Drug Addiction: A Health or Criminal Issue?

deciding whether drug addiction is a health or criminal issue, it is
also important to understand what drug addiction is and how addiction
in general works. People sometimes make a distinction between a
physical addiction and a
psychological addiction
to something. Both are physical in nature, since psychology boils
down to physical processes, but it does seem that a physical
addiction is more serious. And it is the physically addictive nature
of some drugs, as opposed to their psychologically addictive nature
(which they have as well), which makes them controversial substances.

Being physically addicted to drugs such as heroin, crack cocaine and
methamphetamine involves a chemical dependency to these drugs. A
chemical dependence is when the body adjusts to a substance by
including the substance in its normal functioning. This creates
tolerance and withdrawal – the two classic symptoms of physical
addiction. Tolerance is when more of the substance is needed to
recreate the original effect. Withdrawal symptoms occur when the
substance is no longer taken. The symptoms can be very nasty and can
include anxiety, irritability, intense cravings, nausea,
hallucinations, cold sweats and tremors. For anyone who’s seen the
films Trainspotting,
Requiem for a Dream or
The Basketball Diaries,
the portrayal of heroin withdrawal symptoms make the drug seem very
risky and unattractive.

interesting is that there is now evidence that suggests sugar can
also be physically addictive and acts in the brain in a similar way
to cocaine. In a study carried out by Bart Hoebel of Princeton
University, it was found that rats showed classic signs of physical
addiction when consuming sugar on a daily basis, then having that
supply of sugar stopped. When the rats were denied sugar, they worked
extra hard to get it and binged on it even more when they did receive
it. This suggests that the rats were intensely craving the sugar and
relapsed when it was introduced to them again (a relapse being
another tell-tale sign of a physical addiction).

By studying the
brains of these rats, it also became apparent that sugar was acting
on the dopamine and opioid systems in the brain (the reward centres
which give us pleasure) in much the same way that cocaine and heroin
does. After a month of sugar binging, the structure of the brains
also changed, adapting to the increased dopamine levels. As with
cocaine and heroin addiction, this same structural change occurs and
it is associate with tolerance. Once the sugar was taken away from
them, the rats also showed signs of withdrawal, such as anxiety
(chattering teeth and an unwillingness to explore their
surroundings). In Hoebel’s own words: “[heroin], despite being
stronger and resulting from exogenous chemicals, affects the same
processes as sugar.” The bioethicist Julian Savulescu, in his paper
Addiction and Autonomy,
has also claimed that, “we

is worth pointing out is that sugar is a completely legal chemical.
And so are many other physically addictive substances to be fair:
alcohol, tobacco and prescription drugs such as valium, ritalin
(which has a similar chemical structure to cocaine), vicodin,
codeine, methadone, oxycontin (an opiate); the list could go on and
on really. If drug addiction is to be seriously considered a criminal
issue, then would it not be equally justified to arrest or fine an
obese person addicted to fast food or an alcoholic or a smoker? The
cost to maintain a prisoner for a year is £41,000 according to
Juliet Lyon, director of the Prison Reform Trust. Not to mention the
fact that prisons across England and Wales are running out of space.

This puts things into perspective. It now longer seems practical or
beneficial in the long run to send an addict, of any sort, to prison.
You may think that to be an addict is morally wrong, but the
addiction tends to harm the addict, not anyone else. Admittedly, a
person deep into an addiction of any kind can ruin their family life
and even jeopardise the well-being of those who depend on them. But
as John Stuart Mill says, they should be punished for the neglect and
harm to others they cause, not for the use of an addictive substance.
If anything, sending an addict to prison can be more harmful than
their neglect – the addict has their freedom and rights taken away,
and the family is no longer left with a provider.

is also the issue of costs in property theft which are a result of
addiction, with an estimated 70% of all property theft being carried
out addicts. Anyone guilty of theft should be punished, but in order
to prevent addiction-related theft and addiction in general,
addiction should be treated as a medical condition. Russell Brand’s
recent comic relief event ‘Give It Up’ stressed that addiction is an
illness and not a lifestyle choice. Drug researcher David Nutt has
confirmed this by pointing out that drugs, sugar and sex can hijack
the reward systems in the brain, changing the personality and
behaviour of a person in a way which makes them dysfunctional. This
is a useful indicator of a mental illness. 

Although a person may make
a number of conscious choices to use an addictive drug, once they are
addicted, it would be unfair to treat their use of an illegal drug as
something intentional and deserving of punishment. The opinion of
journalist Peter Hitchens that all drug users are selfish, hedonistic
Western kids couldn’t be further from the truth. Not everyone becomes
addicted to cocaine, sweets or sex, but as Russell Brand has
highlighted, about 10% of the population have a tendency to abuse
them and if these people do become addicted, their addiction should
be treated as a health issue, not a criminal issue.

should follow in the footsteps of Portugal. Portugal have
decriminalised all drugs and was in fact the first country to do so.
This initiative was in response to the soaring rates of HIV and
hepatitis infection due to the exchange of dirty heroin needles. The
new plan was to treat addicts as sick people in need of treatment and
not immoral monsters in need of being locked up. If someone is found
to be a drug addict, they are directed to one of the country’s 79
treatment centres where they can get all forms of help, from
counselling to methadone treatment. A decade later since this plan
and addiction rates have been cut in half. Rates of HIV and hepatitis
have also plummeted due to Portugal’s needle-exchange programmes
where addicts can get clean needles instead of borrowing used ones.

Christiana Pires is a leader of one of the Institute of Drugs and
Drugs Addiction’s “harm-reduction teams” in Portugal. These
institutes serve as another vital component of the drug law in the
country. These teams work in schools, neighbourhoods, bars and clubs
explaining the risks of using addictive drugs, without being preachy
about it. Pamphlets and “drug kits” (like silver plates to cut
drugs on and a saline solution to clean your nose) are handed out at
music festivals to ensure that the harms of drug use are reduced. The
teams also offer drug testing to make sure that the drugs people are
using are not contaminated – another way to prevent harm being
caused by drugs which are usually adulterated with other chemicals,
such as cocaine. Not to mention popular club drugs (cocaine and MDMA) which are usually sold as something else, such as some sort of research chemical which has unknown risks and harms.

UK should adopt this sort of attitude. It is realistic, friendly,
evidence-based and effective. Counselling should be there to figure
out the root cause of someone’s addiction; it may be due to poverty, child abuse, loneliness, depression, escapism – any number of reasons.
But the root problem should be dealt with to resolve the addiction.
Some argue, however, that methadone programmes are not so beneficial,
they tend to give the addict a methadone addiction on top of their
heroin addiction.

In response to this problem, a group of Dutch
researchers have tried a counter-intuitive approach. From 1998 to
2001 they gave controlled doses of heroin to heroin addicts who were
also on a methadone programme. The study found that after three years
mental, physical and social functioning were greatly improved and
that dependency on heroin became far less severe. These promising
results might be due to the fact that the prescribed heroin was less
addictive, since street heroin be very addictive, especially “black
tar heroin”. A system of controlled, supervised heroin prescription
therefore looks promising. It could be part of a more
all-encompassing plan in the UK to prevent addiction by treating it
as a health issue, not a criminal issue.


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