The problem of policing illegal drug and substance abuse - Essay Example

?The problem of policing illegal drug and substance abuse ‘Drug abuse on the rise’ is a headline that has been catching our attention quite frequently over the last few years. Today, the pervasive use and abuse of drugs in our society has escalated to rampant extents. No section of the society seems to be immune to this growing menace, not sportspersons, top-level executives, celebs, politicians or police officers. Drug abuse is widespread in all segments of modern society, with a current estimation of 4,396 million users of substances such as cocaine, heroin, alcohol, substituted amphetamines, barbiturates, benzodiazepines, opioids and other synthetic drugs. (UNODC, 2010) Drug abuse, also known as substance abuse, refers to the repeated consumption of a substance or drug in quantities or with means which are injurious to the consumers themselves or to others. This not only causes a wide range of physical, social and psychological damage, but also entails one to criminal penalty. (Fox, 2002) In many cases, it may cause long-term or permanent personality changes as well as lead the consumers to antisocial and criminal activities. (Ray, 2002) Magnitude of Global Drug Abuse In the year 2000 United Nations reported that worldwide there are more than 50 million regular users of morphine, heroin, cocaine and synthetic drugs. (BBC News, 2000) It was also observed that he experimentation with drugs and alcohol was most common amongst the older adolescents. According to a nationwide survey on rates of substance use in the United States, 48.2% of high school students in the US had reportedly consumed an illicit drug during their lifetime, 41.2% of them had consumed alcohol and 19.2% had smoked tobacco. About 21% of them had practised prescription drug abuse. (University of Michigan, 2011) Earlier in 2002, the World Health Organization assessed that nearly 140 million people across the world were addicted to alcohol. (Barker, 2003) Definitions of Drug Abuse The most comprehensive medical definition of the term is provided by the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). The manual defines drug abuse as a "a maladaptive pattern of use indicated by continued use despite knowledge of having a persistent or recurrent social, occupational, psychological or physical problem that is caused or exacerbated by the use or by recurrent use in situations in which it is physically hazardous." It is a situation when “an individual persists in use of alcohol or other drugs despite problems related to use of the substance” and subsequently “compulsive and repetitive use may result in tolerance to the effect of the drug and withdrawal symptoms when use is reduced or stopped”. (DSM, 2000) However, public health practitioners tend to view drug abuse from a broader perspective. Their approach is not restricted to the individual, and rather extends to accentuating the role of society and culture. For instance, the public health model put forward by the Health Officers Council of British Columbia explains a gamut of use, extending from beneficial use to prolonged dependence. The council, in their 2005 policy discussion paper, state that while “beneficial use” of drugs is limited to recreational, casual and medical use that has negligible health or social effects, “chronic dependence” is characterised by routine and compulsive use despite negative health and social effects. (HOC of British Columbia, 2005) Philip Jenkins points out two ambiguous issues related to defining the term "drug abuse". Firstly, he opines that the definition of a "drug" is dubious. For example, GHB (Gamma-Hydroxy-Butyric acid), a naturally occurring compound in the central nervous system of man as well as in wine, beef and small citrus fruits, is considered an illegal drug in many countries. But in contrast, nicotine is not officially regarded as a drug in most countries. Secondly, the word "abuse" suggests an accepted standard of use for any stuff. In most of the Western countries, occasional drinking is often acceptable while drinking several bottles together is perceived as an abuse. But those who staunchly advocate abstinence consider drinking even one glass as an abuse. In some communities, the use of even caffeine or marijuana in any quantity is condemned owing to the fact that the substance is harmful, even in small quantities. (Jenkins, 1999) Hence, the age of the person, the composition of the drug, the situation, the quantity and the reason for consumption are some of the parameters which determine whether a substance is being used or abused. Nature and Typology of Drug Use In recent years, a series of scientific studies have suggested that drug dependence is a multifaceted problem. Its diagnosis and treatment requires the knowledge of multiple disciplines. The use of drugs is the consequence of a complex interaction between an individual’s psychological, biological and environmental factors. Hence, the effective research, prevention and treatment of drug use can be brought about by an application of a multidisciplinary approach. There are some forms of drugs which are used mainly for recreational purposes or amidst definite sub-populations with a particular lifestyle. For example, ecstasy is found more among young people from affluent societies and during events like parties, nightclubs and dance events. The use of such drugs is often associated with the intention to deal with anxiety, to cope up with poor emotional skills, to manage stress and to handle poor involvement in studies or at work. Many studies have revealed a strong link between poverty, social marginalisation and drug dependence. People who come from marginalised segments of the society tend to develop certain medical and psychiatric disorders and often grow into chronic drug users. Adverse childhood experiences such as neglect, poor child-parent attachment, physical assault or sexual abuse can make a child vulnerable to drug use. Such bitter experiences account for majority of the prevalence of cigarette, alcohol and cannabis use, along with violent behaviour in adolescents. (Gerra, 2009) Research also indicates that the prevalence of drug dependence is three times more in individuals with a history of a mental disorder. Patients suffering from bipolar disorder or manic-depressive disorder are more prone to be using psychoactive substances. However, the regular use of psycho-stimulants like amphetamine, cocaine and cannabis can also induce symptoms of psychosis in the users. (WHO, 2004) Misuse of Prescription Drugs The degree of prescription drug abuse is fast surpassing illegal drug abuse on a global scale. According to the 2010 US National Institute of Drug Abuse, seven million people were consuming prescription drugs for nonmedical purpose. (NIDA, 2011) There are diverse sources of procuring prescription drugs for misuse, ranging from family and friends, illegal purchase of medications and locating multiple doctors to prescribe the same medication. Prescription medicines like sedatives, analgesics, anxiolytics and stimulants are nowadays widely used by youngsters for mere mood adjustment or intoxication, overlooking the severe adverse effects caused by an overdose of such medicines. Chronic use of such drugs leads to a transformation in the central nervous system which makes the patient tolerant to the medicine. As a result, more quantity of the substance is needed to create the desired effects and subsequently any effort to stop or lessen the use of this substance leads to withdrawal symptoms. (Antai-Otong, 2008; McCabe, 2009) Trend Analysis of Illicit Drug Use Worldwide, it is assessed that in the year 2010 around 300 million people aged 15-64, i.e. 6.6 per cent of the world’s population in that age group, had used some or the other illicit substance at least once in the preceding year. There were around 253,000 deaths across the world in 2010 among those aged 15-64 due to use of illicit drugs, which accounted for 1.3 per cent of total mortality in that age group. Another alarming fact is that in 2008, almost3 million out of the global total of 16 million injecting drug users were suffering from HIV infection. Again in 2010, some 7.4 million injecting drug users worldwide were infected with hepatitis C and some 2.3 million were infected with hepatitis B. Besides these, there are evidences that non-injecting drug use is also connected with a greater risk of HIV infection, chiefly caused due to unprotected sex. (UNODC, 2010) According to a 2010 report, cannabis is the world’s most extensively used illicit substance. The extent of annual use of cannabis in 2010 ranged from 2.6 to 5 per cent of the adult population in the world. The use of “ecstasy”-group substances on the global scale is estimated at almost 0.2-0.6 per cent of the adult world population. In terms of predominance, amphetamine-type stimulants (excluding "ecstasy") come right after cannabis, with an estimated occurrence of 0.3-1.2 per cent in 2010. Worldwide levels of opioid use in 2010 was projected at 0.6-0.8 per cent of the adult population, of which nearly 50% used opiates, mainly heroin. Global use of cocaine has remained more or less steady at 0.3-0.4 per cent of the adult population. However, there have been some changes in its geographical use, with a significant decline in its use in North America and South America and an escalation in Asia and Africa. (UNODC, 2010) Overall, the prevalence of illicit drug use is more among males when compared to that among females. Amongst high school goers, male students surpass females in the use of cocaine and cannabis in almost all European countries. But, in an exception to this general trend, the use of ecstasy and the non-medical use of sedatives and tranquillizers is more rampant among females than males. In fact, the annual prevalence of such non-medical use among adult and young female populations even outstrips that of cannabis. (UNODC, 2010) Another recent trend that demands attention is the rapid evolution of new psychoactive substances in the drug market. These are nowadays developed synthetically and are known to imitate the effects of drugs. These substances are chemically engineered to remain beyond domestic and international legal controls. In 2010, the use of such substances was reported as an emerging trend in many countries, mainly in Europe and North America. (UNODC, 2010) Drug Policies across the World The governments of different countries across the globe have been attempting to combat the adverse effects of drug abuse on the society and the economy. Governments try to battle against the problem of drug addiction with diverse policies which regulate the market forces of demand and supply of drugs. Measures to cut down demand include prohibition, penalties for drug offenses and imprisonment for persons found guilty of drug offenses. Some of the complementary measures are voluntary rehabilitation or coercive treatment for drug abusers, awareness campaigns and community social services aimed at supporting both the abusers and their families. Policies for supply reduction involve measures such as elimination of the cultivation of plants used to make drugs and culmination of drug trafficking. Also the national governments frame policies which aim at diminishing the harms caused by drug abuse. These include needle exchange programs, drug substitution programs and free drug-testing facilities. (Tannsjo, 1999) Drug laws differ extensively from country to country. Some nations adopt a harm minimisation approach, in which drug laws are fixed with the goal of decreasing the harm caused by drugs and drug policies. However, the United States and the United Nations, who are the key players in the sphere of international drug laws, maintain a code of criminal justice rather than a health-oriented stance. In the last 40 years, subsequent to the global declaration of the “war against drugs”, America has spent more than $1 trillion on the drug war. Millions of people have been imprisoned for drug law violations. Drug arrests have almost quadrupled in the last 25 years. The number of people put behind bars for drug law violations has seen a rise by1100% from 1980 to today. (DPA, 2013) Conviction for drug law violation can cause immense collateral damages to individuals and their families. It may result in the loss of occupation, property, public accommodation, financial aid for studies and even the right to vote. Innumerable lives have been lost to drug overdose and related diseases due to lack of availability of efficient and cost-effective interventions. Yet the practices of drug addiction and misuse are more widespread today than ever. Despite the efforts undertaken by the police and other anti-drug organizations all over the world, people have not stopped using drugs. In acknowledgment of this fact, many agencies today function within the frameworks of harm minimisation. The harm minimisation approach does not ignore drug use, but instead refers to programs intended to check and decrease the harm associated with the use of drugs. It includes supply reduction, demand reduction and harm reduction strategies. This approach looks forward to curtailing the harmful effects of drugs on the individuals and communities, while at the same time sustaining a balanced network of supply reduction, demand reduction and harm reduction tactics and strategies. Supply reduction strategies are meant to unsettle the production and supply of illicit drugs and to bring control and regulation of permissible substances. Demand reduction strategies aim at inhibiting the acceptance of harmful drug use and include some abstinence orientation programs to diminish drug use. Harm reduction strategies are framed with the intention of alleviating drug -induced damage to individuals and communities. (CDC, 2002) Problems associated with Drug Laws Drug and substance abuse is a global problem prevailing in the international market. Unfortunately, there is currently a deficiency of research competencies and data requirements on a worldwide scale, which is hindering the development of a scientific base for framing a rational drug policy. While the efforts to regulate the supply of drugs in poor countries have not been fruitful, in many cases they have even led to undesirable consequences. As a result, the current assortment of drug-specific policies is not charted logically from the harm caused by different substances. Majority of them carry approaches based on the detention and confinement of drug users and have negligible effects on whether the vulnerable class of youngsters initiate and continue the use of illicit drugs. Such policies do not seem likely to achieve their proposed objectives. Drug policies should therefore be beheld with a sense of caution and investigation. The authorities must consider both legal and illegal drug markets during the formulation of drug policies. Evidence-based programs should be expanded in order to treat drug users as this can be a cost-effective method to diminish drug-related damage. Conclusion Nonetheless, there are numerous cases where drug policies have shown positive results. But the concerned authorities need to understand that there is not just one drug problem within or across countries, nor is there any one panacea that will solve the drug problem. They must remain watchful of the diverse ramifications of this complicated issue in their respective zones and figure out the best way to deal with the specific manifestations of drug and substance abuse. The best solution is to continue trying new approaches that move in this direction. We have examples from all over the world that display progress and offer opportunities for improvement. So instead of setting a single exclusive model for success, we should rather look at the diverse procedures for ideas as we together work towards comprehensive reform. REFERENCES Fox, C. (2002). Drug abuse definition, Mosby's medical, nursing and allied health dictionary, Canada: Mosby Elsevier Ray, O. S. & Ksir, C. (2002). Drugs, society, and human behavior. Boston: McGraw-Hill. World Drug Report. (2010). UNODC, retrieved on December 8, 2013 from: http://www.unodc.org/documents/wdr/WDR_2010/2.1_Unterstanding_the_extent_and_nature_of_drug_use.pdf American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. American Psychiatric Pub. A Public Health Approach to Drug Control in Canada (2005) Health Officers Council of British Columbia, retrieved on December 8, 2013 from: http://www.cfdp.ca/bchoc.pdf McCabe, S.E. & Boyd, C.J. (2009). Subtypes of nonmedical prescription drug misuse, Drug Alcohol Depend, 102 (1–3): 63–70. Antai-Otong, D. (2008). Psychiatric Nursing: Biological and Behavioral Concepts, Canada: Thompson Delmar Learning. Topics in Brief: Prescription Drug Abuse. (2011). National Institute of Drug Abuse, retrieved on December 8, 2013 from: http://www.drugabuse.gov/publications/topics-in-brief/prescription-drug-abuse Jenkins, P. (1999). Synthetic panics: the symbolic politics of designer drugs, New York: NYU Press. Johnston, L. D. (2011). Monitoring the Future national results on adolescent drug use: Overview of key findings, 2010. Institute for Social Research, The University of Michigan. Barker, P. (2003). Psychiatric and mental health nursing: the craft and caring. London: Arnold.  The Global Drugs Trade. (2000). BBC News, retrieved on December 8, 2013 from: http://news.bbc.co.uk/hi/english/static/in_depth/world/2000/drugs_trade/default.stm Gerra, G. (2009). Childhood neglect and parental care perception in cocaine addicts: Relation with psychiatric symptoms and biological correlates, Neuroscience and Biobehavioral Reviews, 33, pp. 601-610. Neuroscience of psychoactive substance use and dependence. (2004). World Health Organization, Geneva Tannsjo, T. (1999). Coercive Care: Ethics of Choice in Health & Medicine, New York: Routledge Drug Laws and Drug Enforcement Around the World, Drug Policy Alliance, retrieved on December 10, 2013 from: http://www.drugpolicy.org/drug-laws-and-drug-enforcement-around-world Policy Issues and Challenges in Substance Abuse Treatment. (2002). CDC, retrieved on December 10, 2013 from: http://www.cdc.gov/idu/facts/PolicyFin.pdf Read More