Drug Use and Public Health

The criminalization of drug use in society is extremely problematic. Most people who use drugs do not get addicted.1 Those that do often have pre-existing mental health problems, including family history of alcoholism and depression. Addiction is a disease according to the National Institutes of Health (NIH). It is a chronic, "often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences."2 People are criminalized for having this disease, but most often if they are also poor, Black or Hispanic, and live in the wrong neighborhood.

What does this mean for public health?

Public health professionals should support all decriminalization and legalization efforts for all drugs. The American Public Health Association (APHA) supported medical use for marijuana in 1995.3 Decriminalization efforts in Portugal and Holland have been widely successful in mitigating harm caused from drug use (namely HIV/hepatitis incidence among Intravenous Drug Users).4 There is no reason to keep certain drugs illegal. If anything, it promotes the manufacture and distribution of far more dangerous drugs with no known safety profile.5 Black-market drugs contain adulterants that are far worse than the actual drug.6

Drug users can organize and participate in their own health and wellbeing. From Holland:

We are people from around the world who use drugs. We are people who have been marginalized and discriminated. We have been hurt unnecessarily, put in jail, depicted as evil, and stereotyped as dangerous and disposable. Now it is time to raise our voices as to establish our rights and reclaim the right to be our own spokesman striving for self-representation and self empowerment.7

Harm reduction is the philosophy of minimizing the dangers associated with drug use without involving the criminal justice system. Needle exchange programs (NEPs) provide hypodermic needles to intravenous drug users (IDUs) and allied services (HIV testing, counseling, referrals, etc.). Harm reduction and NEPs specifically are one of the most effective public health programs in existence — one literature review identified fifteen independent studies that show NEPs reduce needle-sharing and reduce the incidence of HIV and hepatitis C among intravenous drug users.8 NEPs are also very, very cost-effective.9,10 Despite this, NEPs are banned from receiving federal funding. See: mass incarceration.

1 http://www.nytimes.com/2013/09/17/science/the-rational-choices-of-crack-addicts.html?_r=0
2 http://www.drugabuse.gov/publications/drugfacts/understanding-drug-abuse-addiction
3 http://www.drugpolicy.org/docUploads/APHAendorse.pdf
4 http://content.time.com/time/health/article/0,8599,1893946,00.html
5 http://www.ncbi.nlm.nih.gov/pubmed/18365939
6 Joint Regional Intelligence Center. (2011). Cocaine contaminated with levamisole. Retrieved from website: http://info.publicintelligence.net/JRIC-Cocaine.pdf
7 http://www.lsd.nl/Adviesbureau/Diensten/drug_user_movement.html
8 Strathdee, S. A., & Vlahov, D. (2001). The effectiveness of needle exchange programs: A review of the science and policy. AIDScience, 1(16).
9 Nguyen, T.Q., Weir, B.W., Pinkerton, S.D., Des Jarlais, D.C., & Holtgrave, D. (J2012). Increasing investment in syringe exchange is cost-saving HIV prevention: modeling hypothetical syringe coverage levels in the United States. 19th International AIDS Conference, Washington DC, Abstract.
10 Gold, M., Gafni, A., Nelligan, P., & Millson, P. (1997). Needle exchange programs: an economic evaluation of a local experience. Canadian Medical Journal,157(3),

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