Drug Control Policies: Problems and Prospects

Abstract

Approximately 1 out of 11 people in the USA suffer from a substance use disorder, and the economic costs associated with these disorders are extensive. This chapter examines the history and current state of national drug control policy. We argue that the allocation of funds to various policies and practices can be largely attributed to approaches that have dominated the field of substance abuse in the USA for many decades. While moral approaches assume that substance abuse is morally wrong and that the use and distribution of certain substances is a crime and therefore deserving of punishment, medical approaches view addiction as a biological or genetic (acute) disease that should be cured or prevented and emphasize treatment and rehabilitation. Despite their difference, both approaches are based on the premise that the only acceptable goal should be abstinence, and they tend to focus on the individual drug user. Since the 1980s, with the emergence of HIV/AIDS and other infectious diseases, many countries worldwide have recognized the need for more pragmatic and public health focused approaches to substance abuse, and a third approach, harm reduction, entered the field. We introduce these approaches and argue that harm reduction approaches are more consistent with the values of the social work profession and thus have profound implications for both policy and practice in our field.