America's Habit

Drug Abuse, Drug Trafficking, & Organized Crime

President's Commission on Organized Crime, 1986

Consultant Paper: Preventing Drug Abuse: What Can We Do?

By Dr. Arnold M. Washton. Submitted: October 1, 1985. Dr. Washton is Director of the Addiction Research and Treatment Center, The Regent Hospital, New York, New York; and Research Director of The National Cocaine Hotline "800-COCAINE," Fair Oaks Hospital, Summit, New Jersey.

The most dramatic increase in drug use has occurred since the 1960's, a time of radical change in political and social beliefs, lifestyles and mores. Traditional values, authorities, and restrictions on behavior were vehemently challenged. Psychoactive drugs and the breakdown of traditional taboos against using them became symbols of the rebellion against the established order. We have come to recognize in the 1980's that we are paying a very high price for the casual attitude towards drugs that developed in the 1960's. Much misinformation has been corrected, and we have begun to formulate a more realistic appraisal of the problem, but now we must take specific actions to reduce the demand for drugs.

Interventions that merely condemn drug use and try to frighten children about the potential dangers ("scare tactics") are futile. The most effective prevention strategies are those that address the factors that make drugs attractive and thwart the process that leads youngsters to try them. Children use drugs for many different reasons. Usually there are at least several factors that enter into the decision to experiment or continue with drug use. Drug use itself is no evidence that parents have failed to properly raise their children. Many children with a good family upbringing have yielded to the enormous outside pressures to use drugs. The influence of peers can often override even the best parental input.

Effective drug abuse prevention must address the most basic and fundamental forces that promote drug-taking in our society. These fall into two main categories: supply and demand.

Reducing Supply

Reducing the supply of illicit drugs is an obvious way of curtailing use. Although this does little to alter the demand for drugs, the widespread availability and abundant supplies of many different types of powerful mood-altering substances makes it easier for our citizens to become involved in drug use. It reinforces the notion that illicit drugs are an expected part of American life. People are more likely to try drugs when they are surrounded by them - and children are no exception. Most American adolescents know someone who "deals" drugs, uses drugs, or is able to get them.

To counter the supply problem, we must continue to enforce and strengthen our laws against the manufacture, sale, and possession of drugs. We must also take a firmer stand against drug-producing countries that receive American foreign aid.

The failure of Prohibition is a dramatic example of how difficult it is to eliminate the use of a drug by law enforcement efforts alone; especially when the drug is so well-entrenched in society. Nonetheless, to legalize drugs, such as cocaine, marijuana, or heroin would cause nothing short of a national disaster. When drugs are cheaper and more readily available, more people use them, become addicted to them, and suffer serious consequences to their health and functioning. Legalization of drugs would create an epidemic of unprecedented proportions.

Although enforcement efforts are necessary to check abuse, they cannot prevent the problem by themselves. Neither can treatment programs, which are utilized only after a serious drug abuse problem has been identified.

Reducing Demand

Prevention of drug use in the United States must focus intensively on the problem of demand. The cultural forces that encourage and perpetuate drug use in our society must be eliminated. We must recognize that drugs have become a deeply-ingrained part of American life and that prevention cannot occur unless social attitudes toward drug use change. Changing social attitudes toward drugs is a difficult undertaking, but not an impossible one. Many segments of society must become involved in the effort. The message that drug use is unacceptable, unhealthy, and unnecessary must be communicated in a credible and consistent manner by the family, schools, media, business community, medical and legal experts, politicians, professional athletes, and other public figures. This message must be reflected in every aspect of American life including education, entertainment, business management practices, and law enforcement. Being free of drugs must become a highly desirable personal attribute: one that is seen as mandatory for success in our society. One might hope that non-involvement with drugs would become at least as desirable as physical fitness and attractiveness.

Several prevention strategies are outlined below.

Recommendations

1. Public Education and Media Campaigns. The media is potentially one of our most powerful prevention tools. It could be used to better educate the public about the dangers of drugs and to change attitudes about drug use through direct and indirect communications. Public service messages, educational programs, documentaries, and greater efforts to eliminate pro-drug programs, might help to counteract accepting attitudes toward drugs.

2. School-based Prevention Programs. Every school system in the United States must have an active and creative drug abuse prevention program. Prevention efforts, such as saying "NO" to drugs and learning of their potential dangers, must start in the early grades, not just in high school. Studies show that drug use often starts before the 7th grade and that by the time youngsters reach teenage it may be too late to change their attitudes about drugs or their willingness to "try" drugs. Nonetheless, early identification of drug-abusing youngsters and swift efforts to ameliorate the problem are essential in our nation's high schools.

In this regard, the "Student Assistance Program" (SAP) in New York's Westchester County has served as a model program to other school systems around the country. The SAP is based on the EAP (Employee Assistance Program) model used successfully in business and industry, utilizing on-site substance abuse counselors, who are especially skilled at identifying drug-abusing youngsters and providing the necessary assistance or referral.

3. Education of Health Professionals. Despite epidemic levels of drug abuse over the past two decades, most health professionals receive no formal training in the diagnosis and treatment of drug dependency. This situation must be corrected by mandating that a core curriculum in the clinical management of drug abuse problems be part of the training of physicians, nurses, psychologists, social workers, and other health professionals.

1. Drug Testing in DWIs. Currently, not a single state in the United States requires drug testing of drivers stopped for suspected driving under the influence of alcohol. Someone "stoned" on drugs may be able to pass a breathalyzer test with no difficulty, but still be too impaired to drive safely.