Questions and Answers

Overcoming Addiction

Addiction is a progressive disease. An active addict does not think clearly or rationally, which can lead him or her down a path of destructive decisions. Addiction can destroy families, relationships, careers and lives. It is a sickness that cannot be ignored and must be dealt with at many different levels. Although overcoming addiction may be a long and hard process, it is a completely treatable disease. Programs that do not encourage abstinence from drugs not only prevent the addict from hitting their motivational bottom but, more importantly, do nothing to raise the "bottom" in order to leverage an earlier recovery process. Because there have been so many different trends within drug treatment, we would like to point out what types of ideologies and treatment have been proven most effective in overcoming addiction and relapse prevention.

Is harm reduction an effective approach to overcoming addiction?

    • The optimal way to truly beat addiction and prevent drug-related harm is an effective harm reduction strategy that targets drug use and includes prevention, education, treatment and law enforcement efforts.
    • Some examples of effective harm reduction strategies are drug courts, best practices treatment programs, 12 step organizations and methadone or other legally prescribed opioid substitution programs with the goal of ending drug use.
    • We should reject ineffective harm reduction tactics that ask society to accept drug use or allege that drugs can be used safely or responsibly, creating the misunderstanding that drug use itself is not harmful and increasing addiction.

Is there an alternative to jail for those struggling with addiction?

    • Yes. Drug courts are special courts for nonviolent, low level offenders whose crimes are connected to drug abuse or addiction. Since first opening in 1989, they have expanded to every state and now number around 2,100.
    • Participants appear periodically before a judge and case workers for as long as 18 months. In properly run courts they submit to drug tests and treatment, and if they successfully graduate, may have their records wiped clean.
    • Called 'therapy with teeth,' drug courts have a lower rate of recidivism; only 16.4 percent of graduates had been rearrested and charged with a felony, according to a 2003 study.
    • Historically, adult substance abuse offenders don't remain abstinent after serving time exclusively; it is with the addition of treatment and the challenge of a drug court program that they are more likely to achieve the goal of remaining drug free.
    • Often drug court programs are an addict's only opportunity for treatment, especially for the most economically disadvantaged.

What kinds of treatment can be effective?

    • Programs that lead addicts to end their drug use.
    • Opioid substitution such as methadone, buprenorphine, etc. that are prescribed by a physician within an abstinence-based treatment program.
    • Treatment that encourages participating in 12 step programs, aftercare, alumni groups, life skills training, faith-based groups or transitional living which all provide needed additional support for recovering addicts.

What kinds of treatment are problematic?

    • Needle exchange programs (NEPs) and Supervised Injection Sites (SISs)
    • In NEPs intravenous drug users are given clean needles but not required to return dirty ones. SISs provide medical personnel to assist drug users in injecting themselves with illegal drugs.
    • Despite their apparent compassionate intent to reduce HIV and other blood borne infections, NEPs and SISs have been shown to be ineffective. In Vancouver, BC, rates of HIV, hepatitis C and other infections such as MRSA have increased, not decreased, since its NEP and SIS were established.
    • Workers at these facilities rarely if ever refer users to treatment which not only misleads addicts into thinking that drugs can be used safely but also abandons users to their addictions with no end in sight.
    • The rationale of needle exchange relies on an intoxicated user to make the responsible decision to safely dispose of his/her dirty needles – an unreasonable, even unfair expectation.
    • As a society we want to bring those struggling with addiction to sobriety by not allowing them to live in denial or protecting them from the consequences of their behavior. If an addict has to hit bottom before getting help, we should raise the bottom, not lower it.
    • Opioid maintenance programs that do not offer comprehensive treatment or strive toward abstinence.
    • Supplying users with their drug of choice such as heroin (August 2008 marked the end of a trial heroin maintenance program in Vancouver, and San Francisco has been considering a similar approach.)

What misperceptions perpetuate addiction?

    • A frequently heard idea is that legalizing drugs would generate revenue and solve the drug problem. It's not that easy; remember H.L. Mencken's warning, "For every complex problem there is a solution which is neat, simple and wrong."
    • Eliminating legal penalties for drug crimes removes accountability for users and forfeits law enforcement interventions that can lead to sobriety.
    • Ideologies that encourage medicalizing illicit drugs or establishing medicine by popular vote not only undermine the protection that government regulation provides but also become a pseudo-intellectual front for those who just want to make their drug of choice legal.
    • Providing 'safe' places to use drugs and distributing clean needles are cheap and easy ways to appear compassionate to drug users when true compassion dictates that we help them in treatment to find a drug free life.
    • The notion that everyone does drugs is completely inaccurate – barely 8% of Americans over 12 and less than 5% globally for those 15 or older – and misleads the most impressionable to think that their drug free lifestyles are out of sync, when the opposite is true.
    • Confining addiction to one socioeconomic group or geographic area denies the fact that drug use is present in all social strata and conveniently relegates the problem to someone else.