Let ’s Be Bl u n t

Issue Guide: Drugs in America February 23, 2019

Let’s Be Blunt: How Should America Redefine its Drug Narrative?

(Drugs Not Included)

Steve Andrews, Jessie Barth, Kaitlyn Bridge, Emily Buckingham, Eddy Cha, Connor DiBella, Josie Golder, Lucia Kupiec, Dan Lennon, Lia O’Leary, Kadambari Prabakar, Nicci Schoedel


History and Current Situation The controversy surrounding drugs stems mainly from two factors: the misuse of

prescription drugs and the vast accessibility of illegal substances. This deliberation will focus mainly on how to untangle the complex web of issues surrounding the overall drug narrative. For the purpose of this deliberation, drugs will be defined as any substance that alters an individual’s physical or mental state, excluding alcohol and tobacco, due to their current legal standing.

The perception and legality of drugs in the United States has changed dramatically since the early 20th century. Cocaine was present in one of America’s favorite drinks, CocaCola, until 1903 and other drugs such as marijuana and opium used to be common sedatives. Even one of the most stigmatized drugs in America, heroin, was used during wartime to calm and distract soldiers. The drugs themselves haven’t changed and their use barely has, merely the perception over time.

This changing perception has attracted politicians to take strong stands on the issue. The “War on Drugs” is the phrase commonly used by politicians in an effort to stop illegal drug trafficking and consumption. This phrase was coined by former president Richard Nixon and has been used since. This “war” has done little over time to combat drug use, with the 80’s being a high point in cocaine production and the 21st century peaking marijuana consumption. The main purpose of the phrase has been to slander drug users in an attempt to make the once mundane turn monstroserous.

In recent years, the misuse of opioid drugs has skyrocketed, thus marking a new and complex chapter in the drug narrative. Americans have begun using these prescription drugs for recreational purposes, and due to their addictive nature about 4,837 overdose deaths occured in the past year alone for people aged 1524. The 2016 National Study of Drug abuse estimates that roughly 1 in 10 people aged 12 and over struggle with some level of substance abuse, including prescription drugs. However, much of the drug addiction among young adults does not start with hard drugs, but rather softer, “gateway drugs” such as marijuana, which, while significantly less harmful, still serve as an introduction to the world of substance use.


Drug addiction can lead to other lifethreatening diseases, such as heart disease, cardiovascular issues, liver failure, severe brain injuries, and increased risk of infectious diseases. Addiction can also increase the prevalence of motor vehicle accidents, impacting both those under the influence and those who are not. It can affect anyone and takes a toll mentally and physically not only on the addict, but also on their family, friends, coworkers, or classmates. Furthermore, certain communities are more prone to drug addiction than others, such as veterans, the LGBTQ community, and college students.

Due to the farreaching impacts of drug addiction, it is important that American society comes together to discuss how to address the drug narrative moving forward. Today’s deliberation attempts to serve as a forum to help members of the community find areas of common ground and tension when it comes to this topic, and to aid in deciding how they would like to see America procede. A Framework for Deliberation

This issue guide covers three different approaches to consider when redefining America’s drug narrative. Each approach is presented in a neutral way that fosters communication and problemsolving rather than debating or taking sides. The benefits and drawbacks of each approach are clearly outlined to enhance discussion. They have been created and researched on terms ensuring that they are viewed and discussed equally. Approach 1: Prevention is a key concept to changing the drug narrative. People should be better educated on the topic of drug addiction. This will steer people away from drugs in the future. Approach 2: The legalization of certain drugs and further decriminalization of all drugs will lead to regulation and a shift from incarcerating drug crimes to just issuing fines. Approach 3: By making rehabilitation more accessible and wellknown, drug addiction becomes something that one can successfully recover from. The state of addiction does not have to be a permanent one.

We will go into more depth with each approach and examine their benefits and drawbacks through conversation that fosters positive communication despite our differences. The goal of this deliberation is to discover points the community disagrees on, then work on finding a happy medium. We urge you to take a moment and listen to your fellow community members and from them learn to look at this issue from a new perspective.

Finally, each approach will be led by a different part of this deliberation group and will have a moderator who guides the discussion. The moderator will remain impartial throughout the entire deliberation only restating what has already been said for further clarification.


Approach 1 Prevention and Education According to the National Institute on Drug Abuse, some children begin using drugs as

early as age 12. This is quite alarming since Americans do not usually picture children who have not even attended their first dance as having a drug addiction. Once addiction starts, it becomes expensive to stop. Drug abuse and addiction cost the United States $200 billion in healthcare, criminal justice, and lost productivity in one year alone.

In order to support the overall wellbeing of citizens, the government has money allocated for preventing substance abuse. It is part of the Prevention and Public Health Fund, which allowed for the national antitobacco campaign to be possible. This allocation of money makes it easier to advocate for media campaigns and other potential healthcare campaigns.

This approach details an increased focus on prevention as the primary strategy to change the drug narrative in America. Proposed mechanisms include educating the general public of the consequences of drug use via a media campaign, having drug prevention programs such as D.A.R.E (Drug and Resistance Education) be mandatory in schools, and making periods of transitions easier, in schools especially.


Changes Proposed

Use media campaigns to educate the general public

Utilize available resources such as the Prevention and Public Health Fund to create an antidrug campaign

Have the campaign be made at the federal level Such a campaign was used to raise awareness about tobacco, and in one year saw

1.6 million smokers try to quit, helping more than 100,000 to succeed Establish mandatory education programs

Improve D.A.R.E. programs and make them a mandatory course in the first semester of ninth grade

Bring in former addicts or those close to one to speak about how drugs severely impacted their lives

The tobacco campaign worked because it evoked strong emotional reactions and made the consequences feel real to those it targeted

Create better transition programs for new students

Drug use is more likely to begin during times of transition, such as moving and changing schools

Allocate more resources for transition programs and new student programs for better integration into the school community

Provide more funding towards mental health resources

Substance abuse is more common amongst those with mental health issues, as they use it as a coping mechanism

Have mental health clinics screen for substance abuse Increase funding toward helping those with mental health issues



Approach 2 Legalization and Regulation In the United States, the Drug Enforcement Administration classifies drugs into 5

schedules based on their medical uses and potential for abuse. Schedule 1 includes drugs like heroin, ecstasy, and marijuana. Meanwhile, drugs such as meth, cocaine, and OxyContin are classified in comparatively “safer” schedules. This system has faced widespread criticism, predominantly due to the classification of marijuana as a Schedule 1 substance. Many people believe marijuana does have medical benefits and is not as harmful as its classification implies, as can be seen in the fact that 33 states have legalized it for medical purposes and 10 for recreational use.

To rewrite the drug narrative in the United States, the way people perceive drugs must change. This approach entails the legalization of soft drugs and the decriminalization of all drugs. To clear any misconceptions, this does not mean allowing the masses easy access to substances like meth and heroin. Instead, it entails legalizing soft drugs that do not cause physical addiction. As for the rest, we would decriminalize them. This would be done by moving from a culture of incarceration and towards a society in which the offense is merely fined. Making this shift could have a number of implications, which are detailed below. Changes Proposed Legalize soft drugs to allow the US government to enact regulations on the substances

The government could enact a minimum age of 21 to purchase legalized drugs Most brain maturation has occurred by that age, so neural development would not

be impacted Purchase limits could decrease the amount of drugs a person can purchase at once

In Pennsylvania, you can only buy two 6 packs of beer at one time We could apply a limitation to the amount of drugs you purchase as well This would help prevent overdose or excessive usage.

The packages that the drug is sold in could have labeling and advertising requirements Like the Surgeon General’s warning on all cigarettes packs, drugs could have a

label with an addiction warning and potential side effects Quality testing could ensure that the substances people are ingesting are as clean and pure

as possible Fungus, bacteria, and butane have been found in marijuana, because it was not

tested for contaminants If soft drugs were legalized, the federal government could administer tests to

ensure that consumers aren’t ingesting any additionally harmful substances


Launch media campaigns to discourage usage of drugs despite their legalization and decriminalization

Recently advertising campaigns have launched showing viewers the “real cost” of tobacco use

These ads depict smokers being treated for lung cancer or graphic images of attractive teens losing their teeth

Something similar could be launched with soft drugs. Commercials could show people the cost of using drugs, as to discourage usage

Change the punishment for drug charges to correct overcrowding and institutionalized racism

Make drug charges a fine rather than a felony or charge with jail time The population of federal inmates has risen by 50%, with an overcrowding rate

reaching nearly 30% According to the Federal Bureau of Prisons, 46% of all inmates are locked up for

drug charges Drug charges contribute a great deal to institutionalized racism

Nearly 80% of all people in federal prison for drug possession and 60% of people in state prison for drug possession are either black or latino

People of color are also more likely to be given a longer sentence for the same offences committed by a white person

Create a drug industry of legalized drugs

The federal government could make billions from taxing this industry A new industry where multiple levels of production are involved would supply a massive

amount of employment This industry supply chain requires farmers, processors, distributors and retailers

along with many contractors to build new locations for retail Reducing government expenditure by eliminating money spent on enforcement, trials,

and prisons More than half of all states have already legalized marijuana for medical purposes

In 2017, Colorado reported a $247,368,473 profit from tax revenues from marijuana sales

In Pueblo County, Colorado, the new marijuana business boasted a net 35 million dollar gain for the local economy allowing them to grant scholarships to local students


Many nations have already legalized and decriminalized drugs successfully In 2001, Portugal decriminalized all drugs to combat the nation’s drug crisis

People in possession of drugs are sent to a meeting with the Commission for the Dissuasion of Drug Addiction who will recommend treatment plans or imposes a small fee

The graph above depicts the steady decrease in drug related deaths in Portugal since 2001

Portugal has the second to lowest number of drug related deaths per year in the EU and decreased drug use in 1524 year olds

Following Portugal, Spain, the Netherlands, Switzerland, and Czech Republic have decriminalized drugs, and Canada, Ireland, France, and Norway are moving to join the ranks


Approach 3 Revamping Rehabilitation

Currently, three different types of rehabilitation services ranging in flexibility and cost exist. The first is inpatient/residential rehab, where the patient lives in a facility and is given medicinal and psychological help. The second is outpatient rehab, where the patient commutes to a center where medical and psychological help is given on a set schedule group. Lastly, there is individual therapy. This entails the patient receiving psychological help from either a group and advisor, or just an advisor.

Despite the variety of proven successful options, many people struggle to access rehabilitation services they need to combat their addiction. According to American Addiction Centers, only 18% of those in need of treatment for addiction received it in 2016. One reason for this is the financial burden of treatment: according to American Addiction Centers, the full cost of rehabilitation ranges from $15,000 to $27,000 depending on insurance, length of treatment, treatment type, and location. People who reside in lowincome areas are most vulnerable to addiction, and are also less likely to have adequate health insurance coverage. In addition, there is a severe shortage of treatment facilities in rural areas, which contain only 8% of all facilities in the US. This poses a geographical obstacle to treatment that is especially problematic when considering the opioid epidemic.

To redefine the drug narrative, this approach focuses on helping those currently suffering from addiction by improving access and availability to rehabilitation, and encouraging them to seek help. Imprisoning people with addiction is currently the common “solution” but it serves to punish people for something they physically and mentally can no longer control. Changes Proposed Readjust the healthcare system to ensure proper service

Expand MedicaidMany states have already done so through the Affordable Care Act. Research by the Kaiser Family Foundation showed states that expanded Medicaid

had a much sharper decline in uninsured rates among lowincome populations than states that did not.

One study in 2014 showed Medicaid expansion reduced previously uninsured patients’ outofpocket medical expenses by $200 that year, on average.

Treatment centers can adjust rates for people who demonstrate need 45% of centers offer free service to people who cannot afford it. The problem here is that many are not aware this is an option, so making it more well known is key.


Rather than focusing on who pays for healthcare, focus on what’s making it so expensive in the first place: inefficient suppliers that charge excessive medicine prices and a lack of quality initial care/prevention services. Cracking down on these will lead to a lower cost for healthcare.

Break down geographic barriers to rehabilitation

Direct an increase of government funding to build more rehabilitation centers. Offer monetary/other incentives to relocate doctors to rural areas. Expand telehealth services, which allow people in isolated areas to talk with

professionals without travelling. Eliminate the stigma surrounding addiction

Though structured forms of rehabilitation have been proven effective, some prefer a more informal structure. Free selfhelp services such as Narcotics Anonymous provide an alternative, though they are more common in urban environments.

Increasing awareness in the variety of treatment options may encourage more people to reach out and seek help.

Educate people about scientific findings emphasizing the nature of addiction as a disease rather than something individuals can control.


Summary

The drug crisis in America has caused a variety of issues, ranging from overcrowding of prisons to lack of rehabilitation. Illicit drugs are one of the greatest threats facing the American nation. Although some changes have been made over the last few decades, there is still much to do and many ways to progress and assist our nation’s future narrative on drugs.

Although there are several possible solutions to the complex web of issues presented by the drug crisis, each requires evaluation based on community values. Below are brief summaries of the three approaches, including the proposed changes, as well as the benefits and drawbacks. Approach 1 : Prevention and Education

Prevention promotes halting the problem before it begins. Some of the proposed changes include educating the general public on consequences of drug use, implementing school level, and making periods of transitions easier for school aged children. The benefits of this approach include saving the federal government billions of dollars and being able to implement a change that has had prior success. The drawbacks include the lack of effectiveness of education programs and potentially increasing the incentive for youth to experiment with drugs. Approach 2 : Legalization and Regulation

Legalization and regulation entails the reorganization of the drug classifications in order to legalize soft drugs with potential benefits and decriminalize drugs that currently elicit jail time. The benefits of this approach include the ability to closely regulate substances, and decrease some of the major issues within the prison system. The drawbacks include the risk of increasing the availability of substances and occurrence of drug related crimes if the penalty is minimized. Approach 3 : Revamping Rehabilitation

Revamping rehabilitation entails making rehabilitation services more accessible and changing the perception of addiction. The benefits of this approach are a decrease in imprisonment for drug charges, and a greater access to services and information. The drawbacks are the high costs this could result in for taxpayers and insurance holders, along with the possibility of growing the stigma surrounding addiction.


Questionnaire

1. Gender and Age: ________________________

2. Have you attended a deliberation before?

3. What was your reason for coming to today’s deliberation?

4. How has your thinking changed since the beginning of the deliberation?

5. What was your favorite approach? Explain why.

6. On a scale of 110, how effective do you think Approach 1 would be in stopping America’s youth from doing drugs? Why?

7. Do you believe combining Approaches 2 and 3 would solve the drug crisis? Why or why not?

8. What is your greatest concern with the approaches we discussed in this deliberation?

9. Where did you find common ground with the rest of the group throughout the deliberation? Were there any unresolved tensions?

10. List at least one thing you learned from our deliberation.

11. What was one thing you would have liked to discuss further?


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