Further Reading

Isn't Drug Czar Barry McCaffrey creating a humane policy by pledging to increase treatment resources and by supporting treatment on demand?

On DRCTALK Digest 2674, Jerry Sutliff wrote:

Dear Talkers,

In the SF examiner today there is a front page article below the fold headlined, "Mayor promises drug treatment on demand." That is important locally but what is important is McCaffrey's statement in the body of the article:

"It seems to me that the mayor of S.F. is right on the money. You simply cannot tell a person who finally decides to get help for their addiction to come back in seven months. In order to be effective, (services) need to be available when the people are ready."

McCaffrey said he was pressing the White House to help pay for such programs in San Francisco and elsewhere around the nation .... McCaffrey ... said he expected the federal government to help cities provide treatment services, and a request to do just that is part of the president's 1998 budget plan. He said the creation of more treatment programs should be a national goal, so cities such as San Francisco didn't become magnets for addicts from all over. "There is a state and federal responsibility to address this -- not just local," McCaffrey said.

IMHO we should be doing something to encourage "treatment on demand supported by the feds" talk, provided the demand is volunteers and no state coercion is involved.

VTY, jerry sutliff


Dear Jerry:

At the 1996 DPF conference, I debated Bob Millman about the role of expanded treatment in drug policy reform. McCaffrey's support for expanded treatment is his basis for claiming that US drug policy is humane. It is the excuse Harvard organizers used for giving McCaffrey the Zinberg Award. It is in fact an integral part of an increasingly repressive and ineffective drug policy, for the following reasons:

  1. treatment without expanded social services is not helpful;
  2. this is because Americans mean by more treatment more 12-step philosophy, which is a spiritual effort to get people to "do the right thing," rather than an opportunity for people to gain resources for improving their lives;
  3. expanding treatment inevitably entails more coercion, which is already the major source for entree into treatment (this is the "humane-sounding" justification for repressive drug laws -- drug laws are necessary because so many in treatment were sent there by the legal system -- and that is only the tip of the iceberg of the ways in which people are forced into treatment they don't want);
  4. since most drug users, even those apprehended by the system, are not abusing the drugs they take, what will they be treated for?;
  5. in areas where we track treatment, namely alcohol, at the same time that treatment has expanded tremendously, the number of drinkers claiming they can't control their drinking has simultaneously tripled;
  6. there is inevitable movement when treatment expands to reach into more stable populations for treatment patients -- that is, lower thresholds of drug use are considered problematic and diseased (e.g., when an employee tests positive for marijuana, he is sent into treatment for "chemical dependence");
  7. as a result, remarkably, as treatment has expanded tremendously in recent decades, homeless substance abusers have likewise increased dramatically -- social service providers say, "they could quit with treatment, and therefore we don't provide assistance to those who continue to use";
  8. in sum, as treatment slots increase, and providers become desperate to fill them, antipathy towards and vilification of drug users increase, there is greater denial of social services for users, penalties are enhanced for users (since they could quit if they only entered treatment), and drug users become more isolated from the social system -- the exact opposite of the goals of harm reduction.

I provide references for and more description of these processes in my article, "The results for drug reform goals of shifting from interdiction/punishment to treatment."

Stanton