Monday, January 6, 2014

Drug of Choice

Can you believe it?  Back at the beginning of the 21st century not only was caffeine legal, but in the big cities, coffee shops appeared on nearly every street corner.  Caffeine was a common additive to soft drinks and in higher doses to so-called energy drinks.  These products were available to children, and there are records of teenagers overdosing and even dying as a result.  Society at that time condoned it and would have been outraged at any suggestion to control or ban it.  Today, a little over one hundred years later we know better.  Only criminals, lowlifes and hoodlum teens would be caught trying to brew the illegal substance.  If caught, they face fines and imprisonment.  Its use leads to other criminal activity including robbery and battery.  It’s sad to see some of our admired celebrities fall into this habit, requiring extensive and repeated rehab.

The preceding is a possible news item from 2114.  It’s possible because today a similar news story could have been accurately written about practices in the early 1900s by substituting “cocaine” for “caffeine.”  The legality of drugs is driven as much by societal pressure as by science.  We see this as marijuana for medicinal use and, just last week, for recreational use becomes more widely legal.  Attitudes are shifting.  The USA Today reports that “fewer teens see [marijuana] as harmful and more smoke it. In 2013, one in 15 [high school] seniors reported using marijuana daily, up from one in 50 in 1993.”

Despite publicity about a war on drugs, drug use is quite prevalent in the US.  “In 2007-2008, 1 out of every 5 children and 9 out of 10 older Americans reported using at least one prescription drug in the past month.”  Over 10% of adults between 20 and 60 use prescription antidepressants and over 10% use prescription pain relief drugs.  The CDC also reports that over the past 10 years the use of five or more prescription drugs in the past month “increased from 6% to 11%.”

Prescription drug abuse is a major problem.  Since they are sometimes taken for recreational purposes, they do produce “a high” or some good feeling, though people who take them “for medicinal purposes” are reluctant to admit it.

As the use (and abuse) of prescription medication increases, opposition to legalizing “street drugs” remains strong, driven by the fear of addiction; but alcohol is addictive for some and people joke about needing caffeine to get going in the morning.  Some addictions carry a stigma, while others are referred to in an almost playful way.  As society defines and redefines what’s good and what’s bad, the laws follow.

As we continue to lose the war on drugs, it costs us in many ways.  We expend precious law enforcement resources.  We allow people to take some drugs with no guidance at all while other drugs contain long lists of warnings.  We tell people to report all drugs and even supplements to their doctors, but make that impossible (or at least unlikely) by branding some as illegal.  We encourage people to risk blowing up themselves, their houses and their children to manufacture illegal drugs.  We let them consume drugs of unknown purity purchased on the street.  We minimize the incremental risk of committing other crimes by making the drug habit criminal.  We give gangs and organized crime a channel to finance other illegal activities.  We fill prisons with non-violent offenders.  We forego billions in taxes.

At the same time we allow alcohol and other drugs to be taken in the society by those who work, drive, take care of children, etc.  Now with the expansion of affordable insurance coverage, even more people will be in a position to pressure their doctors to write unnecessary prescriptions.  The line between legal and illegal use continues to gray.

It’s time to put the utopian objections aside and make a realistic, objective cost/benefit assessment of the situation.

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