In my previous post on this subject, I discussed addiction to alcohol and other drugs. I made the point that addiction to these substances is not an illness, but rather an extremely strong habit.
The notion that alcoholism is a disease gained popularity in the 50’s and 60’s. At about the same time, employers were beginning the practice of offering medical insurance to their staff, and insurance companies routinely included 30 days of treatment per year for alcoholism and/or drug addiction. At the time, there were very few treatment units for these problems, and little use was made of the drug and alcohol provisions in the insurance policies.
America, however, is nothing if not entrepreneurial, and soon private treatment units began to appear, fuelled by insurance dollars. At the same time, a quasi-religious group named Alcoholics Anonymous was thriving, and the commercial treatment units forged a symbiotic alliance with this organization. The treatment units hired senior members of AA as counselors, and “patients” were required to attend AA meetings as part of their treatment. In fact, for most of the units, treatment consisted of induction into the AA fellowship. Group therapy, individual therapy, lectures, films, etc., were all aimed towards encouraging and fostering membership of AA (and, of course, Narcotics Anonymous for people addicted to other drugs). Because alcoholism and drug addiction were conceptualized as illnesses, these programs were technically under the direction of a physician director, but his/her role seldom extended beyond the physical issues of detox, alcohol-induced tissue damage, etc… The actual running of the unit was in the hands of a counselor director (usually a recovered alcoholic and a member of AA).
By the late 80’s, chemical dependency treatment had become one of the fastest-growing (possibly the fastest-growing) industries in the United States. Around 1990, however, the insurance companies decided to pull the plug. And just as the treatment unit boom had been fuelled by insurance dollars, so its demise occurred when these dollars stopped flowing. I was involved in the chemical dependency treatment arena when these changes were occurring, and there was undoubtedly a good deal of hardship on the individuals who lost their employment. But in hindsight, I find myself on the side of the insurance companies. Their position was (and still is, I presume) that alcohol and drug addiction are not in themselves medical problems. So they would pay for detoxification, where this was medically necessary, but not for the 30 days of group therapy and induction into AA. Sometimes they would pay for these kinds of psycho-social interventions in an outpatient setting – but the days of the 30-day-residential (inpatient) programs were over.
There are still a small number of units serving individuals who can foot the bill from their own resources. And of course, there is still a publicly funded system. Most (perhaps all) states provide an involuntary commitment procedure for alcohol and drug addicts who have become dangerous to themselves or others. These individuals are committed to treatment units, sometime at the state hospital, sometimes free-standing. These programs are usually operated on the same general lines as the private units mentioned earlier, and are often described as “revolving doors”. This is because the “clients” routinely return – sometimes two and three times a year -for further “treatment”.
War on Drugs
The war on drugs has been around since the 60’s, but gained enormous momentum in the early 80’s under the Reagan administration. This so-called war which the United States government (along with the governments of many other nations) is waging against its own citizens, has to date cost the tax payer an estimated one trillion dollars (thirty-nine billion dollars so far this year). In addition, it has criminalized literally thousand (millions?) of ordinary people, has filled our prisons to overcrowding and beyond, has fuelled the biggest prison-building program in our nation’s history, has destroyed quality of life in many of our urban areas, and has turned the Mexico-US border area into a war zone.
And all for what? All for the US government’s claim that it has the right to tell people what they may and may not ingest.
First, let me clarify my position. The only drug I have ever used is alcohol. I have had a great deal of illness in recent years, and have occasionally received morphine and dilaudid for pain during inpatient stays at hospitals. I do not advocate the use of drugs for recreation, self-medication, or coping with life’s difficulties. Alcohol, nicotine, cocaine, heroin, etc., are all drugs, and they are all bad for you. And the more you ingest, the worse it gets. And some of the damage is permanent.
However, it is also my position that governments have not the right to tell people what they may or may not put into their bodies. In a democratic republic, political power ultimately resides in the people. And we surrender some of this power to an elected government in the interests of mutual safety, organization of services, etc.. But the notion that the government has the right to determine what an individual may or may not ingest is a throwback to a monarchical type of tyranny that should have no place in a country such as the United States. And as the War on Drugs has clearly demonstrated, they aren’t able to enforce their prohibitions.
So my position is legalize everything. But I would have certain safeguards and protections in place, which I will outline in my next post. Stay tuned.
Next Post: Drugs and Alcohol (Part 3)