The Obama Administration's 2013 National Drug Control Strategy

Apr 24 2013 Published by under General Politics, Public Health

The ONDCP has been twittering up a storm about the release of the latest National Drug Control Strategy document [ PDF ].

The website touts five bullet points:

  • Prevent drug use before it ever begins through education
  • Expand access to treatment for Americans struggling with addiction
  • Reform our criminal justice system
  • Support Americans in recovery

Whether you think the Obama ONDCP has changed quickly enough for your liking or not, there has clearly been a change in the rhetoric compared with past...all the way back to the Reagan ONDCP. Rhetoric such as this....

While law enforcement will always play a vital role in protecting our communities from drug-related crime and violence, we simply cannot incarcerate our way out of the drug problem. Put simply, an enforcement-centric “war on drugs” approach to drug policy is counterproductive, inefficient, and costly. At the other extreme, drug legalization also runs counter to a public health and safety approach to drug policy. The more Americans use drugs, the higher the health, safety, productivity, and criminal justice costs we all have to bear.

...differs very clearly from the prior ONDCP approaches. Even McCaffrey, as conversant as he was with the science*, still leaned heavily toward the punitive side.

Naturally, I am best pleased that they have a section entitled "The Science":

Throughout much of the last century, scientists studying drug abuse labored in the shadows of powerful myths and misconceptions about the nature of addiction. When science began to study addictive behavior in the 1930s, people addicted to drugs were thought to be morally flawed and lacking in willpower. Those views shaped society's responses to drug abuse, treating it as a moral failing rather than a health problem, which led to an emphasis on punitive rather than preventative and therapeutic responses.

And I would say that we still labor under a great deal of resistance, even though the hard edges may have morphed. We hear people trying to parse "only psychological" addiction from "physiological" addiction...what is this if not more of the "moral failing" argument? We also have attempts to define some substances (and non-substance reinforcers) as being out of consideration for genuine addiction.....again, a similar discounting of the science related to addiction. If you grasp the fact that addictions are disruptions of reward pathways, and that there are a limited set of final-common-mechanisms for reward in the brain then it is no surprise that anything which trips the reward triggers has the potential to cause disruption.

Today, thanks to significant advances in neuroscience, our Nation's responses to drug abuse have begun to change. Groundbreaking discoveries about the brain have revolutionized our understanding of drug addiction, enabling us to respond more effectively to the problem.

Science demonstrates that addiction is a disease of the brain—a disease that can be prevented and treated, and from which people can recover.

Well yes...buuuuuut. Our ability to prevent and treat still has a long way to go. And this, I recognize fully, contributes to public misunderstanding. After all, if it is a disease, surely we must have very specific and mechanistically coherent treatments, right? We don't, for the most part, and so skepticism over the assertion of "a disease of the brain" will continue.

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*He was the first Drug Czar I heard address a scientific audience. He was impressive. They guy that came after him during the Bush administration was...not.

3 responses so far

  • Superb post but I was wondering if you could write
    a litte more on this subject? I'd be very thankful if you could elaborate a little bit further. Cheers!

  • spunky says:

    Hahahah! You heard the spambot DM, get cracking!

  • anonymous postdoc says:

    I am gratified to know that you consider it plausible that natural rewards are addictive. It has always seemed patently obvious to me, but I am not a NIDA nerd.

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