Wednesday, January 13, 2016

The War on Drugs

I often check the police log of the local newspaper to see if any of my old patients will surprise me.  Last week a patient whom I had not seen for several years was listed as having been arrested for possession of a Class A substance.  This was not a surprise.  The young man had been struggling with many issues involving work, family and school for years.I remember working with his mother when he was a teenager to try and get him services that  would be more intensive than what I could offer him.  But he was a tough kid to work with, so no one put in the time to push for him to get into the very few places that may have been available.  Perhaps the court system will be his best chance of getting into a program.
There has been a lot of publicity over the last couple of years about the over-use and the illegal use of opioids, which has been leading to an increase in addiction and a noticeable  increase in deaths from overdoses.  Now that many of these deaths are of young adult, middle and upper class White people, it has become an “epidemic.” In response to this there have been more calls for restrictions on the use of many opium based pain medications as well as more treatment programs for people struggling with these drugs.  There are also calls to make treatment the alternative to criminal prosecution.

Of course, much of this problem is the result of the disastrous effects of the everlasting “War on Drugs.”  That war should now be regarded as one of the great failures of American war policy, right up there with the invasion of Iraq and Viet Nam. The only people who classify the War on Drugs as having any success are those who favor the mass incarceration of Black people for non-violent crimes, and the private prisons, who have made billions of dollars in profits from these incarcerations.

By any appraisal of the huge amount of time, money and the destruction of social fiber that has resulted from the War on Drugs will quickly reveal that the entire effort was worse than a failure.  There have been so many destructive  effects that still are undermining American health, safety and quality of life.

Here is a partial list of that pain and suffering this war as caused:

— the criminalization of acts that, if they hurt anyone at all, hurt the person using the drugs.
— that resulted in people being put in jail instead of getting treatment
— that resulted in them using jobs, and not being able to find new ones
—  often these people were deprived of getting driving licenses or voting
— they became burdens to their families
— they were regarded as weak willed, losers and worse
—  this kind of social rejection often led to the return to addiction
Despite the huge amount of time, money and effort devoted to fighting the War on Drugs the actual use of drugs never really diminished.  Illicit drugs are still widely used and distributed. They are distributed by illegal means, mostly being drug cartels.  The money goes to support illegal efforts and make criminals rich.  It is lost to the economy.  It is not taxed.  Thus it is a negative economic benefit. 

Those are the obvious failures. There are many secondary failures that have resulted from these policies.
— The amount of time, money and resources that police department have spent fighting a crime that did not have to be a crime
— a result of this was the development of  greater 
 adversarial conditions between the police and many people who would have trusted them.
— this led to a in a militarization of the the police
— the development of SWAT Teams to chase drug dealers

Also: a big increase in gun violence is related to the vast sums of money earned by drug dealers, the wars over their territories, the use of informants, and the entire unlawful importing, selling, buying and using of drugs.
None of that was necessary.

All of this has been a major factor in the corruption of governments in many countries around the world, especially in South and Central America, as well as many American local police forces.   The American addiction of drugs that are illegal has brought billions of dollars to huge illegal cartels.  There have been countless thousands of deaths in drug wars between cartels, in wars with police and armies, and of many people who were just in the wrong place, or innocent families who had relatives on the wrong team. It has helped to set a climate of corruption, opposition and distrust in many societies, especially in our own, as otherwise law abiding people learn to oppose the police. The need too afford illegal drugs has lead to many robberies and burglaries, even among family members.

The money from illegal drugs has financed revolutions in many countries included Columbia, Afghanistan and ISIS.  
The war on drugs has torn apart families.  The ideas of “Just say no” and “Tough Love”, would never have been necessary if taking drugs had never become a crime, and considered a moral disgrace. 
Treatments for drug “offenders” were much less effective and much more punitive than they would have been without the overlay of legal consequences. Mandated treatments are still a great expense to taxpayers and to the individuals involved.  They often set up requirements that make it difficult to hold on to a job, and they are often a waste of time and money since so many people are forced into treatments when they do not feel that is what they want to do.
Pharmaceutical companies were very active in combatting illegal drugs while promoting their own drugs.  Those lines became blurred and remain blurred today.  They want to sell a lot of pain-killers, but don’t want to be responsible for addictions.  They market drugs that they said would help learning, behavior and mood. But they were against other drugs that people knew made them feel happier or perform better. It is never clear how much drug manufacturers fight against the underground buying and selling of the drugs they manufacture. The pervasive message that a drug will make you feel better, no matter what the problem, has certainly become well established in our culture. People seek drugs for better health, performance and pleasure.  It is not clear why some are legal and some are not.

This is just a partial list of the harm done to people, their families, their communities, the country and the world by the War on Drugs.  This war, like almost all wars was started for political reasons.  The underlying factors were fear and racism.  One of the original fears were the fears of the changes that were happening in the sixties.  People were standing up to their government saying they didn't want to go to war.  Other people were asking for equal rights for women and minorities, especially African Americans.   The status quo was being threatened.  The people who were threatening were the hippies, Blacks and women.  They seemed to be the ones who like to take drugs. It became a big issue of the culture wars.
In just the last four years, since many of the older white people who were threatened are now busy carrying guns, and a non-threatened younger generation is more tolerant, changes are occurring.  There is finally a movement to look at the imbalance in prison sentences that have sent Black people to prison for crack, while white people who use powered cocaine get probation. The legalization of marijuana is slowly becoming acceptable, but there will be many disputes over who gets the money.

All of this is made even more distressing because there is an example of other ways to deal with drug use and abuse, and it has proved very successful.  For the past fifteen years Portugal has decriminalized all drug use. The problem was shifted from the justice system to the health department. 

- “If someone is found in the possession of less than a 10-day supply of anything from marijuana to heroin, he or she is sent to a three-person Commission for the Dissuasion of Drug Addiction, typically made up of a lawyer, a doctor and a social worker. The commission recommends treatment or a minor fine; otherwise, the person is sent off without any penalty. A vast majority of the time, there is no penalty.” —  Policy.mic.com
Since the drugs are available and affordable, and having them is legal, then their is no crime, so the crime rate is way down. There is no secondary crime, such as robberies.  The police will help you if you get sick or want treatment.  The user is not viewed as morally or psychologically deficient.  
And, not surprisingly, the rate of drug abuse has decreased over the years, and so did the spread of HIV.

Unfortunately, it is too late for my former patient to get treatment without having an arrest record to haunt him.  But recently, there are signs that people are realizing that there may be a better approach.  Like everything political in this country, change will not come easily or swiftly. So much depends on awareness, and then of changing the flow of money.  Many people, from drug makers and growers, illegal cartels, corrupt officials, drug companies and diversion programs are making money from the current system.  It will take working with families, courts, police, doctors, drug users and others in the health system to bring about change.  
Eventually, things will change.  The changes in our culture will continue, even if many people fear the unknown.  But our societies ideas about what is helpful, what is healthy, what is legal, and what is pleasurable are evolving. Also, new substances will be developed that will help blur all the lines.  


Until all of that is sorted out, take good care of yourselves and each other.

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