Punitive Approach To Drug Dependence May Be Counterproductive

Katharine A. Neill  PhD Alfred C. Glassell III Postdoctoral Fellow in Drug Policy Baker Institute, Rice University Houston, TX 77005MedicalResearch.com Interview with:
Katharine A. Neill  PhD

Alfred C. Glassell III Postdoctoral Fellow in Drug Policy
Baker Institute, Rice University
Houston, TX 77005

Medical Research: What is the background for this study? What are the main findings?

Dr. Neill: This study is a historical review of drug policy in 20th century United States. It examines drug policy decisions and consequences through a socio-political lens and argues that the prominence of the law-and-order approach to dealing with drug offenders–that emphasizes punishment and incarceration over prevention and treatment–is a result of the construction of drug offenders as social deviants that threaten society. This punitive model has been especially harmful because it has occurred to the detriment of harm reduction approaches to drug use that have greater potential to negate the negative individual and public health consequences of drug use.

Medical Research: What should clinicians and patients take away from your report?

Dr. Neill: For clinicians who see drug dependence as a disease, the negative constructions of drug users is a big reason why harm reduction efforts–which may include education and prevention campaigns, expanded treatment services for individuals seeking help, prevention of dangerous drug use such as driving under the influence, and safe addiction maintenance for individuals who do not or cannot stop using via needle-exchange programs–have not received the same kind of funding as law enforcement approaches. Not only do powerful public safety interests have an interest in maintaining a punishment-over-treatment focus, but the general public’s perceptions of drug users as deviant and dangerous makes the funding of harm reduction efforts politically unpopular, especially programs such as needle-exchange. I suspect that many patients who have sought help for their drug dependence have had direct experiences with this kind of stigma.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Neill: Several things have to happen to refocus attention on drug dependence as a disease that requires medical treatment rather than a deviant behavior that deserves punishment. Changing public perceptions of drug offenders is critical. This is happening in small ways already. Drug war fatigue and a new crop of prescription opiate and heroin users that is whiter and more female than previous users has facilitated more calls for drug treatment and less focus on incarceration. But it is important that drug dependence is viewed as a disease regardless of who the users are. Research can help with this; studies that look at the effectiveness of drug treatment at preventing relapses, the public health benefits of needle-exchange programs, and the negative consequences of incarceration on drug users’ future drug use and recidivism rates, are all examples of important issues that can be explored more. It is also critical to have education campaigns that bring awareness to the public about the true nature of drug addiction.


World Medical & Health Policy Vol 6 Issue 4

Katharine A. Neill Article first published online: 21 DEC 2014

DOI: 10.1002/wmh3.123

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Last Updated on January 20, 2015 by Marie Benz MD FAAD