Pubdate: Thu, 19 Apr 2012
Source: San Francisco Chronicle (CA)
Copyright: 2012 Hearst Communications Inc.
Contact: http://www.sfgate.com/chronicle/submissions/#1
Website: http://www.sfgate.com/chronicle/
Details: http://www.mapinc.org/media/388
Author: Debra J. Saunders

OBAMA'S MEDICALIZATION OF AMERICA'S WAR ON DRUGS

President Obama's drug czar, Gil Kerlikowske, doesn't like the term 
"drug war." He argues that none of the smart guys in law enforcement uses it.

Instead, the smart guys talk about middle-of-the-road strategies that 
emphasize treatment over incarceration - as did both Presidents 
Richard Nixon and George W. Bush - while they also advocate tough law 
enforcement.

Folks in the drug czar's office have "gotten really good at stealing 
the rhetoric of drug policy reformers," griped Bill Piper of the 
antidrug war Drug Policy Alliance, but they don't mean it. Obama may 
talk up having a dialogue on legalization and decriminalization, but 
his newly announced strategy proclaims, "Legalization of drugs will 
not be considered in this approach."

Nonetheless, Rafael Lemaitre, spokesman for the Office for National 
Drug Control Policy, credited the administration's approach as 
representing a "revolution" in drug strategy, one based on science, 
research and evidence. The drug czar's office maintains that 
addiction is "not a moral failing on the part of the individual - but 
a disease of the brain that can be prevented and treated." The 2012 
drug plan emphasizes treatment for "substance-use disorder" - and 
there will be more of that because the disorder happens to be covered 
in the president's Affordable Care Act.

Is it a disease of the brain? I asked Columbia University psychology 
professor Carl Hart, who is also a board member of Drug Policy 
Alliance. Hart laughed. "A behavioral disease, therefore the brain is 
involved? OK, we can say that about everything."

I admit, the addiction-is-an-illness line never worked for me. It 
leaves out personal will. It sanitizes destructive decision making. 
It suggests that people cannot get clean without a health care professional.

Art Caplan, director of the Center for Bioethics at the University of 
Pennsylvania, came up with the best explanation I've heard for the 
disease argument. People don't want to see addicts jailed, he said, 
so they've come up with a scenario to spare users from incarceration. 
Ergo: "The whole drug establishment is invoking the disease model as 
an antidote to the criminal-justice model."

A drug czar fact sheet maintains, "The Obama administration has 
remained clear that we cannot arrest our way out of the drug problem 
through an enforcement-centric 'war on drugs.' " ( I guess the smart 
guys do say "war on drugs.")

But the Obama administration doesn't want to cure the 
criminal-justice system, it wants to medicalize addiction at a time 
when many Americans are looking for alternatives to federal drug 
policies that don't work.

I have no doubt that Kerlikowske believes in treatment. I know people 
who entered programs that helped free them from the bonds of 
self-destruction. But I am skeptical about the efficacy of a 
wholesale expansion of drug treatment programs - especially the 
addicts-cannot-help-it kind. For one thing, addicts have to want to 
get clean in order to get clean.

"Who is the world's biggest believer that addiction is not a 
disease?" asked Caplan. "Alcoholics Anonymous, which has 'a 
volitional orientation.' "
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MAP posted-by: Jay Bergstrom