President Bush has declared today National Methamphetamine Awareness Day. Although methamphetamine abuse and illegal meth labs have recently become subjects of intense national concern, state and federal policymakers have actually been grappling with both problems for more than 40 years (the first illegal U.S. meth lab was discovered in the early 1960s.) The national strategy for dealing with the drug is the same now as it was then: incarcerate as many methamphetamine offenders as possible and hope for the best. This punitive strategy has devastated families and failed to make America safer. In fact, the problems associated with methamphetamine abuse -crime, addiction, child neglect, the spread of HIV/AIDS, etc. - are greater now than they were 40 years ago.
Before you run out to Hallmark to pick up a Happy Meth Awareness Day card for your significant other, here are some questions to consider.
1) Why is the government pursuing a strategy towards methamphetamine that has been failing for 40 years?
For decades policymakers have claimed that restricting access to the chemicals used to illegally make methamphetamine and putting methamphetamine offenders in jail are the “silver bullets” needed to solve meth-related problems. This is in line with their strategy on other illegal drugs. Most of the money spent dealing with cocaine and heroin, for instance, has gone to unsuccessful attempts to reduce availability of the drugs by stopping their production in Latin America, interdicting them at the border, and incarcerating as many drug offenders as possible. Hundreds of billions of dollars and millions of arrests later, illegal drugs remain cheap, potent, and widely available in every community. A supply-side strategy has failed for every drug it has been tried on. There are a number of reasons why it does not work, but chief among them is basic economics. As long as there is a demand for drugs, there will be a supply to meet it. But a wide range of special interests benefit from this failed strategy, including law enforcement agencies, private prisons, prison guard unions and the drug testing industry.
2) Why do elected officials, law enforcement officers and the media continue to ignore science and repeat the myths that methamphetamine is uniquely addictive and people who use it are hooked for life?
Contrary to the myths, treatment for methamphetamine abuse is very effective. A 2003 survey of treatment approaches published in the Journal of Substance Abuse Treatment concluded “that clients who report methamphetamine abuse respond favorably to existing treatment.” A study in Washington State found that “there were no statistically significant differences across a series of outcomes between clients using methamphetamine and those using other substances.” In fact, there have been at least twenty recent studies showing the efficacy of methamphetamine treatment.
In an open letter to the media last year, dozens of treatment professionals warmed that the myth that abuse of methamphetamine cannot be treated is causing great harm:
"Claims that methamphetamine users are virtually untreatable with small recovery rates lack foundation in medical research. Analysis of dropout, retention in treatment and re-incarceration rates and other measures of outcome, in several recent studies indicate that methamphetamine users respond in an equivalent manner as individuals admitted for other drug abuse problems."
Of the estimated 12 million Americans who have tried methamphetamine, only 1.5 million have used it in the last year; and only 583,000 have used it within the last 30 days. The truth is most people who try meth never end up addicted to it and meth addiction is treatable. Meth addiction can cause serious harm to individuals, their families, and their communities; but there’s no reason to panic. Unfortunately, sowing the seeds of hysteria is profitable – to the politicians who gain votes, to the law enforcement agencies that get budget increases, and to the newspapers that sell papers.
3) What role does lack of access to health care play in meth-related problems?
Methamphetamine is a Schedule II drug that doctors can prescribe to treat narcolepsy, Attention Deficit Disorder (ADD), and exogenous obesity under the brand name Desoxyn. Teenagers are sometimes forced to take methamphetamine (and other stimulants) to treat ADD; but adults who use street meth are arrested and thrown in jail. Does this make sense?
How many people arrested for methamphetamine abuse are knowingly or unknowingly using black market drugs to deal with ADD, depression, trauma, and other medical conditions? What role does the lack of access to health care generally, and prescription drugs specifically, play in perpetuating methamphetamine abuse? Would meth use decrease if poor and middle class Americans could afford Adderall, Ritalin, Prozac and other drugs?
4) How much of the meth problem is rooted in America’s “workaholic” culture?
The broad appeal of methamphetamine may be due to the fact that the drug’s effects closely mirror desirable goals in society. It offers seemingly limitless productivity, better sex, weight loss and strong feelings of self-confidence and happiness – at least in the short-run. Its use, like the use of stimulants in general (from coffee and Red Bull to Adderall and cocaine), is deeply embedded in our culture which emphasizes working harder, looking better, and fitting a week’s work of activity into every day.
As the long lines at Starbucks shows, the demand for stimulants in the U.S. is very strong. But for many, short-lasting mild stimulants like coffee and Red Bull are not enough. That’s one reason why millions of Americans have used methamphetamine, cocaine and other illegal drugs.
This begs the question; could policymakers reduce the demand for methamphetamine by increasing the availability of safer, legal drugs that promote wakefulness, vigilance and alertness? To be effective as a policy measure, such stimulants would have to be longer lasting and more potent than caffeine, but without the negative side effects of methamphetamine and cocaine.
5) Why are policymakers short-changing women?
Unlike other illegal drugs, women use methamphetamine at rates similar to men. They also face unique obstacles to recovery, which can range from being the primary caretaker of their children to being physically, emotionally, and sexually abused. Yet, a 2004 government study found that only 30% of treatment facilities in the U.S. have unique programs for women. Only 14% have special programs for pregnant or postpartum women. Less than 10% of treatment programs in the United States provide child care, and only 4% provide residential beds for children. Why haven’t policymakers increased treatment resources for pregnant and parenting women? And given that fear of losing custody of their children keeps many women with substance abuse problems from seeking help, why haven’t they adopted policies that shield parents who seek drug treatment from having their children taken away?
6) Why are policymakers ignoring the growing public health threat posed by methamphetamine abuse?
Since meth can dramatically increase both stamina and confidence, it is heavily associated with high-risk sexual behavior, which can spread HIV/AIDS and other sexually transmitted diseases. Sharing of syringes among people who use meth intravenously is also a factor in the spread of HIV/AIDS, as well as the spread of hepatitis C and other infectious diseases. The strong presence of meth in rural areas, combined with the significant shortage of both drug treatment and HIV/AIDS prevention resources in those areas, make it a growing public health threat. Its growing use in urban areas, most notably in the gay party scene, poses very significant threats there too. Even though thousands will die, policymakers have failed to make sterile syringes widely available. Why?
7) What if the billions of dollars wasted each year incarcerating nonviolent drug offenders was invested in drug treatment instead?
No state guarantees treatment to anyone who wants it; but California guarantees treatment to anyone arrested for simple drug possession. The law, enacted by California voters in 2000 as Proposition 36, diverts approximately 35,000 persons from jail to drug treatment every year—over half of whom identify methamphetamine as their primary drug. A recent evaluation by the University of California Los Angeles (UCLA) found that California taxpayers are saving nearly $2.50 for every dollar invested in the program. The program is estimated to have saved state and local government more than $1 billion over the last five years, while reducing crime and keeping families together. But, people with substance abuse problems shouldn’t have to get arrested to get treatment. Policymakers should ensure that treatment is available to all who need it, whenever they need it, and as often as they need it.
December 1 is World AIDS Day, which was first declared by the World Health Organization and the United Nations General Assembly in 1998. This year's World AIDS Day also comes on the 25th anniversary of the AIDS epidemic. Since 1981 more than 25 million people across the globe have died from AIDS, and today approximately 39.5 million are living with HIV/AIDS.