Health: The policy behind most Drug War legislation is centered on ambiguous concerns for “public health” and “safety.” Unfortunately, the War on Drugs has contributed to neither public health nor safety – indeed, by almost any measure, the Drug War has been more detrimental to public health and safety than the drugs themselves. Part of the problem, indeed perhaps the biggest part, is politicians trying to control human behavior by regulating drugs through prohibition and criminalization. Drug War Stories opposes prohibition and criminalization and supports scientifically-based medical practices focused on harm reduction.
Another part of the problem is that terms often used with respect to drugs are not properly defined or distinguished. Terms like drug use, misuse, abuse, dependence and addiction are often used synonymously, but each term and concept should be considered differently.
When drugs are legal, whether prescribed by a physician, or purchased over the counter, or purchased from a beer cooler at a supermarket, drug use generally conjures up notions of responsibility and justification. A person who is prescribed a medication to help them sleep or deal with pain, or takes a couple of aspirins for a headache, or has a beer to relax after work is using drugs in a way that most people would see as completely justified and responsible.
However, drug abuse is often defined as “the recurrent use of illegal drugs, or the misuse of prescription or over-the-counter drugs with negative consequences.” Thus, a recurring use of an illicit drug is generally considered “abuse” regardless of how responsibly used and justified the use may be. Under this common myth and misperception, a medical marijuana user is still an “abuser,” as is the person who smokes a joint after work to relax. Often, the “negative consequences” of illicit drug use involve nothing more than trouble with the law. The one-size-fits-all description of any illicit drug use as “abuse” is problematic and counterproductive in terms of developing policies that truly promote public health and safety. A person taking too many prescription pain killers and a recreational marijuana user are in completely different situations – one may have a drug dependency and need help while the other probably doesn’t – yet both would be deemed to be “drug abusers.” Indeed, the user of prescribed opiods may well develop a dependency even if they are following directions for use while the casual marijuana user may not ever develop a dependency. Thus, terms like “drug abuse” must be considered, and reconsidered, in light of reality, reason, and sound scientific and medical evidence – not convenient political sound bites and easy solutions. Clearly, criminalization does nothing to promote and protect public health in these situations.
Drug dependence is often defined as a condition where a person requires the continued use of a substance to function “normally” without suffering from withdrawal. Someone with a drug dependency physically requires a particular substance simply to maintain without becoming physically ill. Again, criminalization does nothing to help the drug dependent person or promote and protect public health.
Finally, addiction, according to the American Society of Addiction Medicine (ASAM), is:
a primary, chronic disease of brain reward, motivation, memory and related circuitry. Addiction affects neurotransmission and interactions within reward structures of the brain, including the nucleus accumbens, anterior cingulate cortex, basal forebrain and amygdala, such that motivational hierarchies are altered and addictive behaviors, which may or may not include alcohol and other drug use, supplant healthy, self-care related behaviors. Addiction also affects neurotransmission and interactions between cortical and hippocampal circuits and brain reward structures, such that the memory of previous exposures to rewards (such as food, sex, alcohol and other drugs) leads to a biological and behavioral response to external cues, in turn triggering craving and/or engagement in addictive behaviors.
In other words, addiction involves an actual change in the addict’s brain – the addict is simply not the same person he or she was before the addiction. Arrest and incarceration of an addict simply because they have a disease is both medically unsound and morally repugnant. Drug addiction is a serious issue in our country that must be addressed as a public health, not a criminal, problem. Drug War Stories advocates a sensible drug policy approach, one that treats addicts as a human beings and seeks to decrease addiction and its consequences by focusing on harm reduction.
Our aim is to reduce harms by putting the health consequences of drugs and the War on Drugs into perspective.