America’s drug policy incorporates federal laws that regulate the trade, distribution and use of illicit substances.
Drug policy covers everything from the classification of drugs and which are illegal to legal punishment for drug activity and treatment and rehabilitative services. Federal drug policy is also involved in the development of campaigns for awareness, and the inhibition of drug trafficking and cultivation for the foreign drug market. Certain drugs carry specific penalties. Milder substances — like cannabis — carry lighter punishments, whereas harder drugs carry just the opposite. For example, possessing marijuana in quantities less than 28.5 grams in California, if for personal use, delivers a maximum penalty of just a $100 fine with no possible jail time. However, the possession of any amount of heroin may be classified as a felony in the state.
A Federal View of Addiction
New developments and changes to the federal drug policy express a newfound understanding of what addiction is, and what it isn’t. Once seen as an issue of morality, poor character, and a lack of willpower, addiction is now viewed as a disease that is thrust upon people of all kinds and colors. Of all parties aged 12 and older admitted for substance abuse treatment in 2009, 60 percent were non-Hispanic Caucasians and 21 percent were non-Hispanic African Americans. The focus of drug policy is now on prevention and treatment measures. For a vast number of individuals, a predisposal to addiction is what got them into trouble in the first place. Take for example, a child raised by an alcoholic mother — that youth has a fourfold increased risk of becoming an alcoholic himself. Aims to prevent drug abuse are delivered through education.
The new drug policy also recognizes the need for treatment among the addicted population. Despite a staggering 23.5 million people needing treatment for a substance abuse problem in 2009, only 2.6 million received it. The reformed drug policy is geared toward increasing treatment numbers by making treatment options more readily accessible to substance abusers and addicts nationwide.
The reform of the United States criminal justice system has already begun through some measures of legalization and decriminalization, as previously mentioned. It should be noted that these measures, with regard to marijuana, have already led to fewer arrests in most states. Case in point, in Washington, misdemeanors for the possession of marijuana decreased drastically in the first full year since the drug was legalized in small amounts, going from 5,531 in 2012 to a mere 120 in 2013. Equally as important as the other motives set in motion by the drug policy reform initiative, removing the stigma associated with substance abuse and addiction is high on the list of priorities.
While addiction isn’t biased in terms of whom it plagues, there continues to be specific emphasis on helping certain demographics who are more often affected by substance abuse than others, including military service members and veterans, college students, women, children, families and the Native American population.
The Time for Treatment
Addiction is highly prevalent in American society today. The symptoms of substance abuse and addiction include:
- Using to avoid withdrawal
- Inability to control how much you use or how often
- Preoccupation with drug use and maintaining a supply
- Disengaging from friends and family to use drugs instead
- Continual use of drugs despite the poor effects such behavior has had on your life and well-being
Legalization and Decriminalization
Questions have come to light in recent years over the necessity of imposing harsh sentences for charges involving less harmful drugs. In addition, society and congress alike have questioned whether or not lighter sentences — or having none at all — could actually decrease the use of some substances. Enter the legalization and decriminalization of marijuana. While this trend hasn’t caught on nationwide just yet, it is expected to. Per a 2013 survey, 58 percent of Americans were in support of the legalization of marijuana for personal use.
Currently, 23 states allow medical use of marijuana, as does Washington DC, and 17 have decriminalized it, while both Colorado and Washington have approved it for recreational use in small amounts. This is just one of the many things that drug policy oversees in the United States. While changes to the national drug policy in 2012 include these legal implementations, legalization is not viewed by the US government as a heroic effort by any means.
Proponents of legalization and decriminalization continually promote the theory that drug abuse would be less of a problem if it weren’t illegal. Additionally, those in favor believe that legalization would serve to diminish the number of people incarcerated for drug-related crimes. While the move to legalize illicit drugs would certainly decrease the number of people being prosecuted and thereby locked up, this doesn’t necessarily correlate directly to diminishing drug-related activity. Rather, the government would just stop punishing certain behaviors.
Case in point, the legalization and decriminalization of marijuana in some states serves to allow small amounts of the drug to be in possession without any legal ramification. That being said, larger amounts, trafficking, selling and manufacturing are still punishable by law in the majority of the nation. Those offenders will still be in jail or prison. Likewise, those with small amounts of marijuana in legalized states won’t be prosecuted, but they will still be carrying the drug around with them and using it. So, do legalization and decriminalization merely turn the focus away from the behavior that is still ongoing? The answer is unclear.
There is a grave concern among naysayers of these movements that such feats will only serve to increase the use of said drugs, and they may not be too far from the truth. Children are more likely to engage in substance abuse behaviors when they’ve been raised by parents who seem permissible about such topics. Likewise, among teens who have used the drug one or more times, 65 percent claimed they would be more inclined to use it if it were legal, as did 78 percent of teenaged heavy marijuana users.
Foreign policy plays a big role in what happens in the states. The most dangerous drugs to enter the US from outlying nations are cocaine and heroin. The former stems from the coca plant, which is cultivated mostly in the Andean nations of Columbia, Peru and Bolivia. As much as 90 percent of the cocaine found in America comes from this area.
Heroin comes from the latex-like resin derived from opium poppy pods, grown in majority in Southeast Asia, Latin America and Afghanistan, where most of the US supply comes from, but it is also cultivated in Mexico, which produces seven percent of the world’s heroin supply, the majority of which ends up in the US.
The government has several roles in the regulation of drugs across the country. Officially, the War on Drugs started with President Richard Nixon during his term in 1971. Over the years, other leaders have carried the torch with some success, but criticism hasn’t been lacking. Currently, President Barrack Obama plans to place a strong focus on the abuse of opioid drugs. Both heroin and prescription opioid pain relievers have reached epidemic levels of misuse and abuse in the United States. In 2012, around 669,000 people admitted to being past-year heroin users. While the line is often blurred between the two, heroin-related crimes and deaths generally make it into the news and social media networks more so than those related to its prescription counterpart. Likewise, people are naturally more disturbed by the idea of injecting an illicit drug than taking it from a prescription that was legitimately written by a trusted physician.
Nonetheless, the prescription version of opiates is causing a lot more harm than heroin these days. A reported 210 million prescriptions were written for opioid painkillers in 2010. Furthermore, emergency room visits for these drugs top the charts among all opiates at 135,971 in 2010. Unfortunately, these drugs are likely easier to access, too, with 27 percent of people who misuse or abuse prescription opioid painkillers for 200 or more days in one year getting their supply straight from their own medicine cabinet.
Behind the scenes, sometimes addiction may very well be a direct cause of medical practices perpetuated by the government. Theories exist that point the finger at the medical community for continuing to dole out prescription after prescription for these highly addictive drugs, without educating patients or giving them the opportunity to choose something milder, such as anti-inflammatory drugs, corticosteroids or acetaminophen.
Treatment protocols for opioid addictions have led to a great deal of political skepticism as well. As is always the case where opiate-based drugs are concerned, newer variants come along and the FDA approves them as medical treatments for the latest wrath of opiate addicts. Currently, methadone and buprenorphine are both approved to treat heroin and prescription painkiller addictions. The former boasts a 60 to 90 percent success rate, and the latter 88 percent, but research since wavers on both.
Reform and Rehabilitation
Surely, all drug policy actions haven’t been negative producers. One such initiative is the reform of policies directed at criminals. Due to policy reform, thousands of would-be prisoners have been given second chances at the hands of substance abuse treatment and rehabilitation instead of spending time incarcerated. Research shows that society is in favor of similar actions for harder substances, with 67 percent of Americans surveyed claiming they’d like to see the government concentrate more on rendering treatment for hard drug offenders, like those possessing or selling cocaine and heroin, than locking them up — something only 26 percent supported.
Drug classification starts with the Food and Drug Administration and can be a lengthy process, or a short one, depending on the factors that surround it. In other words, if there is a legitimate — or lucrative — reason to render classification more quickly, it can be done. The FDA has the final say on whether a substance should be classified as a drug at all. The process in determining this classification relies on strict definitions of what comprises a drug and what is considered to be a device — the substance must be one or the other. The Drug Enforcement Agency is responsible for the scheduling of dangerous and controlled substances.
Unfortunately, it’s essentially impossible for the government to stay on top of every new substance that comes onto the market. Drug manufacturers are well aware of this and remain at the ready to disperse the latest and greatest version of a drug as soon as one is banned. Spice is a great example of this. Also known as K2, synthetic marijuana is a compilation of dried leafy materials that are sprayed with a manmade THC copycat chemical. These drugs initially entered the market in late 2008 and their popularity grew pretty quickly. This synthetic form of marijuana led to 2,668 phone calls to poison control centers in 2013.
After a slew of overdoses and negative side effects, the drug and five of the chemicals used to manufacture it were banned in 2011 by the Drug Enforcement Administration. This came after several reports of erratic behavior and spontaneous deaths. Nonetheless, variants continued to roll out that circumvented the judicial jargon just enough to pass as legal for sale and use. Finally, the Synthetic Drug Abuse Prevention Act of 2012 was instilled, which classifies them as Schedule I drugs under the Controlled Substances Act and prohibits the manufacturing, sale or use of any substance that is similar in nature to one that is already banned. Thus far, it seems to be working. In August of 2014, the owner of just one of the many stores that openly sold synthetic drugs was convicted and sentenced to 17.5 years behind bars.
Bath salts are yet another drug that continues to weave around the cones of legality when it comes to drug policy. As with many other synthetic drugs, sketchy marketing alone can make an otherwise dangerous substance pass for a commonplace household item. Case in point, bath salts burst onto the drug scene in the 1960s, but reinvented themselves again in recent years being first seized on US territory in 2008. They were routinely advertised as being commonplace substances like incense until the federal ban on the drugs was enacted in 2012 after the drugs were shown to not only claim lives, but also impose severely adverse effects on some individuals.
Between January 2010 and April 2014, 583 bath salt users reported agitation, an elevated heart rate, high blood pressure and hallucinations as side effects. The biggest proponents of a change to drug laws are poor outcomes from the use of certain drugs like those mentioned above. The negative consequences stemming from the use of some substances are always sure to stir the pot enough to see come statutory changes.
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton