Top federal health officials are offering sharp critiques of U.S. drug-criminalization model. They stress how politicizing addiction has fostered an incarceration system that increases the risk of overdose while biasing the research that could reveal both the benefits and risks of substances like marijuana and psilocybin. She also criticised treatment methods that solely focus on abstinence.
Nora Volkow, Director of the National Institute on Drug Abuse and Drug Policy Alliance (DPA), made these comments last month during an appearance at the International Drug Policy Reform Conference. She was speaking on a panel along with Kassandra Frederickique, Executive Director of the Drug Policy Alliance.
One of the discussion points was the dangers of abstinence-only drug treatment rather than meeting people where they are. Volkow stated that the “inflexibility of abstinence only” “costs many lives”.
The official stated that if a person wanted to receive treatment and refrain from using drugs, it was “great” as a theoretical ideal. “But to impose it as a fact for everyone, who have different backgrounds and circumstances is not realistic.”
Volkow said that the U.S.’s policies and strategies to combat drug abuse have “not helped to address the overdose epidemic,” as evidenced by “overdose deaths continuing to increase.”
What it tells is that whatever we are doing is not enough. She asked at the panel “What do we need do to change this?” A recording was made and shared with Marijuana Moment. This polarized, categorical view that you either abstain or we ignore you and send you to prison is catastrophic. It has contributed to a horrifying problem in our nation with horrific deaths like we have never seen before.
She also spoke about how research is increasingly identifying a link between addiction and “adverse social environments”, including cultures that stigmatize drug use. Volkow cited the U.S. prison system as an example of “commercial determinants” that have compounded issues with substance abuse.
What are the commercial factors that influence health? She asked, “What are the commercial determinants for addiction?” She said that there are many commercial repercussions associated with marketing substances such as alcohol and tobacco. But “we have jails, and those are commercial entities.”
Volkow expressed frustration at policies that force medical professionals to report women who are pregnant when they seek treatment for illicit drugs after testing positive. This practice, which she says is common in 50 states and can result in incarceration for five of them, contributes to the rising mortality rate among pregnant women.
These women are in a desperate situation. They are saying, “I wouldn’t have gone [to treatment]”. She said: “I don’t wanna end up in prison, and I would not want to lose my kid.” She repeated the points she made this year in an opinion piece for STAT News. “So, of course, you do not seek treatment and are in a dangerous situation right now. Illicit drug markets. “And that only makes you more desperate.”
When she testifies before Congress about drug policy, the NIDA director tries to make it abundantly clear “you don’t wish to politicize science.”
She said: “Unfortunately, and you saw it during the COVID Pandemic, we’ve seen a horrendous politicization in science. This is very, extremely unfortunate because it negatively impacts everyone, so this permeates many things.” “But my belief is that science should not be a part of the political or ideologic world.”
DPA’s Frederique emphasized, however, the fact that for a long time, politics and ideologies have permeated the types of research being funded on drug issues.
She said, “The type of research that’s prioritized doesn’t happen in a vacuum. Right?” It is determined by what people are interested in, the questions that are asked and who asks them. “I think that part of what we want to engage in and interrogate, is how can we change the questions?”
Frederique explained that research is prioritized, and funding is focused on the harmful effects of drugs. This reflects the drug war mentality which has shaped public policies. Research on “how drugs work in society” or “what ways do drugs help people?” is relatively scarce.
Volkow responded, “I totally agree.” “I think that the notion that drugs are harmful is a very ideological idea. It’s also, in many ways, our role as an institution to understand the effects of drugs.
She said that some people use cannabis, a drug currently illegal, to obtain medical benefits.
She said, “We must investigate these drugs to determine if they are beneficial or not. This information should be made available to the public.” This is obvious in the case of cannabis, but we are also seeing an increase in interest for psychedelics like psilocybin or ecstasy. It is our duty to spread this knowledge.
Volkow said earlier this year that there are emerging signs that psychoedelics have “significant potential” to be used as therapeutic treatments for certain mental conditions. This topic is of “great interest” to researchers.
In 2021, the director told Marijuana Moment that researchers should prioritize psychedelics research because more people will use the substances as a result of studies demonstrating their therapeutic potential.
She argued last year that drug criminalization “created an structurally racist system” where Black people are “treated worse” than other. Volkow spoke about the relationship between drug criminalization and racial bias in 2021. He said that the U.S. was “currently confronting a long history” of discriminatory policies.
In 2021, in a second essay, the official of health reiterated the fact that the federal drug policy is disproportionately enforced against communities of colour . This can increase the risk of deaths from overdose. She did not endorse decriminalization but indicated that this was the best way to combat addiction and overdoses.
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Image by Dima Solomin.
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