-International Affairs Vice President of PRIDE Youth Programs,
Leads drug prevention and leadership training teams for youth and adults worldwide, especially for youth in North and South America; Chief evaluator for PRIDE Youth Programs prevention activity in U.S.
-President of Evaluation Solutions, a research firm that evaluates program effectiveness for government and private foundation programs.
-Member, International Drug Strategy Task Force of the Drug Prevention Network of the Americas. Author, advisor, and educator for worldwide drug prevention and policy issues - special expertise include youth leadership development, prevention education, drug enforcement, the drug culture, and issues surrounding drug legalization.
-Government - Agency director (drug czar) for all drug prevention, education, treatment, and law enforcement in Michigan for Governor John Engler.
-Special assignment - U.S. Department of Justice in Washington, D.C. during President Reagan’s Administration and was the lead resource for the drug prevention efforts of the US Attorneys nationwide.
-Senior deputy attorney general in Pennsylvania, work on behalf of the states incorporated into the nation’s drug strategy by three U.S. Presidents.
-Chief, intergovernmental affairs for the district attorney of Buffalo, New York.
Contents (click on the respective article):
1. PRIDE Youth Programs
2. A New Global Approach to Reduce Drug Demand – Rooted in Hope, Growing with Success
(Compiled by Robert Peterson On behalf of the International Task Force on Strategic Drug Policy in collaboration with Drug Prevention Network of the Americas and Drug Free America Foundation, Inc.)
1. PRIDE Youth Programs
Perspective is Important
Working with youth and drug prevention in our own nation and others, especially in South America, the very question posed by this hearing, “Is there a such thing as safe drug abuse?” underlies the confusion and mixed messages that concepts such as harm reduction promote.
A lady from Peru who runs a tremendous program for street children and orphans said that she explained to the youngsters that she was leaving to attend a conference on how to counter the drug legalization movement. The children asked her what she meant, and when she explained, a young child asked, “You mean there really are people who want to make dangerous drugs available and legal,” the child concluded: “then the world really has gone crazy hasn’t it?
I will admit my bias right off. I have six children and I work with youth worldwide. I coach girl’s basketball. The lens through which I view drug policy puts kids first. I once heard that in a perfect libertarian world, there are no children. Children mean that we are our brothers’ keeper and that we have to sacrifice some of our own “rights” in the interest of those more vulnerable. I believe that the chief criteria for any drug policy should be what impact the policy will have upon youth and families.
What is the “drug problem?”
It is important that we all acknowledge our world view. One’s definition of the “drug problem” depends on one’s perspective. For the pre-born and for infants, parental drug use is the issue. Pre-natal damage, born addiction, child abuse and neglect are all caused by drug abuse. During the crack epidemic in Philadelphia it was estimated that the drug was involved in 80% of child abuse cases and in half of all child abuse fatalities . Less than 3% of the population used the drug regularly.
For younger children, parental drug use is also the issue. Neglect, abuse, and accidents are all caused by drug use. Whether the drugs come to parents through street dealers or government run drug maintenance clinics makes no difference to the young. Intoxicated and doped parents do not make for good caretakers.
For teens the number one cause of death is accidents. Once again drug use, including alcohol, plays a strong role. Those who say cannabis never killed, ignore the number one killer of youth – accidents. A Maryland study of emergency trauma injuries showed as many marijuana positive as alcohol positive and the use of both drugs together was highly evident. A study of national truck driver fatal accidents provided similar findings.
For young adults drug use is the main threat that they face. Date rape, violence, accidents, and suicide are all highly correlated with drug use. Ask any group of young ladies if they have ever been harassed by an intoxicated male and see what response you receive. Drug users impact non-users in many negative ways.
For non-drug using parents, drug use is also the primary problem. Parents fear for their children and most desire that their youth avoid drugs and drug intoxicated users.
For all of these groups, drug use is the drug problem. The chemical make up of drugs and the effect of drugs on the brain do not change. It does not change if drug use is maintained by the government, health workers or street drug dealers. The late Dr. Robert Gilkeson used to say, “You cannot vote for or against the chemical properties of a molecule.”
What can change is the amount, acceptance, and the ease of drug use and the identity of who is to be held responsible for the damage. The provider of drugs is an accessory to the risk, death, and damages caused by drug use. No child wants a stoned parent.
The Harm Reduction Origin
Did those working with children and youth develop the harm reduction concept? Obviously not. Let us consider the origins and impact of modern “harm reduction.”
Harm reduction is not a new concept, although the terminology was carefully chosen as a marketing ploy. On audio tape, drug legalization groups held entire conference sessions to decide on a term to promote their cause in the 1980’s and early 1990’s. Leaders clearly stated that they need a term to replace the “L” word. The term “harm reduction” was, to my knowledge, first selected and promoted in 1987 by a group of drug lawyers meeting in Great Britain sponsored by the drug legalization group – the Drug Policy Foundation. This group was later merger into the George Soros backed Drug Policy Alliance. The term “Harm reduction” ran a close second with the term “harm minimization” to avoid the “L” word: “legalization.”
Those tied in with legalization groups who take credit for the harm reduction term include Peter McDermott who wrote: “as a member of the Liverpool cabal who hijacked the term Harm Reduction and used it aggressively to advocate change during the 1980’s, I am able to say what we meant when we used the term…..Harm reduction implied a break with the old unworkable dogmas – the philosophy that placed a premium on seeking to obtain abstinence.” He then goes on to discuss the need for a legal supply of clean drugs and injection equipment.
The most important criteria for measuring drug policy of those who developed the concept of harm reduction and drug maintenance was what impact drug policy will have on the right that they, and other consenting adults, have to use drugs. Timothy Leary, the LSD guru of the sixties who was eulogized by many leaders of the harm reduction movement, wanted a constitutional amendment that read” Congress shall not infringe upon the right to alter one’s consciousness.”
The founder of the oldest marijuana smokers’ lobby, the National Organization to Reform Marijuana Laws (NORML) originally wanted legal cocaine and pot, with no age limits, according to a Playboy interview. At least this group admitted it was a lobby for marijuana users.
To civil libertarians and some drug users the drug issue is centered upon the “rights” that they and other individuals have to use drugs. The leaders on the issue knew that their right to use drugs issue would not sell with the public and appear somewhat selfish. They needed to promote it as being in the interests of others. Smartly, they avoided the issue of children and youth.
The “Black Blessing”
Ethan Nadelmann, the chief architect behind the drug legalization and harm reduction and drug “reform” movement backed by George Soros, identified AIDS as a “black blessing.” The AIDS issue could be used to promote the legalizers’ agenda and disguise their self interest as compassion for others.
Why do I say this? First of all, the Drug Policy Foundation and NORML audio taped many of their conferences and I have heard the tapes. It is Mr. Nadelmann who used the term “black blessing” and the legalization strategy was widely discussed.
NORML founder Keith Stroup called medical marijuana a “red herring” to get the drug legal. Others talked about medical marijuana and needle exchanges as steps to their true goal of drug legalization. Why is every major international harm reduction lobby supported by those who seek wider drug liberalization and acceptance? For example, the Harm Reduction Coalition had former NORML President Kevin Zeese and Soros funded advocate Marsha Rosenbaum on the board.
There is a proverb “where a man’s treasure is, there his heart lies.” The major funders and supporters of harm reduction and drug legalization have no history promoting or funding health care, medicinal research, and or treatment for AIDS or drug addiction, other than supporting needle exchanges, drug injection sites, drug maintenance, and marijuana distribution. If compassion for AIDS was really the issue, why isn’t their funding going into providing proven medicines and research for new drugs? If care for addicts was the issue, why do these groups not put funding into effective drug treatment? Why do the top treatment providers disagree with their approach?
One thing is certain; the interests of youth and children were not at the core of the harm reduction philosophy.
This does not mean that everyone who now promotes harm reduction is a closet legalizer. Although nearly all of the major international lobby groups promoting harm reduction and needle exchange are funded by George Soros and legalization proponents, many in the health field, and in politics, have been taught that this is a positive public health concept. Some are not aware of these origins and support it because they are compassionate and care.
Making Drug Peace
Harm reduction is based upon two basic presumptions. The first is that the drug problem cannot be solved so we must accommodate and accept drug use, minimize the costs of use, and learn to live with drug use. As the legalizers put it, we must “make drug peace.”
This sounds logical given the persistence of the problem over the past 40 years. But what about racism, hate crimes, pollution, AIDS, violence, child and spouse abuse, sex abuse, poverty, and ignorance? These problems persisted for far more than 40 years and we do not give up and accommodate them. Drug use among youth has been cut in half in the U.S. over the past 25 years. Has as much progress been made with these other social problems?
Next, what about the children? If we accept and accommodate drug use for some children, whose children will they be? If we give up on some addicts and maintain their drug slavery, who will the parents and children of those addicts be? Can we give up when there is no place to retreat to?
Third, history demonstrates that drug problems can be solved. The U.S. faced record drug addiction and use rates when marijuana, cocaine, and opiates were legal in the early 1900’s. Medical distribution (a form of harm reduction now being promoted) of these drugs failed to curb the epidemic. Instead of harm reduction and drug acceptance, drugs were outlawed in 1914. Public education, prevention aimed at youth, and treatment were implemented and from 1914 to 1940 addiction dropped from 250,000 to 50,000 and crime plummeted. By 1960 drug use was nearly non-existent. Consider other nations success.
Sweden: Amphetamine epidemic in the late 1970’s
Improvement: Student drug use cut in half by 1987
Successful Policy: tougher laws, mandated treatment, drug testing, and public education.
Japan: Amphetamine surge after WWII and a heroin problem in the 1960’s
Improvement: Drug use and addiction cut dramatically
Successful Policy: strong enforcement, rehabilitation, and public non-acceptance of drugs.
China: Major national opium addiction problem
Improvement: Opium use and addiction cut to negligible levels
Successful Policy: public education, rehabilitation, and strict law enforcement.
United States II: Drug use rise to world record levels 1965-1979; marijuana epidemic followed by cocaine epidemic and crime rise; heroin problem in 1970’s;
Improvement: Youth drug use cut in half since 1979; addiction rate growth halted; steady long term crime drop.
Successful Policy: Prevention and education; treatment; drug testing; enforcement
Is Drug Use, Drug Abuse?
Second, harm reduction presumes that drug use is not always drug abuse and that drug use is not the primary cause of drug related harm. This argument generally is promoted from the perspective of compassion for the drug user and addict.
Is drug use, drug abuse? The United Nations defines illegal drug use as drug abuse. The clinical rationalization for this is that illegal drugs are nearly always used for the purpose of intoxication, unlike tobacco and alcohol. When alcohol is always used to get high or drunk, treatment experts identify the user as an abuser. Marijuana, cocaine, heroin, and other drugs are used to get stoned. Use is abuse. Those who use a substance to get stoned or drunk are more likely to develop addiction and other problems.
Is Drug Use the Problem?
Does drug use cause most drug related harm? Intoxication impairs human reason and physical coordination and ability. Intoxicated persons are a risk to themselves and to others. Drug use is the cause of most drug user harm. The ability and responsibility to engage in safe sexual practices, to decide on whether to share needles or to commit crime, to practice good hygiene and nutrition, to ensure public and personal safety, and to provide good child care are all impaired by drug use.
In Michigan a young baby died ingesting the mother’s take home weekend methadone dose, a harm reduction concept. The harm reductionist promotes this as a means to reduce the harm to addict’s going out to seek a weekend fix. The baby’s interest was not an issue. Mothers high on methadone are not responsible caretakers. The government provided the weekend dose. Who is responsible for the baby’s death?
There is no safe illegal drug use. Drug use intoxicates and intoxication impairs reason and increases the risk and/or harm to self and others. Many needles never find their way back to exchanges and there are documented cases of children being pricked by needles left on the street and in parks. Responsible behavior and drug intoxication have an inverse relationship.
Studies show that most HIV among drug users is contracted through unsafe sex, not unclean needles. Drug use is highly correlated with unsafe sex practices, violence, and suicide. Overdose deaths also are caused by the effects of drugs, not the source of the needle used. Young addicts have an 8 fold likelihood of an early death related to drug use, not needle source.
Drug addiction is a form of slavery regardless of where the needle came from. Drug addicts lose will and impair their reason, the very properties that distinguish human dignity and freedom. To maintain drug addiction is to maintain slavery. The very chemistry of the brain is altered by addiction. For the addict, drug use is the problem, indeed drug use is their life obsession.
If your son or daughter was out of control and slowly poisoning their mind, body, and soul should the government response be to provide a free method to ingest the poison?
What is in the interest of children with drug addicted parents?
True compassion to drug addicts and their families is to provide aggressive outreach for treatment and rehabilitation eventually leading to a life free of drug use and addiction. It is unethical to accept addiction, provide needles, and fail to promote treatment and rehabilitation. The criminal justice system is often the number one source of drug treatment referrals. Legalization will cost addicts their lives. Forced treatment has saved lives as President Clinton’s brother testifies. Children want their parents back.
The best studies used to support needle exchange impact combine drug treatment, outreach, and counsel with the exchange program. Treatment and outreach without needle give outs have been equally effective. There is sparse evidence that the needles component is needed or effective. There is ample evidence that treatment and rehabilitation can be effective without needle exchange.
Does Harm Reduction Benefit the User?
Even if the focus is on the interests of drug addicts and not children, does harm reduction benefit the user? There is no convincing evidence that HIV or hepatitis is reduced by needle exchange and conflicting evidence that HIV and hepatitis and overdose deaths may be increased by such programs. The Swiss needle park experiment, with open drug use and needle exchange resulted in Europe’s highest HIV rates and record crime. They park was shut down. I will leave it to the references cited herein to demonstrate the failure of needle exchanges to reduce drug harms.
Needle exchange and drug maintenance sends a clear message to addicts that their drug slavery is acceptable and supported by society. Implicit is the message that society gives up on them and that they will never be free. The message is “here, take your drugs where it will reduce the harm caused to the rest of us and die addicted.”
Does Harm Reduction Cause Harm?
The message to youth is even worse. Drugs are a legitimate choice supported by government and society. After all, would the government and responsible adults legitimize drugs and provide the instruments and substances of addiction if it was wrong?
The history of harm reduction demonstrates that the policy hurts youth, the public, and drug addicts and users.
The U.S. tried medical distribution of cannabis, cocaine, and opiates in the early 1900’s and addiction and abuse was not abated. Laws were passed making the drugs illegal and treatment and education efforts were implemented to reverse the epidemic.
In 1979, harm reduction was brought to schools and “responsible” drug use was taught. Thirteen states decriminalized marijuana with White House support. Law enforcement was minimal zed. The result was world record drug use rates among youth with one in ten high school seniors stoned on marijuana every day of the week.
Stricter drug enforcement, prevention, and treatment led to a dramatic drop in youth drug use (cut in half) and halting the addiction growth rate. Youth drug use rates continue to drop in the U.S. as they are rising in Europe and Canada where harm reduction policies are replacing drug prevention.
In Europe, nations implementing harm reduction have worse drug problems that those rejecting such policies. Spain, in 1983 went from having some of the toughest laws to some of the weakest. A spurt in drug use and crime continues to this day. Spain promotes harm reduction and now has the highest cocaine use rates in Europe.
The Netherlands continues as a drug and crime haven for Europe. Drug use among youth climbed as it dropped in the U.S. Drug cafes rose ten fold in a decade. Drug violators make up half the prison population. The junkies union sued to defeat a proposal to tax drugs so no drug revenues are raised and addicts are supported by state welfare. The Dutch tried licensed heroin distribution but scrapped it after a spurt in crime and overdose deaths.
Switzerland and Great Britain also have liberalized drug policy and opted for harm reduction over prevention. Drug use rates among youth and adults are very high in these nations and increasing. Great Britain tried heroin maintenance years ago, and it resulted in a large black market in the substance. The policy was reversed.
Italy rescinded soft heroin laws due to record addiction rates and overdose deaths and has rejected harm reduction. The drug problem is lower there than in other European nations.
Sweden drug use rates are generally low in Europe and harm reduction is rejected there.
Harm Reduction Impact on Drug Prevention
The major threat to youth of harm reduction is its impact on drug prevention. Harm reduction and drug prevention can never be partners. The United Nations drug term definitions clearly states that harm reduction is not prevention. Harm reduction rejects preventing drug use as a primary goal of drug policy and rejects drug abstinence as the primary goal of drug treatment.
Nations that adopt harm reduction as their centerpiece, reject drug prevention as their primary goal even thought the United Nations agreed that drug prevention is an “indispensable pillar” for drug policy. Preventing all drug harms is not the same as reducing drug harms for some. Only prevention can eliminate drug harms.
For 30 years there has been a direct and drug specific inverse correlation between youth drug use and youth perception of drug harm and risk. Every year that perception of rug harm dropped, drug use increased. Harm reduction downplays the risks of drug use, reduces perceived risk of harm, and claims that drug use can be made “safe.” In Canada “safe” crack use kits are being demanded by addicts.
Harm reduction organizations promote a return to the failed U.S. policy of the late 1970’s that taught “responsible” drug use. Marsha Rosenbaum, a Soros funded West Coast reformer if promoting teaching harm reduction lessons to youth. A leading school book by Ruth Engs in the 1970’s, entitled “Responsible Drug and Alcohol Use,” told youth to clean out seeds from marijuana so they do not pop and to use a roach clip to avoid burning fingers. Drug use rates were never higher than in 1978-79 when this education peaked.
Pat O’Hare, another member of the original “Liverpool cabal” who “hijacked” the term harm reduction called 12 step drug programs complete crap and asked: “if kids can’t have fun with drugs when they’re kids, when can they have fun with them?” Another leader, Julian Cohen states that primary prevention ignores the fun, the pleasure, and the benefits of drug use …. Drug use is fun for young people and drug use brings benefits to them.”
It is clear that preventing drug use and teaching how to use drugs are not compatible nor complimentary. No nation has ever lowered drug use and drug problems through a harm reduction approach.
From the Mouth of Babes?
Let me return to the subcommittee’s original query. Is there a such thing as safe drug use? I believe the child in Peru is right, only if the world has really gone crazy.
Human dignity and liberty is based upon human free will and reason. We cannot act, think, and choose fully as persons when our capacities are impaired. The user and non-user are both endangered by impaired persons. Children and youth often suffer the most dire consequences.
The ability to interact, communicate, and relate to loved ones and others also is impaired. Drug use breaks down the ability to live in community and family. Drugs impair the ability to make safe decisions on child care, driving, sexual and other behavior, and private and public safety.
Accepting drug use and addiction is an accommodation of chemical slavery and impairment. It is not compassion to enable drug use. The Vatican noted in its statement against drug injection rooms and harm reduction that “drug dependence is against life itself.”
The young people that I have had the privilege of meeting in the U.S., Brazil, Chile, Argentina, and Uruguay are optimistic and caring. They are reaching out to other youth with a positive message of a drug-free life. Harm reduction undermines their work and their hopes.
Harm reduction is a philosophy of despair communicating a lack of hope for the addict, their loved ones, and society. It is a message of surrender and accommodation.
Prevention is a positive message of hope that is not just against drugs, but for life. History, science, and human experience gives every reason to continue hoping and to continue fighting.
2. A New Global Approach to Reduce Drug Demand – Rooted in Hope, Growing with Success
(Compiled by Robert Peterson On behalf of the International Task Force on Strategic Drug Policy in collaboration with Drug Prevention Network of the Americas and Drug Free America Foundation, Inc.)
"Drugs destroy lives and communities, undermine sustainable human development and generate crime. Drugs affect all sectors of society in all countries, in particular drug abuse affects the freedom and development of young people, the world’s most valuable asset. Drugs are a grave threat to the health and well-being of all mankind, the independence of States, democracy, the stability of nations, the structure of all societies, and the dignity and hope of millions of people and their families."
Special Session of the General Assembly Devoted to Countering the World Drug Problem Together, 8-10 June 1998: Political Declaration; Guiding Principles of Drug Demand Reduction; and Measures to Enhance International Cooperation to Counter the World Drug Problem.
I. ROOTED IN HOPE
In 1998 member nations of the United Nations agreed to a 10 year goal to reduce worldwide demand for drugs by the year 2008 through both demand and supply reduction initiatives. Prevention guidelines were issued and a five-year UN review session was held in 2003. To reach this goal and to move beyond 2008, a solid plan of action based upon proven research must be cooperatively implemented.
Drug prevention was declared a fundamental pillar of the United Nation’s drug strategy. Prevention is a long-term ongoing process. Funds and programs require continuity and long-term resources to work. Governments and the private sector must make long-range plans and commitments.
Nations agreed to “pledge a sustained political, social, health and educational commitment to investing in demand reduction programs” in the United Nations Declaration on the Guiding Principles of Demand Reduction. Nations were further urged to “demonstrate commitment by allocating sufficient resources to demand reduction …” in an April 15, 2003 Committee on Narcotic Drugs resolution.
In addition, the private and non-governmental sector must help. Businesses and philanthropic foundations should invest in drug prevention.
A. Global Leaders Choose Prevention; Reject Accommodation
In establishing the goal to reduce drug demand, world members were faced with two alternative approaches to the drug issue. A pro-active and united mission to prevent and reduce drug demand could be undertaken, or a position of surrender and accommodation which would accept drug use and only attempt to manage the widespread damage.
A position of hope, based upon evidence and science, was decisively taken. Recognizing the realities and complexity of the drug problem, the global response was comprehensive and balanced. Drug prevention was declared a fundamental pillar of the strategy to reduce demand. Prevention was declared “indispensable in solving the drug problem.”
The alternative approach rejected was one of pessimism, accommodation and surrender. In place of preventing and reducing drug use, this position accepts and enables drug use while attempting to exert limited control over some of the harms associated with select externalities related to such use.
The basic premise is that there is no hope and that society should stop trying to prevent and reduce drug use. While often masked in compassionate or clinical sounding terms, this alternative accepts and enables the chemical enslavement of a proportion of the world population.
The International Task Force on Strategic Drug Policy rejects the more pessimistic view and wholeheartedly agrees with the world community and the United Nations. Drug problems can and must be prevented and treated. There is hope, and together we must reduce drug demand and create a safer and better world for our citizens, and especially our youth.
The United Nations’ call for a balance of demand and supply reduction strategies is necessary to reduce drug demand. This document focuses on global demand reduction strategies but recognizes the vital role of supply reduction to disrupt drug markets through cooperative interdiction, eradication, enforcement, precursor chemical control and financial controls.
B. “Harm Reduction” Does Not Reduce Drug Demand
The UN definition of demand reduction notes that demand reduction is “separate and distinct” from harm reduction. Nations cannot meet their international and treaty obligations to reduce drug demand through so-called “harm reduction” initiatives.
Prevention is the only proven method for reducing and avoiding substance abuse. When drug use is prevented, drug related harms are eliminated. Efforts that merely seek to reduce certain harmful externalities of drug use, often termed “harm reduction,” are not demand reduction initiatives as they do not aim at, nor do they succeed in, reducing the demand for drugs.
Social policies built around harm reduction inevitably ignore or accommodate drug use and focus only on the limited harms to some caused by its use. Harm reduction strategies can undermine and contradict drug prevention messages to society and youth.
Resources expended on harm reduction do not contribute to drug prevention or demand reduction efforts. If utilized, the use of harm reduction strategies closely linked to proven abstinence-based treatment programs should be but one small part of a comprehensive treatment outreach strategy. Care must be taken to ensure that these programs follow the United Nations’ definition of being “separate and distinct” from demand reduction efforts.
To meet international drug demand reduction goals, drug prevention should be given resource priority. Nations were urged to “demonstrate commitment by allocating sufficient resources to demand reduction …” in an April 15, 2003 UN Committee on Narcotic Drugs resolution.
Policies can be implemented to ensure that precious demand reduction resources are not diverted to harm reduction programs. Existing harm reduction resources can be redirected to more positive and proven drug prevention practices to meet international goals for demand reduction.
C. Science Supports Prevention
A position of hope and positive action is more than an optimistic viewpoint or wishful thinking. Scientific research and historical evidence and experience clearly demonstrate that there
is reason to hope and that drug use can be reduced and prevented. Evidence also demonstrates that a negative mentality and accommodation of drug use does not reduce drug use or drug problems.
Although world drug consumption has climbed, there are nations that have dramatically reduced drug use and reversed drug epidemics, especially among youth. Within nations there are communities that have reduced drug problems even as other areas have had drug problems increase.
Researchers and prevention experts now can supply scientific evidence identifying what works and reveal methods to achieve success reducing drug demand. While each nation, culture and community differs, there are cross-cultural universal principles that can be applied.
II. GROWING FROM SUCCESS
To reach the United Nations’ goal for reducing drug demand by the year 2008, new positive and proactive practices and policy must be initiated. The knowledge and lessons learned must be applied with renewed creative energy and dedication.
A. Build Upon Success
Society must work smarter and not just try harder. Pessimistic approaches and accommodation must be rejected. Every policy and practice must communicate a message of hope that does not leave any person or nation behind.
Building upon the experience and work of the United Nations, global regional drug coordinating organizations and five world drug conferences, the International Task Force on Strategic Drug Policy of experts from around the world have put together a plan to advance drug policy and programs into the future. Grounded in hope, this plan takes our knowledge base, science and experience into the future to meet the goal of reducing drug demand.
Every drug policy and practice must communicate a message of hope that does not leave any person or nation behind, users and non-users alike.
IV. DRUG USE DRIVES DRUG DEMAND
The major root of the drug problem, and the one that drives drug supply, is drug demand. Without a worldwide demand for drugs, the drug traffickers and producers would disappear. Fifty years ago, if one dropped a ton of cocaine on the streets of most major cities of the world, the street cleaners would be called out and the drugs would be swept in the gutter. Today, drug users and sellers would cause chaos. This demonstrates that the culture of values and goals drives demand more than any other single factor.
There are those who argue that drug policies and laws are themselves the main drug problem, and that drug use is not the major issue. This false theoretical view disintegrates when one views the drug problem from the perspective of the common citizen or child.
Fifty years ago, if one dropped a ton of cocaine on the streets of most major cities of the world, the street cleaners would be called out and the drugs would be swept in the gutter. Today, drug users and sellers would cause public chaos.
A. Drug Use Causes Most Drug Problems
Illicit drugs are used for the purpose of intoxication. Using legal drugs solely for the purpose of intoxication is a form of drug abuse. UN drug conventions define any consumption of a controlled substance [without a doctor’s prescription and as prescribed] as abuse.
Drug use intoxication is highly correlated with accidents, crime, violence, public nuisance, poor academic and work performance and other behaviors that infringe upon the rights of both users and non-users.
Even first time drug use, especially by risk tolerant and developing youth, increases the risk of harm to self and others.
In many nations accidents are the leading cause of death of teens and young adults. The abuse of alcohol and use of marijuana are major contributors to accident related death and injury of youth and adults.
Those who use a substance to seek and enjoy intoxication also are at higher risk of addiction and compulsive use.
1. The Individual
For the ordinary citizen, it is drug use that causes the most serious problems related to these substances. When drugs come into individual lives and begin to take over those lives, individual will and reasoning power is impaired or destroyed, and individual dignity is lost. Because each individual is interdependent, the damage caused impacts all of society. While many claim a “privacy” right to drugs, the cost and damage from drug use is very public.
2. The Family
The basic unit of society, the family, is the first to suffer. Divorce, abandonment, poverty, child abuse, spousal abuse, fetal injury and addiction, runaway children, accidents, illness and disease, neglect and family dysfunction are all highly correlated with drug use. Physical, behavioral and emotional damage also can be caused by drug use.
3. The Community
Drug use has a major impact on many communities, especially related to public safety and order. Human rights are taken from innocent citizens when open drug use and drug dealing markets arise unchallenged. Crime of all types rises as drug impairment levels rise, and a public nuisance and health hazard is created. Public resources must be diverted for rehabilitation and street control of the problem. The entire educational system is drained of resources to deal with the negative behavioral and academic impact of drugs.
4. The Economy
Economic ills such as unemployment, workplace illness and injury, accidents and lost productivity also are highly correlated to drug use. In many areas of the world, poverty and a poor economy are facts of daily life; however, drug use ensures that these situations will never improve and only increase the misery, suffering and difficulties faced.
5. The User
a. Non-dependent users –
Traditionally, people who used drugs in variable amounts or frequencies but who did not fulfill the criteria for addiction, were labeled as “recreational” or “experimental” drug users which caused little harm to the community. This labeling must be rejected since it conveys that drug use is akin to a simple, harmless activity like tennis or stamp-collecting.
Instead, the “non-dependent” user, who does not perceive consequences of his drug use, acts as a model for his peers to follow. This situation is extremely problematic because although consequences may not always be evident immediately, non-dependent users serve as a reservoir for addiction and do demonstrate behaviors damaging to themselves, others and the community. Non-dependent users must be intervened on before their harmful behavior matures into disease.
b. Dependent users and addicts –
Dependent users and addicts, who by definition are severely injured by drug use, must acknowledge their problem and receive proper, abstinence-based treatment. The issue with dependent users is not so much that a waiting list is preventing them from getting help, but more that denial is a barrier from their becoming drug-free. The addicts’ social circle must support the addict to get treatment.
6. The Environment
Drug users produce and/or provide a market for drugs that can devastate the environment. Drug laboratories and processing plants release poisonous chemicals into the environment with no health or safety protection. Drug growers waste precious natural resources to produce drugs. Drugs that are smoked release carcinogens and other hazardous elements into the air.
Drug users provide the profits and support the links noted by the United Nations “between illicit drug production, trafficking and involvement of terrorist groups, criminals, and transnational organized crime.”
B. All Drug Use Increases Risk
It is critical to understand that all drug use, even first time use, creates an unacceptable risk to the health and safety of both users and non-users alike. Addiction and compulsive use exacerbate these problems, and the risk of addiction starts with first drug use.
One may intend to be responsible when straight, but forget to act this way once intoxicated on drugs. Nations do not excuse drug- impaired crime because of the culpability one has for becoming impaired in the first place.
Even first time and irregular drug use increase the risk of accidents, neglect, risky decision-making and family violence. Illicit drugs and abused pharmaceutical and certain legal drugs are used for the purpose of intoxication, and intoxicated persons pose a risk to public safety and order.
The mental ability to act responsibly is itself impaired by drugs, making the term “responsible use” nonsense and contradictory.
1. Alcohol, Tobacco and Illicit Drugs Distinguished
The intoxication effect is a critical distinction to make when comparing illicit drugs with tobacco and alcohol. Marijuana, cocaine, heroin and illicit drugs intoxicate and impair mental function nearly every time that they are used, and they are used primarily for this intoxicating effect. Tobacco, a costly and deadly drug in terms of disease that also should be targeted for demand reduction, generally does not have the intoxicating and behavioral impact on accidents and safety issues. Alcohol, when used for intoxication, does have this impact and its abuse is a major health issue, but the drug also may be used as a beverage with very minimal mental effect.
Therefore, while alcohol, tobacco and illicit drugs should all be targeted in demand reduction efforts, these critical differences should be kept in mind.
C. Preventing Drug Use is the Solution
Drug use is the driving force behind the world’s drug problems, contributing to nearly every major health, social, economic and ethical obstacle to a safe and healthy global community.
There are two levels to the drug problem. There is the need to control drug production, precursor supply, manufacturing, transportation, illicit finances and marketing, commonly referred to as supply reduction. The drug market is global in scale, and the role of each nation varies by type of drug. One nation may be a consumer and transshipment point for drugs like heroin and be a manufacturer and supplier of drugs like ecstasy. Every nation is involved, and each one impacts the world community.
Supply reduction and disruption are necessary components for reducing drug demand as drug availability and price impact drug use. However, without a demand for drugs, the supply would soon dry up. The long-range solution to the world’s drug problem is to reduce drug demand through drug prevention.
THEREFORE, it is the overwhelming consensus of this body, in agreement with the UN and many national governments and NGOs, that the number one goal of all drug policy should be to reduce the demand for these drugs through a balance of demand and supply reduction.
IV. THE CORE PRINCIPLES OF DRUG POLICIES THAT WORK
The uniqueness of each culture and community must be respected when designing drug policy and programs; however, certain core cross-cultural principles emerge. These core universal principles include:
A. The Three Pillars of Successful Drug Policy
Demand reduction is supported by three inter-related pillars: 1) drug prevention and education; 2) drug treatment; and 3) drug enforcement/interdiction. Every drug policy and plan should consider what impact it will have on reducing and preventing drug demand.
1. Prevention and Education
Foremost among these is drug prevention and education, which aims to stop drug demand before it starts by preventing first drug use from ever occurring. This is the key long-term solution that will reduce the pool of future drug users and thereby strip demand.
The main goal of positive prevention is to build healthy and safe youth, families and communities – it is “for life” and not just “against drugs.” This is done by building upon community and family factors that prevent drug use and reducing and eliminating risk factors correlated with using drugs.
Prevention also works to intervene and redirect early drug use to more positive and healthy activity – preventing first use from becoming regular use.
Treatment focuses on those with drug use problems and addictions to break the cycle of drug use and lead to more positive lifestyles. Treatment can take numerous forms, from community based support group sessions to intensive inpatient professional care. The goal should be eventual drug abstinence to restore individual health, dignity and public safety.
Supply reduction disrupts drug markets, increases or maintains high prices and lowers availability or prevents availability growth.
Law enforcement can support both prevention and treatment by serving as a deterrent to first drug use and leverage for treatment participation. Laws are one of the most visible signs of community norms. To maintain respect, the justice system must ensure that legal consequences rationally correspond to the level of seriousness of the offense. Consequences can range from required drug education attendance, monitored abstinence and treatment, community service and fines to imprisonment for more serious and dangerous drug criminals.
Targeted enforcement can work to reduce drug demand at the local level by eliminating open-air drug use and markets and directing early users into effective intervention and prevention programs. Enforcement also can require those with drug problems to participate in treatment programs and maintain abstinence through drug testing, together with appropriate sanctions.
Demand reduction is supported by three inter-related pillars: 1) drug prevention and education; 2) drug treatment; and 3) drug enforcement/interdiction. The main goal of positive prevention is to build healthy and safe youth, families and communities – it is “for life” and not just “against drugs.”
B. A Global Drug Prevention Plan and Commitment is Needed
Many nations have joint drug enforcement related treaties and goals, but few have comprehensive multi-national drug prevention plans or treaties in place. A global drug prevention strategy, applying the principles and goals of this plan, should be approved by the UN and regional and multi-national bodies.
This effort should be spearheaded by NGOs with experience in youth and drug prevention. It must be supported at the top levels but implemented and tailored at the local community levels. Funding should be directed to the local level with resources widely available in many languages.
C. Nations and Communities Must Have Comprehensive Multi-Level Prevention Plans
National, regional and community plans should be developed with widespread input from citizens, youth and experts to deal comprehensively with the drug problem. The United Nations developed a ten-year plan and the Caribbean has a five-year plan. Rio de Janeiro and the Prevention Cities South American initiative also have strong plans in place. The prevention plan must establish drug prevention as a priority and coordinate interaction. National plans also must include international prevention coordination.
Prevention plans must be based upon a clear assessment and diagnosis of the community drug problem and be designed to meet local needs. The decision-making process must be inclusive and include the voices of NGO’s, youth, parents and community groups. High-level leadership is needed to support prevention as a priority and to keep the issue up front.
D. Prevention Must Have a Communitarian Base
Drug prevention is best developed and delivered at the local community level, based upon local needs and assets. Community organization and commitment through an open participatory process ensures coordination and cultural adaptation of prevention that works.
Drug prevention is a communitarian effort, and the local community can instill and reinforce values and norms conducive to a healthy lifestyle. The Preventive Cities initiative, promoted in Latin American countries, is a prime example of prevention coordination at the local level. The local community must be strengthened and valued.
E. A Clear and Unambiguous Message Must be Communicated
National, state and local norms of behavior must be established, clearly communicating societal values and goals. Youth must both see and hear a consistent message that drug use is wrong and unacceptable and that liberty and dignity can only come with freedom from chemical impairment of reason and will. A positive culture must be supported and developed.
F. Effective Prevention is Positive and Forward Looking
Prevention strives for life filled with freedom and human dignity and opportunity. It is not just a reaction against drugs – it is for life. Prevention looks to form a culture that will encourage and support youth to live healthy, safe and positive lives. There is an important role for the faith community.
G. A Multi-Faceted and Multi-Disciplinary Response is Needed
The drug problem is multi-faceted, and it requires cooperation and coordination from diverse disciplines – youth, parents, sport coaches, media and entertainment, health, education, medical, treatment, employers, clergy, law enforcement and counseling professionals must all work together.
H. A Commitment to the Future Must be Made
The drug problem did not appear overnight, and patience and perseverance is needed. Effective prevention requires a continuous and sustained commitment and resource flow, with full coordination and review. Misleading quick fixes, such as legalizing drugs, are illusions and only exacerbate problems.
I. Evaluation and Assessment Are Important Tools
Policies and programs must be results-driven and demonstrate that they reduce demand. Research is an important tool to measure success and need. Policies and programs must be based upon scientific data, evidence and facts and be cost effective. Without control and accountability, programs will not succeed. The evidence base and research must be expanded for all activities.
J. Respect for Human Rights is Critical
An humanitarian approach is needed with the goal of building healthy societies where individuals can attain their hopes and aspirations by using their will and reason to its fullest ability by preventing the use of toxic chemicals that impair and cloud this ability. In addition to protecting and setting the drug user at liberty, the human rights of non-users must be protected and valued. Where drug use is rampant, the rights of non-users are deprived to the extent that citizens cannot even walk the street safely or sleep at night in peace. Draconian drug policies with harsh penalties for minor offenses, lack of civil rights, unfair and unjust trials and police practices also violate human rights. Everyone has the right to live in a safe and drug-free community.
It is a gross violation of human rights and individual dignity for society to promote policies that accept, encourage and/or enable some degree of the use, abuse and/or addiction to, drugs. By definition, drug dependence and addiction impair or override individual free will by altering brain chemistry. Any policy that would attempt to contain drug problems by allowing a proportion of the population to remain chemically or psychologically enslaved to drugs is inhumane. Such a policy makes society an accomplice to the degradation of the individual user and the source of a dangerous mixed message of drug toleration to youth.
Policies that often enable drug use go under misleading clinical sounding names such as “medicalization” of drugs or “harm reduction.” These policies undermine drug prevention and work for normalization and acceptance of drug use. Any positive aspects of these strategies are already incorporated into the three pillars of demand reduction. Known users may have progressive plans to become liberated from drug use – as long as a continuum is set and followed through.
The message to drug users must be clear – we care about you too much to leave you where you are, and we will not allow you to destroy yourself and those around you.
Drugs are not a private matter – individuals are interdependent, and everyone pays the cost and faces the risk of persons with impaired minds and bodies.
K. Prevention Should be Inclusive and Not Leave Anyone Behind
Drugs are an equal opportunity destroyer, and every child is at risk. No one can be certain when non-dependent drug use will cross over into regular abuse and addiction. The chemicals in the drugs are the same for rich and poor alike. It is an elitist view that certain genetically superior people are not at risk for addiction and should be allowed to use drugs.
V. PREVENTION PRACTICES THAT WORK
A. Treatment System Prevention Practices
1. The goal of treatment should be abstinence from drugs, and progression should be made toward this end. Maintaining addicts on illegal non-therapeutic drugs only enables addiction and continues chemical enslavement and dysfunction.
2. Treatment should support drug abstinence by development and growth in life skills and must not only rehabilitate, but when necessary, habilitate users to become positive people with hope, values and full participation in society.
3. Treatment must be based on scientifically-backed and evidence-based methods and practices that work and that are supported by research.
4. Treatment systems must be accountable and able to demonstrate results to independent assessors. Drug testing can be a useful tool to measure progress.
5. Treatment requires a continuum of care, from initial detoxification to follow up care. Treatment must be viewed as an ongoing process, not a one-time intervention. It must include a relapse prevention strategy, progressive goals and use working models.
6. Treatment includes a range of strategies tailored to individual needs such as support groups, outpatient care, inpatient care, intensive care, detoxification, therapeutic communities and a full range of support services.
7. Treatment must be integrated with other social and family systems, and a coordinated multi-disciplinary referral system should be supported.
8. Treatment availability must be increased and it must be recognized that treatment saves and prevents far higher health, criminal justice and other costs from being incurred. Governments must be confronted with the high cost of not treating drug abuse. The correct level of treatment for a given individual must be assessable.
9. The faith community must get involved, educated and offer support to those struggling with addiction.
10. Drug testing can be used therapeutically as well as for accountability purposes. If drug abuse is a primary health problem, then drug testing can be helpful in the medical assessment of one’s condition and progress.
11. Successes in treatment should be shared by both treatment systems and by individuals who overcome addictions.
12. Social stigma should not be on those who are getting help with drug abuse through treatment, but rather on those who decline to seek help.
13. Treatment must be family centered and incorporate the whole family.
14. Treatment should help instill values and goals consistent with a positive life and reasons to live without drugs.
15. Special consideration should be given to coordination of treatment and the criminal justice system. The justice system is in a unique position to identify problem drug users, refer them to treatment and apply accountability through fair, progressive sanctions to ensure abstinence and treatment participation.
B. Justice and Enforcement System Prevention Practices
1. The criminal justice system must tailor its response to the level of offense and type of offender. A broad array of sanctions and consequences should be available including: mandatory drug education, drug use assessment, fines, community service, regular drug testing with progressive sanctions, treatment, boot camp, intensive treatment, treatment in jail and prison, jail and prison for hardcore, violent and repeat offenders.
2. Courts should focus on abstinence from drugs related to criminal behavior and not just treatment participation. Courts must require regular, frequent drug testing as a condition of release that offenders can be required to pay for, if able. Abstinence from drugs, with or without treatment, should be mandated. Offenders should be required to remain drug free, and treatment should be made widely available as a means of keeping off of drugs for those who desire it.
3. Special drug courts with experienced judges can be established to process and follow up on drug cases.
4. Offenders who violate drug abstinence conditions should face a progressive continuum of responses and sanctions; it is more important for the responses to be consistent and immediate than to be overly harsh. In this way the criminal justice system can be applied as a form of behavior modification with immediate, progressive results.
5. The justice system should be hardest on the large-scale profiteers and traffickers and those who market to children. The goal must be to protect and serve the law abiding public.
6. The justice system must be responsive to the community and accountable for its enforcement of drug laws. Laws should be applied equally regardless of socio-economic status or race.
7. The civil law system should also be applied, and drug dealers should face lawsuits and sanctions as would any other purveyor of hazardous waste and chemicals. Nations should consider enacting the provisions of the Model Drug Dealer Liability Act (see www.modelddla.com ).
8. Courts should use creativity and alternative sentences to apply fair and meaningful consequences. Drug enforcement should be applied to reduce drug demand and to aid drug prevention. Drug use should not be tolerated, and revenue from fines imposed upon drug users can be applied to prevention and treatment programs.
9. Drugs in prison must be eliminated with drug testing, progressive sanctions and treatment and support groups in prison.
10. Drug laws and enforcement should work to protect the rights, dignity and freewill of all citizens and not special interests alone.
11. The justice system must be accountable for results and practices to the public.
C. Prevention Practices That Work
1. Prevention is a long-term ongoing process. Funds and programs require continuity and long- term resources to work. Governments and the private sector must make long-range plans and commitments.
2. The private and non-governmental sector must help. Businesses and philanthropic foundations should invest in drug prevention.
3. Drug prevention must be broad scoped and communitarian in practice. It includes the entire community, which often centers around the school, faith community and family.
4. School-based drug education should be integrated in the curriculum, start early and be continual throughout all grades. It must raise the perception of risk of drug use. Longitudinal, evidence-based prevention programs must be the norm.
5. Drug prevention must be reinforced by experts from all fields: the home and community environment, entertainment, advertising and the schools.
6. Effective prevention must have an unambiguous, clear message of no use of an illicit drug and no abuse of a legal substance – this standard must be enforced; abstinence must be the goal.
7. The message must be coordinated and consistent. It must be reinforced by the total community that drug use is not acceptable.
8. Student random drug and alcohol testing can be a valuable part of a comprehensive drug prevention program. National laws, customs, and resources will determine the process of implementation.
9. Community interventions are essential, and drug use must be confronted and solved at all levels.
10. Social interaction, games, drama, music and the arts should be applied to support a drug-free message and lifestyle.
11. The media must be enlisted as a partner in prevention and assertive outreach, and mutual understanding must be applied.
12.The entertainment industry also must be educated and participate in prevention activity; the industry must be held accountable to place the common good of the children before profits.
13. Community coalitions and partnerships - joining youth, parents, police, schools, recreation, entertainment, health professionals and community programs - provide the best forum to assess drug issues and plan and implement appropriate responses.
14. Youth must be an equal partner and enlisted as a big part of the solution. The youth voice needs to be heard, and peer-to-peer groups should be encouraged and supported.
15. Drug prevention must be cost effective and based upon proven evidence based principles.
16. Effective prevention promotes values more important than money and pleasure and redefines success with truths of what is really important. Prevention must foster and encourage the drive to care about others and to put people first. Therefore, it must reward what it values and reinforce youth who give of themselves.
17. Communities should work together to increase activities that are desirable alternatives to drugs – recreation, sports, arts, scouting, vocations, drug-free clubs, volunteering, community activism and public service opportunities are examples of prevention tools.
18. Prevention must educate the educators and ensure that those in positions of influence know the facts about drugs and prevention strategies.
19. Prevention must be culturally sensitive and speak in a relevant way to the culture. It also must be inclusive and not leave any child behind.
20. It is critical that drug prevention convey the risk and dangers of drugs through effective communication. These facts must be clear and evidence-based. The impact of drugs on the brain is especially relevant. More than 25 years of research demonstrates a direct inverse correlation of the degree to which drugs are perceived as dangerous and the use of drugs.
21. Computer technology, virtual reality, new technologies and multimedia must be used as tools and allies to promote drug prevention.
22. It must be kept foremost in mind that prevention is the goal, education is the tool, and knowledge alone is not enough. Prevention must be reinforced at every level of society.
23. Success stories from around the world must continue to be shared, and prevention must build on successes that recommend sound strategies and systems.
24. Prevention is a long-term ongoing process. Funds and programs require continuity and long-term resources to work. Governments and the private sector must make long-range plans and commitments.
25. Communities must hear the tragic stories of families who have lost a loved one to drugs.
The International Task Force on Strategic Drug Policy hereby recommends:
- That each nation, the United Nations and global and regional multinational bodies adopt drug policies and goals in line with the recommendations provided herein;
- That this global drug prevention plan be adopted worldwide;
- That Drug Prevention be the cornerstone of all drug policy and programs and that drug use must be targeted as the primary source of drug problems;
- That research and science-based approaches be applied and promoted and that further research on effective prevention be undertaken;
- That NGOs experienced in youth and parent drug prevention be equal partners and consulted in developing drug policy; and
- That accommodation and surrender and acceptance of drug use be rejected and that positive and forward-looking approaches be pursued;
APPROVED and ADOPTED this 27th day of June, 2004.
Drug Prevention Network of the Americas
Calvina L. Fay
Drug Free America Foundation, Inc.