essay about drug abuse prevention and control week

Drug Abuse Prevention and Control

This essay will discuss strategies for preventing and controlling drug abuse. It will cover various approaches, including education, policy changes, rehabilitation programs, and law enforcement efforts, to provide a multi-faceted view of drug abuse prevention and control. Additionally, PapersOwl presents more free essays samples linked to Crime Prevention.

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The deep, energetic and sonorous voice of Whitney Houston that graced our ears will truly be missed. She was found dead in her house as a result of cocaine overdose. She was about 48 when she died. So will young Mac Miller and Lil Peep- talented celebrities who died of accidental fentanyl overdose at a very young age. Their stories, we heard due to the status they have achieved in the society. There are millions of other young people all over the world given to illegal drugs misuse and overdose who die daily due to drugs.

Deaths caused by illegal drugs have been estimated to be about 200,000 yearly for injecting drug abusers.

Some of the dangers associated with illegal drug use include overdose, addictions, criminal behavior alongside a myriad of side effects. Illegal drug users or drug abusers pose a threat to themselves and to the environment at large. Seeing the big dangers associated with illegal drug use and the increase in number of illegal drug users, several measures have been taken by different countries to curb this menace. The United states government adopted the Narcotics and Dangerous Drugs law which provided different measures such as compulsory treatment and severe punishment for drug related offences including death penalties for some categories of Drug trafficking.

For example, Malaysian government recently declared death penalty for drug traffickers. Under the Malaysian law, if a person possesses as small as few ounces of marijuana and half an ounce of heroin, the person is declared a trafficker. Other countries such as Vietnam, Saudi Arabia etc. have zero tolerance for illegal drug users. Also, several establishments and non-governmental organizations have launched campaign against drug abuse and illegal drug use.

However, jail terms and prison sentences have proven ineffective in the control of illegal drug use. Criminalization approaches to drug use has mostly exacerbate the problem rather than solving the problem. Recidivism, which is the tendency to relapse into the previous state, has been confirmed in most illegal drug users who serve jail terms. Studies carried out in 15 states showed that one-quarter of the prison inmates released returned to the prisons for other crime related offences including testing positive for drug use. In fact, illegal drugs are sold in prisons despite the security and controlled environment prisons offer. It seems more like the very things the offenders are being punished for are what they are being exposed to in prison cells. Some other post prison trauma such as living with the stigma of being an ex-convict, difficulty in getting a paid employment, difficulty in reuniting with their family or loved ones cause some of the illegal drug users to fall into relapse.

Drug abuse and addiction is one of the key disadvantages of illegal drug use. It has been confirmed that chronic addiction associated with drug abuse is actually an illness that requires help, treatment and care. The emphasis should be placed on drug counseling/psychotherapy and education of individual drug users. The combinations of these two approaches have proven to be more effective than criminalizing illegal drug users. It should be noted that drug abuse as a result of illegal drug use is a health concern and if it is addressed as a health concern, people should not be jailed because of their sicknesses. Furthermore, keeping drug users in prison is quite expensive for the government.

The longer the sentences, the greater the bill. It was discovered that in 2008, the United States government spent 47 billion naira on corrections. These monies could be diverted into building a structure for psychotherapy/drug counseling and drug information centers. Drug users come out better and benefit more from programs like this. In addition, integrating drug education into school curriculum would go a long way in prevention or reducing the incidence of illegal drug use. Early child education and awareness is important

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U.S. Government Accountability Office

The Crisis of Drug Misuse and Federal Efforts to Address It

Earlier this week, many media outlets ran stories highlighting the growing crisis of drug misuse in the United States. Citing Centers for Disease Control and Prevention (CDC) data, the New York Times said that more than 100,000 Americans died from drug overdoses during a yearlong period ending in April 2021.

Drug misuse—the use of illicit drugs and the misuse of prescription drugs, such as opioids—has been a persistent and long-standing public health issue in the United States. National rates of drug misuse have increased over the last two decades, and are a serious risk to public health, our society, and the economy.

GAO has issued numerous reports highlighting steps the federal government can take to improve its response to this crisis. In 2019, before the pandemic, we raised this issue as a critical one needing attention and in 2020, we decided to add drug misuse to our High Risk List —a list of areas that need immediate attention. And since then we have been looking at how the pandemic has impacted these issues.

Today’s WatchBlog post looks at our work on the drug misuse crisis, and federal efforts to address it.

The federal strategy

In recent years, the federal government has spent billions of dollars and has enlisted more than a dozen agencies to help address drug misuse and its effects.

The National Drug Control Strategy is the federal effort to reduce substance use disorders through a coordinated national drug control policy. The Office of National Drug Control Policy (ONDCP) is responsible for overseeing and coordinating this effort.

Our work has identified deficiencies in the most recent iterations of the Strategy, which could serve as an action plan for addressing this high-risk area. In December 2019 , we recommended that ONDCP develop and implement key planning elements, like resource investments and roles and responsibilities, to help it structure its ongoing efforts and to better position the agency to meet statutory requirements for future iterations of the Strategy.

In November 2020 , we recommended that agencies clarify how their programs help to achieve specific goals of the Strategy.

The availability of treatment and recovery programs

As drug misuse has increased, so has demand for treatment and care. But in December 2020 , we reported that treatment availability has not kept pace with need. The Substance Abuse and Mental Health Services Administration (SAMHSA) told us that while drug misuse is widespread, nearly one-third of U.S. counties (31%) did not have facilities offering any level of substance use disorder treatment.

Some key barriers in addressing demand for treatment include workforce shortages, insurance reimbursement and payment models, federal and state requirements, and the stigma of drug abuse.

SAMHSA administers grant programs aimed at expanding access to treatment for substance misuse. But we found that the data SAMHSA relies on to understand the impact of its awards and efforts was unreliable because it included both individuals who received treatments funded by its grant programs and those who didn’t. We recommended that it improve the quality of data it uses.

After treatment, there are some federal programs for those recovering from drug misuse. For example, the Department of Labor (Labor) provides grants to states to address the employment and training needs of those affected by and recovering from substance use disorders.

In May 2020 , we recommended that Labor share information, such as lessons learned, from states participating in the program with all states, tribal governments, and outlying areas. Labor agreed with our recommendation.

Monitoring the impact of federal efforts

Our past work has identified gaps in the availability and reliability of data for measuring the federal government’s progress with addressing drug misuse.

For example, ONDCP and other federal, state, and local government officials have identified challenges with the timeliness, accuracy, and accessibility of data on overdose cases (both fatal and non-fatal) from law enforcement and public health sources. In March 2018 , we recommended that ONDCP lead a review on ways to improve overdose data.

ONDCP is also responsible for evaluating the effectiveness of national drug control policy efforts across the government. But, in March 2020 , we reported that ONDCP had not fully developed performance evaluation plans to measure progress against each of the Strategy’s long-range goals, as required by law.

Without effective long-term plans that clearly articulate goals and objectives as well as specific measures to track performance, federal agencies cannot fully assess whether taxpayer dollars are invested in ways that will achieve desired outcomes, such as reducing access to illicit drugs and expanding treatment for substance use disorders.

COVID-19’s effects on drug misuse and new federal assistance

It’s not yet known just how much the pandemic has impacted mental health and substance use. But, in September 2020, SAMHSA reported opioid overdose deaths have increased in some areas of the country by as much as 25% to 50% during the pandemic compared to the previous year.

In March 2021 , we reported on the effects that the COVID-19 pandemic was having on demand for behavioral health services, including mental health and substance use disorders. The added stressors caused by the pandemic—such as feelings of isolation and financial stress—have contributed to increases in emergency room visits for overdoses and suicide attempts and requests for other behavioral health services. Our podcast with GAO health care expert John Dicken discusses this report.

Under the CARES Act and other subsequent pandemic relief acts, SAMHSA was appropriated around $8 billion for behavioral health services, which include substance abuse prevention and treatment services and community mental health services, among other activities. For example, specific funds are available for the Certified Community Behavioral Health Clinic Expansion Grant program while other funds can be spent to address emergency substance abuse or mental health needs in local communities.

Our work monitoring the federal response to the drug misuse crisis is ongoing, but to learn more about our findings and recommendations so far, visit our High Risk page on this issue.

• Comments on GAO’s WatchBlog? Contact  [email protected] .

GAO Contacts

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Related products, drug misuse: sustained national efforts are necessary for prevention, response, and recovery, product number, drug misuse: agencies have not fully identified how grants that can support drug prevention education programs contribute to national goals, drug misuse: most states have good samaritan laws and research indicates they may have positive effects, drug control: the office of national drug control policy should develop key planning elements to meet statutory requirements, substance use disorder: reliable data needed for substance abuse prevention and treatment block grant program, workforce innovation and opportunity act: additional dol actions needed to help states and employers address substance use disorder, illicit opioids: while greater attention given to combating synthetic opioids, agencies need to better assess their efforts, behavioral health: patient access, provider claims payment, and the effects of the covid-19 pandemic.

GAO's mission is to provide Congress with fact-based, nonpartisan information that can help improve federal government performance and ensure accountability for the benefit of the American people. GAO launched its WatchBlog in January, 2014, as part of its continuing effort to reach its audiences—Congress and the American people—where they are currently looking for information.

The blog format allows GAO to provide a little more context about its work than it can offer on its other social media platforms. Posts will tie GAO work to current events and the news; show how GAO’s work is affecting agencies or legislation; highlight reports, testimonies, and issue areas where GAO does work; and provide information about GAO itself, among other things.

Please send any feedback on GAO's WatchBlog to [email protected] .

108 Drug Abuse Essay Topic Ideas & Examples

🏆 best drug abuse topic ideas & essay examples, 👍 good essay topics on drug abuse, 💡 most interesting drug abuse topics to write about, ❓ drug abuse research questions.

Drug abuse essays are an excellent way to learn about the issue and its influence on various groups and populations while demonstrating your understanding.

Various substances, including alcohol, narcotics, and other mind-altering products, are a popular method for recreation in some communities.

However, they are prone to result in addiction, psychological as well as mental, and lead the person to pursue another dose before anything else.

In doing so, he or she can eventually ruin his or her life, which is why most drugs are currently banned around the world. This article will offer you some tips that will help you write an excellent essay and receive the top grade.

Youth is a major demographic that is affected by addiction issues due to drug consumption. Young people are impressionable and prone to search for new sensations. Drugs can offer a sense of novelty and provide an experience they have not had before, leading to considerable appeal.

Considering that young people are generally not wealthy and have to focus on work to succeed in life, essays on drug among youth can use a variety of excellent topics. You can offer your ideas on the reason for the phenomenon’s existence and ways in which it can be prevented.

However, remember that the purpose of the programs should be to help the people who are at risk.

There are many other drug abuse essay topics that you can explore, with poverty being a prominent example. Despite their conditions, many people turn to substance abuse to try and escape the unpleasant aspects of their life.

These population segments are more likely to suffer after acquiring a drug habit than young people because they generally receive less attention.

Furthermore, poor neighborhoods with relatively low amounts of surveillance by law enforcement are likely to house drug dealers who prey on vulnerable people.

You can discuss this topic or discuss a variety of other ones, as the relationship between poverty and poor outcomes has been researched deeply.

Here are some additional tips for your essay:

• Try to use examples to illustrate your points about various aspects of the issue. Drug addiction essay quotations from people who are affected by the condition or have overcome it can offer valuable insights. They also legitimize your findings by providing parallels with the real world.
• Alcohol essays are an excellent choice, as the substance is legal and available to everyone without much difficulty. Nevertheless, its effects can be devastating, especially if a person’s consumption is chronic.
• Try to write a drug abuse essay outline before starting work, as it will help you to organize the essay. Select some prominent ideas that you want to discuss and organize them in a manner that represents a logical progression. You do not have to discard all of the other concepts, as you can make them sub-headings under your main titles.
• Be sure to include a drug abuse essay introduction and conclusion in your work. They will help you provide a structure to the essay and make it easier for the reader to understand your ideas. The introduction should describe the topic and provide the thesis, and the conclusion should restate your main points.

Visit IvyPanda for drug abuse essay titles, and other useful samples on various subjects to help you with your writing work!

• Drug and Alcohol Abuse For along time now, drug and alcohol abuse in the society has been a problem that affects the youth and the society at large. This paper highlights the problems of drug abuse and alcohol drinking […]
• Drug Trafficking and Drug Abuse Drug trafficking contributes to drug abuse in the society. Drug trafficking also contributes to increased criminal activities that affect the security of citizens.
• Social Media Impact on Drug Abuse Thus, social media platforms definitely contribute to the misuse of various drugs by romanticizing their consumption and making “social drug use” acceptable among users.
• Drug Abuse and Current Generation Drug abuse also breeds an array of behavioral problems among young people, which may affect their suitability to fit in the society.
• Drug Abuse & Its Effects on Families Focusing on the family seems to be by far, the most known and effective way of finding a solution with regards to the “war on drugs” since it more promising to end the vicious cycle […]
• Drug and Substance Abuse Many experts consider addiction as a disease as it affects a specific part of the brain; the limbic system commonly referred to as the pleasure center.
• Merton’s Argument of Deviance: The Case of Drug Abuse The most prominent example in support of Merton’s argument in relation to drug abuse is that cultural and social circumstances play a crucial role in defining people’s desire to engage in drug use.
• Consequences of Drug Abuse The endless stream of drugs, obtainable to the individuals with little or no restrictions, poses a serious inquiry. When assessing the advantages of using pharmaceutical drugs, it is essential to consider the severity of health […]
• Prevention Research: The Fight Against Drug Abuse It is agreeable that US’s ‘War on Drugs’ has been an effective substance abuse prevention plan despite the hiccups that the program faces and its inability to attain some of its designated mandates within the […]
• Reasons Behind Youth’s Engagement to Drug Abuse in the 21st Century Although youths in the 21st century engage in drug abuse due to several factors, it suffices to declare factors such as the rising unemployment status, peer pressure, and their hiked tendency to copy their parents’ […]
• Drug Abuse Among the Youth Essentially, this case study will allow the evaluation of the prevailing cases of drug abuse among the youth. In this regard, the pain and peer pleasure cannot be persevered to allow an explicit cure of […]
• Drug Abuse. “Nine Years Under” Book by Sheri Booker The book is thought provoking and important because it allows representing the difficult social situation and the problems of gang violence and drugs in the United States from the personal point of view.
• Drug Abuse, Aggression and Antisocial Behavior The use of abusive drugs can cause anger in people because of the effect they have on the brain. An example of how alcohol can cause aggression in a person is that it impairs an […]
• “Cocaine: Abuse and Addiction” by National Institute on Drug Abuse The literature provides us with a report of a research that has been conducted in the US regarding the topic of cocaine and drug abuse.
• Drug Abuse Effects on Health and Nervous System These numerous damages severely affect the quality of the brains work and the health of the nervous system. While discussing the effects of drug addiction, it is essential to notice that it has a devastating […]
• Drug Abuse and Prevention Strategies When specialists deal with preventative factors, they pay attention to both mental and physical ways to resist the drug. The symbiosis of these procedures is exceptionally efficient in terms of the drug rehabilitation process when […]
• Youth Drug Abuse Among, Education, and Policies Although drug abuse encompasses improper use of drugs disregarding the prescriptions of medical practitioners, the principal challenges of drug abuse occasion from abuse of drugs such as cocaine, heroin, and marijuana.
• Drug Abuse and Its Psychological Effects The purpose of this paper is to explore in more depth the psychological effects of addiction on the family and inner circle of the addict.
• Policies for Pregnant Women With Drug Abuse Thus, out of all the offered policies, financial support for therapy is the best one, as it motivates prevention and treatment, which, in turn, causes the improvement of this situation.
• The Formative Evaluation: Program of Addressing Drug Abuse in Schools The proposed program sought to educate students about the challenges of drug abuse, its impacts on academic performance, and the best techniques to avoid the vice.
• Alcohol and Drug Abuse in Canada Therefore, it contributes as a central factor in the essence of the character, and it is crucial to understand the core definition and the elements that foster the ideology.
• Mitigating Drug Abuse in Pine View School The inclusion of professionals in the fields of health care, counseling, and drugs is expected to promote the delivery of desirable results.
• Drug Abuse and Its Negative Effects This paper aims to highlight what the field of psychology says about the negative effects of drugs and why people continue using despite the consequences. The main effect is that it creates a memory of […]
• Prevention Programs: Drug Abuse Resistance Education This program focuses on handling peer pressure among youths, a crucial cause of drug abuse in the country. The program is also grounded on sound research, which offers the critical elements vital to handling the […]
• Drug Abuse in Lake County, California The topic of drug abuse is essential for discussion due to the need to develop strategies to prevent and minimize the dangerous consequences of drug abuse in different regions.
• Drug Abuse Among Homeless Young Adults in New Jersey The reason why young adults in New Jersey get involved in drugs and alcohol after becoming homeless is to manage their situations in an attempt to attain the tentative pleasure of life despite their problems. […]
• Community Intervention Practices against Drug Abuse The key features that result in successful community-based intervention on drug abuse are integrated for effectiveness and efficiency. On the other hand, drug abuse refers to the consumption of substances that elicit particular feelings and […]
• Teenage Drug Abuse in the United States The problem of teenage drug abuse inflicts a threat to the future society and health state of the overall population in the United States.
• Substance Abuse: Prevention Strategies and National Benchmarks Still, this desire to get away from problems by means of substances instead of making effort to improve an individual’s environment contributed to the evolution of the challenge of substance abuse into a real public […]
• Alcoholism, Domestic Violence and Drug Abuse Kaur and Ajinkya researched to investigate the “psychological impact of adult alcoholism on spouses and children”. The work of Kaur and Ajinkya, reveals a link between chronic alcoholism and emotional problems on the spouse and […]
• Monitoring the Future: National Survey Results on Drug Use National survey results on drug use obtained by Monitoring the Future have a significant value to the development of various approaches with regard to the prevention of drug abuse.
• The Health Issues Associated With Drug Abuse It is therefore imperative to develop strategies for health promotion to reduce the number of teenagers, the most at-risk family member when it comes to drug abuse.
• Fentanyl – Drug Profile and Specific and Drug Abuse The drug has the effect of depressing the respiratory center, constricting the pupils, as well as depressing the cough reflex. The remainder 75% of fentanyl is swallowed and absorbed in G-tract.
• Cases of Drug Abuse Amongst Nursing Professionals It is noteworthy that at the top of the information, the date posted is Monday, February 14, 2011, yet against the information, the date is February 11, 2011.
• The Treatment of Drug Abuse Any medical practitioner treating a drug abuse patient has to be careful in many aspects, like: He has to be careful on the issue that if the addiction has effected the brain of the patient.
• Drug Courts and Detoxification: Approach to Drug Abuse Treatment However, since 1989, the US federal system has been providing the majority of drug abusers with proper treatment or education with the help of a drug court option.
• Drug Abuse in Adolescents Aged 15-19 Years Old: A Public Health Menace In addition, the objectives of the paper are as follows: the first aim is to analyze the collected data and produce a review of the information.
• Drug Abuse in Adolescents and Its Causes Scientific research shows that the development factors for adolescent drug abuse are not limited to a set of three to five causes, but are usually linked to the integration of destructive environmental conditions.
• Drug Abuse and Addiction Holimon has succeeded in reviving some of her family relations, and she is still putting a lot of effort to get ahead in this area to the fullest extent possible.
• Sports as a Solution to Youth Substance Abuse: Dr. Collingwood’s View His comments made me realize that it would be unwise by the end of the day for any parent to leave their children under the mercy of the media where they learned that doing drugs […]
• Drug Abuse in High School and College With respect to social work and the problem of substance abuse, research has been carried out in terms of investigating the relationship between drug abuse and poverty, the effects of drug abuse on the society.
• Critical Issues in Education: Drug Abuse and Alcoholism For this case, the ministry concerned has a very hard task of ensuring there are no critical issues that are left unsolved that relate to education, failure to which will affect the performance of students […]
• Biopsychosocial Experience in Drug Abuse Treatment There has to be a preventive strategy in every intervention procedure to avoid the occurrence of a disease. I find the course of treatment in this intervention beneficial for the creation of the needed preventive […]
• Addictive Behavior Programs and Drug Abuse Trends The involvement of stakeholders is an essential condition for the effectiveness of this model of work and its results, and all the roles should be allocated in accordance with the capabilities of the program’s participants.
• Substance Misuse in American Youth: A Socio-Cultural Analysis The paper analyzes studies regarding some of the most widespread types of substances, as well as discusses the role of the rap culture in the growing number of young addicts in the U.S.
• Social Behaviour as a Science: Drug Abuse in Youth Thus, the application of social psychology to the phenomenon of youth drug abuse helps to explain how social factors impact the prevalence of and risk for drug abuse.
• Financial Planning for Drug Abuse Prevention in Virginia Estates Therefore, the first preferred sources for the program are the County Commission and the Alabama Department of Corrections. The program can be financed by the Montgomery County Commission in the short term and Alabama Department […]
• Problem of Drug Abuse in Schools The research worked on the hypothesis that the treatment would reduce or result in the total cessation of drug use, and better relations with family and friends.
• Prescription Drug Abuse in the United States The combination of Ibuprofen and acetaminophen are effective for the patients, who want to reduce and control the level of pain.
• Impact of Drug Abuse on Adolescent Development Therefore, it is important for counselors to consider these stages to help them address the issue of substance abuse among adolescents. In the habitual stage, most adolescents take drugs to help them modify their moods.
• Drug Abuse: Age, Gender and Addictive Susceptibility This incorporates the aspects of gender where males and females possess varying biological constitutions that might affect the prescribed treatments in the realms of addiction. It is important to consider the rapidity and susceptibility of […]
• Drug Abuse Prevention Programs Additionally, it is possible to prospect the success of the program in case the required readiness from the community can be unveiled prior to the program execution.
• The Cultural Context and Ethics of Prevention of Drug Abuse The first prevention strategy outlined in the document is the involvement of young people in all levels of the prevention program establishment. Concurrently, it is crucial to relate this technique with the subject of culture […]
• Use of Psychotropic Medications in the Treatment of Drug Abuse This is because the mental illness is, literally, the one that sustains the abuse of drugs and thus after it is healed; the patient will have no reason to continue abusing the drugs.
• Drug Abuse: Awareness Amongst the Youths This project is going to carry out a public awareness campaign with the aim of educating the young people on the hazards related to the vice of drug and substance abuse. The awareness campaign is […]
• A New Alcohol and Drug-Abuse Rehabilitation Center in Liverpool Hospital, Sydney The hospital, in response to this distress, has decided to bring help closer to the people of Liverpool by the construction of the annex facility.
• The Extent of Drug Abuse Among People in America Toronto Mayor Rob Ford Said He Lied about Crack Cocaine Use Because He Was Embarrassed Mayor lied about the use of crack cocaine The article titled “Toronto Mayor Rob Ford said he lied about crack […]
• Drug Use and Abuse in America: Historical Analysis The new law was similar to the Boggs Act of 1951 in that it employed the same formula of using perceived increase in drug use in the country.
• Drug Abuse as an Ethical Issue On the side of duties and obligations, the societal norms stipulate that individuals should be caring to other members of the society especially the children and the old.
• Drug Abuse and Society Regardless of the many intervention measures that can be adopted to solve this problem of drug abuse, the most effective intervention measure is to create awareness to youths to enable them change their behaviors and […]
• Prescription Painkillers, the New Drug Abuse of Choice Studies attribute the recent increase in the misuse of prescription drugs to an increase in the use of the Internet, which facilitates the growth of illegitimate online drug stores and uncontrolled online prescription drug sales.
• Music Analysis: Drug Abuse in Music So in this song the artist is also lamenting the dangers of drugs and the theme of the music is one that advocates against tackling the problem with issues of drug abuse by arguing the […]
• Drug Abuse: Comprehensive Review The effects associated with drug abuse tend to vary depending on an individual’s age and the phase of drug abuse that the person is in.
• Drug Abuse as a Social Problem This poses as problem to the society because many of the people who are unemployed will resort to different ways of seeking money and pleasure.
• Adolescent’s Drug Abuse and Therapy Success When one accepts to put up with negative peer pressure, they end up giving up the personal trusts and values thus the pressure becomes a form of a negative force.”Does peer pressure affect the decision […]
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• Why Has the American Government Not Managed to Stop Drug Abuse All These Years?
• How Does Drug Abuse Affect Personal Development of Hong Kong Teenagers?
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Prevention of substance use disorders in the community and workplace

Reshma malick.

T.T. Ranganathan Clinical Research Foundation, Chennai, Tamil Nadu, India

Prevention in the community and at the workplace is a vital component in substance use disorder treatment and management. Mobilizing the community, creating awareness that addiction to substances is a disease, that it is treatable and that treatment is available are all essential. A cost-effective prevention and treatment approach plays a major role in creating drug free communities. Workplace prevention policies to prevent and manage substance use disorders leads to safer work environments, better motivated teams of workers and a productive workforce.

INTRODUCTION

In communities, whether rural or urban, the problem of substance abuse is rampant. Community level studies show varying prevalence, depending on the methodology and scales used for assessment of substance use disorders.[ 1 ] The recently concluded mental health survey of India estimates the prevalence of substance use, including alcohol use disorders, at 22.4% of the adult population.[ 2 ] The survey also mentions a high treatment gap of 86%. It highlights that the problems are emerging in special populations like children, females and elderly.[ 3 ]

Awareness levels of the fact that getting started with alcohol and other drugs can lead to addiction and that addiction is a disease are very low. The strong stigma attached to seeking help is common and widespread, and because of this, the harmful effects to the person and the family are not squarely faced and dealt with. Addiction is guarded as a huge family secret. As the disease progresses, it becomes known to the whole community and rather than referring him/her to the appropriate treatment facility, the community suggests home remedies, rituals and blames the family. Prevention programmes and sensitization is the need of the hour.

Early prevention intervention in the community

Preventing the growth of this problem in communities calls for a multi-pronged approach and must address the various stages of the life cycle of the population and various segments of the community.

• School-based awareness programmes for children to impart the messages to them at an early age so that they can make healthy choices in life when they grow up. School based interventions on the awareness of harm from substance use have been carried out sporadically in India. The project MYTRI showed that health promotion among adolescents was beneficial in preventing tobacco use.[ 4 ]
• Youth groups in the community, who are important role models may be roped in through awareness programmes and also making use of them to in turn to spread the message.
• Women self-help groups can be educated as members of such groups may be affected by the family member's drug use and most importantly become co-dependent.
• Panchayath leaders or local politicians need to be addressed, as they can support the cause.
• Religious heads from the community need to be involved, as they will positively influence the community to seek professional help.
• The Collector's office/local government bodies can be periodically approached to give out appropriate public service messages.
• The local Public Health Centers need to be equipped with trained staff and appropriate referral mechanism so that early identification and treatment is possible.
• Each community has a specific village festival time when substance abuse can increase; at such times, those who do not use mood altering substances - teetotalers can be identified to partner as agents of change.
• People in the community who provide job opportunities need to be sensitized.
• Local NGOs working in the community need to be made as the focal point of contact.

Awareness needs to be created about the help that is available for the family, educational institution, substance users. This will call for:

• Creating a toll-free number for affected individuals or their families or friends to approach.
• Posters/pamphlets/notices to be displayed.
• Seeking help from the media including print, TV and radio
• Health department to be trained for referral and follow up.
• IRCAs (Integrated Rehabilitation and Counselling Centre for Addicts) sponsored by Ministry of Social Justice and Empowerment) to be made accessible for persons with addiction for availing free services.
• Private doctors need to be sensitized.
• Rural camps can be conducted in partnership with appropriate treatment centres and a host organisation from the community.
• Websites of Government in state and district level need to display services for addiction management.
• Observing all important days like International day against illicit drugs and trafficking, Anti-tobacco day, Gandhi Jayanthi day etc., helps to increase awareness about the problem of substance abuse and addiction.
• Law/police departments need to be engaged to prevent legal problems associated with substance use and intervene for persons with substance use in conflict with the law.
• Use of social media is an increasingly powerful tool even in rural areas. This can work in both enhancing awareness on treatment as well as be exploited by substance using networks.

Rural Camp Model by T T Ranganathan Clinical Research foundation (TTK Hospital)

The camp approach for treatment of alcohol dependence was popularized by the TTK hospital at Manjakkudi in Tamil Nadu. Treatment of alcohol and drug abuse in a camp setting has been found to have good retention rates and favourable outcome at six months.[ 5 , 6 , 7 , 8 ] With over three decades of experience in addiction management, TTK Hospital has been conducting cost effective rural treatment camps in villages. A brief outline of the process involved is as follows:

• Based on the need in the community. Empirical evidence of higher levels of substance use, any survey or studies which indicate this, reports of untoward incidents due to substance use, and lack of availability of treatment facilities in that area may be pointers for identification for the suitability of a camp approach.
• A host organisation is very essential to anchor all support and to establish the camp approach of treatment in the rural community. The host organisation will provide staff, space for conducting the camp and leverage their goodwill in the community to organise the camp.
• Sensitizing the community takes place by conducting awareness programmes, giving information about the treatment camps, motivating them for taking treatment.
• A local physician is identified to provide support during screening, detoxification and for follow- up treatment.
• The patients are required to register for the enrolment in the camp three months before its commencement.
• The medical doctor examines them, assessment is done, and in case of major physical complications, they are referred to nearby hospitals. Other symptomatic ailments are handled by giving medicines.
• The counsellor (psychologist/social worker) does the intake/initial assessment, checks dependence and motivation to quit.
• Tips to remain abstinent are given.
• Team from the treatment agency comprising of counsellors, nurse, driver, arrive at the camp site.
• Those who have enrolled for the camp go through the final screening and medical review. After the medical doctor and the counsellor select them based on eligibility criteria, the patients are inducted into the camp schedule.
• Camp schedule
• Detoxification
• Structured programme for 15 days - including counselling, re-educative classes for patients and their family, group therapy, activities, physical exercise/healthy recreation.
• Exposure to AA/NA
• After camp:
• - regular follow up plan is made and adhered to
• - Home visits are made
• - In case of slip/relapse, help is given.

Several other community-based models of care in the community setting in different parts of India have shown the effectiveness of continued care in improving outcome in alcohol and other substance use disorders.[ 10 , 11 , 12 ]

In a study of patients with alcohol dependence from a lower socio-economic status, weekly follow-up or review in a clinic located within the community showed relatively better drinking and functional outcomes at 3,6 and 9 months as compared to controls.[ 11 ] In a one year prospective study of outcome following treatment of addiction, poor outcome was associated with higher psychosocial problems, family history of alcoholism and more frequent follow-up with mental health services.[ 12 ]

At the Work place

There are a few studies on workplace related substance use problems in India. A study among industrial workers in Goa using the AUDIT estimated a prevalence of 211/1000 of hazardous drinking.[ 13 ]

Assessment of workplace problems related to substance use disorders have neither been systematically addressed nor appropriately addressed. Most existing measures focus on workplace needs rather than on worker's perceptions of difficulties with work and personal life. Recently, a structured tool has been developed in India for assessment of vocational difficulties in persons with substance use disorders.[ 14 ]

The rationale for workplace interventions is that the workplace provides a captive population that can be reached by curative and preventive health care programmes and effective monitoring is possible in such settings. An effective three step approach to deal with issues due to substance use at the workplace include the following:

Developing and implementing a drug free workplace policy, which focuses on:

• A clear message that drug use in workplace is prohibited and encourages employees with substance use related problems to voluntarily seek help
• A workplace policy that aims to protect the health and safety of all employees, maintain product quality and reputation, safeguard employer's assets from self-destruction and protect organisation's image.

Educating the appropriate personnel about the intervention methods:

• Organising awareness programmes for workers/supervisors/management on a regular basis.
• Having IEC materials distributed and displayed in important places.
• Developing protocols and guidelines while dealing with employees with substance dependence
• Taking reformative action by offering them help.
• - Discuss the situation as it is, the deterioration in job performance and feedback about it. Use the report to cite dates and events relating to poor performance. These should be fact based and not appear as qualitative statements
• - State expectations from the employee clearly.
• - If the employee commits to improve, hold him to it and set a commonly agreed date to demonstrate improvement. Do not accept open ended promises.
• - Watch for changes – if the job performance does not change, direct him to the HR personnel for further assessment. In turn, they could refer him to a treatment centre. If the employee does not avail help, the administration may proceed with appropriate action.

Few points to be kept in mind while dealing with problem employees:

- Avoid diagnosing the problem and stating that drinking or substance use is the problem, rather focus attention on poor performance.

- Talk about abuse only if one is using substance in the workplace or comes under the influence to work.

- Avoid giving advice. Bear in mind that the disease of addiction has a huge denial associated with it.

- Avoid enabling behaviours like covering up for the employee, getting trapped in his sympathy-evoking tactics and losing one's temper.

Sending the employees with substance use for treatment.

Instead of terminating the employee's services, referring a problem employee to a treatment centre and making him a productive employee again has the following benefits:

• Ensures problem resolution.
• Makes the problem employee productive again.
• Helps to refocus on productive issues within the organisation.
• Improves the morale and work environment of the organisation.

A few workplace intervention studies for substance use disorders have been carried out in India and found to be effective. The Karnataka State Road Transport Organisation initiated a Workplace Alcohol Prevention Programme and Activity (WAPPA), in the late 1990s. The comprehensive programme provided therapeutic help for employees with substance related problems and included steps to address human resource issues with a view to improving work conditions, employee morale and well-being. An audit conducted after six years showed several improvements among the treated employees, in terms of reduced absenteeism, improved productivity, reduced accidents and improved company image. The audit also revealed other enormous difficult to quantify gains- a healthier, happier workforce, better working environment, better inter-personal relationships, happier families, greater public safety and improved organisational image.[ 15 , 16 , 17 , 18 ]

Case Vignette

Mr M was working in a reputed car manufacturing company for the past five years. He was a talented worker but was into drinking occasionally when he got into the company. Slowly, drinking became a regular practice. He started to get into a binge pattern of drinking in the weekends and was unable to report to work on Mondays. His supervisor started to notice this, along with the fact that he was getting irritable with team members, not able to complete targets, was borrowing money etc., One day, as he was smelling of alcohol, he was sent home with a warning. This was brought to the notice of the HR personnel department. M was called for counselling. After an initial assessment with him and his wife, the welfare officer took him to the addiction treatment centre for an intake assessment. He was diagnosed with substance abuse disorder and need for treatment and rehabilitation was explained. His wife was asked to attend family therapy programme. The welfare officer presented his case to the management and arranged for his treatment.

He completed his treatment, counselling was provided for him and his family. The welfare officer and his supervisor were called for the support person programme. A follow up plan was developed. He started on his recovery and rejoined work. The welfare officer made home visits and at times accompanied him for his follow up. There were qualitative improvements in his work and personal life which was identified and appreciated by the company. He became a role model in his company, co-workers started to seek his help in getting out of substance dependence. He spoke to his colleagues in staff development programmes to motivate them to make smart choices. Soon, one after the other a few of his affected colleagues also took help and a self-help group was initiated in the company”.

Summary and future directions:

• Early intervention is very important targeting all groups in community.
• The participation of key stake holders in the community and their involvement is essential.
• Awareness programmes in the community need to be done in a comprehensive manner, providing facts, healthy alternatives and messages on how to say ‘No’ to drugs.
• A holistic approach is necessary: the linking of prevention activities, medical help, self-help groups and treatment facilities provides wholesome recovery.
• Government bodies need to be involved.
• Periodic awareness programmes to all employees across the hierarchy helps.
• Specific programmes for management, supervisory level staff, medical staff who are placed in industries, security department and workers need to be organised separately as their roles are different.
• HR personnel need to be trained to help employees with substance use problems by early identification through poor job performance and referral to treatment agencies,
• Self-help groups can be formed from among those who are seeking help to quit and recover.
• The organisation can bring into implementation practices like not serving alcohol at business meetings or during team lunches.
• Posters on healthy alternatives need to be displayed in important places.

SELECT REFERENCES

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Richard Nixon

Special message to the congress on drug abuse prevention and control..

To the Congress of the United States:

In New York City more people between the ages of fifteen and thirty-five years die as a result of narcotics than from any other single cause.

In 1960, less than 200 narcotic deaths were recorded in New York City. In 1970, the figure had risen to over 1,000. These statistics do not reflect a problem indigenous to New York City. Although New York is the one major city in the Nation which has kept good statistics on drug addiction, the problem is national and international. We are moving to deal with it on both levels.

As part of this administration's ongoing efforts to stem the tide of drug abuse which has swept America in the last decade, we submitted legislation in July of 1969 for a comprehensive reform of Federal drug enforcement laws. Fifteen months later, in October, 1970, the Congress passed this vitally-needed legislation, and it is now producing excellent results. Nevertheless, in the fifteen months between the submission of that legislation and its passage, much valuable time was lost.

We must now candidly recognize that the deliberate procedures embodied in present efforts to control drug abuse are not sufficient in themselves. The problem has assumed the dimensions of a national emergency. I intend to take every step necessary to deal with this emergency, including asking the Congress for an amendment to my 1972 budget to provide an additional $155 million to carry out these steps. This will provide a total of $371 million for programs to control drug abuse in America.

A NEW APPROACH TO REHABILITATION

While experience thus far indicates that the enforcement provisions of the Comprehensive Drug Abuse Prevention and Control Act of 1970 are effective, they are not sufficient in themselves to. eliminate drug abuse. Enforcement must be coupled with a rational approach to the reclamation of the drug user himself. The laws of supply and demand function in the illegal drug business as in any other. We are taking steps under the Comprehensive Drug Act to deal with the supply side of the equation and I am recommending additional steps to be taken now. But we must also deal with demand. We must rehabilitate the drug user if we are to eliminate drug abuse and all the antisocial activities that flow from drug abuse.

Narcotic addiction is a major contributor to crime. The cost of supplying a narcotic habit can run from $30 a day to $100 a day. This is $210 to $700 a week, or $10,000 a year to over $36,000 a year. Untreated narcotic addicts do not ordinarily hold jobs. Instead, they often turn to shoplifting, mugging, burglary, armed robbery, and so on. They also support themselves by starting other people-young people--on drugs. The financial costs of addiction are more than $2 billion every year, but these costs can at least be measured. The human costs cannot. American society should not be required to bear either cost.

Despite the fact that drug addiction destroys lives, destroys families, and destroys communities, we are still not moving fast enough to meet the problem in an effective way. Our efforts are strained through the Federal bureaucracy. Of those we can reach at all under the present Federal system--and the number is relatively small--of those we try to help and who want help, we cure only a tragically small percentage.

Despite the magnitude of the problem, despite our very limited success in meeting it, and despite the common recognition of both circumstances, we nevertheless have thus far failed to develop a concerted effort to find a better solution to this increasingly grave threat. At present, there are nine Federal agencies involved in one fashion or another with the problem of drug addiction. There are anti-drug abuse efforts in Federal programs ranging from vocational rehabilitation to highway safety. In this manner our efforts have been fragmented through competing priorities, lack of communication, multiple authority, and limited and dispersed resources. The magnitude and the severity of the present threat will no longer permit this piecemeal and bureaucratically-dispersed effort at drug control. If we cannot destroy the drug menace in America, then it will surely in time destroy us. I am not prepared to accept this alternative.

Therefore, I am transmitting legislation to the Congress to consolidate at the highest level a full-scale attack on the problem of drug abuse in America. I am proposing the appropriation of additional funds to meet the cost of rehabilitating drug users, and I will ask for additional funds to increase our enforcement efforts to further tighten the noose around the necks of drug peddlers, and thereby loosen the noose around the necks of drug users.

At the same time I am proposing additional steps to strike at the "supply" side of the drug equation--to halt the drug traffic by striking at the illegal producers of drugs, the growing of those plants from which drugs are derived, and trafficking in these drugs beyond our borders.

America has the largest number of heroin addicts of any nation in the world. And yet, America does not grow opium-of which heroin is a derivative--nor does it manufacture heroin, which is a laboratory process carried out abroad. This deadly poison in the American life stream is, in other words, a foreign import. In the last year, heroin seizures by Federal agencies surpassed the total seized in the previous ten years. Nevertheless, it is estimated that we are stopping less than 20 percent of the drugs aimed at this Nation. No serious attack on our national drug problem can ignore the international implications of such an effort, nor can the domestic effort succeed without attacking the problem on an international plane. I intend to do that.

A COORDINATED FEDERAL RESPONSE

Not very long ago, it was possible for Americans to persuade themselves, with some justification, that narcotic addiction was a class problem. Whether or not this was an accurate picture is irrelevant today, because now the problem is universal. But despite the increasing dimensions of the problem, and despite increasing consciousness of the problem, we have made little headway in understanding what is involved in drug abuse or how to deal with it.

The very nature of the drug abuse problem has meant that its extent and seriousness have been shrouded in secrecy, not only by the criminal elements who profit from drug use, but by the drug users themselves--the people whom society is attempting to reach and help. This fact has added immeasurably to the difficulties of medical assistance, rehabilitation, and government action to counter drug abuse, and to find basic and permanent methods to stop it. Even now, there are no precise national statistics as to the number of drug-dependent citizens in the United States, the rate at which drug abuse is increasing, or where and how this increase is taking place. Most of what we think we know is extrapolated from those few States and cities where the dimensions of the problem have forced closer attention, including the maintenance of statistics.

A large number of Federal Government agencies are involved in efforts to fight the drug problem either with new programs or by expanding existing programs. Many of these programs are still experimental in nature. This is appropriate. The problems of drug abuse must be faced on many fronts at the same time, and we do not yet know which efforts will be most successful. But we must recognize that piecemeal efforts, even where individually successful, cannot have a major impact on the drug abuse problem unless and until they are forged together into a broader and more integrated program involving all levels of government and private effort. We need a coordinated effort if we are to move effectively against drug abuse.

The magnitude of the problem, the national and international implications of the problem, and the limited capacities of States and cities to deal with the problem all reinforce the conclusion that coordination of this effort must take place at the highest levels of the Federal Government.

Therefore, I propose the establishment of a central authority with overall responsibility for all major Federal drug abuse prevention, education, treatment, rehabilitation, training, and research programs in all Federal agencies. This authority would be known as the Special Action Office of Drug Abuse Prevention. It would be located within the Executive Office of the President and would be headed by a Director accountable to the President. Because this is an emergency response to a national problem which we intend to bring under control, the Office would be established to operate only for a period of three years from its date of enactment, and the President would have the option of extending its life for an additional two years if desirable.

This Office would provide strengthened Federal leadership in finding solutions to drug abuse problems. It would establish priorities and instill a sense of urgency in Federal and federally-supported drug abuse programs, and it would increase coordination between Federal, State, and local rehabilitation efforts.

More specifically, the Special Action Office would develop overall Federal strategy for drug abuse prevention programs, set program goals, objectives and priorities, carry out programs through other Federal agencies, develop guidance and standards for operating agencies, and evaluate performance of all programs to determine where success is being achieved. It would extend its efforts into research, prevention, training, education, treatment, rehabilitation, and the development of necessary reports, statistics, and social indicators for use by all public and private groups. It would not be directly concerned with the problems of reducing drug supply, or with the law enforcement aspects of drug abuse control.

It would concentrate on the "demand" side of the drug equation--the use and the user of drugs.

The program authority of the Director would be exercised through working agreements with other Federal agencies. In this fashion, full advantage would be taken of the skills and resources these agencies can bring to bear on solving drug abuse problems by linking them with a highly goal-oriented authority capable of functioning across departmental lines. By eliminating bureaucratic red tape, and jurisdictional disputes between agencies, the Special Action Office would do what cannot be done presently: it would mount a wholly coordinated national attack on a national problem. It would use all available resources of the Federal Government to identify the problems precisely, and it would allocate resources to attack those problems. In practice, implementing departments and agencies would be bound to meet specific terms and standards for performance. These terms and standards would be set forth under inter-agency agreement through a Program Plan defining objectives, costs, schedule, performance requirements, technical limits, and other factors essential to program success.

With the authority of the Program Plan, the Director of the Special Action Office could demand performance instead of hoping for it. Agencies would receive money based on performance and their retention of funding and program authority would depend upon periodic appraisal of their performance.

In order to meet the need for realistic central program appraisal, the Office would develop special program monitoring and evaluation capabilities so that it could realistically determine which activities and techniques were producing results. This evaluation would be tied to the planning process so that knowledge about success/failure results could guide the selection of future plans and priorities.

In addition to the inter-agency agreement and Program Plan approach described above, the Office would have direct authority to let grants or make contracts with industrial, commercial, or nonprofit organizations. This authority would be used in specific instances where there is no appropriate Federal agency prepared to undertake a program, or where for some other reason it would be faster, cheaper, or more effective to grant or contract directly.

Within the broad mission of the Special Action Office, the Director would set specific objectives for accomplishment during the first three years of Office activity. These objectives would target such areas as reduction in the overall national rate of drug addiction, reduction in drug-related deaths, reduction of drug use in schools, impact on the number of men rejected for military duty because of drug abuse, and so forth. A primary objective of the Office would be the development of a reliable set of social indicators which accurately show the nature, extent, and trends in the drug abuse problem.

These specific targets for accomplishment would act to focus the efforts of the drug abuse prevention program, not on intermediate achievements such as numbers of treatments given or educational programs conducted, but rather on ultimate "payoff" accomplishments in the reduction of the human and social costs of drug abuse. Our programs cannot be judged on the fulfillment of quotas and other bureaucratic indexes of accomplishment. They must be judged by the number of human beings who are brought out of the hell of addiction, and by the number of human beings who are dissuaded from entering that hell.

I urge the Congress to give this proposal the highest priority, and I trust it will do so. Nevertheless, due to the need for immediate action, I am issuing today, June 17, an Executive Order [11599] establishing within the Executive Office of the President a Special Action Office for Drug Abuse Prevention. Until the Congress passes the legislation giving full authority to this Office, a Special Consultant to the President for Narcotics and Dangerous Drugs will institute to the extent legally possible the functions of the Special Action Office.

REHABILITATION: A NEW PRIORITY

When traffic in narcotics is no longer profitable, then that traffic will cease. Increased enforcement and vigorous application of the fullest penalties provided by law are two of the steps in rendering narcotics trade unprofitable. But as long as there is a demand, there will be those willing to take the risks of meeting the demand. So we must also act to destroy the market for drugs, and this means the prevention of new addicts, and the rehabilitation of those who are addicted.

To do this, I am asking the Congress for a total of $105 million in addition to funds already contained in my 1972 budget to be used solely for the treatment and rehabilitation of drug-addicted individuals.

I will also ask the Congress to provide an additional $10 million in funds to increase and improve education and training in the field of dangerous drugs. This will increase the money available for education and training to more than $24 million. It has become fashionable to suppose that no drugs are as dangerous as they are commonly thought to be, and that the use of some drugs entails no risk at all. These are misconceptions, and every day we reap the tragic results of these misconceptions when young people are "turned on" to drugs believing that narcotics addiction is something that happens to other people. We need an expanded effort to show that addiction is all too often a one-way street beginning with "innocent" experimentation and ending in death. Between these extremes is the degradation that addiction inflicts on those who believed that it could not happen to them.

While by no means a major part of the American narcotics problem, an especially disheartening aspect of that problem involves those of our men in Vietnam who have used drugs. Peer pressures combine with easy availability to foster drug use. We are taking steps to end the availability of drugs in South Vietnam but, in addition, the nature of drug addiction, and the peculiar aspects of the present problem as it involves veterans, make it imperative that rehabilitation procedures be undertaken immediately. In Vietnam, for example, heroin is cheap and 95 percent pure, and its effects are commonly achieved through smoking or "snorting" the drug. In the United States, the drug is impure, consisting of only about 5 percent heroin, and it must be "mainlined" or injected into the bloodstream to achieve an effect comparable to that which may have been experienced in Vietnam. Further, a habit which costs $5 a day to maintain in Vietnam can cost $100 a day to maintain in the United States, and those who continue to use heroin slip into the twilight world of crime, bad drugs, and all too often a premature death.

In order to expedite the rehabilitation process of Vietnam veterans, I have ordered the immediate establishment of testing procedures and initial rehabilitation efforts to be taken in Vietnam. This procedure is under way and testing will commence in a matter of days. The Department of Defense will provide rehabilitation programs to all servicemen being returned for discharge who want this help, and we will be requesting legislation to permit the military services to retain for treatment any individual due for discharge who is a narcotic addict. All of our servicemen must be accorded the right to rehabilitation.

Rehabilitation procedures, which are required subsequent to discharge, will be effected under the aegis of the Director of the Special Action Office who will have the authority to refer patients to private hospitals as well as VA hospitals as circumstances require.

The Veterans Administration medical facilities are a great national resource which can be of immeasurable assistance in the effort against this grave national problem. Restrictive and exclusionary use of these facilities under present statutes means that we are wasting a critically needed national resource. We are commonly closing the doors to those who need help the most. This is a luxury we cannot afford. Authority will be sought by the new Office to make the facilities of the Veterans Administration available to all former servicemen in need of drug rehabilitation, regardless of the nature of their discharge from the service.

I am asking the Congress to increase the present budget of the Veterans Administration by $14 million to permit the immediate initiation of this program. This money would be used to assist in the immediate development and emplacement of VA rehabilitation centers which will permit both inpatient and outpatient care of addicts in a community setting.

I am also asking that the Congress amend the Narcotic Addict Rehabilitation Act of 1966 to broaden the authority under this Act for the use of methadone maintenance programs. These programs would be carried out under the most rigid standards and would be subjected to constant and painstaking reevaluation of their effectiveness. At this time, the evidence indicates that methadone is a useful tool in the work of rehabilitating heroin addicts, and that tool ought to be available to those who must do this work.

Finally, I will instruct the Special Consultant for Narcotics and Dangerous Drugs to review immediately all Federal laws pertaining to rehabilitation and I will submit any legislation needed to expedite the Federal rehabilitative role, and to correct overlapping authorities and other shortcomings.

ADDITIONAL ENFORCEMENT NEEDS

The Comprehensive Drug Abuse Prevention and Control Act of 1970 provides a sound base for the attack on the problem of the availability of narcotics in America. In addition to tighter and more enforceable regulatory controls, the measure provides law enforcement with stronger and better tools. Equally important, the Act contains credible and proper penalties against violators of the drug law. Severe punishments are invoked against the drug pushers and peddlers while more lenient and flexible sanctions are provided for the users. A seller can receive fifteen years for a first offense involving hard narcotics, thirty years if the sale is to a minor, and up to life in prison if the transaction is part of a continuing criminal enterprise.

These new penalties allow judges more discretion, which we feel will restore credibility to the drug control laws and eliminate some of the difficulties prosecutors and judges have had in the past arising out of minimum mandatory penalties for all violators.

The penalty structure in the 1970 Drug Act became effective on May 1 of this year. While it is too soon to assess its effect, I expect it to help enable us to deter or remove from our midst those who traffic in narcotics and other dangerous drugs.

To complement the new Federal drug law, a uniform State drug control law has been drafted and recommended to the States. Nineteen States have already adopted it and others have it under active consideration. Adoption of this uniform law will facilitate joint and effective action by all levels of government.

Although I do not presently anticipate a necessity for alteration of the purposes or principles of existing enforcement statutes, there is a clear need for some additional enforcement legislation.

To help expedite the prosecution of narcotic trafficking cases, we are asking the Congress to provide legislation which would permit the United States Government to utilize information obtained by foreign police, provided that such information was obtained in compliance with the laws of that country.

We are also asking that the Congress provide legislation which would permit a chemist to submit written findings of his analysis in drug cases. This would speed the process of criminal justice.

The problems of addict identification are equalled and surpassed by the problem of drug identification. To expedite work in this area of narcotics enforcement, I am asking the Congress to provide $2 million to be allotted to the research and development of equipment and techniques for the detection of illegal drugs and drug traffic.

I am asking the Congress to provide $2 million to the Department of Agriculture for research and development of herbicides which can be used to destroy growths of narcotics-producing plants without adverse ecological effects.

I am asking the Congress to authorize and fund 325 additional positions within the Bureau of Narcotics and Dangerous Drugs to increase their capacity for apprehending those engaged in narcotics trafficking here and abroad and to investigate domestic industrial producers of drugs.

Finally, I am asking the Congress to provide a supplemental appropriation of $25.6 million for the Treasury Department. This will increase funds available to this Department for drug abuse control to nearly $45 million. Of this sum, $18.1 million would be used to enable the Bureau of Customs to develop the technical capacity to deal with smuggling by air and sea, to increase the investigative staff charged with pursuit and apprehension of smugglers, and to increase inspection personnel who search persons, baggage, and cargo entering the country. The remaining $7.5 million would permit the Internal Revenue Service to intensify investigation of persons involved in large-scale narcotics trafficking.

These steps would strengthen our efforts to root out the cancerous growth of narcotics addiction in America. It is impossible to say that the enforcement legislation I have asked for here will be conclusive--that we will not need further legislation. We cannot fully know at this time what further steps will be necessary. As those steps define themselves, we will be prepared to seek further legislation to take any action and every action necessary to wipe out the menace of drug addiction in America. But domestic enforcement alone cannot do the job. If we are to stop the flow of narcotics into the lifeblood of this country, I believe we must stop it at the source.

INTERNATIONAL

There are several broad categories of drugs: those of the cannabis family-such as marihuana and hashish; those which are used as sedatives, such as the barbiturates and certain tranquilizers; those which elevate mood and suppress appetite, such as the amphetamines; and, drugs such as LSD and mescaline, which are commonly called hallucinogens. Finally, there are the narcotic analgesics, including opium and its derivatives-morphine and codeine. Heroin is made from morphine.

Heroin addiction is the most difficult to control and the most socially destructive form of addiction in America today. Heroin is a fact of life and a cause of death among an increasing number of citizens in America, and it is heroin addiction that must command priority in the struggle against drugs.

To wage an effective war against heroin addiction, we must have international cooperation. In order to secure such cooperation, I am initiating a worldwide escalation in our existing programs for the control of narcotics traffic, and I am proposing a number of new steps for this purpose.

First, on Monday, June 14, I recalled the United States Ambassadors to Turkey, France, Mexico, Luxembourg, Thailand, the Republic of Vietnam, and the United Nations for consultations on how we can better cooperate with other nations in the effort to regulate the present substantial world opium output and narcotics trafficking. I sought to make it equally clear that I consider the heroin addiction of American citizens an international problem of grave concern to this Nation, and I instructed our Ambassadors to make this clear to their host governments. We want good relations with other countries, but we cannot buy good relations at the expense of temporizing on this problem.

Second, United States Ambassadors to all East Asian governments will meet in Bangkok, Thailand, tomorrow, June 18, to review the increasing problem in that area, with particular .concern for the effects of this problem on American servicemen in Southeast Asia.

Third, it is clear that the only really effective way to end heroin production is to end opium production and the growing of poppies. I will propose that as an international goal. It is essential to recognize that opium is, at present, a legitimate source of income to many of those nations which produce it. Morphine and codeine both have legitimate medical applications.

It is the production of morphine and codeine for medical purposes which justifies the maintenance of opium production, and it is this production which in turn contributes to the world's heroin supply. The development of effective substitutes for these derivatives would eliminate any valid reason for opium production. While modern medicine has developed effective and broadly-used substitutes for morphine, it has yet to provide a fully acceptable substitute for codeine. Therefore, I am directing that Federal research efforts in the United States be intensified with the aim of developing at the earliest possible date synthetic substitutes for all opium derivatives. At the same time I am requesting the Director General of the World Health Organization to appoint a study panel of experts to make periodic technical assessments of any synthetics which might replace opiates with the aim of effecting substitutions as soon as possible.

Fourth, I am requesting $I million to be used by the Bureau of Narcotics and Dangerous Drugs for training of foreign narcotics enforcement officers. Additional personnel within the Bureau of Narcotics and Dangerous Drugs would permit the strengthening of the investigative capacities of BNDD offices in the U.S., as well as their ability to assist host governments in the hiring, training, and deployment of personnel and the procurement of necessary equipment for drug abuse control.

Fifth, I am asking the Congress to amend and approve the International Security Assistance Act of 1971 and the International Development and Humanitarian Assistance Act of 1971 to permit assistance to presently proscribed nations in their efforts to end drug trafficking. The drug problem crosses ideological boundaries and surmounts national differences. If we are barred in any way in our effort to deal with this matter, our efforts will be crippled, and our will subject to question. I intend to leave no room for other nations to question our commitment to this matter.

Sixth, we must recognize that cooperation in control of dangerous drugs works both ways. While the sources of our chief narcotics problem are foreign, the United States is a source of illegal psychotropic drugs which afflict other nations. If we expect other governments to help stop the flow of heroin to our shores, we must act with equal vigor to prevent equally dangerous substances from going into their nations from our own. Accordingly, I am submitting to the Senate for its advice and consent the Convention on Psychotropic Substances which was recently signed by the United States and 22 other nations. In addition, I will submit to the Congress any legislation made necessary by the Convention including the complete licensing, inspection, and control of the manufacture, distribution, and trade in dangerous synthetic drugs.

Seventh, the United States has already pledged $2 million to a Special Fund created on April 1 of this year by the Secretary General of the United Nations and aimed at planning and executing a concerted UN effort against the world drug problem. We will continue our strong backing of UN drug-control efforts by encouraging other countries to contribute and by requesting the Congress to make additional contributions to this fund as their need is demonstrated.

Finally, we have proposed, and we are strongly urging multilateral support for, amendments to the Single Convention on Narcotics which would enable the International Narcotics Control Board to:

--require from signatories details about opium poppy cultivation and opium production-thus permitting the Board access to essential information about narcotics raw materials from which illicit diversion occurs;

---base its decisions about the various nations' activities with narcotic drugs not only as at present on information officially submitted by the governments, but also on information which the Board obtains through public or private sources--thus enhancing data available to the Board in regard to illicit traffic;

--carry out, with the consent of the nation concerned, on-the-spot inquiries on drug related activities;

--modify signatories' annual estimates of intended poppy acreage and opium production with a view to reducing acreage or production; and

--in extreme cases, require signatories to embargo the export and/or import of drugs to or from a particular country that has failed to meet its obligations under the Convention.

I believe the foregoing proposals establish a new and needed dimension in the international effort to halt drug production, drug traffic, and drug abuse. These proposals put the problems and the search for solutions in proper perspective, and will give this Nation its best opportunity to end the flow of drugs, and most particularly heroin, into America, by literally cutting it off root and branch at the source.

Narcotics addiction is a problem which afflicts both the body and the soul of America. It is a problem which baffles many Americans. In our history we have faced great difficulties again and again, wars and depressions and divisions among our people have tested our will as a people-and we have prevailed.

We have fought together in war, we have worked together in hard times, and we have reached out to each other in division--to close the gaps between our people and keep America whole.

The threat of narcotics among our people is one which properly frightens many Americans. It comes quietly into homes and destroys children, it moves into neighborhoods and breaks the fiber of community which makes neighbors. It is a problem which demands compassion, and not simply condemnation, for those who become the victims of narcotics and dangerous drugs. We must try to better understand the confusion and disillusion and despair that bring people, particularly young people, to the use of narcotics and dangerous drugs.

We are not without some understanding in this matter, however. And we are not without the will to deal with this matter. We have the moral resources to do the job. Now we need the authority and the funds to match our moral resources. I am confident that we will prevail in this struggle as we have in many others. But time is critical. Every day we lose compounds the tragedy which drugs inflict on individual Americans. The final issue is not whether we will conquer drug abuse, but how soon. Part of this answer lies with the Congress now and the speed with which it moves to support the struggle against drug abuse.

RICHARD NIXON The White House June 17, 1971

Note: The proposed drug abuse control legislation was S. 2097.

On the same day, the White House released a summary of highlights of Administration actions in the fields of drug abuse prevention and control and a fact sheet on the message.

Richard Nixon, Special Message to the Congress on Drug Abuse Prevention and Control. Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/240245

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FACT SHEET: White   House Releases 2022 National Drug Control Strategy that Outlines Comprehensive Path Forward to Address Addiction and the Overdose   Epidemic

Today, President Biden sent his Administration’s inaugural National Drug Control Strategy to Congress at a time when drug overdoses have taken a heartbreaking toll, claiming 106,854 lives in the most recent 12-month period. The Strategy delivers on the call to action in President Biden’s Unity Agenda through a whole-of-government approach to beat the overdose epidemic.

The Strategy focuses on two critical drivers of the epidemic: untreated addiction and drug trafficking. It instructs federal agencies to prioritize actions that will save lives, get people the care they need, go after drug traffickers’ profits, and make better use of data to guide all these efforts.

Addressing Untreated Addiction for Those At-Risk of an Overdose According to the 2020 National Survey on Drug Use and Health, among the 41.1 million people who needed treatment for substance use disorders (SUD), only 2.7 million (6.5-percent) of them received treatment at a specialty treatment facility over the previous year. One reason for this gap is that people with addiction and those who care for them face too many barriers to treatment. Similarly, key tools like naloxone and syringe services programs are often restricted or underfunded at the community level, which limits access for people who use drugs. For example, some states still have legal barriers that limit access to naloxone, and even in states where those barriers don’t exist, naloxone does not always make it to those most at-risk of an overdose. The President’s National Drug Control Strategy is the first-ever to champion harm reduction to meet people where they are and engage them in care and services. It also calls for actions that will expand access to evidence-based treatments that have been shown to reduce overdose risk and mortality. Finally, it emphasizes the need to develop stronger data collection and analysis systems to better deploy public health interventions.

• Expand high-impact harm reduction interventions like naloxone The Biden-Harris Administration’s efforts focus on meeting people where they are, and building trust and engagement with them to provide care and services. Specifically, the Strategy calls for greater access to harm reduction interventions including naloxone, drug test strips, and syringe services programs. It directs federal agencies to integrate harm reduction into the U.S system of care to save lives and increase access to treatment. It also calls for collaboration on harm reduction between public health and public safety officials, and changes in state laws and policies to support the expansion of harm reduction efforts across the country.
• Ensure those at highest-risk of an overdose can access evidence-based treatment The Biden-Harris Administration’s efforts to expand access to treatment are focused around delivering treatment to those at the highest-risk of overdosing, which includes people experiencing homelessness, those who are incarcerated or re-entering society, and people who inject drugs. The Strategy directs federal agencies to take actions that meet people who need treatment where they are, improves the quality of treatment to include payment reform, supports those at-risk of an overdose, and builds up the Nation’s treatment workforce and infrastructure. It also includes a chapter on Criminal Justice that focuses on direct actions that will improve the delivery of evidence-based treatment when appropriate for people in carceral settings or in the reentry process in addition to other justice-impacted persons.
• Improve data systems and research that guide drug policy development. The Biden-Harris Administration is committed to deploying an evidence-based approach to policy-making as directed in the Presidential Memorandum on scientific integrity and evidence-based policymaking. Development of effective drug policy requires timely and rigorous data covering the full range of trends and activities, including consumption patterns, drug use consequences, prevention, harm reduction, treatment, recovery, drug production, transportation and distribution by drug trafficking organizations, and many more. The Strategy directs relevant agencies to strengthen existing data systems, establish new data systems, including for non-fatal overdoses, and enhance the usefulness of drug data for practitioners, researchers and policy-makers.

Going After Drug Trafficking and Illicit Drug Profits Law enforcement agencies at all levels—federal, state, local, Tribal, and territorial—work to reduce domestic and international cultivated and synthetic drug production and trafficking with the goal of protecting Americans. However, drug producers continue to produce entirely new synthetic drugs, and drug traffickers continue to refine their methods and techniques for distributing them throughout our communities.

The Strategy builds on the President’s FY 23 budget request for a $300 million increase to support the work of Customs and Border Protection (CBP)–one of the largest ever increases for CBP–and for a $300 million increase for the Drug Enforcement Administration. The Strategy prioritizes a targeted response to drug traffickers and transnational criminal organizations (TCOs) by hitting them where it hurts the most: their wallets. It also includes efforts to strengthen domestic law enforcement cooperation to disrupt the trafficking of illicit drugs within the United States, and increase collaboration with international partners to disrupt the supply chain of illicit substances and the precursor chemicals used to produce them. Lastly, the National Drug Control Strategy includes three companion documents that direct Federal agencies to take actions that stop the trafficking of drugs across our Caribbean, Northern, and Southwest Borders.

• Obstruct and disrupt financial activities of transnational criminal organizations (TCOs) that manufacture illicit drugs and traffic them into the United States The illicit drugs smuggled throughout the world generate enormous revenue, which must be moved and laundered so that traffickers can profit from their illicit enterprise.TCOs also require funds to operate their illicit supply chains and exert their transnational corruptive influence. While bulk cash smuggling remains one of the predominant methods for moving illicit proceeds, smugglers also use trade-based money laundering (TBML) such as Black-Market Peso Exchanges and mirror transfers via informal networks. Additionally, TCOs are adept at using darknet markets and virtual assets to launder funds. The National Drug Control Strategy directs agencies to strengthen and employ every available tool, and seek new ones, to uncover financial networks to obstruct and disrupt the illicit financial activities that fund the TCOs who produce and traffic illicit drugs into the United States.
• Reduce the supply of illicit drugs through domestic collaboration and international coordination. The Strategy directs federal agencies to improve cooperation across all levels of government to strengthen our domestic response to drug trafficking; commercially disrupt the production, trafficking, and distribution of illicit substances; improve assessment of supply reduction initiatives; and protect individuals and the environment at home from criminal exploitation. The Strategy also aims to strengthen foreign partnerships to address drug production and trafficking, leverage the influence of multilateral organizations to tackle shared challenge of synthetic drugs, and protect individuals and the environment abroad from criminal exploitation by those involved in drug trafficking.
• Reduce the supply of illicit drugs smuggled across our borders. The Biden-Harris Administration is focused on stopping drugs from entering our communities. The President’s National Drug Control Strategy includes specific border strategies that direct federal agencies to strengthen interdiction and law enforcement capabilities on our Nation’s borders, counter criminal networks, disrupt illicit finance efforts, target drug transportation routes and modalities, and otherwise aggressively reduce the trafficking of illicit drugs. The Strategy also directs agencies to work with partner governments in drug producing and transit countries to prevent illicit drugs from ever reaching our borders.

In addition, the Strategy directs federal agencies to expand efforts to prevent substance use among school-aged children and young adults, and support community-led coalitions implementing evidence-based prevention strategies across the country. It directs federal agencies to expand scientific understanding of the recovery process by establishing a federal recovery research agenda; adopt flexible, responsive approaches that help people with SUD find and follow a pathway to recovery or remission that works for them; and eliminate barriers and increase economic opportunities for people in recovery. And the Strategy includes specific actions to improve access to medication for opioid use disorder (MOUD) programs for jails and prisons; identify ways to advance racial equity in the investigation, arrest, and sentencing for drug related offenses without negatively impacting public safety; divert non-violent individuals from the criminal justice system and juvenile justice systems to treatment when appropriate; and remove barriers and expand supportive  services to help reintegrate people into society after incarceration.

The Biden-Harris Administration has already taken significant actions to address addiction and the overdose epidemic based on the President’s Drug Policy Priorities for Year One .

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• UN Observances

By resolution 42/112 of 7 December 1987, the General Assembly decided to observe 26 June as the International Day against Drug Abuse and Illicit Trafficking as an expression of its determination to strengthen action and cooperation to achieve the goal of an international society free of drug abuse.

Supported each year by individuals, communities, and various organizations all over the world, this global observance aims to raise awareness of the major problem that illicit drugs represent to society.

The evidence is clear: invest in prevention

The global drug problem presents a multifaceted challenge that touches the lives of millions worldwide. From individuals struggling with substance use disorders to communities grappling with the consequences of drug trafficking and organized crime, the impact of drugs is far-reaching and complex. Central to addressing this challenge is the imperative to adopt a scientific evidence-based approach that prioritizes prevention and treatment.

The International Day against Drug Abuse and Illicit Trafficking, or World Drug Day, is marked on 26 June every year to strengthen action and cooperation in achieving a world free of drug abuse. This year’s World Drug Day campaign recognizes that effective drug policies must be rooted in science, research, full respect for human rights, compassion, and a deep understanding of the social, economic, and health implications of drug use.

Together, let us amplify our efforts to combat the global drug problem, guided by the principles of science, compassion, and solidarity. Through collective action and a commitment to evidence-based solutions, we can create a world where individuals are empowered to lead healthy, fulfilling lives.

#WorldDrugDay #InvestInPrevention

World Drug Report

Every year, UNODC issues the World Drug Report , full of key statistics and factual data obtained through official sources, a science-based approach and research. UNODC continues to provide facts and practical solutions to address the current world drug problem and remains committed to attaining health for all. Health and justice sectors are under pressure and access to services and support is obstructed when we can least afford it.

Why Is Cocaine Trafficking Surging?

For two decades, the United Nations Office on Drugs and Crime (UNODC) has been helping make the world safer from drugs, organized crime, corruption and terrorism. We are committed to achieving health, security and justice for all by tackling these threats and promoting peace and sustainable well-being as deterrents to them.

The World Drug Report provides a global overview of the supply and demand of opiates, cocaine, cannabis, amphetamine-type stimulants and new psychoactive substances (NPS), as well as their impact on health. It highlights, through improved research and more precise data, that the adverse health consequences of drug use are more widespread than previously thought.

Why do we mark International Days?

International days and weeks are occasions to educate the public on issues of concern, to mobilize political will and resources to address global problems, and to celebrate and reinforce achievements of humanity. The existence of international days predates the establishment of the United Nations, but the UN has embraced them as a powerful advocacy tool. We also mark other UN observances .

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Drugs, Brains, and Behavior: The Science of Addiction Preventing Drug Misuse and Addiction: The Best Strategy

Why is adolescence a critical time for preventing drug addiction.

As noted previously, early use of drugs increases a person's chances of becoming addicted. Remember, drugs change the brain—and this can lead to addiction and other serious problems. So, preventing early use of drugs or alcohol may go a long way in reducing these risks.

Risk of drug use increases greatly during times of transition. For an adult, a divorce or loss of a job may increase the risk of drug use. For a teenager, risky times include moving, family divorce, or changing schools. 35  When children advance from elementary through middle school, they face new and challenging social, family, and academic situations. Often during this period, children are exposed to substances such as cigarettes and alcohol for the first time. When they enter high school, teens may encounter greater availability of drugs, drug use by older teens, and social activities where drugs are used. When individuals leave high school and live more independently, either in college or as an employed adult, they may find themselves exposed to drug use while separated from the protective structure provided by family and school.

A certain amount of risk-taking is a normal part of adolescent development. The desire to try new things and become more independent is healthy, but it may also increase teens’ tendencies to experiment with drugs. The parts of the brain that control judgment and decision-making do not fully develop until people are in their early or mid-20s. This limits a teen’s ability to accurately assess the risks of drug experimentation and makes young people more vulnerable to peer pressure. 36

Because the brain is still developing, using drugs at this age has more potential to disrupt brain function in areas critical to motivation, memory, learning, judgment, and behavior control. 12  

Can research-based programs prevent drug addiction in youth?

Yes.  The term research-based or evidence-based means that these programs have been designed based on current scientific evidence, thoroughly tested, and shown to produce positive results. Scientists have developed a broad range of programs that positively alter the balance between risk and protective factors for drug use in families, schools, and communities. Studies have shown that research-based programs, such as described in NIDA’s  Principles of Substance Abuse Prevention for Early Childhood: A Research-Based Guide   and  Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders , can significantly reduce early use of tobacco, alcohol, and other drugs. 37  Also, while many social and cultural factors affect drug use trends, when young people perceive drug use as harmful, they often reduce their level of use. 38

How do research-based prevention programs work?

These prevention programs work to boost protective factors and eliminate or reduce risk factors for drug use. The programs are designed for various ages and can be used in individual or group settings, such as the school and home. There are three types of programs:

• Universal programs address risk and protective factors common to all children in a given setting, such as a school or community.
• Selective programs are for groups of children and teens who have specific factors that put them at increased risk of drug use.
• Indicated programs are designed for youth who have already started using drugs.

Young Brains Under Study

Using cutting-edge imaging technology, scientists from the NIDA’s Adolescent Brain Cognitive Development (ABCD) Study will look at how childhood experiences, including use of any drugs, interact with each other and with a child’s changing biology to affect brain development and social, behavioral, academic, health, and other outcomes. As the only study of its kind, the ABCD study will yield critical insights into the foundational aspects of adolescence that shape a person’s future.

Economics of Prevention

Evidence-based interventions for substance use can save society money in medical costs and help individuals remain productive members of society. Such programs can return anywhere from very little to $65 per every dollar invested in prevention. 39

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Overdose Deaths Have Surged During the Pandemic, C.D.C. Data Shows

The latest numbers surpass even the yearly tolls during the height of the opioid epidemic and mark a reversal of progress against addiction in recent years.

By Abby Goodnough

WASHINGTON — More than 87,000 Americans died of drug overdoses over the 12-month period that ended in September, according to preliminary federal data , eclipsing the toll from any year since the opioid epidemic began in the 1990s.

The surge represents an increasingly urgent public health crisis, one that has drawn less attention and fewer resources while the nation has battled the coronavirus pandemic.

Deaths from overdoses started rising again in the months leading up to the coronavirus pandemic — after dropping slightly in 2018 for the first time in decades — and it is hard to gauge just how closely the two phenomena are linked. But the pandemic unquestionably exacerbated the trend, which grew much worse last spring: The biggest jump in overdose deaths took place in April and May, when fear and stress were rampant, job losses were multiplying and the strictest lockdown measures were in effect.

Many treatment programs closed during that time, at least temporarily, and “drop-in centers” that provide support, clean syringes and naloxone, the lifesaving medication that reverses overdoses, cut back services that in many cases have yet to be fully restored.

The preliminary data released Wednesday by the Centers for Disease Control and Prevention show a 29 percent rise in overdose deaths from October 2019 through September 2020 — the most recent data available — compared with the previous 12-month period. Illicitly manufactured fentanyl and other synthetic opioids were the primary drivers, although many fatal overdoses have also involved stimulant drugs, particularly methamphetamine.

And unlike in the early years of the opioid epidemic , when deaths were largely among white Americans in rural and suburban areas, the current crisis is affecting Black Americans disproportionately.

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Office on drugs and crime, youth initiative.

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Substance Use Prevention; a Personal Reflection

Written by nur raihana binti zakaria.

Illustration by Karthika Pillai

It has been more than 40 years since drug use was declared a national security problem in Malaysia in the 1980s. From the latest drug statistics available, the National Anti-Drugs Agency of Malaysia reported in January to June 2020, around 67% of people who use drugs in Malaysia were adolescents and youth, which represents almost 67 thousand individuals.

This alarming fact caught my attention and inspired me to dive into substance use prevention. Therefore, it was a privilege for me to participate in the United Nations Office on Drugs and Crime (UNODC) Youth Forum 2021 on Substance Use Prevention.

Before joining the Youth Forum, I was fully aware that the known overwhelming impact of substance use on individuals, families, and communities and the reality of the potentially life-long and complex recovery process of substance use requires effective, supportive, and comprehensive-collaborative interventions.

While I kept wondering what makes one get involved in substance, little did I realize that determining the cause(s) will be endless as it is more complicated, and it would never be that straightforward or clear cut.

The vulnerability factors may come throughout the developmental and life phases and are interrelated between individuals, family, school, and community – sometimes leading to a vicious cycle. Understanding this fact is one of the core points in substance use prevention because it will help us be more empathetic and less judgemental.

Substance use prevention aims to avoid or delay the initiation of substance use, or if someone has already engaged in substance use, it will be more effective to engage in treatment interventions to stave off the development of substance use disorders.

During the Youth Forum, I had an “aha” moment and realized that the overall aim of substance use prevention is much broader. It aims to ensure the healthy and safe development of young people and their well-being and resilience so that they can discern and optimize their talents and potential and become altruistic contributing members of their community. Thus, prevention interventions should begin as early as infancy. His means not only parents, but every member of the society shall be empowered with appropriate skills such as social life skills, parenting and caregiving skills, and decision-making skills. Effective prevention forwards children, youth, and adults positive and constructive engagement with their families and schools, workplaces, and communities.

I was impressed with the way Ms. Elizabeth Mattfeld, a Project Coordinator with the Prevention, Treatment, and Rehabilitation Unit of UNODC, enlightened us on substance use prevention, making it more understandable. She started explaining substance use prevention by emphasizing what is not; “substance use is not treatment, nor punishment.” She then highlighted that in prevention, it is never about telling people the danger of drugs or any other psychoactive substances, or commanding people not to befriend people who use drugs or any other don’ts; or labeling and identifying who are at risk. Instead, prevention aspires to improve skills, endurance, educate the do’s, and subsequently promote individuals to function in a healthy physical and socio-cultural-spiritual environment in the long run. And there is no way for us to ignore any aspects of physical health, mental health, nutrition, education, family well-being, financial, policy-making, or law in substance use prevention, let alone to look at those aspects independently. Substance use prevention is indeed a long-term strategy within a holistic approach to preventing individuals from engaging in drug abuse by focusing on evidence-based programs that can strengthen protective factors and reduce risk factors; and everything in between.

Reflecting on what we have or used to do worldwide, we must agree that many countries are yet to have successful models or efforts in prevention. I acknowledge all agencies’ or ministries’ commitment to creating a society free of drug threats to ensure the community’s well-being, maintaining national stability and resilience.

However, it is always good to take a step back and ponder on the efficiency and efficacy of the intervention taken. Moving forward, we could do better - prevention shall be more inclusive and voluntary, rather than spending resources on the selective approach like prevention education programs conducted among families, primary school students, and youth who are at risk or already identified engaging in substance use.

Besides, we should pay more attention to how we practice substance use prevention, what works, and how we evaluate its efficiency. For example, some may think the lack of knowledge about substances and the consequences of their use are among the main factors that increase an individual’s vulnerability or contribute to the initial reasons for drug use initiation. But I was a bit surprised that knowledge or information alone does not change behavior and does not work for substance use prevention. When policies and practices rely only on feeding the public with knowledge about substances and their adverse effects, substance use prevention is compromised.

We should refine our actions and comprehend that developing skills such as communication, decision-making, rational thinking, and stress reduction are critical as part of a comprehensive substance use prevention program.

In substance use prevention, we must be determined to adhere to evidence-based approaches. We must be ready to unlearn our old beliefs and usual practices that may be inconsistent with science. Substance use prevention is not a taboo or gut feeling, it is scientific, and it is worth fighting for. Unfortunately, Even when considerable funding is spent on treatment, only one in eight people worldwide can access this treatment. Investing more diligently in prevention, we can save up to 10 dollars for every dollar spent, reduce substance use and protect our young generation worldwide.

In conclusion, I am now well-informed that to make substance use prevention successful, we need continuous multiple prevention programs at every community level involving many stakeholders. Those are what we need to create a healthy, effective, and sustainable prevention system. All elements of prevention and roles taken (or ignored) by individuals are interconnected; strengthening every single element will cause a snowball effect; anyone could start the positive action and give sustained results in return, like a domino effect; and we need everyone’s small and light touch in substance use prevention to bring the butterfly effect; ultimately lead to what we all have been dreaming for: healthy, happy, resilient and proactive young people who can contribute to the community and society. Yes, long way to go, but I have the utmost faith that prevention works.

1 International Standards on Drug Use Prevention. (2018). Retrieved 20 March 2021, from https://www.unodc.org/unodc/en/prevention/prevention-standards.html

2 National Drug Policy. (2017). Retrieved 15 January 2021, from https://www.adk.gov.my/wp-content/uploads/Buku-Dasar-Dadah-Negara-EN.pdf

3 Annual Report National Anti-Drugs Agency. (2019). Retrieved 15 January 2021, from https://www.adk.gov.my/wp-content/uploads/Buku-Laporan-Tahunan-AADK-2019.pdf

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