Should drugs be a public health issue. By that I am refering to the the harm reduction theory. Should we treat addicts or incarcerate them? Should we spend more time educating against drug use?
It is clear to me that we have lost the war on drugs. Still we incarcerate first time drug offenders at an alarming rate. Should we treat addicts and punish only the dealers that have delivered or sold large quantities? Who has any ideas from a public health perspective. I am not an advocate for legalizing drugs. On the other hand I do not think long prison terms is the answer.
Mar 7, '01
You pose good questions and I don't have any answers. I work in drug and alcohol prevention in a high school. I also do some early case finding.
I think having some logical legal consequences associated with chemicals (like DUI's or MIP's) helps students to come to understand that their behavior is costing them something and that, perhaps, that cost is too high. At the same time, I have a buddy who works in a prison for women and she is dismayed at the number of women (who are all too often mom's) who get long prison sentences that affect them and their families when they could really use treatment. Do these mom's need punitive treatment or treatment. Hardliners view treatment as going soft since they are viewed as criminals not clients. However any one who works with addicted pops will tell you that addicts can be criminals in anyone's book. Personally, shorter sentences and treatment have some appeal to me.
Naegle and D'Avanzo in their book _Addictions and substance abuse: strategies for advanced practice nursing_ talk about some of the historical aspects of drugs and the author of that particular chapter gives a very interesting perspective on how and when America changed from being treatment oriented to legally oriented. I'd recommend this reading to any one.
As a public health nurse, I can have probably a higher level of comfort with harm reduction than many. Needle exchange programs are harm reduction. For specific at risk populations this is a compassionate and appropriate intervention, I believe. Condom distribution in a high school falls into the same category. Both of these programs tend to evoke strong responses from would-be users, parents, family members, tax payers. Target population is the key.
If you haven't read Marlatt's classic work on harm reduction, you should. It is thought provoking even though I admit that I squirmed with discomfort with some of it.
I do ascribe to some components of harm reduction with my students, as do many folks who work with teens. We'd rather keep the dialogue going than "insist" on exemplary behavior as a condition of continued contact.
Mar 7, '01
good questions chili, I don't have answers, either. I would be interested in hearing a rehab nurse's take on prosecuting/rehabing and who the most common re-offenders (age group,sex,financial class,etc) are.