PHARMACOPEIA

addictThere’s been a fair bit of coverage lately on substance abuse & dependence. Put them all together and you come up with some surprising and alarming findings:

  • The US Department of Health does an annual survey that indicates that about 10% of adults are either dependent on or chronic abusers of alcohol or drugs. Alcohol heads the list (8%), followed by illegal drugs (2%) and prescription drugs (1%). The proportion dependent on or abusing inhalants and over-the-counter (OTC) drugs is under 0.5% but is far and away the fastest growing category, currently doubling each year. Rates of dependence and abuse are twice as high in the 18-25 age group in all categories, twice as high among the unemployed in all categories, and 50% higher among Native Americans than those of other ethnic groups. These are truly epidemic numbers, higher than ever before in history, and far higher than during the ‘tune in, turn on, drop out’ hippie days of the 1960s and 1970s.
  • Another 8% of adults are listed as having a serious mental illness (SMI). Even accounting for the significant overlap between SMI and substance abuse and dependence, that means that one in six North Americans is struggling with one or the other, and that means one third of households have someone in the home with one or the other. Over 40 million North American adults afflicted. As I reported last fall, a significant proportion of both groups is either in prison or homeless (probably about 3 million), where their illnesses will almost certainly get worse.
  • By any imaginable measure, the ‘war on drugs’ is a total failure, ruining lives and costing billions while having no effect on either the availability or use of drugs.
  • There are more people hooked on prescription pain killers than on cocaine.
  • Inhalants and OTC drugs are the substances of choice for those under 18. Nearly 20% of kids have used inhalants by the age of 12. Preferred inhalants include the aerosols in spray paint, cooking spray, aerosol whipped cream and hair spray, nail polish, paint and nail polish removers and thinners, spot removers, video head cleaners, corrrection fluid, cements and model glues, nitrite-based room deodorizers, propane, helium and gasoline (gasoline is a particular problem among third world and arctic Native American children). The active petrochemical compounds in most inhalants are addictive and can cause severe brain damage.
  • As reported recently on several public affairs programs, the latest fashionable drug among the young is dextromethorphan (DXM), most commonly consumed in massive doses (16 pills at a time once tolerance has been built up) of over-the-counter cough and cold remedies like Coricidin and Robitussin. The epidemic has caused many pharmacies to move their cold supplies behind the counter and restrict sale to three boxes at a time. Because Coricidin contains chlorpheniramine maleate, and many cold remedies contain analgesics (pain killers), both of which are toxic in the type of doses needed to get a DXM high, abusers are warned to stick to ‘straight’ DXM products. The manufacturers of these products, of course, waive all responsibility. DXM is from the same chemical family as morphine and codeine, but not believed to be as addictive. Overdoses produce a legal PCP-like high, but with huge risks. The ultimate tragedy is that, like most of the commercial crap foisted on us by the big corporations, DXM doesn’t do anything to relieve your cough anyway.

I’m sure it comes as no surprise to readers of How to Save the World that I don’t believe that making substances illegal, and putting people in jail for consuming them, accomplishes anything. It would be nice if we could put the money and energy from the ‘drug war’ into dealing with the underlying causes of SMI and substance abuse, into technologies that would prevent impaired people from driving, and into developing safe, non-addictive, effective, low-cost recreational and medical-use drugs to replace the dangerous, addictive, useless, expensive ones. That way, substance users wouldn’t fry their brains, kill people with cars, clog the prisons, need to steal, or hurt their fetuses, those of us that like to get high could do so cheaply, safely and hassle-free, the Rush Limbaughs of the world could keep their sorry asses out of rehab. and the millions of disease sufferers in the third world could get treatment instead of empty promises. But I’m not holding my breath.

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2 Responses to PHARMACOPEIA

  1. Marijo says:

    In principle, I am entirely on your side, and I believe that legalization of most drugs (and prostitution) would lead to more important benefits than costs. Working, as I do, with the courts, jails, and laws, however, I can say that we are beginning to use the system in more intelligent ways, using arrests to funnel people into treatment, and monitoring their progress with Drug Courts and Mental Health Courts and working with the jails to insure that the addicts and SMI people who end up there get the attention they need. It is a slow process and as always, funds and resources are limited, but there is improvement. I think I’m going to be posting about this in the near future.

  2. Dave Pollard says:

    Marijo: That’s great. Quite a few of this blog’s readers are medical and social services professionals, and I’d love to hear their view on how to deal with this intractable problem. I’ll keep a close eye for it on ‘What Happens When…’

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