Focusing on abuse, not use: A proposed new direction for US drug policy

Abstract

How professionals and societies deal with drugs and drug consumption is premised on how abuse is defined. The “War on Drugs” approach promotes the belief that “any use is abuse” where the currently illicit drugs are concerned. Regrettably, any distinction between use and abuse has been notably absent from most public policy decisions on drug issues. Even a cursory review of both supply and demand reduction policies of the past century reveals a startling lack of awareness of this distinction. The failure of differentiation undermines prevention, treatment, and the criminal justice system. Treatment, thus, tends to show a bias toward ineffective models such as “boot camps” and “tough love”. It has contributed to controversy over maintenance treatments, such as methadone, buprenorphine, and heroin, which have proven to be highly effective for some addicted persons. It leads to treatment options for the addictions being far more limited and constrained than is typical in other areas of health care. Admittedly, studying non-problematic drug use has been a challenge, but clearly the use of illegal drugs is often not harmful, any more than is moderate alcohol use. Addiction is a fatal disease for some and that disease should be the focus of our policies.