National Institute on Drug Abuse Speaks on Addiction and how we are handling it wrong

Head of National Institute on Drug Abuse says Prison Not the Answer to Addiction

One of the nation’s top drug officials has once again pointed out the current criminalization and stigmatizing approach to addiction aren’t working and continue to disproportionately impact minority communities.

National Institute on Drug Abuse (NIDA) Director Nora Volkow has discussed the harms of the ‘war on drugs’ and the need to take an alternative approach, in part by decriminalizing substance misuse and promoting treatment through a public-health-focused model. She expanded on those points during an interview with scientific journal publisher Springer Nature about a variety of drug policy issues and a new op-ed she wrote for Scientific American.

The overarching themes again concern the current criminalization and stigmatizing approach to drugs and the real need for change. While there are several possible iterations of decriminalization that could replace the existing system, Volkow said that one thing is apparent: the ‘war on drugs’ has had outsized consequences for minority communities, and that alone should be reason to reevaluate the country’s law enforcement-centric policies on drugs.

“It is clear that the United States is currently reckoning with a long history of discriminatory and racist policies, many of which still continue today,” Volkow said. “The War on Drugs was no exception, and by incarcerating Black people at disproportionately high rates, it has had radiating effects into health, economic security and mobility, education, housing, families — areas intrinsically connected with the well-being and success of so many Black and other people of color.”

The country’s top drug science official said that there’s no need for additional studies to shed light on the harms of criminalization. “In science, we often must say that we don’t yet have an answer, that ‘more research is needed,’” she added. “But the evidence here is straightforward and solid, and needs to inform an urgent conversation.”

That conversation has been happening for decades in advocacy and civil-rights circles — and there are legislative efforts that have been introduced and enacted to help repair the harms of the ‘war on drugs’ — but her comments are a notable call-to-action from the nation’s leading drug official.

When asked if she felt there was “consensus” on the need to shift to a public-health approach to substance misuse, Volkow said serious work needs to be done. “There is stigma associated with drug use and addiction that is deeply ingrained in culture and society around the world. Many diseases, particularly mental health disorders, are stigmatized,” she said. “As humans, we are taught to fear sickness, and to alienate what is different from us.”

But this is a losing proposition, she added.

“We all get sick, we all have needs, and we all benefit from a system that works to treat diseases and conditions with evidence-based care and compassion,” Volkow continued. “Making this cognitive shift will likely be critical to achieving the political will to implement a widespread public health approach.

She also talked about the record-high drug overdose deaths in the U.S. during 2020 and said that is just one more reason to “re-evaluate how we are addressing drug use. The science provides some answers as to what is working and isn’t regarding the issue of criminalization,” she said.

In the Scientific American op-ed, Volkow noted the record-high overdose deaths should tell us “that something is wrong,” and that the data are “shouting for change.”

“It is no longer a question of ‘doing more’ to combat our nation’s drug problems. What we as a society are doing — putting people with drug addiction behind bars, underinvesting in prevention and compassionate medical care — is not working,” she said. “Even as we work to create better scientific solutions to this crisis, it is beyond frustrating — it is tragic — to see the effective prevention and treatment tools we already have just not being used.”

She added that harm reduction services like syringe exchange programs “need to be a part of any solution to our drug crisis, as these have been shown to reduce HIV and hepatitis C transmission, and help link people to treatment for addiction and other conditions.”

Researchers are evaluating whether “innovative but historically controversial strategies” such as safe consumption sites where people can use illegal drugs under medical supervision can be cost-effective and “reduce deaths and improve health,” she said. “The risk of incarceration does not deter drug use, let alone address addiction; it perpetuates stigma, and disproportionately harms the most vulnerable communities.

“Radical change to save lives is long overdue,” Volkow wrote. “It is crucial that scientists help policymakers and other leaders rethink how we collectively address drugs and drug use, looking to the evidence base of what improves health and reduces harms across communities, and funding research to develop new prevention and treatment tools.”

In a podcast interview with Drug Policy Alliance founder Ethan Nadelmann that aired last week, she acknowledged that marijuana legalization has not led to increased youth use, despite her earlier fears, and she spoke about the therapeutic potential of certain psychedelics that have long been deemed “dangerous” under federal law.

This piece is a part of a content sharing arrangement between The News Station and Marijuana Moment.

Kyle Jaeger is Marijuana Moment's Los Angeles-based associate editor. His work has also appeared in High Times, VICE, etc.

Kyle Jaeger is Marijuana Moment's Los Angeles-based associate editor. His work has also appeared in High Times, VICE, etc.

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