COMMENTARY

Tackling the Nation's Drug Problem

James L. Lindon, PharmD, PhD, JD

Disclosures

September 28, 2011

In This Article

The Escalation of Illicit Drug Use

For the first time in 8 years, illicit drug use in the United States is increasing. In 2009 (the last year for which statistics are available), 22 million Americans used an illicit drug, 9% more than the previous year. Use of prescription drugs, marijuana, MDMA (ecstasy), and methamphetamine are all increasing; only cocaine shows a decline in use. Prescription drug abuse is the country's fastest growing drug problem.[1]

A National Drug Control Strategy

Last spring, President Obama announced his Administration's inaugural National Drug Control Strategy, which establishes 5-year goals for reducing drug use and its consequences through a balanced policy of prevention, treatment, enforcement, and international cooperation.[2]

President Obama said that the nation's drug problem is complex and proposed that it should be treated similar to other public health concerns, such as smoking or drunk-driving, where the end goals are to raise awareness, change attitudes, and reduce demand for drugs.[3] The administration's drug control strategy will focus on allotting more resources for drug prevention and treatment using a broad, multifaceted approach. This strategy also aims to eliminate barriers to drug treatment, and encourage healthcare providers to take a more active role.

The president's strategic points for accomplishing these goals are summarized as follows[4]:

  • To increase screening and early intervention for substance use in all healthcare settings and to expand prescription drug monitoring programs;

  • To expand addiction treatment in community health centers and the Indian Health Service;

  • To support law enforcement efforts to reduce drug availability, promote alternatives to incarceration, and mandate treatment and court monitoring for chronic drug-using offenders;

  • To maximize federal support for law enforcement drug task forces, assist tribal authorities in combating drug trafficking, and interdict the southbound flow of currency and weapons;

  • To conduct joint counterdrug law enforcement operations with international partners, promote alternative livelihoods for coca and opium farmers, and target the illicit finances of drug-trafficking organizations; and

  • To enhance current data systems and assess the availability, price, and purity of illicit drugs on the street so that it is known when our programs have a measurable impact on drug markets.

The outcome goals of the president's plan were modest -- to reduce morbidity and mortality associated with the use of addictive substances by 10%-15% within 5 years. The difference between President Obama's plan and that of the previous administration was primarily one of focus. Similar to previous administrations the president made it clear that he was not in favor of wholesale drug legalization. However, he seems to favor policies and practices that might best be characterized as early detection of drug addiction, drug treatment, and harm reduction.

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