To
my citesAlaska's drug policy, a question arises are we doing what's most effective? A few things to consider
The Mascone Act, which was passed by California Senate in 1975. The Act lowered penalties for possession of cannabis under an ounce to a misdemeanor. Statical indicators of cannabis use showed no increase in cannabis use.(1)
Alaska had extremely permissive cannabis laws in the 1980''s. In 1982 the cannabis use among high school seniors was one third lower when compared to other American.(2)
An issue of the "ABA Journal" published the results of a poll of 350 state judges and 49 federal judges. The results in part are as follows
90 percent of federal judges think mandatory minimums are a bad Idea.
88 percent of federal judges think Mandatory minimums are too harsh for first time offenders only 2 percent felt they were fair.(3)
A Nation wide survey of police chiefs by the police foundation said that 85% wanted sweeping changes in this nations drug polices, and 60% said enforcement has not reduced the problem. (4)
Legal Coercion may help steer some problem drug users toward treatment. Legal coercion, for other problem drug users, who have a more severe drug problem and other problems may actually be steered away from drug treatment from such coercion.(5)
We must as Alaskans must set our policies with accurate information. Two myths we have about drug abuse are
A. A drug users will quit when they bottom out.
B. Auto-remission of addiction does not exist
"Bottoming out"is often seen as the only way someone will quit drug use. Opiate addicts also cited these other reasons they quit opiate use.
1. Become converts to religious, spiritual, or ideological groups.
2 change their behavior when their environment changes.
3. Retire from drug use but maintain some element of the lifestyle.
4. Become alcoholics or mentally ill
5. Simply drift into the mainstream(6)
Investigators said after they review research on reformed drug addicts "Some of the evidence even suggests that untreated addicts may have as good or possibly even a better chance at breaking the bond of addiction than the treated heroin user"(7)
A study of non-chronically dependent opium users found. 1/3 had been in a state of drift and needed no regulation of use, over a quarter had experienced episodes of dependence, the rest governed the use to prevent loss of control.(8)
"Chippers" must develop and internalize social rituals around occasional use either individually or through their using group " to avoid addiction. (9)
Of opiate users who had controlled use (for at least a year) most only experience deviant behavior was their drug use. Controlled users set up rules for their drug use in order to prevent addiction.(10)
Setting of Vietnam encouraged temporary addiction. 80% of Heroin users quit before they left Vietnam. This lead researchers to say "It is possible that this pattern of temporary addiction with recovery to abstention or casual use may also be common in civilian addicts who have not come to official attention."(11)
Alcoholics who Believed they would fail had a high relapse rate.(12)
Two interfering variables that block auto remission are
(A) society view on the severity of the behaviors the person is trying to change.
(B) the Stigma placed on the behavior, the person is trying to change. Ie Drug use ALWAYS leads to addiction, and addiction doesn't get cured.(13)
But auto-remission doesn't always happen how can we help the people don't go through auto-remission. The answer could be effective drug treatment. But there are barricades to effective treatment, two of them are
A. Lack of sufficient stable funding for proper drug treatment.
B. No effective outreach programs.(14)
A treatment based policy falls under the term "harm reduction". Where we reduce the harm a drug user has on himself and society. What makes harm reduction an attractive proposal? One benefit is
a "low threshold to access to services" as opposed to high threshold access of services that demand reduction has(15)
Also anyone who's read the police blotter has seen many of the same names come up again and again In an experiment researchers found "Forced referrals to Alcoholics anonymous and to an alcoholism clinics failed to reduce the likelihood of recidivism among population of convicted chronic drunken offenders "(16)
Treatment must be holistic in nature to be the most successful "Successful intervention in this respect, for example, counseling with this regard to martial problems and assistance in trying to find a job." (17)
Reviewers found that "Empirical questioning will encourage a multi disciplinary perspective, because addictions cannot be understood by any single approach."(18)
"Intervention/treatment should consider the whole patient including spirituality. "Affiliation with a highly structured group espousing a coherent belief system be it Alcoholics Anonymous, the catholic or protestant or LDS church seems to correlate with abstention from illicit drugs or alcohol "(19)
A trend that occurred in the 1980's, was simply called intervention, or formerly known as Johnson Intervention. Interventions are promoted people who often claim it's the addicts only hope. The intervention basic ideal is family, friends and coworkers confront the drug user about his drug use. A word of warning, doing a "Intervention" does not mean the person will stop using drugs. Researchers found. People who part in the Johnson Intervention had higher relapse rates than 3 of the other four groups studied. (20)
Another standard for current drug polices is "Alcoholics Anonymous." Though spirituality is important AA has drawbacks and won't work for all people. It may not work for people who
1. Are uncomfortable in large crowds or intimate meetings.
2. Are not religiously oriented and are not satisfied with the religious tone of AA meetings.
3. Are members of a minority classes, such as women, ethnicity other than Caucasian, and lower socioeconomic status
4. Do not fit AA definition of alcoholism or who have a desire of controlled drinking as a goal
5. Are Dually-Diagnosed, with both alcoholism and another serious disorder, and are in need of psychologically-based treatment"(21)
In Alaska what drugs do Alaskans seek treatment for, a note the following number may also reflect court referral.
12.6% of adult Alaskans need treatment for alcohol
1.2% of adult Alaskans need treatment for drugs and alcohol
0.5% need treatment of drugs only
29.9% of women with dependent children require alcohol treatment.(22)
Over all what drugs did these clients say they need treatment for
78.8% Alcohol
9.0 Marijuana/hashish
8.2 Cocaine/crack
1.3 Heroin
2.7 Other(23)
With shrinking state and federal monies does treatment make sense?
Since 1990 the state has spent an average 25 million annually, and 370 million from 1980 to 1998 for treatment and prevention programs for drug and alcohol abuse.(24)
A study show for every dollar spent on treatment programs $11.54 in social cost are saved, and
a more current study showed for every dollar spent on treatment spent on treatment programs $5.60 was avoided being spent by the tax payer, this study also showed of people who successfully completed out patient treatment were arrested at a 45% lower than those who did not complete treatment. People who Successfully completed treatment were incarcerated at a rate 70% lower that those who did not, and a decrease in child welfare cases.(25)
Treatment VS incarceration cost
$1,800 Regular outpatient
$2,500 Insensitive outpatient
$3,900 Methadone maintenance
$4,400 short term residential
$6,800 long term residential
$25,900 incarceration(26)
A new trend in drug treatment is meeting with some success, that is having special treatment for women. These programs often meet the numerous different issues that women may have different then men.
"Program implementation require resolutions to numerous barriers including securing a facility for women and children, hiring and training of staff, establishing and maintaining community linkages, treatment considerations, and critical decisions faced by treatment staff as they modify client-centered programs to incorporate gender-specific and family centered programs"
of the few studies that studies women only treatment they generally found they have superior outcomes such as reduced antisocial behavior, decreased criminal activity increased stay in treatment programs.(27)
researchers also said about women based treatment. "Preliminary results suggest the demonstration program increases retention in treatment."(28)
Of the 56 women who entered women's treatment program 41% left as successes of these who successfully complete the program they have better mental health, loner periods of sobriety and better parenting skills
Children in the program also showed gains in interpersonal skills, physical well being, cognitive language skills and school performance (for children who attended school). (29)
What general treatment methods
One month after psychedelic therapy (LSD)15% returned to drinking, while 40% of the control group returned to drinking. Results of Psychedelic therapy opiate addicted patients after one year was 25% of the study group remind free from opiates as opposed to 5% non-treated.(30)
What about Ibogaine? Research has shown "At the end of the 24-38-hr psychoactive period induced by the drug at these doses, none of the subjects displayed significant opiate withdrawal symptoms. At the lowest dose of 700 mg, one subject recontinued his drug abuse after 2 days; of the remaining six individuals who took 1,000 mg or above, two relapsed after a number of weeks, one reverted to intermittent heroin use, and three appear to have remained drug-free 14 weeks or more after undergoing this experimental treatment. Ibogaine may be of value in the present and could serve as a model for the development of improved agents for the treatment of substance abuse in the future. "(31)
The Swiss Heroin maintenance experiment in 1992 that had 1,000 users results were. Base line numbers are in brackets "[]"
[Base line] After 1 year
Bad physical health status [27%] 10%
Poor mental health [48%] 18%
daily illegal heroin use [86%] 3%
cocaine use [31%] 7%
illegal income source [70%] 14%(32)
Finally to set a new course for a new drug treatment its best we follow Stanton Peele's advice "Only when private treatment centers are motivated to participate in actual clinical trials will an effective alcoholism treatment system be possible in the United States."(33)
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