Anti Drug Essay 2008
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Impact of Drugs on Society
The trafficking and abuse of drugs in the United States affect nearly all aspects of our lives. The economic cost alone is immense, estimated at nearly $215 billion. The damage caused by drug abuse and addiction is reflected in an overburdened justice system, a strained healthcare system, lost productivity, and environmental destruction.
The Demand for Illicit Drugs
NSDUH data show that in 2008, 14.2 percent of individuals 12 years of age and older had used illicit drugs during the past year. Marijuana is the most commonly used illicit drug, with 25.8 million individuals 12 years of age and older (10.3%) reporting past year use. That rate remains stable from the previous year (10.1%) (see Table B1 in Appendix B). Psychotherapeutics ranked second, with 15.2 million individuals reporting past year "nonmedical use" in 2008, a decrease from 16.3 million in 2007. In 2008, approximately 5.3 million individuals aged 12 and older reported past year cocaine use, 850,000 reported past year methamphetamine use, and 453,000 reported past year heroin use.
Rates of drug use vary by age. Rates are highest for young adults aged 18 to 25, with 33.5 percent reporting illicit drug use in the past year. Nineteen percent of youth aged 12 to 17 report past year illicit drug use. Finally, 10.3 percent of adults aged 26 and older report past year illicit drug use. These rates are relatively stable when compared with 2007 rates.
In 2008, approximately 2.9 million individuals tried an illicit drug or used a prescription drug nonmedically for the first time, representing nearly 8,000 initiates per day. More than half of these new users (56.6%) report that marijuana was the first illicit substance that they had tried. Other past year illicit drug initiates report that their first drug was a psychotherapeutic drug used nonmedically (29.6%), an inhalant (9.7%), or a hallucinogen (3.2%). By drug category, marijuana and pain relievers used nonmedically each had an estimated 2.2 million past year first-time users. Also identified frequently as the first drug used by initiates were tranquilizers (nonmedical use--1.1 million), ecstasy/MDMA (0.9 million), inhalants (0.7 million), cocaine (0.7 million), and stimulants (0.6 million). Methamphetamine appears to be fading in popularity among initiates. In 2008, an estimated 95,000 individuals tried methamphetamine for the first time--a 39 percent decrease from the 2007 estimate (157,000) and a 70 percent decrease from the 2004 estimate (318,000).
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The Consequences of Illicit Drug Use
The consequences of illicit drug use are widespread, causing permanent physical and emotional damage to users and negatively impacting their families, coworkers, and many others with whom they have contact. Drug use negatively impacts a user's health, often leading to sickness and disease. In many cases, users die prematurely from drug overdoses or other drug-associated illnesses (see text box). Some users are parents, whose deaths leave their children in the care of relatives or in foster care. Drug law violations constitute a substantial proportion of incarcerations in local, state, and federal facilities and represent the most common arrest category.
Colombian Cocaine Producers Increase Use of a Harmful Cutting Agent
Since late 2007, cocaine has increasingly contained levamisole, a pharmaceutical agent that typically is used for livestock deworming. According to Drug Enforcement Administration (DEA) Cocaine Signature Program data, before 2008, less than 10 percent of the tested wholesale-level cocaine samples contained levamisole. By 2009, approximately 71 percent of the tested cocaine samples contained levamisole. Because levamisole is being found in kilogram quantities of cocaine, investigators are confident that Colombian traffickers are adding it as part of the production process, possibly to enhance the effects of the cocaine. However, levamisole can be hazardous to humans, especially those with weakened immune systems. Ingesting levamisole can cause a person to develop agranulocytosis, a serious, sometimes fatal, blood disorder. At least 20 confirmed and probable cases of agranulocytosis, including two deaths, have been associated with cocaine adulterated with levamisole. The consequences of abusing levamisole are serious enough that in September 2009, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a nationwide public alert on its effects.
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Impact on Health and Health Care Systems
Drug use and abuse may lead to specialized treatment, ED visits (sometimes involving death), contraction of illnesses, and prolonged hospital stays.
In 2008, NSDUH estimated that 7 million individuals aged 12 and older were dependent on or had abused illicit drugs in the past year, compared with 6.9 million in 2007. The drugs with the highest dependence or abuse levels were marijuana, prescription pain relievers, and cocaine. The number of individuals reporting past year marijuana abuse or dependence was 4.2 million in 2008, compared with 3.9 million in 2007; the number of individuals reporting past year prescription pain reliever abuse or dependence was 1.7 million in both 2007 and 2008; and the number of individuals reporting past year cocaine abuse or dependence was 1.4 million in 2008, compared with 1.6 million in 2007.
Many individuals who become dependent on illicit drugs eventually seek treatment. The Treatment Episode Data Set (TEDS) provides information regarding the demographics and substance abuse patterns of treatment admissions to state-licensed treatment facilities for drug dependence. In 2007, there were approximately 1.8 million admissions to state-licensed treatment facilities for illicit drug dependence or abuse. The highest percentage of admissions reported opiates as the primary drug of choice (31%, primarily heroin) followed by marijuana/hashish (27%), cocaine (22%), and stimulants (13%). Although approaches to treatment vary by drug, more than half of the admissions were to ambulatory (outpatient, intensive outpatient, and detox) facilities rather than residential facilities. (See Table B2 in Appendix B for data on admissions for specific drugs.)
Individuals often experience adverse reactions to drugs--including nonfatal overdoses--that require them to go to the hospital. In 2006, the Drug Abuse Warning Network (DAWN) reported that of 113 million hospital ED visits--1,742,887 (1.5%)--were related to drug misuse or drug abuse. An estimated 31 percent of these visits involved illicit drugs only, 28 percent involved CPDs, and 13 percent involved illicit drugs in combination with alcohol. When drug misuse or abuse plays a role in these ED visits, the most commonly reported substances are cocaine, marijuana, heroin, and stimulants (typically amphetamines or methamphetamine).
A 2007 DAWN survey of 63 metropolitan areas found an average of 12.1 deaths per 100,000 persons related to drug use. Rates of drug-related deaths range from 1.1 per 100,000 in Sioux Falls, South Dakota, to 26.1 per 100,000 in the New Orleans area. DAWN also records the number of drug-related suicide deaths. In 2007, the number of drug-related suicides per 100,000 persons ranged from less than one in several jurisdictions (including Chicago, Dallas-Fort Worth, and Minneapolis) to 6.2 per 100,000 in Fargo, North Dakota. To put these statistics in perspective, the Centers for Disease Control and Prevention (CDC) reports other nonnatural death rates as follows: Motor vehicle accidents, 15.1 per 100,000; nontransport accidents (e.g., falls, accidental drownings), 24.4 per 100,000; suicide, 11.1 per 100,000; and homicides, 6.2 per 100,000.
The consequences of drug use usually are not limited to the user and often extend to the user's family and the greater community. According to SAMHSA, combined data from 2002 to 2007 indicate that during the prior year, an estimated 2.1 million American children (3%) lived with at least one parent who was dependent on or abused illicit drugs, and 1 in 10 children under 18 lived with a substance-addicted or substance-abusing parent. Moreover, the U.S. Department of Health and Human Services estimated in 1999 that substance abuse was a factor in two-thirds of all foster care placements.
Many states have enacted drug-endangered children laws to protect children from the consequences of drug production, trafficking, and abuse. Typically associated with methamphetamine production, drug-endangered children are exposed not only to abuse and neglect but also to fires, explosions, and physical health hazards such as toxic chemicals. In 2009, 980 children were reported to the El Paso Intelligence Center (EPIC) as present at or affected by methamphetamine laboratories, including 8 who were injured and 2 who were killed at the laboratories. These statistics do not include children killed by random gunfire associated with drug activity or who were physically or sexually abused by a "caretaker" involved in drug trafficking or under the influence of drugs.
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Impact on Crime and Criminal Justice Systems
The consequences of illicit drug use impact the entire criminal justice system, taxing resources at each stage of the arrest, adjudication, incarceration, and post-release supervision process. Although drug courts and diversion programs in many jurisdictions have helped to alleviate this burden (see text box), substance abuse within the criminal justice population remains widespread.
To alleviate the burden that drug use and abuse have caused to the nation's criminal justice system, most jurisdictions have developed drug courts or other diversion programs aimed at breaking the drug addiction and crime cycle. In these nonadversarial, coordinated approaches to processing drug cases, participants receive a full continuum of treatment services, are subject to frequent urinalyses, and experience strict judicial monitoring in lieu of traditional incarceration. Once the offender successfully completes treatment, charges may be dropped.
Since the first drug court became operational in Miami in 1989, the number of drug courts has grown each year, and such courts now exist in all 50 states as well as the District of Columbia, Northern Mariana Islands, Puerto Rico, and Indian Country. As of July 2009, there were 2,038 active drug court programs and 226 in the planning stages. Research has shown that drug courts are associated with reduced recidivism by participants and result in cost savings. For instance, a 2006 study of nine California drug courts showed that drug court graduates had recidivism rates of 17 percent, while a comparison group who did not participate in drug court had recidivism rates of 41 percent. A study of the drug court in Portland, Oregon, found that the program reduced crime by 30 percent over 5 years and saved the county more than $79 million over 10 years. With success stories abundant, drug courts have gained approval at the local, state, and federal levels.
The most recent annual data from the Federal Bureau of Investigation (FBI) show that 12.2 percent of more than 14 million arrests in 2008 were for drug violations, the most common arrest crime category. The proportion of total drug arrests has increased over the past 20 years: in 1987, only 7.4 percent of all arrests were for drug violations. Approximately 4 percent of all homicides in 2008 were drug-related, a percentage that has not changed significantly over the same 20-year period.
The characteristics of populations under correctional supervision reflect these arrest patterns. According to the Bureau of Justice Statistics (BJS), 20 percent of state prisoners and 53 percent of federal prisoners are incarcerated because of a drug offense. Moreover, 27 percent of individuals on probation and 37 percent of individuals on parole at the end of 2007 had committed a drug offense.
The drug-crime link is also reflected in arrestee data. In 2008, the Arrestee Drug Abuse Monitoring (ADAM) II program found that the median percentage of male arrestees who tested positive in the 10 ADAM II cities for any of 10 drugs, including cocaine, marijuana, methamphetamine, opioids, and phencyclidine (PCP), was 67.6 percent, down slightly from 69.2 percent in 2007. Other data reflect the link as well. In 2002, a BJS survey found that 68 percent of jail inmates were dependent on or abusing drugs and alcohol and that 55 percent had used illicit drugs during the month before their offense. In 2004, a similar BJS self-report survey identified the drug-crime link more precisely: 17 percent of state prisoners and 18 percent of federal prisoners had committed their most recent offense to acquire money to buy drugs. Property and drug offenders were more likely than violent and public-order offenders to commit crimes for drug money.
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Impact on Productivity
Premature mortality, illness, injury leading to incapacitation, and imprisonment all serve to directly reduce national productivity. Public financial resources expended in the areas of health care and criminal justice as a result of illegal drug trafficking and use are resources that would otherwise be available for other policy initiatives.
There is a great loss of productivity associated with drug-related premature mortality. In 2005, 26,858 deaths were unintentional or undetermined-intent poisonings; in 2004, 95 percent of these poisonings were caused by drugs. Although it is difficult to place a dollar value on a human life, a rough calculation of lost productivity can be made based on the present discounted value of a person's lifetime earnings.
There are also health-related productivity losses. An individual who enters a residential drug treatment program or is admitted to a hospital for drug treatment becomes incapacitated and is removed from the labor force. According to TEDS data, there were approximately 1.8 million admissions to state-licensed treatment facilities for illicit drug dependence or abuse in 2007. Productivity losses in this area alone are enormous. Health-related productivity losses are higher still when lost productivity associated with drug-related hospital admissions (including victims of drug-related crimes) is included.
The approximately one-quarter of offenders in state and local correctional facilities and the more than half of offenders in federal facilities incarcerated on drug-related charges represent an estimated 620,000 individuals who are not in the workforce. The cost of their incarceration therefore has two components: keeping them behind bars and the results of their nonproductivity while they are there.
Finally, there is productivity lost to drug-related unemployment and drug-related absenteeism. According to the 2008 NSDUH, 19.6 percent of unemployed adults may be defined as current users of illicit drugs. Based on population estimates from the same study, this translates into approximately 1.8 million unemployed individuals who were current drug abusers. Further, approximately 8 percent of individuals employed full time and 10.2 percent of individuals employed part-time were current users of illicit drugs. Individuals who are employed but have chronic absenteeism resulting from illicit drug use also accrue substantial lost productivity.
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Impact on the Environment
The environmental impact of illicit drugs is largely the result of outdoor cannabis cultivation and methamphetamine production. Many of the chemicals used to produce methamphetamine are flammable, and the improper storage, use, and disposal of such chemicals that are typical among methamphetamine producers often lead to fires and explosions at clandestine laboratories. Additionally, the process used to produce methamphetamine results in toxic chemicals--between 5 and 7 pounds of waste per pound of methamphetamine--that are typically discarded improperly in fields, streams, forests, and sewer systems, causing extensive environmental damage.
Currently, there are no conclusive estimates regarding the nationwide cost of methamphetamine production site remediation because many of the methamphetamine laboratories and dumpsites in the United States are undiscovered due to their clandestine locations. However, in California alone, from January through December 10, 2009, the California Department of Toxic Substance Control responded to and cleaned up 232 laboratories and dumpsites at a cost of $776,889, or approximately $3,349 per site.
Outdoor cannabis cultivation, particularly on public lands, is causing increasing environmental damage. Grow site operators often contaminate and alter watersheds, clear-cut native vegetation, discard garbage and nonbiodegradable materials at deserted sites, create wildfire hazards, and divert natural water courses. For example, cultivators often dam streams and redirect the water through plastic gravity-fed irrigation tubing to supply water to individual plants. The high demand for water often strains small streams and damages downstream vegetation that depend on consistent water flow. In addition, law enforcement officials are increasingly encountering dumpsites of highly toxic insecticides, chemical repellants, and poisons that are produced in Mexico, purchased by Mexican criminal groups, and transported into the country for use at their cannabis grow sites. These toxic chemicals enter and contaminate ground water, pollute watersheds, kill fish and other wildlife, and eventually enter residential water supplies. Moreover, the National Parks Conservation Association (NPCA) reports that while preparing land for cannabis cultivation, growers commonly clear the forest understory, which allows nonnative plants to supplant native ones, adversely affecting the ecosystem. They also terrace the land--especially in mountainous areas--which results in rapid erosion.
Limited research on the environmental impact of the improper disposal of pharmaceuticals indicates that contamination from dissolved pharmaceutical drugs is present in extremely low levels in most of the nation's water supply. The harm to aquatic life and the environment has not been determined, and according to the Environmental Protection Agency, scientists have found no evidence of adverse human health effects from the minute residue found in water supplies. Nonetheless, as a precaution based on environmental research to date, the ONDCP and the Food and Drug Administration suggest that consumers use take-back programs to dispose of unused prescription drugs (see text box in Vulnerabilities section).
4. Nonmedical use of prescription-type psychotherapeutics includes the nonmedical use of pain relievers, tranquilizers, stimulants, and sedatives but excludes over-the-counter drugs.
5. DAWN defines drug-related deaths as deaths that are natural or accidental with drug involvement, deaths involving homicide by drug, and deaths with drug involvement when the manner of death denoted by the medical examiner is "could not be determined."
6. Data include alcohol dependence or alcohol abuse.
7. The research also included antibiotics, steroids, and more than 100 pharmaceuticals.
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Psychoactive drugs are everywhere. Any discussion of drug use needs to take this into account. The broad category of “psychoactive drugs” consists of natural and synthetic substances that alter a person’s thoughts or feelings. There exist hundreds of plants, which, if eaten, smoked, snorted, or injected, will affect the mind—whether acting as a stimulant, depressant, or psychedelic. Thousands of known chemicals will do the same. Used recreationally, medicinally, or for work, some are illegal and others not: They include coffee, wine, and tobacco; prescription pain medications, sleep aids, and antidepressants; as well as cannabis, LSD, and heroin. Psychoactives are in the kitchen, in the hardware store, in the greenhouse, in home medicine cabinets, and in fuel tanks across the country.
Everyone uses them. Would you believe that nearly 90% of 45-year-olds in the United States have tried an illegal drug in their lifetime? As of 2006, more than 35 million Americans had taken an illicit drug in the previous year. Monitoring the Future (MTF), the best current survey about illegal drug use in the United States, reports that one in five college students used an illicit drug in the past month. Nearly all adults in the U.S. have tried alcohol, while over 80% use caffeine daily. Last year there were over 180 million prescriptions written for opiates alone, and a diverse assortment of psychoactives are increasingly used by older Americans from coast to coast.
They are not going away. Humans have used psychoactive substances for as long as we have records and some of the largest corporations in the world are actively developing new ones for the future. There is no magic bullet that will suddenly make these compounds disappear from our society. If there were, the past century of ever-increasing penalties for possession and sale of recreationally used drugs, along with massive anti-drug “education” campaigns, would have reduced use. But they have not.
The United States has implemented random drug testing of junior high and high school students who participate in chess club. No-knock warrants allow police to invade private homes with guns drawn in case a suspect might try to flush illegal drugs down the toilet. Taxpayers spend 8 billion dollars each year to incarcerate drug law offenders,[8,9] and pay for ideologically driven, abstinence-only education programs that are so factually misleading that they often fail to acknowledge the pleasurable or useful effects of the substances they teach about.
Despite these extreme measures, a majority of the population age 18-65 has chosen to try an illegal drug. The mainstream reaction is to continue the calls for “getting tougher.” Instead of working towards unrealistic, naïve goals such as a “drug free century,” our response has been to step back and reassess, asking: How can society adapt to the realities of the communication age and develop more sophistication and balance regarding the use of psychoactive drugs?
Modern humans must learn how to relate to psychoactives responsibly, treating them with respect and awareness, working to minimize harms and maximize benefits, and integrating use into a healthy, enjoyable, and productive life. But above all else, in a world filled with materials and technologies that affect the mind, adults must have the robust education and accurate, pragmatic information necessary to help them take charge of their relationships with psychoactives and teach their children how to do so from an early age.
EVERYONE MAKES CHOICES
Many people would agree that drug culture reform is needed, but we must recognize that “the drug culture” now includes everyone. Modern life involves daily decisions about psychoactives. The option of caffeine use is encountered multiple times a day. It is rare to watch an hour-long television show without seeing an advertisement for a mind altering pharmaceutical or a legal recreational drug. Late night coverage of the 2008 Summer Olympics was sponsored by Ambien, a popular sleep aid with memory-scrambling side effects whose commercials enticed audiences nationwide with comforting images of dreamy, refreshing, sedative-assisted sleep. A large portion of the population is exposed to the possibility of taking LSD, even if only 10-20% ever try it.[11,12] In today’s world, everyone must choose how they relate to innumerable psychoactive drugs. Whether or not one decides to use a specific drug, that decision should be made with skill, knowledge, and self-awareness, supported by accurate information.
Struck by the quantity and complexity of choices being made about psychoactives, and dismayed by the poor quality of accessible information, in 1995 we began a project called Erowid. Dedicated to providing an online library of information about psychoactives to the public through its website Erowid.org, the project has grown to serve over 60,000 visitors per day. In 2008, Erowid became an educational 501(c)(3) non-profit under the name Erowid Center.
In thirteen years of learning about both legal and illegal psychoactives, we have collected over 30,000 documents and 75,000 self-reports that catalog the choices people make and provide insight into the results of those choices. These reports include everything from pedestrian recreational use to life-changing spiritual experiences and personal tragedies. We have also learned that there are many subcultural niches in which responsible use of psychoactive drugs is taken very seriously. These communities disapprove of recklessness, and consider care a top virtue, regardless of whether use is for recreational, medicinal, self-improvement, work-productivity, or spiritual purposes.
WHAT DOES RESPONSIBLE USE LOOK LIKE?
“Know your body. Know your mind. Know your substance. Know your source.” One of Erowid’s earliest slogans, this directive encourages people to pay close attention to multiple aspects of their psychoactive substance use. These include understanding the individuality of response; avoiding drugs contraindicated because of health issues; learning enough about each substance to avoid unexpected effects and overdoses; and choosing both substance and information sources carefully in order to reduce risks. While these principles may seem obvious, they are seldom taught in contemporary drug education.
Alcohol is a good case to study, as its use is accepted in our culture and is not illegal for those over 21. Yet healthy and pragmatic drinking practices are seldom taught by parents, schools, or the government. By the time young adults reach the legal drinking age in the United States the vast majority of them have already consumed alcohol. In 2006, according to the National Survey on Drug Use and Health, the average age at which Americans first tried alcohol was 16.5, with only one in ten waiting until they were legally of age to drink. And they haven’t just had a sip; nearly 40% of 20-year-olds have gotten drunk in the last month. The opportunity to teach responsible use of alcohol—the most commonly consumed and arguably one of the most dangerous strong psychoactives—is missed. The situation is much worse for controlled substances.
Teaching responsible, intentional use to young people does not require giving detailed instructions on how to use illegal psychoactives. The general principles can be taught through education about prescribed medications, alcohol, or other legal drugs. There are many practical lessons about how to safely and responsibly use psychoactives, whether learned from personal subjective experience, research, or the hard-won wisdom of others.
Fundamentals of Responsible Psychoactive Use
- Investigate the health risks and dangers of the specific psychoactive and of the class of drugs to which it belongs.
- Learn about interactions with other recreational drugs, medications, supplements, and activities.
- Review individual health concerns, predispositions, and family health history.
- Choose a source or product carefully to help ensure correct identification and purity
(avoid materials with an unknown source or of unknown quality).
- Know whether the drug is likely to reduce the ability to drive, operate equipment, or pay attention to necessary tasks.
- Take oneself “off duty” from responsibilities that might be interfered with (job, child care, etc.), and arrange for someone else to be “on duty” for such responsibilities.
- Anticipate reasonably foreseeable risks to oneself and others and employ safeguards to minimize those risks.
- Choose an appropriate occasion and location for use.
- Select and measure dosages carefully.
- Begin with a low dose until individual reactions are known and thereafter use the minimum dose necessary to achieve the desired effects: lower doses are safer doses.
- Reflect on and adjust use to minimize physical and mental health problems.
- Note changes in health over time that may be related to use.
- Modify use if it interferes with work or personal goals.
- Check in with peers and family and accept feedback about one’s use.
- Track reactions to specific drugs and dosages in order to avoid repeating mistakes.
- Seek treatment if needed.
- Decide not to use when the time isn’t right, the material is suspect, or the situation is otherwise problematic.
People are usually willing to modify their behavior to reduce harms and increase benefits. Just as most of those who drink alcohol prefer to avoid hangovers and dangerous levels of consumption (so long as they can still enjoy alcohol’s intoxicating effects), most users of other psychoactive drugs would also happily take steps to minimize risks. In a pilot paper looking at the impact of web-based data about psychoactive substances, Boyer et al. found that:
”[…] all respondents in our cohort modified their drug use after reviewing online drug information. This observation suggests that the Internet has a profound ability to affect decisions related to psychoactive substance use in a cohort of innovative drug users. Interestingly, 8 of the 12 participants adopted behaviors intended to minimize the risks associated with drug use, a finding that suggests that attempts to reduce the harm associated with psychoactive substances are fostered by online information.”
Some might argue the same point that professor Mark Kleiman makes in his book Against Excess: “The fact that some people can use a drug responsibly and even beneficially does not imply that it is safe. We all know people who drink and take no harm from it, and we all know people whose lives have been wrecked by alcohol.” But as Kleiman also notes, just because some people do not work to minimize risks and use a drug dangerously or to their own detriment does not mean that is true of everyone who tries it.
OBSTACLES TO RESPONSIBLE USE
Unfortunately, some actions that are part of a responsible relationship with psychoactives can also expose individuals to social and legal problems if applied to illicit drugs. Current policies and programs pose complex challenges for those wishing to use these substances as conscientiously and safely as possible.
Twentieth-century drug control policies were largely based on the idea that prohibition was the most effective way to reduce problems associated with psychoactive use. Disturbingly, prohibitionist policies have compromised individual responsibility as well as the integrity and objectivity of education, medicine, and science.
One of the fundamentals of responsible use is to know the identity and purity of psychoactives that are consumed. Yet current policies make it difficult to be sure that materials purchased on the black market are pure or even correctly identified. For example, the Drug Enforcement Administration (DEA) prohibits most testing that would help identify street drugs. Erowid Center operates the only public ecstasy testing program in the United States (www.ecstasydata.org). However, the program is hamstrung by a 1974 DEA policy that prohibits laboratories from providing quantitative data about anonymously submitted samples of controlled substances—a policy that was enacted out of concern that such testing would provide “quality control” for the black market. When forced by circumstances, most people will use illicit psychoactives without quality control. The DEA’s censorship policy is an ineffective control strategy, which stands in the way of responsible use and public health, and which gives the DEA exclusive access to information about the contents of black market drugs.
Clearly, the population should be educated about the potential harms associated with psychoactive use, but providing any other, more practical information is heretical and potentially criminal. Our government explicitly discourages nuanced education about psychoactives. For example, for state-funded programs related to illicit drugs or alcohol, California legislates that “No aspect of the program may include a message on ‘responsible use.’” Media campaigns and educational materials almost universally share a single target message, prioritizing a decrease in use over accuracy and balance. Further, many web filtering systems, including those employed by hospitals and schools across the country, explicitly censor sites such as Erowid.org because they provide useful information.
While physicians are the primary experts available to give medical opinions about drug-related health issues, current policies cause many psychoactive users not to seek treatment or advice. Those who do so may risk legal trouble, insurance problems, and disclosure of their use to employers and family. Teens, faced with a friend who has overdosed, often hesitate to call an ambulance for fear of serious repercussions; they are well aware that physicians and the health care system can not be trusted as confidants or allies when it comes to psychoactive drugs. It is important for the public to have access to the sort of personalized medical advice that is only available when they can talk to their physicians without fearing the consequences.
Current policies also skew the science. With over a billion dollars per year in public financing, the National Institute on Drug Abuse (NIDA) funds 85% of the world’s research on recreational drugs. However, it is narrowly dedicated to studying “the addictive and adverse health consequences of drugs of abuse.” NIDA’s mandate artificially stacks the deck with findings that show negative effects. Policy makers, judges, and even experts in the field can draw mistaken conclusions from this imbalanced collection of research, leading many to dismiss responsible use as an unreasonable objective.
Developing and promoting more sophisticated language, thereby learning to better discriminate between different types and classes of drugs, is the first step towards a culture of responsible use. Unfortunately, it is common for those on the national stage to use the unqualified term “drugs” when discussing psychoactive substances, as if everyone knows exactly what is meant. But cannabis is not oxycodone, nor do stimulants behave like depressants.
This “drugs” meme has done long-term damage to the public’s critical thinking skills due to the unspoken assumption that everyone knows which drugs are the bad ones. Certainly they’re not talking about ibuprofen, and probably not coffee—but how about Viagra, Prozac, or dextromethorphan (a common ingredient in cough medicines, also used recreationally)? One often hears that people should not drive while on “drugs,” but this is much truer of depressants and psychedelics and less true of stimulants. The right dose of caffeine or amphetamine has been shown to improve driving, especially among tired individuals[24,25]—a fact well known to long-distance drivers and the U.S. military. Specificity in language is necessary for making good personal decisions, teaching others, and drafting appropriate laws. Not everyone has to be an expert on all psychoactive drugs, but we do need to be critical thinkers.
EDUCATION AND ACCURATE KNOWLEDGE
Responsible psychoactive use requires access to accurate, detailed, and practical information. Education is more important than changes to control policies or social reform. Those who choose to use caffeine, cannabis, LSD, amphetamine, Ritalin, or heroin need to know how much is too much, which drugs might interact dangerously, and how to minimize risks and optimize benefits. People need to be trained to seek this information and to put it to use.
As Boyer et al. found, people are willing to modify their behavior in order to reduce risks, but this is only possible if they know what the actual risks are. Unfortunately, there are severe problems with partisan, policy-driven information sources. While the quality of government-sponsored sources has improved over the last decade, sites such as Freevibe.com, a youth-oriented website funded by the federal government, still include laughable exaggerations like “heart and lung failure“ as a general effect of hallucinogens—a deceptive claim they have made for more than eight years. Scientific literature reviews on the most common hallucinogens do not support their claims; most recently, Johns Hopkins researchers found that, “hallucinogens generally possess relatively low physiological toxicity and have not been shown to result in organ damage.” Once people realize that a source is deceptive, as is the case for those teens visiting Freevibe who know someone who has tried LSD or psilocybin-containing (“magic”) mushrooms, they will be inclined to distrust all information from that source.
Public information sources should prioritize accuracy and completeness over maintaining a single, politically driven message. It is inconsistent with the democratic ideals of American culture to corrupt information in order to support public policies. The issues are complex and sources should reflect that.
In government-sponsored information, the benefits of disapproved drug use are absent, a void obvious to all but the least curious reader. Individuals try psychoactives largely based on the belief that they will be beneficial in some way: fun, enlightening, anti-depressive, anxiolytic, inhibition-reducing, etc. A recent study has confirmed what many users of “magic” mushrooms have described for decades: In the right context, the effects can be profound and can improve quality of life. According to the researchers, “67% of the volunteers rated the experience with psilocybin to be either the single most meaningful experience of his or her life or among the top five most meaningful experiences of his or her life.”
While there is no question that the specialized, supportive circumstances of this research made positive reactions more likely and reduced the chance of negative outcomes, the findings are also consistent with a large survey conducted on Erowid.org in 2005 that asked about the life impact of LSD use. With nearly 50,000 valid responses, 53.4% of those who reported having taken LSD said that it had affected their life positively, compared to 3.4% who said it had a negative impact (21.9% reported “no effect,” 17.2% reported a “mix of positive and negative effects,” and 4.1% did not answer or didn’t know). As of September 2008, none of the top government-funded public drug information websites had a single mention of any benefit associated with psilocybin.
Misrepresentation and oversimplification in this complex field of study damage society’s ability to engage in accurate and honest dialog about issues that affect everyone’s daily lives. When private or government-sponsored prohibitionist organizations are found untrustworthy, people seek information elsewhere. Unfortunately, advice provided by peers about the risks and benefits of recreational drugs can also be of dubious value. Teenagers, especially, can not provide each other with the quality of information they need and deserve.
Public educational resources need to provide comprehensive, honest information in order to be worthy of trust. To climb out of the well of distrust our culture has dug, students, teachers, parents, law enforcement officers, medical professionals, marginalized subcultures, and the general public all need to look to the same libraries, rely on the same sources, and expect balance and neutrality in the reporting of scientific findings. Establishing a culture of responsible use—built on a foundation of unbiased, factual information—is essential to the practical long-term management of psychoactives in our society.
[Conflict of Interest Disclosure: This article was written partially under the influence of oolong tea, diet cherry Coke, and California chardonnay.]
Fire and Earth Erowid are the co-founders of Erowid Center, an IRS-approved 501(c)(3) non-profit educational organization which runs Erowid.org, an online library of information about psychoactive plants and chemicals.
 Johnston LD, O’Malley PM, Bachman JG, et al. “Monitoring the Future National Survey Results on Drug Use, 1975-2006. Vol II.” NIDA. 2007. 98.
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 SAMHSA. “Older Adults: Substance Use and Mental Problems.” http://www.oas.samhsa.gov/aging.cfm Accessed Sep 4, 2008.
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 Substance Abuse and Mental Health Services Administration (SAMHSA). “Results from the 2006 National Survey on Drug Use and Health: Detailed Tables.” 2007. Tables 1.11A.
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 Sites searched on September 3, 2008 included Freevibe.com, AboveTheInfluence.com, TheAntiDrug.com, MediaCampaign.org, and WhiteHouseDrugPolicy.gov.
Also from this issue
Towards a Culture of Responsible Psychoactive Drug Use by Earth and Fire Erowid
In their lead essay, Earth and Fire Erowid stress the importance of developing responsible, fully informed relationships toward psychoactive drugs. Although drug prohibition has persisted for decades, the overwhelming majority of adults have tried at least one illegal drug, and these substances aren’t going away any time soon. Sadly, prohibition itself has stunted our knowledge of these substances, and, as in so many things, ignorance is both dangerous and irresponsible. Provocatively, they criticize even the word “drugs” as a tag for illegal psychoactives: Lumping them all together, they write, betrays a lack of understanding of their vastly different effects, risk profiles and — yes — benefits.
Is Responsible Drug Use Possible? by Jonathan Caulkins
Jonathan Caulkins argues that the responsible use of psychoactive drugs is an overstretched concept, if by “psychoactive drugs” we mean everything from caffeine to heroin. In many cases, he argues, temperance may be the only responsible “use” of a given substance.
Further, state prohibitions on pleasurable but risky acts are hardly confined to this area of law; their violation is not a genuine form of civil disobedience as long as pleasure itself is the real goal of the act. And the risks remain regardless. Duly enacted laws in a democracy deserve far more respect than this, and following the law is a part of the responsibility of all citizens.
True Temperance by Jacob Sullum
Jacob Sullum notes that temperance and abstinence have been wrongly conflated, and that the Aristotelian view of temperance encompassed all of the moderate, reasoned, and honorable pleasures of life. He reiterates that virtually everyone uses psychoactive drugs of one kind or another, and that the overwhelming majority of use is responsible. He challenges the notion that the state has any interest in the private actions of individuals that do not harm anyone else, and he terms the impulse to protect people from themselves “unethical” and “an open-ended rationale for government intervention that logically leads to totalitarianism.”
Drug Policy in Principle, and in Practice by Mark Kleiman
Mark Kleiman takes up a theme already addressed by the other participants, namely the distinctions to be found within the catchall category “illegal drugs.” He notes that the risk profiles, motivations for use, and public health considerations of these substances are so far removed from one another that it may make no sense to continue to treat them as similar in public policy. Given the choice between full legalization and the status quo, he would choose the status quo, but, he argues, these alternatives should not be the only ones we consider.