Factors that foster addiction in the United States

Abstract:

The culture of the United States is unique in its diversity and generally precipitated attitude toward individualism and self-reliance.  Yet societal and personal struggles with substance abuse and dependence in the United States are hardly unique as drug use is a human condition.  The United States has made leaps and bounds in the last century in its policies and social attitudes toward drug abuse, however there are still many reforms needed.  This essay will explore the unique issues that the United States faces when dealing with substance use.  This treatise will to address the deficiencies in public policy and reforms needed in United States drug policy and substance abuse treatment.  Ultimately this article will attempt to show the need for significant fundamental changes in the attitudes and policies toward substance use, abuse, dependence and treatment.

United States Public Policy and Substance Abuse: Factors that foster addiction in the United States

There are many factors that foster and precipitate substance use and dependence in the United States.  For instance, there are cultural norms, social injustices, individual mental health issues, and many other societal problems that contribute to substance use and abuse among individuals and peer groups.  Unfortunately these issues are symptoms of a greater problem, and they will remain inflexible unless public policy changes are made.  There are three key flaws in United States drug policy.  Those flaws are inadequate and misguided substance abuse education, a lack of faith in the efficacy of addiction treatment in the medical profession and lastly the criminalization of drug use and abuse.

The first issue to address in the United States is how we educate children about drugs.  Drug abuse education has suffered from an identity crisis in the United States, and policy makers have struggled with how to address the issue.  Should it be addressed at all?  Should blatant lies be told in the hopes that those lies will deter drug use?  Or should children of all creeds and ethnicities learn to “just say no?”

As of today, there is mounting that evidence-based education is an effective approach to dealing with the issue of substance use and abuse (Cahill, 2007).  According to Helen Cahill, evidence based drug education works best if it is introduced before most children are introduced to drugs in an uncontrolled environment.  Ideally the information should be delivered in age appropriate packets that do not encroach upon the recipient child’s level of social and psychological development (2007).  However, this is not always possible.

Many children are introduced to drug use and abuse long before the majority of their peers, be it by their parents, siblings or neighborhood environment.  This exemplifies the need to address drug abuse early and identify children who are at risk to early exposure to drug abuse.  Identifying at risk children based on self-reporting may not be feasible, however many behavior traits may shed light on a child’s propensity towards drug abuse in later life.  For instance children may be at risk for drug abuse in later life should they display poor restraint, subdued desire to thrive, desire to seek novel sensations, lack of ego control, learning deficits, unconscientiousness, low self esteem or shyness (Hampson et al., 2006).

These traits do not guarantee that a child will develop substance abuse in later life, however it has been shown that alcohol abuse is linked to unconscientiousness and extroverted tendencies in childhood.  Also, emotional instability in young males has been linked to substance abuse issues in later life.  These factors are significant, as traits such as conscientiousness have been linked to longevity (Hampson et al. 2006).  Longevity suggests life long risk avoidance behaviors.  These are traits that are worth identifying at an early age in order to introduce preemptive intervention.  If any institution has this capacity, it is the education system.

However it is important to note that once at risk students are identified, they should not be grouped separately from other student populations.  Consorting high-risk students may cause those children to internalize the idea that they are abnormal or deviant (Cahill, 2007).  Ideally, at risk students should be dispersed as evenly as possible among a student body.  This affords high-risk children the opportunity to internalize the positive perspectives of their successful peers.

It is also important to consider how educators address the issue of drug abuse.  Some experts have indicated that it is best to allow students to make their own judgments based on unbiased presentation of evidence.  Cahill suggests teachers should refrain from treating students as prey to their own ignorance or.  Most importantly, instructors should avoid taking a moral stance or using scare tactics (2007).

According to Cahill, the risks to taking moral stances and using scare tactics outweigh the benefits.  Taking a moral standpoint on drug use and using scare tactics to back up that standpoint will likely only prescribe to students what a teacher deems to be desirable behaviors. This may lead to resistance.  Also, using scare tactics may glamorize the behaviors that the person using those scare tactics wishes to deter (2007).

An excellent example of a very public scare tactic is a public service advertisement that was aired during the early part of the twenty first century.  It depicts three black males smoking a joint in a car while getting food from a drive through restaurant.  The young men in the ad are laughing and having a good time, and they are also clearly distracted.  At the very end of the ad they fail to see a little girl in front of them on a bicycle and it is implied that they run the girl over with their car.

Such a commercial may have produced a broad range of reactions from various individuals depending on their background.  While some may have agreed with the message that cannabis is harmful, others may have seen the events of the commercial as unlikely or inane.  Those who identify as black may have reacted very negatively to this ad because they may have seen the commercial as overtly derogatory.  In any event the potential negative reactions to the ad detract from the intended message.  This may lead individuals to decide that there is nothing wrong with the behavior depicted in the advertisement.

Another issue with using scare tactics is that adolescents tend to overestimate the drug usage and risk taking behaviors of their peers.  A teacher who lends too much attention to the worst cases runs the risk of normalizing high-risk behavior  (Cahill, 2007).  It may be useful for schools to conduct anonymous school-wide behavior assessments that evaluate drug use and sexual activity among other factors such as involvement in school activities.  These statistics could then be presented to students to paint a more realistic picture of the behaviors of their peers.

Of course there are some issues to such a proposal.  At the risk of using anecdotal evidence, I recall an informal school wide survey conducted at a minor state university that I attended that assessed alcohol use and safe sex practices among freshmen students.  Unfortunately 80% of respondents reported drinking regularly.  Since the respondents were freshmen, it is reasonable to assume that the vast majority was underage.  On the upside, 4 in 5 students reported regularly using condoms during sexual intercourse.  Sometimes the bad must be taken with the good in the pursuit of truth.

Truth is the basis of the normalization approach to substance abuse education.  The goal of normalization is to attempt to dismiss the notion that many adolescents have that many of their peers engage in risk taking behavior by presenting factual evidence (Cahill, 2007).  According to Cahill, it is possible to bolster the normalization approach by encouraging students to feel connected to their school (2007).  Ideally this will create the sense that students and their peers take pride in being members of their school’s community rather than engage in drug use.  The best-case scenario is this effort transcends illusion and succeeds in the task.

The opposite of prevention efforts is treatment of substance abuse.  Approximately 40% of emergency room patients use illegal drugs (Agrawal, Everett & Sharma, 2010).  It is possible that this number is considerably higher given that many may fail to report their drug use to ER doctors for fear of legal ramifications or denial of treatment.  It is easy to see why many ER doctors feel cynical about treating drug abusers.  However, those very doctors are the first responders for presenting an intervention for hospitalized drug users.

Sadly, the medical profession has many deficiencies in addressing substance abuse and dependence.  Lack of skill, time constraints, and poor confidence in treatment efficacy all hinder treatment and intervention (Agrawal, Everett & Sharma, 2010).  According to a recent study conducted by Agrawal et al., medical professionals grow more pessimistic toward substance abuse treatment outcomes with the more training that they have.  Only 22% of third year medical students interviewed for this study believe that addiction is treatable.  It has also been found that 30% to 60% of clinicians believe that treatment outcomes for substance abusers are either very poor or negligible (2010).  This is unfortunate as attending one Alcoholics Anonymous or Narcotics Anonymous will yield a multitude of success stories.  It is reasonable that medical students should be required to attend at least one AA or NA meeting during their training to instill an understanding that there is a light at the end of the tunnel of substance abuse treatment.

Clinicians should feel even more optimistic about treatment outcomes given that there is now evidence that web based self-intervention programs are helpful for some problem drinkers.  In a recent study conducted by Reid Hester, Harold Delaney and William Campbell through the University of New Mexico, non-dependent problem drinkers can learn to reduce their drinking and mitigate alcohol related problems through web-based intervention.  The study evaluated the efficacy of web-based interventions through www.moderationmanagement.com and www.moderatedrinking.com (2011).

According to the study, participants were able to reduce their drinking considerably.  Participants reduced their median peak blood alcohol concentration by 49% after one year.  Also, participants reduced their average drinks-per-drinking-day from approximately 5 drinks a day to 3 (Hester, Delaney & Campbell 2011).  Although a reduction in consumption is not abstinence, a reduction in consumption means a reduction in health related consequences in addition to the reported reductions in drinking related problems that participants faced.  It is important to note that the best candidates for such an intervention were found to be well-educated, middle class, non-dependent drinkers.  A broader implementation of such programs has the potential to free resources for higher risks groups.

Apart from prevention and treatment, there is one more considerably significant area of public policy that is proving to be more archaic and draconian as time passes.  That is the criminalization of substance abuse.  According to the 2007/2008 Human Development Report, the United States has 738 prisoners per 100,000 persons.  To lend some perspective, out the 70 nations considered to have high levels of human development, the runner up was the Russian Federation with 611 prisoners per 100,000 persons.  All other top nations had less, including Cuba (Watkins et al. 2007).  Additionally, the Russian Federation has 19.9 homicides per 100,000 persons while the United States only has 5.6.  Thus, while Russia has 355% more violent crime, the United States imprisons 120% more of its population (Watkins et al. 2007).

Nearly 20% of persons incarcerated at the state level are incarcerated for drug related offenses, while more than 50% of federal prisoners are incarcerated for drug offenses (Bewley-Taylor, Hallan, & Allen 2009).  This is a tragedy given that prisoners who receive drug treatment while incarcerated are greater than three times more likely to recidivate than those who receive treatment under intensive community supervision.  Incarceration also costs the taxpayers in excess of 1000% more than combined work-release treatment programs per annum.

The payoffs for treatment are tremendous.  From 1995 to 2005 the federal government increased treatment funding a mere 14.6% while treatment admissions rose 37.4% and violent crime fell 31.5 percent (Natarajan et al. 2008).  Although progress has been made, it is very clear that the United States is still stuck in the past.

In contrast, a decade ago, Portugal underwent a massive social reform experiment by decriminalizing the possession of all drugs for personal use.  At the same time, Portugal doubled treatment funding.  Rather than incarcerating drug offenders, Portugal now refers drug offenders to treatment.  Three person panels comprised of legal advisors, social workers and medical professionals prescribe treatment and minor legal sanctions such fines and community service rather than jail time for drug offenders (Hughes & Stevens, 2007)).

According to Caitlin Hughes and Alex Stevens of the Beckley Foundation, by 2007, Portugal had realized considerable returns on its investment in reform.  As admissions for treatment rose, drug related death and illness rates fell.  From 1999 to 2003 Portugal had achieved a 59% reduction in drug related deaths while in the same time frame achieving a 17% reduction in new human immunodeficiency virus (HIV) cases.  From 2001 to 2005 prison overcrowding dropped by 17.5%, allowing prisons to operate near their intended capacity.  Although cannabis use rose, there was 50% drop in treatment referrals for heroin users.  Additionally an increase in cannabis use during this time may be attributable to a Europe-wide trend as well as increased reporting due to decreased fear of legal ramifications (Hughes & Stevens, 2007).

The previously outlined facts in this essay exemplify the need for drastic public policy changes in the United States to reduce addiction rates.  There is a need for greater implementation of evidence-based education while eliminating scare tactic oriented prevention methods.  The unencumbered truth must be allowed to avoid skewing individual perceptions of the realities of drug use.  There is also a vast need for improved medical training to intervene in substance abuse cases as medical professionals are often poised to be first responders to substance abuse dilemmas.  Most importantly there is a dire need to move away from the criminalization of addiction.  When these changes are made, the United States will be free to address the broader factors that engender addiction such as cultural perceptions and social injustice.

Although a drastic change such as decriminalization may have the potential to increase the use of certain softer drugs, the societal benefit in an overall reduction in drug related deaths and disease is undeniable.  Is it better that individuals who chose to use drugs remain uninformed, and at great legal peril, while posing a vast liability to society and themselves, or is it preferable that individuals chose to use drugs in an informed manor with the security of an intervention network in a socially directed manor devoid of legal repercussions that often lead to socioeconomic disparity?   These are the questions that United States policy makers should be asking and addressing.

References

Agrawal, S., Everett, W. W., & Sharma, S. (2010). Medical student views of substance abuse treatment, policy and training. Drugs: education, prevention and policy, 17(5), 587–602. doi:10.3109/09687630902729602

Cahill, H. W. (2007). Challenges in adopting evidence-based school drug education programmes. Drug and Alcohol Review, 26, 673-679. doi:10.1080/09595230701613593

Hampson et al. (2006). Forty years on: Teachers’ assessments of children’s personality traits predict self-reported health behaviors and outcomes at midlife. Health Psychology, 25 (1), 57–64. doi:10.1037/0278-6133.25.1.57

Hester, R. K., Delaney, H. D., & Campbell, W. (2011). Moderatedrinking.com and moderation management: Outcomes of a randomized clinical trial with non-dependent problem drinkers. Journal of Consulting and Clinical Psychology, 79(2), 215-224. doi:10.1037/a0022487

Hughes, C., & Stevens, A. (2007). The effects of decriminalization of drug use in portugal. The Beckley Foundation Drug Policy Grogramme, 14, 1-10.

Natarajan et al. (2008). Substance abuse treatment and public safety. Justice Policy Institute , 1-17. Retrieved from http://www.justicepolicy.org/research/1949

Watkins et al. (2007). Fighting climate change: Human solidarity in a divided world. Human Development Report 2007/2008, 337. Retrieved from http://hdr.undp.org/en/reports/global/hdr2007-2008/

Advertisements

Protesters, Please Remain Peaceful

I am not writing this to convince anyone to support the Occupy Wall Street movement, nor I’m writing this to convince anyone they should be against it.  I’m writing this because I have seen something that shocked me.  The video was captured in Oakland, yet it look like something one might have seen in a newsreel showing protesting during the Arab Spring.  Seeing something like that in a country that is not your own makes it difficult to attach emotion to the event, it simply does not seem real.  It’s just another fact, a piece of information that is not tangible.  However this is here.  It isn’t over there.  It isn’t across an ocean.  This is home, and that completely alters how one perceives and event like this.  Upon viewing this I was immediately jolted from watching another youtube video or news clip with a sense of disconnection from the reality of the images in the video when the grenade went off in the group of people trying to help the injured man on the ground.  I am disturbed in the fullest sense of the word.  The name of the injured man is Scott Olsen.  He is currently in critical condition.

However this was not the only disturbing thing I saw in the video.  Early in the video, protesters can be seen throwing objects at the police.  This is not peaceful demonstration.  Because of that the impact of the harm inflicted upon Mr. Olsen will be diminished.  Now that is a damn shame because what I saw shocked and upset me.  I would like others to empathize with my feelings of disbelief and sadness because what I saw was wrong.  However, many people will tell me that I am sympathizing with rioters, not protesters.

If you are going to protest, please remain peaceful.  Study the peaceful protest techniques that Dr. Martin Luther King employed.  Do not resort to violence, even if violence is inflicted upon you.  If you resort to violence, than you have damaged your cause irreparably.  Encourage other protesters to be peaceful as well.  If a protester is not being peaceful, tell him or her to stop.  Tell them that they are weakening your cause.  Dr. King lead an oppressed race to equality peacefully against the greatest of odds.  If Dr. King was able to do this, your cause can succeed peacefully too.

The Grinch Who Did Smack

Created by UseYourIllusionII from reddit.com.  Thanks for letting me share this here.  You rock!

How to Avoid Getting Busted

Getting busted for possession of marijuana has significant and often life altering ramifications.  A conviction for possession of marijuana can land you in jail, cost you thousands in legal fees and fines, prevent you from getting federal financial aide if you are a student, keep you from finding a job and even affect were you find housing.  Even if you are one of the lucky ones who lives in a medical marijuana state and have a medical marijuana card, your life can still be made a living hell by the police, even if a conviction is never secured.  Even a few hours is very unpleasant.

I am assuming that taking a ride in the back of a police car is very low on your list of priorities, so I’m offering some practical advice that will help keep your ass out of the slammer.

  • Never carry more than you can eat; Dogs aren’t the only animals that can smell fresh bud.  Unless the officer who pulls you over has a non-functioning nose, he or she will probably be able to smell that bud in your pocket.  It isn’t a crime to have weed in your stomach, but it is a crime to have weed in your pocket.  This amusing fictional account illustrates my point pretty well.
  • Don’t carry a pipe; You can’t eat a pipe.  At least you probably can’t eat one that is very big.  However a joint much easier to consume.
  • Use the trunk; The trunk of your car is somewhat less likely to be searched than the car itself, and there is a bit more legal protection for the contents of your trunk.  If you are carrying more than you can eat, put it in the trunk.
  • Use a mason jar; Unlike plastic bags, mason jars not only keep your bud fresh, they also contain the smell better.  Did I mention that they are dirt cheap and better for the environment?
  • Use gloves; Dogs can smell better than you can.  A lot better.  While you may have thought that you were pretty cleaver by putting your mason-jar -o’ weed  in the trunk, you neglected to realize that you made a fatal error when you handled all of your nugs with your bare hands.  The weed scent still lingering on your hands then contaminated your everything that you touched; your trunk, your car door, everything, and guess what?  A dog can smell all of it.  Wearing gloves while handling your nugs and then taking them off once they are secure in a jar will help mitigate this problem.
  • Don’t trifle with secret code; The correspondence between you and the friendly stranger who sells weed to you should be no more complicated than “mind if I swing by?”  There is nothing incriminating about that.  Anything more complicated is liable to arouse suspicion in the event of a third-party listening in.  You never know who is listening, and worse you never know how long your mobile provider keeps text messages that you send.
  • Loose lips sink ships so keep ’em zipped; This hardly needs saying, but if you are doing something illegal KEEP YOUR FUCKING MOUTH SHUT!  Don’t tell anyone, especially not your girlfriend.
  • Put it in food; If you need to take bud with you to your destination, it is a good idea to put it in food.  However, I don’t mean sticking your baggie in a burrito.  You need to cook the bud into your food.  There are a lot of ways to do this by cooking your bud into butter.  Unfortunately most cannabutter recipes call for using an obscene amount of weed.  Fortunately for you, firecrackers are a quick and easy alternative that use no more bud than an average bowl.
  • Use a sploof; I’m of the opinion that this doesn’t really work.  Even so, something is better than nothing.
  • Smoke in the bathroom; for most homes, the bathroom is the only room with a fan that vents directly outside.  Put a towel under the door and you should be able to contain the smell fairly well.
  • Don’t smoke in your car; Upholstery does a very good job of absorbing odors.  Keep incriminating odors away from upholstery.
  • Ozium; The shit works and it is as close as your nearest Walmart (the bastards).  It smells like an old woman’s vag, but it does more than just mask odors, it makes them disappear.  Keep one can in your car and one can next to your bong.  Don’t eat anything or touch your nugs without washing your hands after you use it.
  • Break one law at a time; smoking a joint and talking on your cell phone while driving ten over in a school zone is bound to get you busted.  Try to keep the number of laws you are breaking to one or less if you value your freedom.
  • Don’t look like a stoner; Blood shot eyes?  Reek of weed?  Snack food wrappers everywhere?  Nacho cheese on your pot leaf logo?  Difficulty deciding if you would like two burritos or three?  All red flags.
  • Stay away from the park after dark; In fact, just stay away from the park.  I know more than a few people who have gotten busted toking at their local park.  Cops love to swing by and check on city parks after nightfall, so if you’re strolling out of the park at sundown with a pipe and a dub on you, and a cop is lurking nearby, you’re probably fucked.  Also, getting caught in a park may carry heavier fines.
  • Be aware of olfactory fatigue; Ever notice how you don’t smell something after you have been around it for a while?  This is called olfactory fatigue, and humans are very susceptible to this phenomenon.  Keep that in mind the next time you get done smoking and decide that you don’t smell like weed.
  • Tobacco will not cover the smell of weed; Tobacco and weed smell nothing alike.  Lighting a cig to cover up the smell of your joint, or rolling a spliff in the hopes that other folks will only notice the tobacco is a rouse that is likely to fail.
  • Don’t share your cannabis using habits on non-anonymous social networking sites; Updating your facebook status to “blazed” is probably a poor choice.  Photographs of you smoking weed is even worse.  Sure it might not get you busted, and there isn’t anything illegal about having a photo of you smoking, but at the very least it could ruin your chances of getting a job, and at the very worse it could be used as character evidence in a criminal proceeding.

I’ll add more items to this list as I think of them, so check back.  If anyone would like to add something to the list, leave a comment and I’ll throw it in the mix.

Word of the Day

>Redankulous (adj):  A term to describe cannabis bud that is ridiculously dank.  Not to be confused with redonkulous, which is a silly word and should not be used in any situation, ever.

I Rescued a Pineapple

I rescued a pineapple today. It was sitting with the other house plants in a sad state of affairs at Home Depot of all places. I just couldn’t stand to let it continue to be neglected and forgotten.

Long Term Cannabis Use Doesn’t Cause Cognitive Decline, Lucky You

According to this study long-term cannabis use has little effect on cognitive function.  Of course you’ll have to pay to read the fucking study, but hey at least Time did a nice little write-up about it, which I’m guessing better tuned to your short attention span anyhow.

The gist of the study is that 2000 Australian men and women were studied for a period of 8 years.  Periodically the participants were given exams to test their cognitive abilities.  Participants were also asked to volunteer information about their usage habits.

With this information I hope that you will now feel free to continue your weed smoking unencumbered by fear of cognitive attenuation.