In this trenchant piece, originally delivered at the annual conference of the Drug Policy Foundation, and now published in the International Journal of Drug Policy, Stanton evaluates the popular drug reform conception that shifting from coercive drug policies to treatment will radically transform the American drug use and treatment scene. Stanton disagrees, maintaining that expanding the treatment system will (1) expand what is already largely coercive treatment serving as an adjunct to the criminal justice system, (2) refuse to acknowledge nonharmful use and force mainly nonproblem users into treatment, (3) serve to divert social resources from the worst-off street users who are the main symbols of the drug epidemic, (4) have an overall negative impact on outcomes for drug users in the United States. Read this before endorsing blindly the concept that more treatment is good.

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Prepublication version of article appearing in the International Journal of Drug Policy, 9:43-56, 1998.
© Copyright 1998 Stanton Peele. All rights reserved.

A version of this article appeared on the Internet: PsychNews International, 1(6), 1996, and was presented to the 10th International Conference on Drug Policy Reform, Washington, DC, Nov. 6-9, 1996. The version on this page is not exactly the same as the version published in IJDP because of typesetting and editing errors made by Elsevier.

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Abstract

The most popular idea in drug reform is that money now spent on interdicting drugs and arresting and imprisoning drug users should instead be spent on treating drug abusers. However, the likely results of such an expansion of treatment—based on the current example of massive treatment of alcohol problems in the U.S.—would be counter to critical drug policy reform goals. These goals include provision of social services for the severely addicted, acceptance of nonharmful illicit substance use, diminution of moralism in public health and policy towards substance use, and elimination of guilt and self-doubt among controlled drug users. Expansion of alcohol treatment in the U.S. has not led to adoption of treatments demonstrated to be effective but rather supports moralistic approaches that capitalize on deep-seated American ambivalence towards alcohol. Finally, there is no evidence that substance abuse treatment reduces overall substance abuse rates. In the case of alcohol, expanded treatment has coincided with greater numbers of Americans reporting they are alcohol dependent, while studies of community populations find that untreated alcohol and drug dependent subjects fare better than those who are treated.

Treating Drug Use

The most popular version of drug reform is that we should shift funds from our massive drug interdiction and law enforcement efforts to the treatment of people with drug problems (of course, treatment for drug abuse is already a massive enterprise in the U.S.; SAMHSA, 1997). The failures of current punitive approaches are so obvious, and the value of treatment is so unquestioned, that a wide range of those involved in substance abuse policy and treatment endorse this shift.

There is also a large industry engaged in propagandizing on behalf of this position. On the Internet (www.health.org/csat/) and through other media, "Treatment Works! Month" is celebrated annually. "Designed by SAMHSA (Substance Abuse and Mental Health Services Administration)/CSAT (Center for Substance Abuse Treatment) with the cooperation of the National Association of Alcoholism and Drug Abuse Counselors (NAADAC), these promotional materials will help educate people throughout your state, county, city or community about the true value of treatment and the fact that it really works."

September 1996 is the 7th annual celebration of Treatment Works! Month. It's time to celebrate and promote the fact that treatment is an effective way of tackling America's substance abuse problems. Treatment not only saves the taxpayer a tremendous amount of money in the long run, it also saves lives; reduces crime and health care costs; and reunites families. In short, treatment helps everyone, not only the individual battling addiction.