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  • Writer's pictureDr. Lloyd

Why our country has lost the “war” on drugs and how can we win?



For decades, addiction in the US has been ‘fought” with punishment, military action in other countries, and border interdiction, despite the fact they do not work.


As a result, drugs have won "the war on drugs". Overdose deaths keep rising. Fentanyl has been weaponized by drug dealers to build their businesses. 44% of prison arrests have been on drug offenses. Vast amounts of money have been futilely spent on the “war”.


In a thoughtful and balanced way, E. Tammy Kim, reporting for The New Yorker, described the “battle” over decriminalizing (not legalizing) drugs in Oregon. The state was second in the country for (known) drug addiction and its addiction services scored near to last in the country.


In November of 2020, 58% of Oregon voters chose to approve Measure 110, which decriminalized possession of (small amounts) of illegal drugs and funded the measure with $100 million/annually for drug and alcohol treatment services. Legislative passage of the Measure soon ensued. Early succusses from decriminalization bred strong protestations of the Measure, which was the beginning of a needed, humane, public health approach to the state’s drug epidemic. An all too familiar “battle” had begun.


Here we go again. Decriminalization helps protect those using substance from useless but damaging jail and prison terms, where they become further socialized in breaking laws. Banning what people want will fail. Prohibition of alcoholic beverages in the US (1920-1933) may be the first major such failure. But its lesson went unheard. People get what they want, by hook or by crook.


Drugs are what people with addictions use - they are not armies at the gate. We use drugs because they work, at least initially, in quickly quieting psychic and physical pain.  Addiction is "self-induced changes in neurotransmission that result in problem behavior." There is no external enemy. Instead, a powerful convergence of biology and social circumstances, an interplay of nature and nurture, produces addictions (including to drugs and alcohol as well as compulsive behaviors like gambling, video games and some sexual disorders).


We have yet to see a national prevention and treatment approach informed by and applied with a public health approach to addiction. Public health has ‘beat’ many illnesses and preventable deaths in the US, including polio, smallpox, malaria, motor vehicle deaths, and tobacco morbidity and mortality.


Perhaps the greatest challenges, however, to successfully effecting a public health solution to addiction are termed the social determinants of health. Ninety percent (90%) of the determinants of our health derive from our lifetime personal behaviors and social environment, not from the provision of health care. Those determinants include poor nutrition, excessive drinking and abuse of drugs, smoking, and physical inactivity. Those determinants also include a range of social factors, including childhood physical, emotional, and sexual trauma (Adverse Childhood Experiences - ACEs), poor and limited education, food insecurity, poor or absent housing, and unemployment.


These drivers of our ill health and shorter lives do not comport with "war". Their remedies lie in the strengthening and revitalization of families and communities. In improving neighborhoods that have been scourged by poverty, crime, and an improbable exit from the "'hood". All are breeding grounds for addiction.


The prospect of a life with safety, stability, work, community, purpose, and dignity will surely the most difficult goals to achieve to beat back our drug epidemic. Yet they will have the greatest likelihood of success for our country’s drug and alcohol epidemic. Addiction is the enemy of personal wellbeing and success, a transient, ‘solution’ to the pains of living an emotionally and socially impoverished life.


Pied à pied, inch by inch, step by step.

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