Criminal drug possession – Felony versus misdemeanor

In all but 13 States in the U.S., drug possession for personal use is still considered a felony punishable by years in prison and hefty fines. This despite the fact that a significant portion of those arrested meet criteria for dependence (addiction) on the drugs they are caught with, and the fact that our own federal drug abuse agencies (The National Institute on Drug Abuse – NIDA) considers addiction to be a medical condition that involves reduced control over the drug use itself. I guess that’s why the federal government also considers possession for personal use as a misdemeanor.

Drug users don't belong in prisonIn essence these state laws are putting drug users, and especially drug addicts, at risk of being locked up for years, placed on parole, and subject to the endless other barriers to employment and housing, which make it more difficult for these convicted felons to reintegrate into the community. As if fighting drug addiction wasn’t hard enough.

The question is, would reducing the penalty for drug possession for personal use to a misdemeanor in more states result in increased drug use and crime or would it actually help free up resources being used for incarceration towards more effective strategies for combating the problem?

California State senator Mark Leno is bringing up a bill for consideration in the state senate (SB1506) that is seeking to do just that – reducing the penalty for possession for personal use of any drug to a misdemeanor. Mind you, this law is not to affect any other drug-related offenses such as drug possession for sale, drug manufacturing, or transportation. What it would do is cap the maximum incarceration length of possession at one year in jail (not more years in prison) as well as cap the maximum community supervision length at 5 years (3 years are commonly assigned for such offenses).

I know what some of you are saying – drug users know they’re breaking the law and they should be punished for it. Indeed, punishing them for it will make them less likely to use, which will leave them facing no jail time instead of continuously facing single years in jail for reduced drug possession offenses. Besides, if we cut the penalties for drug possession aren’t we being soft on crime? Aren’t we saying that using drugs is okay?

The problem with that argument is that it assumes that states that have higher penalties for drug possession for personal use have lower rates of crime, drug use, or drug possession arrests. The don’t. Indeed, the 13 states (and D.C.) that already consider drug possession for personal use a misdemeanor have incarceration rates that are no higher, illicit drug use rates that are slightly lower, and addiction treatment admission rates that are on par and even a bit higher than the rates of felony states. Again, that means the states that reduced the penalty for drug possession see less arrests, more people in addiction treatment, and a smaller percentage of their population using such drugs. Interestingly, those results are somewhat similar to the effect complete decriminalization had on drug use, crime, and addiction treatment in Portugal.

In previous articles we’ve spoken about the stigma of addiction and the barriers people report to entering addiction treatment in the U.S. Aside from cost and lack of information, people usually report that they either don’t want help, think they can handle the problem on their own or are too ashamed to ask for help. We’ve also reported on the ridiculous prison overcrowding problem in California due to the high incarceration rates of drug users. The question of decriminalization has come up many times (see here, here, and here) and the evidence I’ve seen keeps pointing towards the conclusion that reduced penalties get more people into addiction treatment while reducing incarceration rates with no real collateral increased in illicit drug use or crime. When you think about it, since the Harrison Narcotics act of 1914 essentially created the black drug market in the U.S. when it restricted, for the first time, the sale of narcotics, it makes sense that loosening up those restriction would reduce the size of that same black market and with it drug-associated crime.

I have spent the last 10 years researching the best ways to fight addiction problems and almost everything I’ve seen suggests that treatment and prevention efforts, not long jail or prison sentences, are the best ways to combat the problem. I have seen evidence that very shirt-term incarceration can help certain resistant offenders, but those efforts can easily be applied for misdemeanor and require nothing close to multiple-year sentences. For that reason, I support not only Senator Leno’s SB1506 bill in California, but other efforts around the country to reduce the criminal penalties associated with simple drug possession to get more of the people who need help into addiction treatment and away from jails. It saves us money, it is more humane, and it just makes sense.

If you want to help Senator Leno pass this bill, contact his office through this link: http://sd03.senate.ca.gov/

 

Citations/Reading:

U.S. Census Bureau, 2012 Statistical Abstract, Table 308. Crime Rates by State, 2008 and 2009, and by Type, 2009 (2012).

Collins et al., (2010). The Cost of Substance Abuse: The Use of Administrative Data to Investigate Treatment Benefits in a Rural Mountain State. Western Criminology Review 11(3), 13-28.

Gardiner, Urada, and Anglin (2011). Band-Aids and Bullhorns: Why California’s Drug Policy Is Failing and What We Can Do to Fix It. Criminal Justice Policy Review, 23, 108-135.

Internet addiction – Epidemic or fad?

By Adi Jaffe, Ph.D., and Yalda Uhls, MA, MBA

1 in 3 people consider the Internet to be as important as air, water, food and shelter. Given how intensely people feel about this technology, is it any wonder that some psychologists are convinced that Internet addiction is a real pathology?  True, claiming that people are as dependent on the Internet as they are on air, food, or water is obviously a non-starter; it’s pretty clear that the actual role of technology is far less compulsory in terms of human survival.

But does this kind of dependence, compulsory or otherwise, qualify as an addiction?

While the DSM only currently recognizes specific dependence on substances as an addiction, it is apparent that a subset of people who overuse the Internet and digital media tools also display behaviors exhibited by substance abusers.  In the last decade, as the problem became more widely acknowledged, a few psychological measures have been developed to identify Internet addiction. While none of these are perfect, certain measures are becoming more accepted in the field (like Young’s Internet Addiction Test).  Using these scales, studies have identified correlates of Internet addiction and found that ADHD, depression, social phobia and hostility were all linked to excessive Internet use, a pattern reminiscent of correlates of alcohol and drug addictions as well.

The internet is just a tool, why should people who overuse it be considered addicts?

Some of the most compelling evidence comes from Asia.  In Korea, a country where technology is deeply enmeshed in the culture and Internet cafes abound, Internet addiction is considered one of the country’s most serious problems.  In the last decade, many people have died after marathon sessions of playing online video games, presumably from exhaustion and lack of nutrition, as they ignored their basic needs so they could continue to play a game. It’s a bit reminiscent of animal studies in which rats with electrodes implanted in their dopamine “pleasure centers” forgo food for lever presses to their own demise.  China has struggled with similar issues and in 2007 the country restricted game use to less than three hours a day (it’s important to note that there’s some loose consensus that more than 38 hours of recreational internet use a week is problematic).  In Korea, where they may be ahead of the curve in terms of dealing with the issue, more than 1,000 counselors have been trained in the treatment of Internet addiction and nearly 200 hospitals enlisted in the effort.  Moreover, preventive measures were recently introduced in schools and free Internet rescue camps are offered throughout the country.

In America, current estimates are that a child between the ages of 8-18 uses digital media nearly eight hours a day, while extreme users spend up to 12 hours a day with media, every day of the week.  Children are spending more time with screens than with their parents or at school; are we doing enough to protect vulnerable children from developing an addiction to the Internet?  No laws currently exist to protect children from excessive internet use. Doesn’t society have a responsibility to protect children, in the way we attempt to protect them from drugs and alcohol? If so, what would such protection look like and how would it be enforced?

You might be asking yourself whether people are actually addicted to the Internet itself or whether the Internet is simply a tool where other more basic pathologies, such as poor impulse control or social phobias, or fetishes are played out?

In the case of certain online behaviors, it may be simple to define the behavior as problematic because similar behavior offline has long been established as socially unacceptable when performed to excess.  For example, well established addictive behaviors such as gambling or sexual activity are easily played out online.   Even respected public leaders such as former congressman Anthony Weiner admit they have problems that are beyond their own control and that they need professional treatment.  In case you haven’t heard about Weiner, he was the Congressman who resigned after being exposed for texting sexually explicit photos of himself to constituents he had never met. Sounds like something an ignorant teenager might do right?  So when does this kind of behavior cross the threshold to compulsion or addiction when performed repeatedly?

Examples such as Weiners’ may be relatively easy to identify as a problematic compulsion but when online behavior is sanctioned by society as in the case of sending non-sexual texts, emails, or surfing the Internet for hours on end, it is more difficult to determine exactly when the line between normal and dysfunctional is crossed. Indeed, when one considers the “crackberry” nickname given to certain smart phones, a direct comparison to addiction seems relevant. Nevertheless, those who constantly check emails at the dinner table, on vacations, and while driving, are often extremely successful executives whose business culture demands this level of connectedness.  Indeed, some schools even promote the use of digital media as an exciting learning tool; for example, the curriculum for one elementary school in New York is designed entirely around video games. Given the potential for harmful behavior, how do we reconcile overuse of the Internet when our culture often validates and supports its use?

With all of these difficult issues still to be resolved, the answer to the question of whether or not Internet addiction is the same as substance abuse is obviously not yet, and may never be, crystal clear.  However, according to everything we know right now, there’s no question that for at least a subset of Internet users, online life can become disruptive to normal functioning. The question is how to minimize that sort of risk as our society becomes more and more globally dependent on technology.

If you think you might have a problem with the Internet, ask yourself the following questions – if you answer yes to more than 5 of these problems, you may need to seek treatment.

1. Do you often feel preoccupied with the Internet (think about previous online activity or anticipate next online session)?
2. Do you feel the need to use the Internet with increasing amounts of time in order to achieve satisfaction?
3. Have you repeatedly made unsuccessful efforts to control, cut back, or stop your Internet use?
4. Do you feel restless, moody, depressed, or irritable when attempting to cut down or stop Internet use?
5. Do you stay online longer than originally intended?
6. Have you jeopardized or risked the loss of significant relationship, job, educational or career opportunity because of the Internet?
7. Have you lied to family members, therapist, or others to conceal the extent of your involvement with the Internet?
8. Do you use the Internet as a way of escaping from problems or of relieving a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression)?

As with other compulsive or addictive behavioral patterns, the key to combating internet-addiction-like symptoms is to intervene early. Since many addicts start out using their respective drug/behavior of choice as a coping mechanism, realizing early on that unhealthy patterns of behavior are developing is crucial. If a child draws his or her self-esteem from retreat into the online world, it would be extremely helpful to find additional activities that could similarly boost confidence. If compulsive use patterns do develop, it is likely going to take a concerted effort to break them without bringing up serious resistance. Techniques such as Motivational Interviewing (MI) will likely prove as useful in this domain as they have with substance abuse and addiction – gentle guidance is often more effective than cornering a troubled individual and forcing them to act.

The good news? Internet withdrawal is not likely to cause much in terms of physiological withdrawal symptoms, so if cutting off access does become necessary, at least there’s no risk of going into shock, cardiac arrest, or DT-like symptoms. Still, expect that psychological withdrawal-like symptoms will be similar to those experienced with many drugs: Depression, anhedonia, anxiety, irritableness, sleep disturbances, and more are all likely to be part of the picture. If we’re talking about cutting off a child, expect screaming… lot’s of screaming.

 

For more information about technology and its effects on human development, visit Yalda T. Uhls’ website:  Inthedigitalage.com

 

Citations:

Cisco Survey on Internet, 2011: http://www.cisco.com/en/US/netsol/ns1120/index.html

American Psychiatric Association. (2008). Issues for DSM-V: Internet addiction.

Byun, S., Ruffini, C. R., Mills, J. E., Douglas, A. C., Niang, M., Stephchenkova, S., Lee, S. K., et al. (2009). Internet addiction: Metasynthesis of 1996-2006 quantitative research. Cyberpsychology and Behavior, 12(2), 203-207.

Christakis, D. A. (2010). Internet addiction: A 21st century epidemic? BMC Medicine, 8.

Young, K.S. (1998). Internet addiction: The emergence of a new clinical disorder. CyberPsychology & Behavior 1:237-244.

Drug Policy Alliance and the Recovery Movement

I had the opportunity to sit on a panel today during a drug policy alliance session on the role of the recovery movement in drug policy discussions. While it was obvious that everyone on the panel could generally agree that the current U.S. policy when it comes to drug use, abuse, and addiction is not working and unsustainable, it wasn’t clear that we had a common roadmap of how to get to a better place.

Some of the panel speakers were in recovery and others weren’t and while most were from the U.S. we had a representative of the Scandinavian approach for a nice little “reality check” and a bit more balance than one normally gets on these things. From student representatives of the Columbia University Students for Sensible Drug Policy to the distinguished William Moyers from Hazeldon, our panel certainly didn’t lack in a breadth of experiences. Still, even our eight member-panel couldn’t appease everyone when it came to diversity (we missed the mark on racial representativeness). The discussion was civil, but definitely showed that there are serious differences that need to be bridged if the decriminalization discussion is to ever get serious.

I’m all for collaboration and I definitely think that we need to end up in a place where drug use is no longer criminalized as it currently is. Quadrupling our prison population in a few decades with approximately 20% of inmates incarcerated for drug offenses is stupid, expensive, and does little to stop the problem we’re trying to deal with as evidenced by the relatively stable rate of use, abuse, and addiction in this country.

But how do we move forward? Do we make these drugs legal for everyone to use or place an age limit on it? Do we pretend that there’s no risk that use of legal substances will go up to meet the rates of alcohol and tobacco abuse or do we prepare for the possibility that it might? Do we completely remove legal sanctions from the discussion or do we keep them for a specific subset of hard to reach individuals?

As far as I’m concerned, until these questions are considered and dealt with, there’s not going to be any change. Unfortunately, from my reading of the panel and crowd today, even at a Drug Policy Alliance conference, the responses to each of those questions is likely to bring up a lot of debate. I guess that means our work is not yet done…

College drinking and frats – A match made in alcohol heaven?

contributing author: Gacia Tachejian

animal-houseIf you asked college students in America what goes on at a Fraternity or Sorority party they would tell you that drinking alcohol is a major component. The movie Animal House made heavy college drinking a well known fact decades ago, and research backs it up.

Studies have consistently shown that the highest rates of heavy alcohol use and alcohol disorders occur in the college-age population. But who’s to blame? Although heavy alcohol use has been documented within Greek organizations, the question of whether the Greek environment fosters substance use or whether heavy substance users chose to be in Greek environments has not been researched until now.

In order to find out whether the Frats/Sororities were the main influence for heavy alcohol use or if individuals joining the Greek organizations were simply heavier alcohol abusers researchers recently collected data from 3,720 pre-college students who were then followed for the 4 years of college they enrolled in (talk about a lot of work).

Of the almost 4000 participants there were students who joined the Greek environment and those who didn’t. Also, there were students who were late joiners and students who joined but withdrew before they graduated. After looking at all the different categories, one thing was apparent:

Students, who at any given period were part of a fraternity or a sorority, drank more alcohol and had more negative, alcohol-related consequences while being a member of a Greek organization. Also, once they deactivated, those participants drank less and had less drinking-related consequences.

The real issue as to why this is so important has to do with the consequences of alcohol use. Problems like drinking and driving (and possible DUI arrests), alcohol abuse, alcohol poisoning, and violence are a serious problem among college students. Apparently, Greek Environments make these consequences more likely.

It’s important to note: If the only finding her was that participants in the Greek system drank more alcohol or were more likely to drink alcohol at all that would be one thing (this findings was also true here by the way), but the fact that they were also more likely to have negative consequences associated with their drinking suggests that interventions might be useful within this college-environment.

Something to think about next time you’re bored on a Thursday night…

Citation:

Park, Aesoon, Sher, J., Kenneth, S., & Krull, L., Jennifer (2008) Risky Drinking in College Changes as Fraternity/Sorority Affiliation Changes: A Person – Environment Perspective. Psychology of Addictive Behaviors, Vol. 22, No. 2, 219-229.

420, smoking weed, and drug problems : Marijuana facts

Co-authored by: Jamie Felzer

It’s April 20th, or 4-20, and anyone who smokes marijuana knows what that means – It’s time to smoke weed- a lot of weed!

In honor of this “stoner” holiday, or perhaps in reverence of its implications, I wanted to put together a post that explored some recent findings having to do with the most commonly used illegal substance in the U.S.
These two studies deal specifically with smoking weed, teenagers, and drug problems.

Study 1 – Misconceptions of marijuana use prevalence

An article in the Journal of Studies on Alcohol and Drugs has revealed that most young adults greatly overestimate how many of their peers smoke weed. Teens surveyed believed that 98% of their peers smoked marijuana at least once a year – In reality, only 51.5% off the teens reported actually ever smoking marijuana.

To make matters worse, even though only 15% of the teens reported using once a month or more, the estimate among peers was closer to 65%!!! Since we know that perception of peer behavior affects adolescents greatly, such misconceptions can easily lead to false peer-pressure towards marijuana use.

So next time instead of assuming everyone smokes weed, think again.It’s one of the most commonly used drugs but the notion that everyone smokes weed is simply wrong.

Reference: Kilmer, Walker, Lee, Palmer, Mallett, Fabiano, & Larrimer (2006). Misperceptions of College Students Marijuana use: Implications for Prevention. Journal of Studies on Alcohol and Drugs, 67, pp. 277-281.

Study 2 – Teens reducing use can reduce marijuana dependence risk

This next study dealt with early patterns of weed smoking as possible predictors of later problems use. They followed more than 1500 respondents from adolescence (ages 15-17) into young adulthood (ages 21-24).

The article revealed some interesting overall patterns, but I’ll keep the results short and simple, it is 4-20 after all…

The good news? Teens who reduced their use during the first phase of the study (the teens years) were at a significantly lower risk for marijuana dependence and regular use in early adulthood. This suggests that successful interventions may be effective at reducing later problem use.

The bad news? All marijuana smokers who used at least weekly showed the highest risk for later problems even if they reduced their use… This is not that surprising of a finding though since dependence usually involves regular use.

The bottom line? Reducing marijuana use at any stage will lower your risk for later problem use, but those who find themselves smoking often are most likely to end up in some trouble even if they try to cut down. Knowledge is power, so if you think you might be at risk and are concerned, talking to someone can’t hurt. Knowing marijuana facts can’t hurt either.

Reference: Swift, Coffey, Carlin, Degenhardt, Calabria & Patton (2009). Are adolescents who moderate their cannabis use at lower risk of later regular and dependent cannabis use? Addiction, 104, pp 806-814.

For a different view on 420, see this video:


Early drug use problems: Kids, inhalants, and huffing.

Parents can save lives by educating their kids about the dangers of inhalants22.9 million Americans report trying inhalants at least once in their lives.

When it comes to drug use problems, inhalants are often the first drugs that kids decide to experiment with. The habit is often called huffing. While use of alcohol, tobacco, marijuana, cocaine, ecstasy, and other drugs peaks around the 12th grade, inhalant use peaks in the 8th grade. A study conducted by the National Institute on Drug Abuse found that 17.3% of 8th graders have abused inhalants before.

Why does kids’ drug-use start with inhalants so early in life?

Many kids start inhalant drug use by accident; they like the smell of glue, whiteout, or gasoline, take a long inhale, get high, and keep going. For others, inhalant use is introduced through friends.

Also, attaining drugs can be somewhat of a challenge when you are 13 years old. Inhalants solve this problem. Inhalants are found in a variety of household products including: spray paint, nail polish remover, whiteout, marker, gasoline, glue, keyboard cleaner, shoe polish, and aerosol sprays. These products are easy to buy and relatively inexpensive, even for young kids. They can often be found readily in the house, which also makes them easy to hide.

Inhalants, the brain, and organ damage

Inhalants can be breathed in directly or concentrated in a container such as a plastic bag or cloth and then inhaled. Most inhalants work by depressing the central nervous system. The chemicals are absorbed through the lungs and proceed into the bloodstream, where they quickly reach the brain and other organs. Inhalant intoxication looks very similar to being drunk: Slurred speech, bad coordination, euphoria, dizziness, and drowsiness are all common during inhalant drug use.

The inhalant high only lasts a few minutes, so people often use inhalants repeatedly for several hours. This can have some devastating long-term effects. Brain damage, nerve damage, and organ damage are all possible. Inhalant use can impair vision, hearing, and movement. Inhalant drug-use is also linked with a variety of mental disorders, including antisocial personality disorder and depression. In pregnant animals, inhalant use has been linked to low birth weight, skeletal abnormalities, and delayed development.

Most tragically, even a single session of inhalant use can cause heart failure and consequently, death. The National Inhalant Prevention Coalition reports 100 to 125 inhalant-related deaths per year. This is particularly sad considering the fact that many of these individuals are kids and haven’t even left middle school yet.

Dr. Jaffe talking about huffing and inhalant abuse on Fox News

Citations:

1. Seigial, J.T., Alvaro, E.M., Patel, N., Crano, W.D. (2009) “…you would probably want to do it. Cause that’s what made them popular.” Exploring Perceptions of Inhalant Utility Among Young Adolescent Nonusers and Occasional Users. Substance Use & Misuse. 44(597-615)
2. NIDA. Inhalant Abuse. 2005