You can get garden variety health advice from the daily newspaper, the "health" section of most book stores, and of course thousands of web sites. I'm hoping to present thought provoking and maybe change provoking thoughts about individual and community health. This blog is not just what to do about health, but how to think about it. I'm looking forward to an exchange of ideas with readers. July, 2010


Tuesday, July 20, 2010

Drug Abuse Doldrums

For most of my now upper middle-aged life, there has been a war on drugs in this country. It has been book-marked by a war on poverty and a war on terror. None has really worked out. Maybe we should declare a war on wars, except for the old fashioned kind - boots on the ground, shoot when you see the whites of their eyes. President Obama has hardly mentioned drug abuse of the illegal version, except perhaps the drug battles spilling over the border from Mexico. He certainly hasn't spent any time talking about what I think is our biggest drug problem, alcohol abuse. And, he is not a champion for reducing tobacco consumption because he seems to struggle with a smoking addiction himself.

I don't necessarily fault him for this silence. The nation is preoccupied by fairly daunting challenges: two wars, near collapse of the financial system, high unemployment, a dysfunctional Congress, a petro fouling of the Mexican Gulf, 13 million illegal aliens, and continuing threats to national security from terrorist organizations. In addition, the President has to walk the dog and check the kids’ homework. All in a day’s work when you are the leader of the free world. While the toll taken by drug abuse has continued unabated, other problems have taken on greater importance and garner more of the nation’s attention.

However, I think there is something else going on. A couple of decades back, the firm resolve of presidents and PTA officers in the face of the “menace” of drugs was accompanied by great optimism. People believed that drugs could be stopped. With enough grit, energy, and investment, we would have drug-free schools and communities. After all, the U.S. wins wars, and we will win this one as well. Forty years in, people have become cynical and burned out. So many programs have been ineffective, and billions of dollars have been spent, with good intentions, but with no results. Abuse of alcohol, tobacco, and other drugs has waxed and waned, but the trends have been mostly unrelated to what governments and community groups have been doing to bend the consumption curve.

From time to time, people ask me what works in drug abuse prevention. “Works” is a loaded word, because it implies that there is something which might really have a huge impact on adolescent and adult drug abuse. Would that were true. In fact, our only chance of bringing about a less drugged citizenry is a combination of small initiatives, none of which makes much difference by itself, but as a package has some promise. This is not being done in any substantial way, but instead we rely on school-based education, which is mostly ineffective, and we put people in jail, which has mostly made these problems worse.

Perhaps in some future time and with some future President, the stars will line up so that White House leadership might be the missing piece to bring us around to efficient and effective approaches to this problem. Even then, don’t hold your breath.

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