A Call for Consistency

 

 

 

 

 

 

 

 

 

“ We had two bags of grass, seventy-five pellets of mescaline, five sheets of high-powered blotter acid, a shaker of cocaine and a whole galaxy of multicolored uppers, downers, screamers, laughers... Also a quart of tequila, a quart of rum, a case of Budweiser, a pint of raw ether, and two dozen amyls... But the only thing that worried me was the ether. There is nothing more helpless and irresponsible than a man in the depths of an ether binge...”

 

- Hunter S. Thompson “Fear and Loathing in Las Vegas”

 

 

 

How can you argue with that?

 

 

 

Was Dr. Thompson describing the allure of drug use or does he parody the excesses of our drug culture? Does he give permission to a generation jaded by the disillusions of Watergate and the Vietnam war for consumption in excess? Or is he shocking us by using hyperbole to warn of the madness resulting from over use of psychoactive substances? A generation who came of age reading the hilarious screeds of “Gonzo Journalism” now control the current drug policy in America. Our leaders come from a position focusing on a menacing mix of old myths and fears of rampant drug use by people gone mad by unfettered experimentation. It is not a new phenomenon, these misunderstandings have persisted for centuries, incorporating generational, racial and cultural fears. The essential concern comes from the new technologies, such as widespread involuntary drug testing, which incorporate fears of a society overrun by drug crazed lunatics. They take paranoia into the new millennium. With the ability to drug test citizens in an increasingly casual manner, the distrust of the masses by those in power ushers in an era of progressive weakening of personal freedoms. It is this fear that has fueled policies that have nearly Draconian overtones.

 

Our current drug policies are giving the Federal government an increasingly paternal interest in our citizenry. We all become children of the state, and are treated as such. “By prejudging the value of the individual's desires and ends, paternalism imposes a conformity that limits human possibilities.”ⁱ Personal freedom begins to take a back seat to the desires for power. By referring to any policy as drug control, it is suggested that our neighbors who partake in drugs, or any form of medical or non-medical psychoactive substances (including tobacco and alcohol), need to be controlled and cannot be responsible for their actions. No matter what the circumstance, individuals become vilified, even when behavior is moderate and responsible. According to the Substance Abuse & Mental Health Services Administration (SAMSDA) the number Americans in 2007 who reported illicit substance use at least once in their lifetime was 114,275,000ⁱⁱ. That represents 1 in 3 Americans. To those charged with developing America's drug policies, the degree between the experimental user and compulsive drug abuser is shrinking, and not worthy of substantial examination, even though it encompasses a large section of the population. But to some policymakers, a drug user is a drug user, no matter what the motive or reasons.

 

Control policy based on exaggerated fears result in losses of individuality, a blandness of personality which emerges when individuals strive to conform. Individuality is the ideal America has always seen as a source of pride. When we consent to be controlled, either overtly by voting for those who advocate such policies, or implicitly by silent inaction, we are allowing our leaders to drag the stereotypes, along with classic fears – many of which have a tenuous link to reality - into our modern age.

 

A common theme in the 2008 National Drug Control Strategy is the continuing use of involuntary drug testing. Involuntary testing, most primarily by urinalysis, has become increasingly pervasive in our society. The notion of this practice starts with schoolchildren, where “random testing gives students a powerful incentive to abstain from drug use,” making the adaptation of programs of involuntary drug testing a condition for Federal funds.ⁱⁱⁱ What is troubling is the use of the term “powerful incentive.” It denotes a degree of fear which can be instilled into children at an early age, creating an environment that can inhibit self-expression and individualism and retard performance. The presumption of guilt by the involuntary testing of children has serious consequences. It fosters the belief that this kind of control is acceptable, and demonstrates a level of fear promoted by those in charge as the way things should be. The use of these tactics creates an implied acceptance of behavior by government that could lead to the creation of a “nanny state,” where personal responsibility is replaced with a government taking a paternal role. By developing an environment of fear and mistrust, the responsibility of parents and family is assigned to bureaucrats. It also creates a fertile ground for resentment and other forms of rebellion, one of the most common is increased psychoactive substance use.

 

With the 2009 budget for national drug control estimated at $14.1 billion^iv the justification should be clear that random drug testing would be a useful tool in controlling drug use. But that is not the case. In a 2007 study conducted by the Oregon Health and Science University, published in The Journal Of Adolescent Health, the effectiveness of random drug testing of student athletes was anything but clear. The study suggests that other factors for later substance abuse, such as a well developed mistrust of authority, actually increased as a result.

 

Student-athletes from intervention and control schools did not differ in past 1-month use of illicit drug or a combination of drug and alcohol use at any of the four follow-up periods. At the final assessment, DAT (Drug Alcohol Testing) athletes believed less in testing benefits (p < .05) and less that testing was a reason not to use drugs (p < .01). No DAT deterrent effects were evident for past month use during any of four follow-up periods. Prior-year drug use was reduced in two of four follow-up self-reports, and a combination of drug and alcohol use was reduced at two assessments as well. Overall, drug testing was accompanied by an increase in some risk factors for future substance use. More research is needed before DAT is considered an effective deterrent for school-based athletes.^v

 

 

 

The most fundamental problem with urine drug testing methods is that what is tested is not drugs but the presence of metabolites, the byproducts of substance use. The metabolites of the substances most commonly tested for; alcohol, cocaine, methamphetamines and heroin – psychoactive substances which have the most effect on individual productivity – pass through the body within 24-48 hours, leaving no metabolites to test for.^vi This leaves testing ineffective to a large degree, and the door is wide open for inaccurate results. The only truly compelling part of drug testing is the fear of the test itself.

 

Is controlling children, limiting freedoms and living with the presumption of guilt the price society will pay for a statistically small drop in student drug use?  The following is from the SAMHDA 2007 National Survey on Drug Use and Health (National Findings):^vii

 

 

 

 

 

Substance Dependence or Abuse in the Past Year among Persons Aged 12 or Older: 2002-2007

 

 

 

 

Past Month Use of Selected Illicit Drugs among Persons Aged 12 or Older: 2002-2007

 

 

 

With huge annual budgets given towards the “War on Drugs,” tallied at $13.66 billion in 2008^viii the return on our investment after five years should be expected to be higher than 0.3%. Even with these poor returns, Federal school funds are being increasingly attached to programs such as random drug testing^ix. What is the overall message presented to students when legal prescription use is widespread, $217 billion in 2007 and projected to reach $515 billion by 2017.^x Legal consumption of alcohol, caffeine and tobacco is permitted at a “proper age,” and are seen in our culture as a rite of passage. Is substance use bad, and users should be feared, just because authorities say they are?

 

If we are to live in a country which celebrates the freedom of youth, and encourages youngsters to live to their full creative potential, setting them off in a shroud of fear and a cloud of misinformation is a bad start. The double standard for substances such as alcohol and nicotine gives children the idea that it is acceptable to say one thing for certain activities, but do something different for others. Drug usage is prohibited, but when it is sanctioned by doctors, as in prescription medication, it is encouraged. It is allowable to drink alcohol but marijuana, which is arguably more harmful, is decried as a scourge.

 

It is this environment of hypocrisy that gives motive to antisocial behavior, mistrust of authority and heightened curiosity in experimentation of the banned substances. Without rational responsibility towards our children, how can we expect them to grow up any different? To raise a thoughtful generation, we must act that way ourselves.

 

In developing a nation becoming accustomed with the idea that they can be tested for psychoactive substances at any time, from school to the workplace, none can be more disturbing than the idea that health care providers are the “key to increasing awareness” of drug use. The sacrosanct confidentiality between doctor and patient appears to be ancillary to the government's goals in controlling the drug using population. The National Drug Control Policy offers an ominous suggestion:

 

It is estimated that 180 million Americans age 18 or older see a health care provider at least once a year. These visits provide a very valuable opportunity for drug and alcohol screening. With a few carefully worded questions using an evidence-based questionnaire, health-care providers can learn a great deal about whether a patient is at risk for problems related to substance abuse... It can be incorporated into routine practice in medical settings.^xi

 

 

The success of any medical professional is the relationship established with their patients. We see a doctor to help, and their mission is to bring us to health. Honest exchange is essential for any health care professional to be effective. The chance of a doctor undermining trust for the sake of drug control goals set by the Federal government would have a devastating effect on the health care industry. People would lose faith in doctors en masse, fueled by the idea that moral judgments would cloud medical decisions . The overtones of our drug control policy and the “opportunity” health care providers are presented is truly frightening to anyone concerned with personal liberties.

 

The increasing reliance on involuntary drug testing, especially on schoolchildren, is the most blatant example of the worrisome direction of our society. The willingness to arbitrarily punish certain behaviors makes moral judgments relative and subjective. It has the effect of confusion and an overall weakening of respect for society. Behavior such as alcohol and tobacco use is not illegal, and only becomes restricted when it begins to effect others, such as driving drunk or second hand smoke. They continue to be activities governed by a degree of personal responsibility, where the individual makes the decision to use alcohol and tobacco. We Americans allow a somewhat libertarian view of these activities, but selectively prohibit others (with prejudice).

 

Again, there are many acts which, being directly injurious only to the agents themselves, ought not to be legally interdicted, but which, if done publicly, are a violation of good manners, and coming thus within the category of offences against others, may rightfully be prohibited. Of this kind are offences against decency; on which it is unnecessary to dwell, the rather as they are only connected indirectly with our subject, the objection to publicity being equally strong in the case of many actions not in themselves condemnable, nor supposed to be so.^xii

 

John Stuart Mill, one of the founders of Libertarian thought, understood the need for prohibitions for the public good, but not at the expense of the most valuable asset of the state, the individual. “(A) State, which dwarfs its men, in order that they may be more docile instruments in its hands even for beneficial purposes, will find that with small men no great thing can really be accomplished...”^xiii Prohibitions are necessary only when they negatively impact others, especially if violence is involved, but not when they effect an individual's own activities.

 

The Federal government is willing to spend billions on restricting behavior of drug users that ultimately impact the active users represented by statistically small segment of the population. The number of active drug users are holding steady at approximately 8%, in spite of the increased efforts to prohibit^xiv. Many experiment, but the majority never continue to use these substances. The government uses restrictions and the promotion of fear by creating a presumption of guilt for more people than illicit drugs will ever effect. The loss of freedom advocated by policymakers, and to those who consent to these restrictions, to some degree affects everyone in America. Once liberties are gone, it is very difficult to get them back.

 

This reliance on double standards, and the willingness to use fear as an incentive to inhibit drug usage is the wrong message to citizens, especially our next generation – who will eventually be in charge. We want them to be rational, and need them to use reason in solving our common problems. By allowing a huge variance in responses to modern challenges, from substance use to economics to the fears of terrorist attack , we are working against the kind of measured reflection that creates real solutions to the world's problems.

 

The individual is the most affected by drug usage. But we are all harmed by drug usage policies. Pushing away from the moralistic slant of current attempts to control requires nothing less than an entire paradigm shift. Primarily, the notion of control to address the prevalence of psychoactive substances is wrong. Individual freedom is a cornerstone of any activity of the state, and that is counter to the environment of fear promoted by random testing. Consistency is the key. We must teach our children the value of respect for the individual in all aspects of life. That begins when we all act in a responsible manner, and focus on reason and thoughtful reflection.

 

“(T)eenagers' moderate patronage of soft drugs in Western nations appears to be a generally healthy reaction to the alarming damage they see hard-drug abuse causing among adults around them.”^xv

 

The budget assigned to control supply must be scaled back, with Federal funds reinvested in public awareness of health issues, including education and training of public health care workers. This includes establishment of a common medical standard, along with minimum level of health care, created with the purpose of maintaining a degree of wellness consistent for all Americans. It is a goal that is not only reasonable but achievable. Decriminalization of drugs and a consistency in attitude towards all non-medical substance use will benefit the entire social structure by promoting equality and increased productivity by maintaining a healthy workforce. Create tolerance for those who choose to indulge in “harder” psychoactive substances by an environment of inclusion, treatment and support. It will set a social standard that celebrates diversity and fairness and becomes the example for the world. It will also lessen the need for experimentation and rebellion that fosters increased drug experimentation and continued use.

 

This social shift requires a substantial reevaluation of current drug laws with the understanding that a large section of the world's economy is reliant on drug consumption by Americans. The current black market economy created by the drug trade can be tapped for additional revenue by decriminalization and financially support the changes enacted by legalization. Taxation would be established, similar to the taxation on tobacco and alcohol, but not to a level where consumers would again establish a black market for affordable product, as is the case with pharmaceuticals. The usage, quality and dosage of psychoactive substances set by scientific experts should be left to those who are best equipped to handle distribution - trained health professionals. Any increase in usage levels would be addressed by the properly trained experts in a modernized health care system. The availability of the decriminalized substances would be regulated, as is alcohol.

 

Those imprisoned for non-violent drug violations would be released with the associated funds reinvested into health care and education. The Federal and State budgets set for the control of supply would be funneled back into society, effecting the greatest amount of people with a focus personal responsibilities for activities impacting others and the society. Law-enforcement resources would be freed to focus on the safety and security of the community.

 

The importance of health, and the focus on wellness, is a more effective tool than fear in reduction of substance use. It begins with the encouragement and realization of individual potential instead of conformity. It starts by addressing some of the feeling of self-worth that is the core for the need to use drugs. An awareness of how a healthy lifestyle is essential to becoming a valued part of community is necessary, impacted in part by avoidance of non-medical psychoactive substances. A rate of attrition will offset any increase in experimentation as a result of decriminalization. Natural recovery from drug use is achieved by setting positive examples in society, along with a more compassionate and less fearful environment.

 

The reduction of tobacco use, primarily in cigarette smoking by 12 to 17 year olds, demonstrates a more substantial decline than the reduction in illicit drug usage.^xvi This has been achieved in part by an increased awareness on personal health, and has been a major factor in the establishment of various smoking bans throughout America. Many of these laws are beginning to cast the same shadow of a nanny state as random drug testing, and should be monitored just as well. But it demonstrates an attempt at rational understanding of the health benefits of both legal and illegal substance use. It seems to be a better deterrent than a random and unequal prohibition of other drugs. This would replace the current method of user trial and error.

 

The problems associated by drug use is complex, and there are no easy answers. But a shift in America is needed, a shift towards a more rational and consistent approach to substance use. The best path is developing a sensible approach to drug usage that is not in dismay or imposing archaic stereotypes such as those parodied in “Fear and Loathing.” It can start by addressing some of the inequities in health care and to address feelings of individual worthlessness which lies as the core of much of the drug usage. By creating a reality that respects every member in a society free of fear, we can begin losing the need to alter reality by drugs.