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Readers’ Hopes, Dreams and Fears for 2010

Alcoholism & Drug Abuse Weekly

Peter Provet, Ph.D., President and CEO, Odyssey House, New York

Below are reflections from some ADAW readers on the hopes and fears for 2010, for the field and for policy.

Integration of substance abuse prevention and treatment into national health care reform: As the national debate on health care has been long waged on multiple fronts, substance abuse and its treatment have barely been addressed. Its costs to society, direct and indirect, are great. Greater access and availability to treatment are necessary.

Greater public and political appreciation of the impact of substance abuse on society as a whole: Substance abuse is not a “wedge” issue affecting a marginal, discrete population. Its impact on children, families, communities, and local economies is profound and must be fully recognized in order for the political and economic will to be adequately directed towards its eradication.

Continued decriminalization of substance abuse with a concomitant increase in alternative-to-incarceration programs: The abuse of drugs and alcohol must be understood and appreciated more within a medical and psychiatric framework and less within a criminal context. Sale versus use of illegal drugs must be further differentiated. Successful programs offering individuals treatment instead of prosecution and incarceration must be nationally replicated.

Legalization of the use of currently illicit substances must not be confused with decriminalization. Society must assertively use all appropriate measures to discourage substance abuse, particularly among our youth. Legal sanctions, while debatable philosophically, provide the greatest such deterrent. Treatment, work experience, and community service, thoughtfully structured and administered, should be the primary consequences of drug use, not criminal punishment.

Greater investment in the research of substance abuse and its prevention and treatment: A powerful, effective national campaign to prevent substance abuse, specifically among youth, needs to be developed and adequately funded as a long-term investment strategy. The genetic and biological underpinnings of substance abuse must continue to be researched. Behavioral treatment models, “best practices,” must be refined as well as broadened.

A balanced approach to federal drug policy: Presidential leadership must be demonstrated to make substance abuse treatment a national priority and focus federal resources on demand reduction at home rather than interdiction abroad. For too many years the national funding priority has been on the world-wide eradication of drugs and their cultivation rather than on domestic abuse and treatment. Initial indications from the White House Office of National Drug Control Policy are positive in this regard, though greater presidential resolve will be necessary to shift this historical imbalance.

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