Friday, November 20, 2015


AZ Central
My Turn: Why Bernie Sanders is wrong about legal pot
Ed Gogek, AZ I See It October 22, 2015

Doctor: The Democratic presidential candidate can't have it both ways: Free health care and legal marijuana simply don't go together.
During last week’s Democratic debate, Vermont Sen. Bernie Sanders said the United States should model its social policies on Sweden, Norway and Denmark — countries that provide free health care, free college and paid family leave.
But by saying he’d vote to legalize marijuana, Sanders made it much harder to convince Americans to adopt these programs.
Swedish history shows why.
In the 1970s, Sweden did what we’re doing now: told police to ignore drug possession and only pursue serious crime. But drug abuse soared, so the country reversed course. Today, Sweden and its neighbors have some of the world’s toughest drug laws, including tough marijuana laws.
None of the Scandinavian countries have decriminalized marijuana. Nor do they permit its medical use. An 84-acre autonomous district in Copenhagen is allowed to flout marijuana laws, but the rest of Denmark enforces them strictly.
This doesn’t mean jailing drug users. Sweden uses the threat of jail to get substance abusers into treatment, and because crime is mostly caused by substance abuse, this policy prevents crime — so well that over the past decade the country has closed four prisons.
Tough marijuana laws also help keep Swedish socialism affordable, and that’s why supporting legalization is a problem for Sanders. People already worry about what his programs would cost.
For example, a Rand Corporation report says California spends $110 million yearly on schizophrenia hospitalizations caused by marijuana; for the whole U.S., that’s over $1 billion per year. Marijuana also causes addiction and injuries from auto accidents, which are expensive problems to treat.
How can Sanders ask America to pay for free health care if he’s promoting a marijuana policy that would make health care more expensive?
Research on postal employees, published in the Journal of the American Medical Association in 1990, found that marijuana users had more disciplinary problems, more absenteeism and higher turnover. A 2012 study showed that marijuana users have less commitment to work. One company already left Colorado, citing employees who were too stoned to be productive.
Sanders wants the U.S. to require paid family leave and a high minimum wage. But if at the same time we legalize a drug that causes poor work performance, it could bankrupt businesses.
University of Maryland study found that college students who used marijuana, even occasionally, studied less, skipped more classes, earned lower grades and were less likely to graduate. How can Sanders ask America to pay for free college, and then promote a drug policy that leads students to waste the experience?
Sanders deserves credit for promoting policies that would give American families the same financial security citizens in other rich countries enjoy. The Scandinavian programs he supports — free health care, free college, a living wage, good pensions and family leave — would greatly benefit most Americans.
However, it’s hard to take seriously someone who would also increase the cost of these programs unnecessarily. By endorsing marijuana legalization, Bernie Sanders has made himself a less convincing salesman for the ideas he cares about most.
Dr. Ed Gogek of Prescott is an addiction psychiatrist and author of "Marijuana Debunked: A handbook for parents, pundits and politicians who want to know the case against legalization."

Wednesday, November 11, 2015


New York Times

The Opinion Pages

Should Drug Addicts Be Forced Into Treatment?

Massachusetts Gov. Charlie Baker wants to give hospitals the power to commit substance abusers. Is this the right approach?

 Drug Addiction Recovery Often Starts With Coercion

Robert L. DuPont, a psychiatrist, is the president of the Institute for Behavior and Health Inc. He was the director of the National Institute on Drug Abuse from 1973 to 1978.
UPDATED NOVEMBER 11, 2015, 3:21 AM

Addiction hijacks the brain. Families dealing with addicted loved ones know this. Research shows that 95 percent of people suffering from substance use disorders do not think that they have a problem or need treatment. Few addicts enter treatment without meaningful coercion, most often from families or the criminal justice system.
The challenge in responding to this seemingly simple question about coerced treatment is in the details. Surely not everyone who is addicted to drugs should be committed to treatment. The opposite is also true. Some addicts should be committed to treatment against their will. Not all coercion is commitment and not all commitment has the force of law.
Two good examples of effective coercion that overcome addiction are HOPE Probation and the state-based Physician Health Programs, both of which are enforced by intensive random monitoring and permit no use of alcohol or other drugs. While these two programs share many similar features, they deal with very different populations of serious substance users: one with convicted felons on probation and the other with  

physicians. Both are voluntary in the sense that individuals can choose to not abide by the program requirements, but in both cases the consequences may be serious. For probationers in HOPE, the risk of failing is prison and for physicians in P.H.P., it is the loss of a medical license. Both programs produce excellent outcomes for most participants.

Families faced with addiction often reluctantly, and only after many failures, use “tough love” to promote treatment and recovery while insisting that their addicted loved ones be drug-free. Families usually have to use a significant measure of coercion not only to get addicts into treatment but also to keep them there and to prevent relapse upon discharge.
As a psychiatrist specializing in the treatment of addiction, I am struck by the stark contrast between addicted people who are using alcohol and other drugs actively and those who are in stable recovery. In the process of recovery there is a transition from near-universal denial of problems and rejection of treatment to gratitude for and acceptance of the coercion that got them on that path. The addict’s will is different when using drugs and when in recovery.
Recovery from addiction may or may not involve treatment. It takes years of hard work – usually with the sustained support of recovery communities. Because of the denial that characterizes the cunning, baffling and powerful disease of addiction, recovery often starts with substantial coercion.