Chapter 18: Rethinking Drug Policy

drug legalization

when the sale, acquisition, use, and possession of recreational drugs are legal for adults (alcohol and tobacco)

drug prohibition

when the sale, acquisition, use and possession of drugs are banned

drug decriminalization

when the possession of illegal drugs for personal use is not a criminal offense

ideal drug policies strikes…

a balance between individual freedom and public health and safety

a drug-related crisis

impetus for developing new drug policies

three different forms of drug policies

drug legalization, drug prohibition, and drug decriminalization

what is the most common cause of arrests?

drug related offenses

what would decrease under drug legalization

impurities and adulterants in drugs and violence associated with drug trafficking

Sqitzerland’s heroin-assisted treatment program decreased…

number of people who contracted HIV

safe drug consumption facilities

are designed to reduce harm, providing a safe space for individuals to use drugs under medical supervision and access healthcare services.

Give an example of an unintended consequence associated with inappropriate drug policy?

Racial discrimination

alcohol - detoxification

benzodiazepines

alcohol - maintenance

antabuse, naltrexone, and acamprosate

opioids - detoxification

methadone and buprenorphine

opioids - maintenance

methadone and naltrexone

opioids - antagonist

naloxone

nicotine - maintenance

patches, gum, nasal spray, lozenge, inhaler, zyban, and chantix

what three drugs don’t have accepted medicinal treatments?

cocaine, marijuana, and hallucinogens

types of pharmacotherapies treatment

agonists (substitution therapy), antagonists therapy, and aversion/punishment therapy

agonists or substitution therapy

involves replacing an opioid with another opioid, such as methadone or buprenorphine, to help manage opioid addiction

antagonists therapy

medications that block the effects of other substances or hormones, essentially "turning off" their activity.

aversion/punishment therapy

a behavioral technique where an undesirable behavior is paired with an unpleasant stimulus to reduce its occurrence. (emetic drug with alcohol use)

SBIRT

screening, brief intervention, and referral to treament

motivational enhancement therapy

USED TO BOOST THE MOTIVATION TO CHANGE OF AN AMBIVALENT OR LESS
READY SUBSTANCE ABUSER
• A NONCONFRONTATIONAL PROCESS OF DETERMINING THE ABUSER’S
CURRENT STAGE OF CHANGE AND THEN HELPING THE INDIVIDUAL MOVE
FORWARD

contingency management

AN APPROACH IN WHICH INDIVIDUALS RECEIVE IMMEDIATE REWARDS FOR
PROVIDING DRUG-FREE URINE SAMPLES
• VALUE OF THE REWARDS INCREASES WITH CONSECUTIVE DRUG-FREE
SAMPLES

skill building counseling

what should we be doing

state requirement for drug education and public outcry about a local “epidemic”

strategies to enhance public health and safety

drug-purity testing, heroin-assisted treatment, and safe drug consumption sites

drug-purity testing

1999: Spanish nongovernmental organization, Energy Control, started offering confidential drug-testing services

provided free of cost to citizens and credited for decreasing harms associated with illegal drug use and potentially saving lives

Instituted at places wher substance use is pervasive

heroin-assisted treatment history

1980s-1990s: swiss public health officials were faced with increasing rates of HIV infections and inplemeneted heroin-assisted treatment and have seen positive outcomes

heroin assisted treatment

the prescription of pharmaceutical heroin (diacetylmorphine) to people with severe opioid use disorders who have not responded well to more traditional forms of treatment like methadone or buprenorphine.

cognitive behavioral therapy

a type of talk therapy that helps individuals change unhelpful thoughts, feelings, and behaviors. It focuses on the relationship between thoughts, feelings, and behaviors

in what ways is treatment cost effective?

reducing crime and increasing employment