problem is that at these purity levels, the chance of a user overdosing are much higher too, and that’s where the body-count comes in.
The stuff is cheap, at least in relation to the old heroin that used to come in from the far-east, but the body count’s mounting and the problems only getting worse. Heroin overdose death rates have gone up at 20%-50% and they’re still going strong. Many of the people who are most concerned about this are hoping that heroin doesn’t bring about the same epidemic that crack did in the 80s.
Avoiding death by talking
As usual, I don’t believe in running away from a problem like this. Instead, this is exactly the kind of thing that education, information, and a good dose of harm reduction can fix. We need to make sure people know that the potency of this stuff can kill you. The only way to make sure that less people die from black-tar heroin is to let them know that they need to be careful with it because one mistake can mean death.
I’m hardly ever the “just say no” type and I think that in this situation, an approach like that will leave us in deeper and deeper trouble. The AP article I based this on talked about yearly seizures of heroin quadrupling to 86 kilograms across the U.S.-Mexico border last year. By comparison, cocaine seizures in 2008 totaled more than 8000 Kilos! I can tell you one thing, as someone with experience as a drug dealer, getting 86 kilos across the border isn’t that hard with the amount of Mexican corruption and “help” dealers can get. Where’s there’s money, there’s a way, and it seems that this heroin trend is offering up some money.
It’s that experience of mine that makes me believe we have to work towards understanding addiction and who develops it, and getting better at prevention, intervention, and treatment. Try as we might, solving this problem by the supply side isn’t going to work, I don’t care how hard Calderon is willing to fight.