How other countries are winning the war on drugs – Kingsport Times News

In yesterday’s newspaper, I wrote about how challenging it has been to win the war on drugs by attempting to block drug distribution. After a half-century implementing this strategy, we are $1.5 trillion poorer, drugs are more widely available, gang violence (fueled by drug profits) is widespread, our jails are bursting, and the number of overdose deaths has doubled each decade. We have failed to block the supply of drugs.
Just one drug, fentanyl, has killed more Americans than all wars combined since World War II.
We need to continue prohibiting the sale and importation of illicit drugs. But there must also be emphasis on “demand reduction” and “harm prevention.”
Demand reduction involves helping people thrive without drugs. Harm prevention is about minimizing damage to society when people do use drugs.
This article will discuss what some American locations as well as foreign countries are doing as they seek ways reduce societal costs of drug addiction.
Portugal was suffering a surge of heroin use in 2001, along with widespread HIV infections, spread by dirty needles. In response, Portugal developed a comprehensive approach to drug use. When people are caught with less than a 10-day drug supply, they are sent to a local commission consisting of a doctor, lawyer and social worker.
Instead of sending the user to jail, this commission is empowered to enroll the user into long-term programs designed to get them drug free. After treatment, recovering addicts are provided help with job training, employment support and housing, thus reducing drug-induced unemployment and homelessness.
Addicts who continue using drugs can exchange dirty needles for clean ones at pharmacies. Overdose deaths in Portugal dropped by 80%; drug-related HIV infections by 90%.
The United Kingdom, Netherlands, Austria and others provide free drug testing, especially where youth congregate (e.g., music events) to help prevent overdosing.
Doctors in the Netherlands prescribe heroin to addicts. When addicts purchase their drug at a pharmacy, they get a safe product that is less likely to cause overdoses and ER visits. The drug costs less than illegal drugs, so the addict is less likely to steal to raise cash, and it deprives drug gangs of money.
Iceland, a prosperous, modern country of 300,000 people, has reduced demand more than any other country. The Icelandic Prevention Model is a response to their perception back in the 1990s that their youth were using drugs and alcohol at an exorbitant rate.
Iceland’s approach is based on research suggesting kids use drugs for one of two reasons: (1) self-medication as a way to cope with stress, or (2) a way to seek thrills. IPM is managed by parent councils, which Americans might think of as a cross between our local PTA and Boy/Girl Scouts. The councils develop, at state expense, social and activity-oriented programs for their neighborhood designed to address the needs of teens in both groups.
For example, there are typically spelunking, climbing and kayaking opportunities offered for thrill-seekers. For kids seeking relief from stress, there are programs like music, dance and art. Nearly every town and village has a geothermally heated swimming pool open year round. In Iceland’a climate, that is noteworthy.
Furthermore, councils meet with parents of teens and ask them to commit to spend time and do activities with their teens. Teens 13 to 16 years old have a curfew: 10 p.m. in winter and midnight in summer. Any teen out late is likely to be scolded by the nearest adult. In addition, the schools have detailed educational programs about drugs, stress management and life skills.
As a result of IPM, teens who reported being drunk in the previous month plummeted from 42% in 1998 to 5% in 2016. Use of cannabis dropped from 17% to 7%, and smoking cigarettes fell from 23% to 3%.
Iceland is a small, homogenous country. All of IPM might not translate to U.S. society, but there is much to emulate. There are organizations in Canada and throughout Europe, looking to incorporate aspects of IPM into their societies.
Here in the U.S., New York City recently opened the nation’s first overdose prevention center, where addicts can take illegal drugs in a safe environment. Other states and cities are looking at similar projects. Space is provided with clean needles and syringes to reduce needle-born disease. A nurse is present, so if someone overdoses, a narcotic agonist can be administered and the addict won’t consume ambulance and emergency room resources.
Some people reject these approaches as “coddling” addicts. They fear it will cause drug use to increase by making it less punitive. Yet, that has not occurred. To the contrary, rates of addiction remain level or drop, while the cost of enforcement and societal costs decline.
The U.S. is currently failing to stop the flow of drugs into or within the country. The changes we need are complicated and not easily communicated with sound bites. Do our political leaders (president, governors, congressional delegates, state legislators) have the guts to rise above the stale one-liners about “getting tough on crime” and “securing the border”? Will they advocate for solutions that might actually work? If not, we need to express our dissatisfaction, and elect candidates who will.
David Kashdan, Ph.D., is retired director of Eastman Chemical Research Division and a senior consultant with RISE: Research Institutes of Sweden. Email him at
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