Drug abuse is essentially defined as the excessive, dangerous and undesirable use of certain substances (Abadinsky, 2007). It has the potential to harm the user and in turn harm others. Although the word “drug” literally means dry substance, the term has evolved over the years. Today, drug abuse can even refer to alcohol or tobacco. Alcohol and tobacco are referred to as “gateway drugs” that lead to use of substances more dangerous and degenerative. Many therefore prefer to use the term substance abuse rather than drug abuse.
Drug abuse is characterized by the following: a difficulty from stopping use; an exhibition of withdrawal symptoms when quitting; and an increasing tolerance to the substance. Since its nature is neither fully medical, behavioral, or even environmental, many experts debate on its reference as a disease (Abadinsky, 2007). Unlike other diseases, drug abuse is more of a social problem. Treatment therefore has more social implications than any other disease. Experts agree that drug abuse is a disease that is quite difficult to totally cure. Treatment is geared towards remission or improvement rather than complete alleviation (Abadinsky, 2007).
There are several treatment principles adapted. Abadinsky suggests at least 13 principles that can be applied to drug abuse treatment. One of the most important things to remember is that single treatment approach to drug abuse is not universal. Each individual has preferences, attitudes, behavior and even thought processes that are different from others. It is important that the way drug abuse treatment is introduced suits the individual well. Identifying the appropriate treatment for each individual is critical. An inappropriate method or approach may cause more harm than good.
Drug abuse treatment is highly dependent on the positive response of the individual for it to generate positive results. Another principle that is important to drug abuse treatment is that since drug abuse is in part a behavioral problem, individual and group counseling and other similar therapies are important components. Interpersonal relationships are crucial to an individual’s progress in treatment. Most people who are affected by drugs withdraw from society. Group therapies and other social interactions are conducted so that individuals learn the right social behaviors while recovering from the disease.
As stated earlier drug abuse is neither purely medical nor behavioral. In fact the disease is also thought of as a psychological problem as well as a social concern. The disease has a very strong impact to society. It is a problem that the community shares. The threat is not only on the individual but to other people as well. Therefore treatment is a social endeavor. It is a communal effort that requires a lot of involvement from the individual and those who are closely related to them. Society plays an important role in dealing with drug abuse. Overtime the disease has taken the top priority in social concerns and issues.
The effect of the disease on people has spun so many endeavors to control its havoc on society. In the United States, more and more young people are declared drug dependent in recent years. This is another growing concern connected to drug abuse. This stems from early introduction to subtle substances like nicotine and alcohol (Abadinsky, 2007). Recent studies show that early introduction to addictive substances has a higher progression rate to drug use. At the same time, many studies have shown that young people are more likely to be hooked on drugs than older people once addictive substances are introduced.
Therefore, the treatment approach to this disease should also have an educational element to it. Many agencies have been active in conducting preventive drives and campaigns against drug abuse. Both the public and private sectors continue to work together in finding solutions to this ever persistent problem. Arguably abstinence is still the most effective way to conquer this problem. It helps to emphasize this point in preventive measures adapted. In the United States the profile of drug users is getting younger and younger each year.
In 2007 alone it has been surveyed that 1 out of 4 high school students are already addicted to nicotine (Abadinsky, 2007). Before progression of drug use happens appropriate control measures must be taken. Regulatory policies, information services and educational materials should be made available so that people are constantly guided accordingly when it comes to drug use and abuse. Again, it is essential that the community gets involved in this kind of preventive measure. Treating drug abuse should have a holistic approach. It requires that all possible angles and routes be taken.
While the immediate desire is to treat drug abuse, the approach should also have a preventive characteristic to it so that control extends to its looming threat in the future. Illustrate the Therapeutic Community Approach to Drug Treatment A therapeutic community is simply a treatment facility that provides care to a diversified group of substance abusers (De Leon, 2000). These communities have been in existence for more than 40 years now in the United States (NIDA, 2005). In this drug-free residential setting, treatment goes through various levels or stages. The individual is guided properly in completing the hierarchical model of treatment.
The main difference of a therapeutic community approach from other drug abuse treatment approaches is the close involvement of community staff and those in recovery in the process (NIDA, 2005). Within the therapeutic community, they are regarded heavily as change agents that play an important role to the treatment of an individual. The staff and those who are in recovery work closely with individuals undergoing treatment. They participate during group therapies and other counselling activities. They are referred to as change agents because they have the strongest influence on the individual while in a therapeutic community.
Treatment in these facilities is focused on the “whole person approach” (De Leon, 2000). An individual who completes the treatment essentially returns to society a changed person. The diversified group of individuals in these communities is treated two ways. For those who were socially mature prior to drug abuse is rehabilitated to recover old and familiar social behavior. They are changed into people who can thrive as a productive member of society. On the other hand, individuals who have difficulty adapting socially from the beginning are taught valuable lessons to make them more capable of engaging in society.
They are exposed to situations that would develop their interpersonal skills. While these situations are relatively controlled, they provide very good stimuli in learning adaptive ways in society. The “whole person approach” (De Leon, 2000) also emphasizes that participation of the individual is critical to recovery (NIDA, 2005). There are two important elements to completing the treatment process in therapeutic communities. The first element is “self-help”. The individual is expected to be totally in the process to gain improvement.
There is great expectation riding on the individual’s voluntary submission to the approach to gain recovery. However, what makes therapeutic communities even more notable is its element of “mutual self-help” (NIDA, 2005). This element encourages the development of strong bond between individuals towards recovery. They are taught that people need each other’s support in order to achieve treatment. This is how individuals either recover social behavior or learn social concepts. The therapeutic communities rely on many group-counseling processes to help individuals overcome their addiction to drugs.
Peer influence is constantly encouraged. Within these facilities, interpersonal relationships are fostered and given high importance. This is the reason why many who complete the process in therapeutic communities remain close after treatment. The bonds that are developed are lasting and progressive. Individuals find strong support for each other. The relationships that are fostered within these communities are meant to serve as a support system for a lifetime. This approach to drug abuse treatment uses the community itself as part of the method (NIDA, 2005). It builds individuals while building strong communities.
Therapeutic communities have a varied set of residents that are more often brought to these treatment facilities with different levels and types of drug abuse. Commonly however, these individuals are thought to have difficulty functioning well in society. Many have neglected social norms and behaviors. Most have various criminal records that range from simple misdemeanors to more serious violations. Through the controlled residential setting, individuals are taught appropriate social behaviors that will make them more productive once treatment is completed (NIDA, 2005).
The individuals within therapeutic communities are always very diverse. They come from different backgrounds and are affected by drug use in different levels and ways. Many still are have different ethnicity and cultures. The approach helps individuals deal with these differences in a less threatening manner. Through this controlled environment, they learn to appreciate difference in people. It helps them develop skills to handle situations involving other people that in the height of their addiction seemed extremely volatile.
Studies show that those who have completed treatment in therapeutic communities eventually have lower levels of drug use, alcohol intake, criminal behavior and depression (NIDA, 2005). Many of those who recover from drug abuse through therapeutic communities volunteer in the process for other individuals. They also gain skills that generate for them jobs, friends, family and a different life in general. And while they continue their battle with drugs in the outside, they are more confident because of the strong support they have received while within these communities. This support extends to their struggles even on the outside.
Describe the Harm Reduction Approach to Drug Policy For many years, governments, agencies and societies have tried different approaches to dealing with drug abuse. Policies and various controls were drafted to try and eradicate this growing social concern. However, not all controls prove to be effective. In fact, many of these controls even increase the curiosity towards drug use. Experts then believed that since drug use cannot be totally stopped, moderating its use is the best way to address the growing number of drug abusers. Harm reduction was first introduced in 1972 (Duncan, Nicholson, Clifford, Hawkins, and Petosa, 2007).
Harm Reduction is about reducing the adverse effect (Nadelmann, Cohen, Drucker, Locher, Stimson, and Wodak, 1994) of drug use and abuse. It works under the premise that drug use is an inevitable part of human nature (Duncan, Nicholson, Clifford, Hawkins, and Petosa, 2007) policies should therefore be designed not to totally contain it but to actually moderate its use. Many agree that in today’s society zero tolerance to drug abuse is actually unethical to public health, human rights and civil liberties (Nadelmann, Cohen, Drucker, Locher, Stimson, and Wodak, 1994).
It is necessary that policies be designed around human rights considerations. Harm Reduction is actually the answer to controlling drug abuse without going against the integral rights of individuals involved. Harm Reduction provides a clear distinction between the misuse of drugs and controlled usage. This policy design acknowledges that drug use is necessitated by certain situations that are usually medical and sometime behavioral in nature. However it also acknowledges that drug laws are integral in most public health and social welfare policies (Nadelmann, Cohen, Drucker, Locher, Stimson, and Wodak, 1994).
Human Reduction stands to protect both the individual and society in dealing with drug abuse. While Harm Reduction still considers abstinence as the most effect control of drug abuse, the approach presents other options to dealing with this social concern. This approach is probably the most humane way of controlling drug abuse. Drug laws are not considered as moral standards. Individuals determined as drug abusers are not isolated but instead integrated into society (Nadelmann, Cohen, Drucker, Locher, Stimson, and Wodak, 1994). The most important thing to consider about Harm Reduction is its effect in drug control in the future.
Because it considers the realistic dynamics of drug use, it actually provides the opportunity to mitigate the negative consequences of the problem (Duncan, Nicholson, Clifford, Hawkins, and Petosa, 2007). Many European countries have adapted this approach to their fight against drug abuse. In Switzerland and the Netherlands, this approach was initially to fight the growing cases of HIV infections. HIV infections are heavily associated with the use of needles and syringes in drug use. Therefore, this was the countries’ answer to this threatening social problem. Harm Reduction is essentially a way to lure individuals towards treatment.
It encourages individuals to volunteer themselves to diagnosis and treatment. Because the approach does not discriminate against individuals who are suspected drug abusers, they are less threatened to admit their problem. In the last few years, European countries that have used Harm Reduction as the primary policy foundation against drug abuse have seen very positive results (Duncan, Nicholson, Clifford, Hawkins, and Petosa, 2007). In the United States, Harm Reduction is not as popular. Not all of the country has adapted its use per se in policy drafting against drug abuse.
While the United States has similar policies that align with Harm Reduction, there has been no direct reference to the approach (Duncan, Nicholson, Cliffor, Hawkins, and Petosa, 2007). In fact only a handful of the states have outwardly shown support for this approach. The main reason may be because the United States is still motivated by a highly moralistic fervor. And unlike maybe Australia and the Netherlands, the United States still possesses a struggle that questions the whole assumption of Harm Reduction. Harm Reduction is seen in most parts a toleration of drug use.
European countries that have fully adapted this approach also have embraced its assumption that drug use is an integral part of life. “Drug” in this case encompasses all, including those that have curative or supplementary elements. The United States has yet to fully agree on this definition of “drug” to be able to totally incorporate Harm Reduction into their policy design. References Abadinsky, H. (2007). ‘Drug use and abuse: A comprehensive introduction 6th Edition’ US, Wadsworth Publishing. De Leon, G. (2000). ‘The therapeutic community: Theory, model and method’. US, Springer Publishing Company. Duncan, D. , Nicholson, T. , Clifford, P.
, Hawkins, W. , and Petosa, R. (2007). ’Harm reduction: An emerging new paradigm for drug education’. Retrieved on May 16, 2008 from http://www. druglibary. org/schaffer/other/harmcov. htm Nadelmann, E. , Cohen, P. , Drucker, E. , Locher, U. , Stimson, G. , and Wodak, A. (1994). ‘The harm reduction approach to drug control: International progress’. Retrieved on May 16, 2008 from http://paranoia. lycaeum. org/war. on. drugs/debate/harm-reduction. htm NIDA: National Institute on Drug Abuse (2005). ‘What is a therapeutic community? ’. Retrieved on May 16, 2008 from http://www. nida. nih. gov/researchreports/therapeutic/therapeutic. html