Wednesday, March 10, 2010

No, mandatory drug treatment is not the answer

Most of the drug debate takes place over the clear-cut issues: should the government be telling people what they can put into their bodies or shouldn't it? But beyond overt prohibition -- and with the potential to outlast repeal -- is the vast, mushy middle-ground where the government "helps" those poor souls who just can't handle their drugs. Surely, pushing addicts into treatment to help them with their abuse is an act of compassion, not an authoritarian intrusion. Ah, but who is an addict, and what's abuse? And who is to say we don't all run the risk of a bit of compassion in our lives if we award our would be saviors with the power to intervene?

In his guest post, "Leave my drugs alone," Denny Chapin, Managing Editor at, writes:
People will always abuse drugs, always disrupt families, and always harm others in pursuit of a high. And people will always defend their abuse, deny its effects, and bring themselves and others down with them. If we accept this reality, we can still act for a future of change, bring hope to families, and shake the dirt from career drug addicts. And to that degree, we must take action. Never is it 'just their problem'; it's ours.

Chapin concedes that "many drug users casually use drugs without negatively impacting those around them," but he asserts that the government may have a duty to intervene and force drug users into treatment when their drug use negatively impacts those around them -- particularly children -- and that it "must enforce mandatory drug treatment" when drug use leads to criminal activity.

There's truth in what Chapin says -- particularly about the ability of many people to casually use drugs "without negatively impacting those around them." While getting solid statistics about addiction is difficult, Reason magazine's Jacob Sullum pointed out in 2003, "A survey of high school seniors found that 1 percent had used heroin in the previous year, while 0.1 percent had used it on 20 or more days in the previous month. Assuming that daily use is a reasonable proxy for opiate addiction, one in 10 of the students who had taken heroin in the last year might have qualified as addicts." By contrast, when it comes to perfectly legal booze, according to the National Institutes of Health, "[a]bout 15 percent of those who experiment become alcohol-dependent at some point in life. This compares to a dependency rate of 25 percent in those who experiment with smoking tobacco, and around 4 percent in marijuana smokers."

Most users, then, do so without becoming addicted, and Chapin quotes Alan I. Leshner, Director of the National Institute of Drug Abuse, to the effect that addiction is "uncontrollable, compulsive drug seeking and use, even in the face of negative health and social consequences."

Chapin is also correct that abusers often do deny that they're abusing drugs and that their behavior is problematic. Then again, so do people accused of addiction and abuse who are actually just engaging in recreational behavior. The difficulty lies in separating use from abuse and in distinguishing criminal behavior caused by an intoxicating substance from criminal behavior caused by a criminal's innate unwillingness to respect the rights and property of others. For starters, what is drug abuse?

That strikes some people as a silly question, but it's absolutely fundamental. And there's no fixed definition of "abuse." Asked whether he thought drug abuse should be illegal, the prominent psychologist, lawyer and drug researcher Stanton Peele replied, "The answer to the question depends on what you mean by drug abuse—whether any use of illicit drugs, extreme or addictive drug use, or illegal behavior associated with drug use or extreme drug use."

Chapin seems to flirt with the first definition, suggesting that the mere act of ingesting certain intoxicants is, itself, abusive:
Does our government have a responsibility to get heroin out of households? "They're my kids, so what if they see a few needles or a joint around? I'm not forcing them to do anything." This disposition is far more dubious, with the potential to truly harm the future generations of Americans, our youth.

Does seeing a few needles or a joint really harm kids? If it does, does it really harm kids so much that their parents should be forced by armed men into drug treatment programs? If that's the case, mandatory treatment for drug abuse becomes something of a tautology, with all ingestion defined as "abuse" and evidence of a need for a forcible response. Drug treatment, then, is less of a medical response than an ideological one, and those providing treatment are acting less as psychologists, physicians and therapists than as agents of state policy.

But what if we go to Peele's second definition: illegal behavior associated with drug use? And by "illegal behavior" we mean real crimes against people and property. It's this definition that Chapin addresses when he says, "many criminals are forced into treatment programs because their crime was caused by, or related to their addiction, resulting from their uncontrolled, compulsive, and harmful behavior."

Since many crimes are a result of drug use, mandatory treatment, we're told, is the obvious response.

Peele differs, saying "addicts—or any drug users—should be liable for any crimes they commit, whether committed while intoxicated, in the pursuit of their addiction, or under any other conditions. In this regard, I differ from many advocates for addicts, who may say that—since addicts are out of control of their behavior—they should not be liable for their actions, at least while intoxicated." (Peele, by the way, also takes issue with the way many 12-step programs go about their business, especially with coerced participants.)

The idea here is that people are responsible for their actions -- the devil didn't make them do it, and neither did the booze or the methamphetamine. Yes, a criminal may have alcohol or drugs in his or her system when he knocks over a convenience store, but that was the culmination of a series of choices. Treatment might be offered to criminals in the same way as other medical and educational services are offered, as a means of maintaining or improving their health and changing their circumstances. But pursuing drug treatment would have to be the choice of the criminal who is responsible for his or her own actions in all circumstances.

Fundamentally, the argument for mandatory treatment comes down to two fundamentals: all drug use is abuse, and drugs make people do bad things they wouldn't otherwise do. But not all use is abusive -- in fact, most drug use is not. And an asshole who does bad things and takes drugs is, at the end of the day, just an asshole.

Forgetting those points creates an invitation to the government to intervene in our lives if we simply engage in behavior that rubs officialdom the wrong way -- and it also allows the powers-that-be to let real criminals off easy for their bad decisions.

Chapin argues that, with mandatory treatment, "[a]t their worst, an addict won't benefit from treatment, simply going through the motions." But that's not the worst; the worst is that people living peaceful lives will lose their freedom and become subjects of forcible government intervention.

If you want to be compassionate toward those who use intoxicants to excess, that's great. Just don't arm that compassion with handcuffs and guns.



Blogger liberranter said...

"[a]t their worst, an addict won't benefit from treatment, simply going through the motions."

A statement in response to which I would ask Mr. Chapin "then what possible benefit to 'society' (oh, that beautiful abstraction!) comes from wasting scarce treatment resources that would be much better used on someone who actually WANTS help and would be willing to sacrifice and commit (i.e., pay) for them than on someone who clearly doesn't?"

What Mr. Chapin, like all statists, clearly fails to understand is that genuine and lasting change in a person's behavior is the result of free will and that no amount of coercion will achieve the desired ends. Where drug use is concerned, the habitual user will NEVER be "cured" of their "addiction" (or however one cares to define chronic use) if they do not desire to be cured. Couple this with J.D.'s spot-on statement that, regardless of whether or not they use drugs, "an asshole who does bad things and takes drugs is, at the end of the day, [still] just an asshole" who would have committed a crime no matter what their state of mind and it becomes apparent why "mandatory drug treatment" at government gunpoint is, always has been, and always will be an abject failure as great as the War on Drugs itself.

March 10, 2010 1:06 PM  
Anonymous Mike Gogulski said...

Applause, J.D. This is so solid.

March 11, 2010 3:19 AM  
Anonymous Danimal said...

Great give-and-take, and I admire you for posting an opposite view.

This brings to mind a post on a paramedic blog that I follow. He was asking, "Does the government have a right to step in and mitigate the living conditions of someone who may not be legally retarded, but is obviously not behaving appropriately or living in accordance with societal norms? "

My response, of course, was the Libertarian position, I was surprised that others felt the government should step in and do something about it

March 15, 2010 6:44 PM  

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