This is another example of a blog post that I created nearly a year ago but did not bother to publish. Just in case you are interested in the problem of drug addiction, you might find some of this interesting, if a little dated.
After reading an article about drug addiction, my interest was piqued, so I did a little digging on the subject. I have never used illicit drugs and do not intend intend to. However, I found this exercise to be somewhat illuminating, at least from a psychological standpoint.
Here are some conclusions that I came to. They are not the conclusions of an expert. Don't mistake this for the advice of a professional.
--The U.S.'s war on drugs--at least in its present form--has been the most disastrous of all our wars. The Obama administration quietly (and wisely) has begun to change course.
--The pharmaceutical industry is unwittingly a big part of the problem.
--Legalizing drugs will not stop drug abuse, any more than legalizing alcohol stopped alcohol abuse. But our current approach is not working, and is instead turning our prison system into a training ground for criminals. It's also ruining lives of people who do not have (or did not have) a serious drug addiction problem beyond cannabis.
--Some rehab programs are far more successful than others. It's not necessarily a hopeless situation.
--We may be able to learn a lot by examining the different drug policies of other countries.
MOST DANGEROUS ABUSED DRUGS IN THE WORLD
Based on overall societal harm--i.e., lives lost--
alcohol and
tobacco are the most harmful drugs on the planet. This is in large part due to the fact that their legality, availability and cultural acceptance makes them widely used.
Based on a weighted average of (a) impact on society, (b) addictive property and (c) individual harm, someone has compiled this
list of the worlds most dangerous drugs, in order of most to least dangerous. Not surprisingly, alcohol and tobacco are on this list as well. Of course, there are other drugs not on this list that are very dangerous but not (yet) widespread.
Cannibis is documented to be the
least dangerous drug. Supposedly, no one has ever died purely from overdosing on pot or using pot. Compare this to the millions who have died from health problems or overdose problems or accidents traced directly to alcohol or tobacco. On the other hand, due to its illegal status--and thus its social link to more dangerous illegal drugs--it often serves as a "gateway drug".
Here are some examples of some really bad drugs not on this list:
"Bath Salts", a "legal" fake meth, has recently been in the news because of cases where its users became
completely psychotic. Another "legal" drug, fake marijuana, (
"K2" or "Spice"), sold as incense, is proving to be much more addicting than marijuana. While not as dangerous as some other drugs, its availability and the misconceptions around its addictive nature make it far worse than cannabis.
There are medical reasons why Methamphetamine has been labelled one of the world's
most dangerous drugs. However,
Krokodil, a home-made form of of fake meth used in Russia by people who can't afford Heroin, may be even worse, as discussed in
this documentary,
Fentanyl is a form of "fake" heroin, but it is about 75 times more potent, and as a result,
many more drug overdoses are seen in many parts of the U.S. A combination of heroin and fentanyl such as
"cheese" has resulted in many deadly overdoses.
As an aside, some drugs are mis-used for criminal purposes rather than to "get high". Think GHB (the date rape drug) is bad? It's nothing compared to
Scopolamine or "Devil's Breath", used by criminals in Brazil to "hypnotize" their fully-awake but amnesiatic victims. Scopolamine is easily obtainable in Brazil and it has a
long and dark history. It was also
once used as a truth serum. Like many abused drugs, scopolamine has some legitimate medical uses, such as minute amounts used to treat sea-sickness and motion sickness, to prevent nausea after anesthesia and surgery, to treat the tremors in Parkinson's disease, and even to treat depression in some patients.
DRUB ABUSE STATISTICS
Drug Use Facts
Main problem drugs, by country
Addiction rates of various drugs
Prescription Drug Overdoses by State
International U.S. Policy Objectives Survey
Age distribution of Treatment Admissions for Various Drugs
THE WAR ON DRUGS: DIFFERENT COUNTRIES' POLICIES
U.S.
1. Drug production, possession, sale, transport and use of all drugs--both hard and soft--is illegal and subject to incarceration.
2. U.S. represents 5% of world population but houses 25% of worlds prison inmates
3. 500,000 incarcerated for marijuana use, out of a total of 2.3 million inmates (22%)
4. Philosophy: Illegal drugs are a crime problem, not a public health problem
Netherlands
1. Production, possession, sale, and transport of drugs is illegal, with the exception that small amounts of soft drugs (i.e., pot) are legal to have in possession, to grow, to sell and to use
2. Actual use of both soft (i.e., cannabis) and hard drugs is legal
3. While growing larger amounts of cannabis is illegal, enforcement of this is not a priority
4. Philosophy: Help addicts rather than incarcerate them; make a clear distinction between pot and hard drugs; focus on harm reduction more than enforcement.
Other countries with drug policies worth comparing (good and bad): Portugal, Spain, Russia
A British News Article Detailing the U.S.'s Disastrous War on Drugs (2010)
Obama Administration's New Drug Control Policy Reform (2012)
NEUROBIOLOGY AND PATHOLOGY OF ADDICTION
Alcohol and Drugs
Neurochemistry of Relapse and Recovery
Is Addiction a Disease?
Gambling, also
this and
this and
this
Video Game Addiction, also
this
Internet Addiction
Food Addiction, also
this and
this
Sugar and Obesity
Addiction to money (not neurobiology, though)
WHY DO PEOPLE START TAKING DRUGS?
1. A person wants to escape from his troubles (i.e., war, poverty, bad memories, dysfunctional family, personal problems and fears, etc.), and/or may have an
addictive personality or even an existing mental disorder that makes him more vulnerable to the use of drugs.
2. Or sometimes, the person is a happy, intelligent, upstanding, nice person from a good family who just decides one day to try a drug just once to see what it feels like to "get high", perhaps just out of curiosity or for the sake of a new adventure. The person has absolutely no intention of continuing to use it or of getting hooked on it. They just want to find out what the feeling is like.
3. The drugs are legal--so the person figures they're safe to try. (But even drugs like tobacco and alcohol can be
more addictive than some illegal drugs; not to mention, being the #1 and #2 killers.)
4. The person is prescribed painkillers like vicodin and oxycontin, or perhaps prozac for depression, and they (or someone else) now have them in their possession. From that point, it's very easy to pop another leftover pill just to duplicate that good feeling they might have experienced, or for another family member or friend to do so. This is a huge problem. There are now
more deaths by overdose from these drugs than from cocaine and heroin combined.
5. They are easy to obtain. This includes prescribed and over-the-counter pharmaceuticals or "disguised" drugs and many street drugs such as Marijuana. Combine this with rebellion, boredom, curiosity, or peer pressure.
6. Proximity to drug use (i.e., at a party or with friends) combined with peer pressure and curiosity, especially for adolescents, who are more likely to take risks.
7. Branching out from alcohol or marijuana with the intention of getting an enhanced buzz.
8. Self-medication for pain, stress, depression, etc. with marijuana, alcohol, other drugs. The likelihood of taking the drug and subsequently getting addicted is even greater if the person has an existing mental illness such as depression or bipolar disorder.
9. A common perception is that people try drugs because they are weak, have low morals and are lazy, trashy, angry, rebellious, impulsive, unsociable, unintelligent, non-conformist types who want the reward of "feeling good" without having to earn it. This perception may contain a grain of truth in some cases, but in the vast majority of circumstances it is actually a perception of what people inevitably become like after they have already become addicted to drugs.
Nobody ever plans to get addicted to drugs--he or she wants to try a drug "just once". And even after becoming psychologically addicted, the person still tells himself that he is not in danger of becoming addicted--until it is too late.
The following description of a user's experience with heroin addiction (taken from a discussion board) may be illuminating and in many ways typical of drug addiction:
"Heroin initially makes you forget all your troubles, it makes you feel content and happy, even if prior to use you were borderline suicidal. It takes the user, wraps him up in this safety blanket, and allows everything to be nice again, no matter what. Therefore, if you're--say--suffering from depression, and then try heroin, you're going to have a hard time staying away.
Look at heroin addiction around the world. It's available almost everywhere, but where does it remain? In the first-world middle classes? Rarely. In working-class neighborhoods where life is tough, quality of life is low? In countries ravaged by war? In countries ravaged by poverty? Massively.
Now, although heroin appeals especially to people who have things they want to escape from, either physically or mentally, it is also enjoyable no matter who you are. It is extremely psychologically and physically addictive.
Long before a physical addiction has built up, while the user himself still feels 'safe' from addiction, a psychological addiction is already festering. And it is this which tricks your mind into taking heroin a day before you said you would, or to 'reward' yourself for something -- anything! Usage spaced by months becomes weeks, by weeks, becomes days, and suddenly, you're using every day.
Once physical addiction takes hold, which again is relatively rapid, the user is no longer using for that high. In fact, the high is dramatically lowered, once the 'honeymoon' period with heroin use is over. Instead, the user is using because he is both physically and psychologically unable to function without heroin. It is this need which turns junkies from individuals, into the stereotyped addict, who engages in nearly any activity in order to get his next dose."
IS THERE A PARTICULAR "GATEWAY DRUG"?
Marijuana is often described as a
"gateway" drug to eventual use of harder, more dangerous drugs. Cannibis is supposedly only about as addictive as caffeine, and there's little biological or chemical evidence to directly implicate it as a gateway drug. However, there are
compelling reasons why pot really does serve as a gateway to hard drugs nonetheless, whether for psychological, neurobiological or social reasons.
Are there other "gateway drugs"? Many experts claim that tobacco and alcohol deserve the title even more than Marijuana. Compared with lifetime nondrinkers, adults who have consumed alcohol were 26 times more likely to use cocaine, 14 times more likely to use cannabis, and 13 times more likely to use psychedelic drugs. And those who started smoking tobacco by the age of 12 were 26 times more likely to start using cannabis or other illicit drugs by age 17. A typical progression is smoking, drinking, cannabis, and finally, harder drugs. Prescription drugs (often very dangerous by themselves) also can become "gateway drugs"--for example, painkillers like Vicodin and Oxycontin as well as
inhalents. And finally, "legal" disguised drugs like "K2" and "Bath salts" are probably becoming "gateway drugs" as well, due to their easy availability.
Nevertheless, marijuana is the drug still most often cited as a "gateway drug". This is because it is easy to find, most likely to be first introduced by a friend at a party, and often peddled by the same people who peddle the more dangerous hard drugs--due to its illegal status. And most people know Marijuana is supposed to be relatively harmless--ironically, this makes it even more likely to become a gateway drug because people are less afraid of it. Some argue that legalizing pot would mostly eliminate it as a gateway drug since it would then be more socially isolated from peddlers and users of harder illegal drugs--this is a topic of controversy.
People typically first start using drugs when they are 11-20 years old, when peer pressure is a major factor, and when the "wiring" of a person's brain for critical thinking and risk avoidance has not yet been fully developed. Tragically, continued drug use then prevents this important brain circuitry from being fully developed. Instead, a strong memory pathway connecting drug use and the feeling of pleasure is established, that supersedes everything else.
One final tidbit: Some people suggest that sugar is the original gateway drug. Gateway theory suggests that, all other things being equal, an adolescent who uses any one drug is more likely to use another drug. Considering the similar neurobiological effects of sugar, some have suggested that
sugar is actually the very first gateway drug, leading to food addiction (and obesity) or to drug or alcohol addiction.
A study on lab rats seems to further support a link to later alcohol addiction. In addition to this, excessive childhood consumption of sugar shows some
correlation to violent behavior in later life. This study does not prove a direct cause-and-effect relationship; in fact, one might find a whole host of things that are correlated and which would prove difficult to sort out. For instance, there is likely to be a correlation between dozens of different negative factors, i.e., drug abuse, poverty, IQ, violence, child neglect or abuse, alcoholism, crime, etc.
There are most likely many different pathways to drug addiction. No one substance, behavior or personality trait can carry all the blame for someone starting down this road. Instead, a certain "balanced" combination of nature and nurture ingredients is likely to be required in order for a person NOT to be prone to addiction--reminiscent of Tolstoy's quote that while "happy families are all alike, every unhappy family is unhappy in its own way." Finally, there seem to be many cases where a person may be intelligent, may come from a privileged home and good parents etc., and yet still become addicted to drugs. This supports that idea that--for better or worse--chance circumstances may have a bigger role in shaping people's lives than we might imagine.
THE PHARMACEUTICAL INDUSTRY AND DRUG ADDICTION
The pharmaceutical industry has saved many lives, and is one of the miracles of the modern world. However, just like some other industries, it has its dark side. Based on the statistics and facts listed below, you can determine for yourself to what extent this industry has spawned the problem of drug abuse.
Here are some alarming statistics from the CDC regarding addiction to prescription drugs:
--In 2010, about 12 million Americans (age 12 or older) reported non-medical use of prescription painkillers in the previous year.
-- Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month. Although most of these pills were prescribed for a medical purposes, many ended up in the hands of people who misused or abused them.
--Prescription painkiller overdoses killed nearly 15,000 people in the US in 2008. This is more than 3 times the 4,000 people killed by these drugs in 1999. There are now more deaths by overdose from prescription painkillers than from cocaine and heroin combined.
--Nearly half a million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers.
--Nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.
--The quantity of prescription painkillers sold to pharmacies, hospitals, and doctors’ offices was 4 times larger in 2010 than in 1999.
--Many states report problems with "pill mills" where doctors prescribe large quantities of painkillers to people who don’t need them medically. Some people also obtain prescriptions from multiple prescribers by "doctor shopping."
Here are some additional statistics compiled by the woman behind Confessions of an Rx Drug Pusher. (This link has some fascinating videos with additional information.)
--The U.S. represents 5% of the world's population, yet we take 70% of the worlds pharmaceutical drug prescriptions.
--More U.S. soldiers have returned from Iraq and then died as a result of prescription drugs than died in the war.
--The U.S. and New Zealand are the only two countries in the world who allow direct advertising by the pharmaceutical industry.
--Sloppy handwriting is the cause of 7000 patient deaths each year, while preventable medication mistakes hurt 1.5 million people.
--At least 106,000 people die each year from adverse drug reactions.
--These medical errors and deaths are equivalent to 6 jumbo jets falling out of the sky each and every day...the only difference is the media coverage--there are no public displays of grief for those who die of faulty medicine.
--A mere 6% of all listed adverse drug reactions are actually identified in practice. Most side effects are instead mistaken for new disease symptoms, leading to further drugging and unnecessary medical procedures, increasing the risk of death even further.
--The mortality rate for people between the ages of 45-64 who took their prescription drugs correctly, rose 90% in just 5 years.
--In 2001, Pfizer was the most profitable Fortune 500 company in the world, with $7.8 billion in profits.
--In 2002, the profits from the top 10 drug companies comprising the Fortune 500 exceeded the profit of the other 490 companies.
--More than half of the U.S. population received unnecessary medical treatment--that's about 50,000 people per day. Forty-two percent have been directly affected by a medical mistake, from a procedure or drug, and 84% of our population personally know someone who's been a victim of a medical error.
--The American medical system is the #1 killer in the United States. The deaths, caused by conventional medicine, in just one decade, equate to approximately 8 million. That's more than all the casualties from all the wars America has fought in its entire history.
--In 2006, healthcare spending reached $2 trillion, far more than most other developed countries per capita.
Here are some issues with the pharmaceutical industry that I personally find troubling:
For profit reasons, U.S. drug companies have made a concerted effort to prevent drug re-importation, when in fact, it is safe. (from Confessions of a Healthcare Hitman)
THC, the active ingredient in Cannabis is known to have many medicinal properties; it is as addictive as caffeine, and no deaths have ever been linked to its use. In some cases, it can do the job of a half-dozen potent pharmaceutical drugs but with none of the harmful side affects or addiction potential. The pharmaceutical industry does not like cannibis. They promote the idea that it has no medicinal value...that is, unless they can patent derivatives of it and make lots of money. If doctors were able to prescribe marijuana (or its active ingredient, THC) and pharmacists to dispense it, this would supposedly lead to an "epidemic of prescription drug abuse"--but this is already happening with existing prescription drugs, which are far more dangerous and addicting than marijuana. More likely, what would really happen is that drug company profits from dozens of these existing, more dangerous and less effective drugs would decline.
A problem with prescription of drugs for depression and a host of other mental illnesses is that there are usually
no specific biological tests the psychiatrist can use to diagnose these illnesses. Rather, diagnosis is based on interpretations of the DSM (psychiatric diagnosis) manual--a manual which is facing increasing criticism and the accusation that it
is not based on good science. This naturally results in inconsistent or even false diagnoses, especially when a psychiatrist is afraid of getting sued later on if he doesn't come up with a specific diagnosis and prescription, and then something bad happens later on with the patient. Result? More psychiatric medications are prescribed, even if the patient is lying about his symptoms in order to get the prescription.
Most prescribed drugs do not "cure" people of mental disease, but only mask the symptoms. Once someone gets started on a drug regimen, they may stay on it for life. Drugs often lose their efficacy over time, and dosages must be gradually increased or changed. Finally, drug side affects present the doctor with an opportunity to prescribe yet more drugs. This is profitable (and therefore acceptable) for the drug companies and their researcher scientists, as they naturally "follow the money".
Another problem is that
drug companies pay doctors, who are influenced to prescribed particular medicines,
also described here. Follow the money.
Drug companies spend a gargantuan amount on marketing and administration...and when they do their clinical trials, they generally do NOT have to compare their new drugs with existing drugs or with the best standard treatment--but only against a placebo. This means that "recycled" and trivial "me too" drugs dominate the market of new drugs. Only a small percentage of new drugs introduced represent actual improvements over existing drugs. This adds to their profits but doesn't benefit anybody else in the process.
Some companies engage in
drug profiteering based on shortages. Often this is indirectly related to ballooning purchases of drugs used for street purposes, causing the
DEA's approved production numbers to be inadequate. Other reasons include
quality issues or lack of profit due to generic drugs. This seems inexcusable if it is a consequence of sloppy, inefficient production management coupled with a monopoly on the manufacture of certain drugs.
There are usually alternative treatments for any specific problem, but these are rarely considered by a doctor if he has a drug purported to be specifically for that ailment. Rather than deal with the complexities and review all the possible sources of and best solutions to a problem, it's easier and quicker (and perhaps less risky for the doctor) to just prescribe a popular drug. For example, while Ritalin has arguably been a relatively effective "solution" for millions of ADHD sufferers, there nevertheless exist alternative treatments for ADHD that may be more effective or have fewer side effects. (See
Overview,
Neurofeedback,
Cannabis,
TM,
Natural medicine,
L-theanine,
Non-western diet,
Omega-3s,
PhosphatidylSerine plus Omega-3.)
Ritalin addiction is on the rise, and its use with alcohol can often be deadly.
An increase in medication given to children accompanies the
dramatic increase seen in chronic childhood illnesses and diseases like ADHD, autism, asthma, eczema, obesity, type I and II diabetes, etc. One may question whether there is a possible connection to
environmental toxins and their
epigenetic effect,
childhood vaccinations,
antibiotic usage,
processed food diets, or some other underlying factor whose understanding may lead to a better solution than today's prescription drugs. For the drug companies, though, drugs are the only answer, and the power of money ensures that it stays that way and that no research is done beyond finding a new "blockbuster" drug to mask the symptoms. Also, little is known about the long-term affects of some widely prescribed drugs given to children and their effect on brain development and overall health.
Most dangerous and addictive drugs are either a direct or indirect result of the pharmaceutical industry. Any technology can be used for good or evil. However, the addictive aspect of many of this industry's products, and its effect on the human brain, has increased the potential for biological and societal harm.
So who makes money off other people's addiction? Casinos, stock trading companies, video game developers, producers of porn, illegal drug rings, drug dealers, private companies running prisons and...and...pharmaceutical companies. The drug companies profit from the drugs whether they are used for legitimate purposes or not, and the necessarily tight control of some drugs guarantees they will be expensive. Even when used for legitimate purposes, a drug used long term and whose dosage may need to be increased over time results in the same kind of profit stream associated with illegal addictive drugs.
IS THERE A RELATIONSHIP BETWEEN DRUG ADDICTION AND MORAL CHARACTER?
Temptation often leads to addiction. What does the Bible say about temptation? Some might believe that turning our drug problem into a "moral" issue is inappropriate. However, some of the most successful drug rehab programs use principles from the Bible--especially the avoidance of temptation. Susceptibility to temptation is certainly one aspect of the drug problem, so we should understand it.
Here is some ancient wisdom from the Bible regarding temptation, addiction and recovery.
It is important to instill self-discipline in a child:
"Surely I have behaved and quieted myself, as a child that is weaned of his mother" (Psalm 131:2)
Don't withhold correction from a child (Proverbs 22:15; 23:13; 29:15; Eccl 10:16)
"Train up a child in the way he should go..." (Proverbs 22:6; Gal 4:1-2)
Certain character traits can increase the risk of being tempted and falling prey to an addiction:
Lack of firm convictions (Luke 8:13)
Lack of self discipline (2 Timothy 2:21; John 15:2; Psalm 1:15; 119:101; Proverbs 1:15; 1st Peter 3:10; Jer 14:10;
Laziness and perversity (Proverbs 22:5)
Criminal tendencies (Psalms 9:16; Proverbs 29:6)
Susceptibility to others' influences (Proverbs 29:25)
Tendency to associate with a bad crowd (Proverbs 13:20, Psalms 1:1)
Rebelliousness (Proverbs 14:16; 15:20)
Lack of morals or conscience (Proverbs 14:9,12,16; 2nd Peter 2:12-14)
A tendency toward strife (18:6-7)
Selfishness (Gal 6:7-9, Eph 2:3)
Certain universal temptations can also lead to addiction, perdition and self-destruction:
Pursuit of money and power (Proverbs 23:4; 28:22; Eccl 2; 1st Tim 6:10-11)
Pursuit of pleasure (Eccl. 2:1-2; Proverbs 21:17; Luke 8:14)
Alcohol (Proverbs 23:20; 23:35)
Illicit sex (Proverbs 23:27, Eccl 7:25-26, 1st Cor 6:18)
A temptation cannot be overcome. It can only be avoided.
Flee from temptation (1st Cor 10:14, 2nd Tim 2:22, 1st Tim 6:11, 1st Cor 6:18)
A prayer to avoid temptation. (Matthew 6:13)
Your good intentions alone are not enough to avoid temptation. (Matthew 26:41; Romans 7:17-26)
God provides a way to escape temptation. (1st Cor 10:13)
Temptation occurs when you turn your attention to a particular thought or memory--instead, fill your mind with other, good, healthy thoughts. (Proverbs 24:9; James 1:13-15; Phillipians 4:8; Proverbs 6:18; Gen 6:4-6; Isaiah 55:7; Phil 3:13)
Information, understanding, wisdom and the fear of God give you power to avoid the temptations that can trap you and cost you your life (Proverbs 1:4,7; 4:5-7; 7:4-27, 13:14; 14:27; 24:4,5)
Additional advice for recovery of an addict:
If someone is overtaken in a fault, it is your responsibility to help him, in a spirit of meekness. (Galations 6:1)
You will greatly increase your chances of succeeding in your battle if you first seek (and heed) wise advice from multiple counselors. (Proverbs 12:15; 13:13-14; 24:6)
A good person keeps getting back up when he falls. (Proverbs 24:16)
MOST SUCCESSFUL DRUG REHAB PROGRAMS IN THE WORLD
It would be great if more effective drugs were developed to aid in the recovery of an addict. Such efforts are, indeed, being pursued. In the mean time, one might ask "what are the characteristics of a successful drug rehab program?"
Before discussing this, it's important to understand the neurobiology of addiction:
Neurobiology of Addicton for Dummies -- This is a very helpful, easy-to-understand presentation
Stanford Marshmallow Study
Self Control, Addiction and Brain Differences
Learning to juggle grows brain networks
Le Mont Michael Expectations
Le Mont Michael Policies
10 Tips for 1st year of Recovery
Drug based "cure" for alcoholism in rats
The
San Patrignano treatment center in Italy is
one of the most successful drug-free approaches to drug treatment in the world, advertising a 72% success rate for those staying at least 18 months. The
St. Jude Retreats have a relatively high success rate of 62%. Note that these percentages are based on particular assumptions, so they cannot be compared on an apples-to-apples basis. These are just two examples of good treatment centers. (Note that many treatment centers advertise high success rates, but cannot point to any independent studies to confirm it. Also, some drug treatment centers are a disguised racket; for example, a cursory review of
this program might look impressive until you
read this. )
These success rates compare to an industry average of between 16-20%, with the majority of drug abusers relapsing. So is there something that these rehab facilities are doing differently that accounts for this relatively high success rate? Here are some clues:
1. None of these programs use the AA-derived 12-step program, and they do not psychologically "break down" their clients. The well-intentioned (but poorly performing) 12-step program uses a watered-down "piece" of religion as a "tool" to kick a habit, whose participants often enter the program as an alternative to jail time. These are often people with limited commitment and who have no real interest in changing their lifestyle, beliefs or their way of thinking, beyond just this one particular habit. People typically drop out of the 12-step program before a year is up, not really seeing it as something they need or want to do for multiple years, much less seeing it as part of a religion to be practiced all their lives. The program also tends to scare people away unless/until they're desperate. (This criticism does not generally apply to Christian drug rehab programs, just to the 12-step program. And despite theological, psychological and and practical problems, even the 12-step program does have some good points.)
2. These programs are typically MUCH longer than the typical 30 days--more like 3-18 months or more. Most drug treatment programs are 30 days in length, because that is what insurance companies will pay for. In general, the success of a drug treatment program appears to be
roughly proportional to the time length of participation.
3. These programs typically take the client completely out of his former negative environment to a new, sheltered community. It is important that the former addict give up his old identity and culture--and often, this means giving up his old druggie friends, his old personal appearance, his old thinking patterns, etc. Then afterwards, the best success is often achieved when the person does NOT go back to the same environment he came from--perhaps moving to a different location, etc., to be away from his old influences, and to start a new career with the new job training and coping skills he has gained. These programs also typically provide ongoing support and reassurance that help is still available for him if/when he needs it--in other words, an effective relapse prevention program.
4. These programs
do not treat alcohol as a chronic disease, believing that this just allows people to feel like victims. This bucks the conventional wisdom, at least in terms of how the residents are treated. For instance, the San Patrignano philosophy is that drug abuse in not a disease of the body, but "a disease of the soul"--and it is not a chronic disease, even if it is a recurring one. The St. Jude programs call the "disease of addiction" model a sham, and do not believe in labeling "regular problems" as diseases and disorders. These programs are based on the assumption that it really is possible to stop taking drugs. Complete sobriety is the goal, regardless of what drugs were taken. Based on this assumption, the programs do not use drugs (beyond initial detox) as part of their treatment. (It may seem shocking, but success with drug abuse recovery has been--in general--so dismal that many professionals have developed the defeatist opinion that drug addicts are unrecoverable and the objective is merely to improve the quality of life of those who continue to be drug addicts.)
5. These programs typically are NOT focused on the drug abuse, and do NOT label their residents as drug abusers. Instead they address issues that made the person vulnerable to drug abuse in the first place. The founder of the San Patrignano community described it as follows: “Among the problems that affect the drug addict, drug use is the least relevant. The core of the problem is not drugs, nor the abstinence crisis: it is the human being with his fears and the black holes that threaten to suck him in. That is why I do not like to say nor hear that ours is a community for drug addicts. Ours is a community for living, where you can restart after years spent as a social outcast. Ours, if we really need a definition, is a community against social marginalization.” The San Patrignano community provides continuing studies as well as job training and social re-integration as a key part of their program. An educational and social approach based on compassion and empowerment that teaches life skills is typical of these programs, rather than a medical or drug-based approach.
6. These programs seek to provide the client with new interests and new friends, and to give his life new meaning, while keeping him busy with "normal" activities that are nevertheless physically and mentally challenging, that encourage him to try new things and challenge himself, activities that boost his self confidence, self reliance, self-control and his sense of responsibility and accomplishment. Education and job training are also critically important. If, upon leaving rehab, the client is still not employable, and/or has not developed new interests and found new purpose and meaning in his life, he is in danger of becoming bored or depressed--
and this is the surest way for him to have a relapse.
HOW TO IDENTIFY A DRUG USER--typical characteristics
There are many clues that suggest someone MIGHT be a substance abuser. These included behavioral clues, psychological/spiritual clues, personal grooming and physical appearance clues, clues based on characteristics of family and friends, and health symptoms.
Here are some URL links that list identifiable characteristics of a substance abuser:
1.
Typical characteristics of a substance abuser
2.
Seven psychologica/spiritual characteristics of functioning alcoholics
3.
Identifying a drug abuser in a waiting room or at a pharmacy counter
4.
Characteristics of drug inhalers
Beside the more obvious clues, sometimes even the most seemingly unrelated characteristics or events can serve as clues for drug use; i.e.,
someone who mistreats animals or has a pit-bull chained in his yard, or, if your child is on drugs, missing teaspoons from your kitchen drawer, missing money or valuable items from your home.
Multiple tattoos are often an indicator of deviant behavior, including drug abuse. Body piercings, sagging pants, side-ways worn baseball caps and spiked hair can also be hints that a person is associated with a drug culture. Even a preference for
rave music,
techno music or certain types of
dance music can be a strong indicator of drug use, as well as pop or punk music whose
lyrics have references to pot.
Hip hop / rap, techno, R&B and reggae music is often associated with a whole range of drug and alcohol abuse. Even country music has some association with alcohol abuse, although it is not a strong link.
Perhaps some of the strongest indirect clues for long term drug addiction--and the most tragic--are poverty, joblessness, homelessness, loss of friends and social support, loss of self respect and morals, anti-social or deviant behavior, and depression.
